[Senate Report 118-84]
[From the U.S. Government Publishing Office]
Calendar No. 187
118th Congress } { Report
SENATE
1st Session } { 118-84
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2024
_______
July 27, 2023.--Ordered to be printed
_______
Ms. Baldwin, from the Committee on Appropriations,
submitted the following
REPORT
[To accompany S. 2624]
The Committee on Appropriations reports an original bill
(S. 2624) making appropriations for Departments of Labor,
Health and Human Services, and Education, and related agencies
for the fiscal year ending September 30, 2024, 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...............$1,445,830,783,000
Amount of 2023
appropriations............................ 1,430,661,909,000
Amount of 2024 budget estimate.........................1,470,554,232,000
Bill as recommended to Senate compared to:
2023 appropriations................................. +15,168,874,000
2024 budget estimate................................ -24,723,449,000
CONTENTS
----------
Page
List of Abbreviations............................................ 4
Summary of Budget Estimates and Committee Recommendations........ 7
Overview..................................................... 7
Title I: Department of Labor:
Employment and Training Administration....................... 9
Employee Benefits Security Administration.................... 20
Pension Benefit Guaranty Corporation......................... 21
Wage and Hour Division....................................... 22
Office of Labor-Management Standards......................... 23
Office of Federal Contract Compliance Programs............... 23
Office of Workers' Compensation Programs..................... 24
Division of Energy Employees Occupational Illness
Compensation............................................... 25
Occupational Safety and Health Administration................ 26
Mine Safety and Health Administration........................ 27
Bureau of Labor Statistics................................... 28
Office of Disability Employment Policy....................... 29
Departmental Management...................................... 30
General Provisions........................................... 34
Title II: Department of Health and Human Services:
Health Resources and Services Administration................. 36
Centers for Disease Control and Prevention................... 57
National Institutes of Health................................ 88
Substance Abuse and Mental Health Services Administration.... 137
Agency for Healthcare Research and Quality................... 154
Centers for Medicare and Medicaid Services................... 156
Administration for Children and Families..................... 163
Administration for Community Living.......................... 180
Administration for Strategic Preparedness and Response....... 186
Office of the Secretary...................................... 196
General Provisions........................................... 208
Title III: Department of Education:
Education for the Disadvantaged.............................. 211
Impact Aid................................................... 214
School Improvement Programs.................................. 216
School Readiness............................................. 220
Indian Education............................................. 220
Innovation and Improvement................................... 222
Safe Schools and Citizenship Education....................... 227
English Language Acquisition................................. 229
Special Education............................................ 230
Rehabilitation Services...................................... 232
Special Institutions for Persons With Disabilities:
American Printing House for the Blind.................... 234
National Technical Institute for the Deaf................ 234
Gallaudet University..................................... 234
Career, Technical, and Adult Education....................... 235
Student Financial Assistance................................. 236
Student Aid Administration................................... 238
Higher Education............................................. 239
Howard University............................................ 246
College Housing and Academic Facilities Loans Program........ 246
Historically Black College and University Capital Financing
Program Account............................................ 247
Institute of Education Sciences.............................. 247
Departmental Management:
Program Administration................................... 250
Office for Civil Rights.................................. 256
Office of the Inspector General.......................... 257
General Provisions........................................... 257
Title IV: Related Agencies:
Committee for Purchase From People Who Are Blind or Severely
Disabled................................................... 259
Corporation for National and Community Service............... 259
Corporation for Public Broadcasting.......................... 263
Federal Mediation and Conciliation Service................... 264
Federal Mine Safety and Health Review Commission............. 264
Institute of Museum and Library Services..................... 264
Medicaid and CHIP Payment and Access Commission.............. 266
Medicare Payment Advisory Commission......................... 266
National Council on Disability............................... 266
National Labor Relations Board............................... 267
National Mediation Board..................................... 267
Occupational Safety and Health Review Commission............. 267
Railroad Retirement Board.................................... 267
Social Security Administration............................... 268
Title V: General Provisions...................................... 274
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the Sen- ate................................................... 276
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules
of the Senate.................................................. 277
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 278
Budgetary Impact of Bill......................................... 280
Disclosure of Congressionally Directed Spending Items............ 281
Comparative Statement of New Budget Authority.................... 363
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, 2024
SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS
For fiscal year 2024, the Committee recommends total budget
authority of $1,445,830,783,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
This amount includes $195,231,000,000 in current year base
discretionary funding consistent with the subcommittee's
allocation. In addition, the bill includes $4,500,000,000 in
discretionary funding designated as emergency, and
$2,447,000,000 in program integrity cap adjustments.
Fiscal year 2023 levels cited in this Committee Report
reflect the enacted amounts in Public Law 117-328, the
Consolidated Appropriations Act, 2023, adjusted for
comparability where noted.
OVERVIEW
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, 28 percent of the total for regular base discretionary
funding in fiscal year 2024. The subcommittee's effective base
discretionary funding allocation, which includes discretionary
funding offset by savings in changes in mandatory programs and
other similar adjustments is $1,218,000,000 below the
comparable fiscal year 2023 level. This required difficult
choices to prioritize funding in a bill that funds programs
that touch the lives of every American. The Labor-HHS-Education
bill 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 2024, 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 also appreciates 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 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, 2023.................................... $4,140,911,000
Budget estimate, 2024................................... 4,420,684,000
Committee recommendation................................ 4,016,526,000
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 2024 will
support the program from July 1, 2024, through June 30, 2025. A
portion of this account's funding, $1,772,000,000, becomes
available on October 1, 2024, for the 2024 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, 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 the Workforce
Innovation and Opportunity Act. 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.
Communities Affected by Substance Use.--The Committee
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.
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 encourages
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 requests a briefing within 120 days of
enactment for the Committees on Appropriations, the Senate
Committee on Health, Education, Labor, and Pensions, and the
House Committee on Education and the Workforce on any actions
taken and any recommendations for statutory changes that can
support greater collaboration between the workforce development
and education systems.
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 and the Centers for Medicare and Medicaid
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 submit a report to the Committees
on Appropriations not later than 270 days after enactment.
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.
Modernizing Workforce Development Programming.--The
Committee encourages ETA to collaborate with state workforce
agencies to modernize workforce development programming. The
Committee is 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 that take into account the time
constraints of underemployed workers who may work multiple jobs
or have caretaking responsibilities that limit their ability to
use in-person services. Finally, the Committee further
encourages the Department to develop a comprehensive long-term
strategy for the delivery of online training and development
programming.
Opportunity Youth.--The Committee encourages 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 assist in the implementation of
WIOA 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.
Regional Coordination.--The Committee encourages the
Department to include regional councils and councils of
governments as eligible entities in grant competitions when
allowable. Furthermore, the Committee encourages the Department
to actively seek opportunities to encourage and expand greater
regional collaboration and to work with entities that have
previous experience with administering Federal funding that
resulted in successful, comprehensive, well-coordinated
outcomes.
Small Businesses.--The Committee encourages the Department
to support the employment needs of small businesses and
entrepreneurial skills training through WIOA programs.
Submarine Construction Workforce.--The Committee encourages
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. The Committee strongly
encourages the Secretary to make funding available through
workforce development and apprenticeship programs, consistent
with National Guideline Standards of Apprenticeship for Water
and Wastewater System Operations Specialists and the WIOA
system, to establish, implement, and expand registered
apprenticeship programs to address shortages of such 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 2024, which occurs from
July 1, 2024, through June 30, 2025. The bill provides that
$173,649,000 is available for obligation on July 1, 2024, and
that $712,000,000 is available on October 1, 2024. Both
categories of funding are available for obligation through June
30, 2025.
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 2024, which occurs from April 1, 2024, through
June 30, 2025.
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 2024, which occurs from July 1, 2024, through June
30, 2025. The bill provides that $235,553,000 is available for
obligation on July 1, 2024, and that $860,000,000 is available
on October 1, 2024. Both categories of funding are available
for obligation through June 30, 2025.
National Programs
Dislocated Worker Assistance National Reserve
The Committee recommends $305,859,000 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 2024. The bill provides that
$105,859,000 is available for obligation on July 1, 2024, and
that $200,000,000 is available on October 1, 2024. Both
categories of funding are available for obligation through
September 30, 2025.
Automation Impacted Industries.--The Committee supports
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 and the need for early workforce readiness,
employment, and training opportunities that help youth develop
soft skills, such as responsibility, organization, and time
management, and to learn workplace safety. The Committee
recommendation includes $10,000,000 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 DOL's coordination with other agencies implementing
the Infrastructure Investment and Jobs Act, and Inflation
Reduction Act, and the Corporation for National and Community
Service.
Higher Education Workforce Development Programs.--The
Committee supports funding for projects to help better align
workforce development efforts with postsecondary education,
including supporting expanded skills instruction,
apprenticeships, and other work-based learning opportunities,
including cooperative education and upskilling and reskilling
efforts in industries like manufacturing, information
technology, healthcare, and energy, among others.
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 strongly supports
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 $55,000,000 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.
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 section 167 training, technical
assistance, and related activities, including funds for migrant
rest center activities.
YouthBuild
The Committee recommendation includes $105,000,000 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. Additionally, the Committee encourages the use of
``next-gen'' apprenticeship grants to encourage higher
education institutions to support registered apprenticeships in
emerging and nontraditional industries. This can expand
registered apprenticeship to industries and careers that are
not currently using or are underutilizing this system, deliver
transferable, durable 21st century skills, and create
affordable transfer opportunities to a college education for
our youth. 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.
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.
Civilian Climate Corps
The Committee recommendation does not include funding for a
new Civilian Climate Corps program.
SECTOR Partnerships
The Committee recommendation does not include funding for a
new SECTOR Partnerships program.
Congressionally Directed Spending
The Committee recommendation includes $107,939,000 for the
projects, and in the amounts, specified in the table at the end
of this Committee Report.
JOB CORPS
Appropriations, 2023.................................... $1,760,155,000
Budget estimate, 2024................................... 1,835,467,000
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, 2024, to June 30, 2026. 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.
Gulfport Job Corps Center.--The Committee remains
encouraged by the continued progress made toward the rebuilding
of the Gulfport Job Corps Center, including the significant
design development work made by the architecture and
engineering firm. The Committee expects the Department to
remain diligently committed to this project and directs the
Department to continue to prioritize the Gulfport Job Corps
Center among pending construction cases in the CRA account. The
Committee requests updates biannually regarding progress on
this project.
Homeless Youth.--The Committee strongly encourages the
Department to streamline application requirements for homeless
youth in Job Corps.
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.
Slot Utilization.--As millions of disconnected youth
struggle with housing instability, food insecurity, and
unemployment, the Committee encourages the full resumption of
Job Corps operations, including the reintegration of
nonresidential students into normal classes, similar to other
schools and institutions of higher education across the
country.
Substance Use and Behavioral Health.--The Committee
requests that the Department make recommendations, including
legislative changes, to address substance use and behavioral
health challenges of Job Corps participants.
Wages and Benefits.--The Committee has previously expressed
concern regarding the impact of the transition to fixed-price
Job Corps contracts on staff compensation. The Committee looks
forward to the report required in House Report 117-403 on this
issue and requests a briefing within 120 days of enactment on
how the Department is ensuring that Job Corps centers are able
to provide high quality services under fixed-price contracts.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriations, 2023.................................... $405,000,000
Budget estimate, 2024................................... 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 Asian American Native Hawaiian Pacific
Islander [AANHPI] and the Native American Indian populations
for national grants to national AANHPI and Native American
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.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriations, 2023.................................... $494,400,000
Budget estimate, 2024................................... 30,700,000
Committee recommendation................................ 30,700,000
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, 2023.................................... $4,009,150,000
Budget estimate, 2024................................... 4,592,414,000
Committee recommendation................................ 4,072,150,000
The Committee recommendation includes $3,988,084,000
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 $3,206,635,000 for
Unemployment Insurance [UI] activities. For UI State
operations, the Committee recommends $2,815,635,000.
The Committee recommendation includes $382,000,000 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
$265,000,000 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.
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 encourages DOL to encourage States to adopt
compatible rules, and 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, 5 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.
Prompt Processing of H-2B Visas.--The Committee strongly
encourages 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. The Committee looks
forward to receiving the report the Department was directed to
complete in the joint explanatory statement accompanying the
Consolidated Appropriations Act, 2023.
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 looks forward to
receiving the Occupational Licensing report detailing best
practices learned and a breakdown of future resources needed
for continued implementation of such initiative. 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.
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, 2023.................................... $172,915,000
Budget estimate, 2024................................... 225,466,000
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, Older Americans Act [OAA] (Public Law 116-131), 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.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriations, 2023.................................... $191,100,000
Budget estimate, 2024................................... 248,959,000
Committee recommendation................................ 191,100,000
The Committee recommends $191,100,000 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. Bill language continues
to allow EBSA to obligate up to $3,000,000 for two fiscal years
for the expert witness program. The budget requests similar
language, except such funds would remain available until
expended. 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 last year's CJ.
Implementation of Employee Ownership Initiative.--Within
available resources, the Committee expects EBSA 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 requests EBSA to describe in its
fiscal year 2025 CJ actions completed and planned related to
the initiative.
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 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 urges continued work
to achieve compliance with requirements for parity between
mental and physical healthcare coverage.
Pension Benefit Guaranty Corporation
Appropriations, 2023.................................... $493,314,000
Budget estimate, 2024................................... 512,900,000
Committee recommendation................................ 512,900,000
The Pension Benefit Guaranty Corporation's [PBGC] estimated
obligations for fiscal year 2024 include single-employer
benefit payments of $7,419,000,000, multi-employer financial
assistance of $197,000,000, Investment Management Fees Program
of $139,800,000 and consolidated administrative expenses of
$512,900,000, including $7,857,000 available for the Office of
Inspector General. 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 $13,966,000,000 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, 2028, 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 on
Appropriations. 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, 2028.
Wage and Hour Division
SALARIES AND EXPENSES
Appropriations, 2023.................................... $260,000,000
Budget estimate, 2024................................... 340,953,000
Committee recommendation................................ 264,500,000
The Committee recommends $264,500,000 for the Wage and Hour
Division [WHD].
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 essential workers,
ensuring prevailing wage protections, and combatting
exploitative child labor.
Preventing Exploitative Child Labor.--The Committee
recommendation supports further 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 utilize strategic
enforcement in industries known to have high incidents of child
labor violations. The Committee supports 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 recently signed memorandum of agreement.
The Committee expects the fiscal year 2025 CJ to describe WHD
accomplishments in preventing exploitative child labor in the
prior year and plans for the budget year.
Protecting Vulnerable Workers.--The Committee is aware WHD
continues to work toward prioritizing high impact cases
involving the most vulnerable worker populations that can have
the greatest positive effect in reducing employer exploitation
of workers and improving compliance with applicable
requirements. This must include protecting American and an
increasing number of temporary foreign workers by preventing
abuses of temporary foreign worker programs. The Committee
requests a briefing not later than 45 days after enactment of
this act on WHD's prioritization process for investigations in
foreign worker programs, including the H-1B, H-2A, H-2B and TN
visa programs, and its plans and resource requirements to
improve employer compliance with applicable requirements given
the increasing numbers of such workers.
14(c) Program Oversight.--The WHD processes certificate
applications and conducts oversight of the FLSA 14(c) program
allowing employers to pay sub-minimum wages to certain
employees if the employer holds a certificate from DOL. The
Government Accountability Office [GAO] issued a report in
February 2023 regarding Department oversight of the program and
recommendations to improve certificate processing and
oversight. The Committee requests a briefing not later than 60
days after enactment of this act on WHD implementation of the
GAO recommendations. Such briefing must also cover WHD plans
and associated timeline to archive all approved and pending
certificate applications and make such data available each
quarter of the fiscal year on a Department website.
Office of Labor-Management Standards
SALARIES AND EXPENSES
Appropriations, 2023.................................... $48,515,000
Budget estimate, 2024................................... 53,469,000
Committee recommendation................................ 48,515,000
The Committee recommends $48,515,000 for the Office of
Labor-Management Standards [OLMS].
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, 2023.................................... $110,976,000
Budget estimate, 2024................................... 151,462,000
Committee recommendation................................ 110,976,000
The Committee recommends $110,976,000 for the Office of
Federal Contract Compliance Programs.
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.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriations, 2023.................................... $122,705,000
Budget estimate, 2024................................... 151,946,000
Committee recommendation................................ 122,705,000
The Committee recommends $122,705,000 for the Office of
Workers' Compensation Programs [OWCP]. The bill provides
authority to expend $120,500,000 from the special fund
established by the Longshore and Harbor Workers' Compensation
Act. In addition, $2,205,000 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.
SPECIAL BENEFITS
Appropriations, 2023.................................... $250,000,000
Budget estimate, 2024................................... 700,000,000
Committee recommendation................................ 700,000,000
The Committee recommends $700,000,000 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, 2023.................................... $47,031,000
Budget estimate, 2024................................... 33,140,000
Committee recommendation................................ 33,140,000
The Committee recommends a mandatory appropriation of
$22,890,000 in fiscal year 2024 for special benefits for
disabled coal miners. This is in addition to the $10,250,000
appropriated last year as an advance for the first quarter of
fiscal year 2024, for a total program level of $33,140,000 in
fiscal year 2024.
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
$7,000,000 for the first quarter of fiscal year 2025. 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, 2023.................................... $64,564,000
Budget estimate, 2024................................... 66,532,000
Committee recommendation................................ 66,532,000
The Committee recommends $66,532,000 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, 2023.................................... $394,896,000
Budget estimate, 2024................................... 452,867,000
Committee recommendation................................ 452,867,000
The bill provides an estimated $452,867,000 as requested
for this mandatory appropriations account. This estimate is
comprised of $85,961,000 for administrative expenses and an
estimated $366,906,000 for benefit payment and interest costs.
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 $44,059,000 for
the part C costs of the Division of Coal Mine Workers'
Compensation Programs; up to $41,178,000 for Departmental
Management, Salaries and Expenses; and up to $368,000 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, 2023.................................... $632,309,000
Budget estimate, 2024................................... 738,668,000
Committee recommendation................................ 628,522,000
The Committee recommends $628,522,000 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 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 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 $120,000,000
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 describe in its fiscal year 2025
CJ progress made toward and timeline for publishing a final
rule, and the agency's implementation plan, including related
training and support for Compliance Safety and Health Officers.
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 $10,000,000 for
the OSHA Susan Harwood Training Grant program. The Committee
adopts language proposed in the President's budget to eliminate
the set-aside for Capacity Building Developmental grants. The
Committee understands OSHA intends to continue to offer a
funding opportunity for such grant types, as well as those for
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 workers in low-wage industries and workers in
dangerous industries.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2023.................................... $387,816,000
Budget estimate, 2024................................... 438,094,000
Committee recommendation................................ 387,816,000
The Committee recommendation includes $387,816,000 for the
Mine Safety and Health Administration [MSHA].
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 not use any funds to weaken or
eliminate the Final Rule Lowering Miners' Exposure to
Respirable Coal Mine Dust.
Respirable Crystalline Silica Standard [RCS].--The
Committee is aware of numerous reports from recent years
indicating concerning trends in black lung cases, particularly
in central Appalachia. According to these studies, one in every
five miners with 25 years or more experience has black lung. In
many of these miners, the disease has progressed to its most
severe stage as a result of coal and silica dust inhalation.
The administration's June 2023 Notice of Proposed Rulemaking to
address the existing permissible exposure limit of RCS for all
miners and to update the existing respiratory protection
standards for miner exposure to RCS is an important step in
helping reverse these troubling trends. The Committee directs
MSHA to provide regular updates on progress toward a final
rule.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriations, 2023.................................... $697,952,000
Budget estimate, 2024................................... 758,370,000
Committee recommendation................................ 697,952,000
The Committee recommends $697,952,000 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 $629,952,000 in Federal funds.
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.
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 three 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 and, specifically in fiscal year 2024, on
design efforts, including methodological areas such as
sampling, survey operations, content determinations,
questionnaire and materials development, dissemination
planning, and systems work. 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 5-year plan without delay.
Worker Sentiment Survey.--The Committee recognizes there is
a lack of available information about the feelings employed
workers have about the economy, their job satisfaction, and
opportunities for growth and advancement. Better understanding
worker sentiment could provide important insights into
workplaces and the economy and help shape better worker-focused
policies for the future. The Committee request BLS provide
recommendations for such a survey program and an estimated
budget for development and annual operating costs in the fiscal
year 2025 CJ. The Committee requests BLS work with the Census
Bureau on how to integrate questions into current surveys and
collections that would provide information on worker sentiment
on a monthly basis and jointly report to the Committee not
later than 180 days after enactment the options and costs for
such a monthly data collection.
Non-Profit Employment and Wage Data.--The Committee
recognizes the importance of the non-profit sector workforce as
a critical partner to government and a frontline service
provider in communities nationwide. The Committee directs BLS
to report in its fiscal year 2025 CJ the cost and operational
steps necessary to provide distinct, public, and quarterly data
on non-profit employment. Covered non-profit data should
include the number of establishments, employment figures, and
average worker wages at the National, State, county, and
metropolitan area, and be provided by field and major subfield.
Specifically, the report shall analyze the cost and steps for
including this data as part of the BLS Quarterly Census of
Employment and Wages program.
Office of Disability Employment Policy
Appropriations, 2023.................................... $43,000,000
Budget estimate, 2024................................... 60,549,000
Committee recommendation................................ 37,000,000
The Committee recommends $37,000,000 for the Office of
Disability Employment Policy [ODEP] to provide leadership,
develop policy and initiatives, support technical assistance
and implementation and award grants 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 bill includes requested 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, 2023.................................... $392,197,000
Budget estimate, 2024................................... 545,524,000
Committee recommendation................................ 392,697,000
The Committee recommendation includes $392,697,000 for the
Departmental Management account. Of this amount, $392,389,000
is available from general funds and $308,000 is available by
transfer from the Employment Security account of the
Unemployment Trust Fund. In addition, $41,178,000 is available
by transfer from the Black Lung Disability Trust Fund.
The Departmental Management 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 supports further efforts to combat exploitative
child labor and violations of child labor provisions of the
Fair Labor Standards Act and work with employers to remove
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 2023 and
2024: 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 for
violations of child labor provisions.
The Committee recognizes the efforts of the Department to
increase collaboration to robustly enforce Federal child labor
laws. The Committee directs the agency to continue to review
and evaluate current enforcement efforts, rescind harmful
regulations and sub-regulatory guidance that impede
coordination, and ensure all parts of the Department are using
the tools and policies at their disposal to combat this crisis.
This includes robust coordinated outreach and education to
rebuild trust in government enforcement, and bolstering data
collection. The Committee requests the Department to describe
in the fiscal year 2025 CJ steps taken and planned to fulfill
this directive.
Bureau of International Labor Affairs [ILAB].--The
Committee recommendation includes $116,125,000 for the Bureau
of International Labor Affairs [ILAB] to carry out its
statutory responsibilities, of which $81,725,000 is available
for obligation through December 31, 2024. 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 available to DOL in the United States-Mexico-Canada
Agreement Implementation Act (Public Law 116-113) in the fiscal
year 2025 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, 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, 2025. 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 2025 and future CJs updates on the
implementation and planned implementation of such act for the
current and future budget years.
Women's Bureau.--The Committee recommendation provides
$23,000,000 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 Tax Credit Awareness.--The Committee
encourages WB to begin coordinating a campaign designed to
increase awareness of tax credits for paid family and medical
leave authorized under section 45S of the Internal Revenue Code
of 1986 and similar provisions. The Committee directs the
Department to submit a report within 180 days after enactment
on the progress of the awareness campaign.
Voting-Related Activities.--The Committee directs the
Secretary 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.
VETERANS' EMPLOYMENT AND TRAINING
Appropriations, 2023.................................... $335,341,000
Budget estimate, 2024................................... 347,627,000
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 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.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriations, 2023.................................... $34,269,000
Budget estimate, 2024................................... 79,193,000
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, 2025.
The Committee continues to request that the Department
submit a report to the Committees on Appropriations 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, 2023.................................... $97,028,000
Budget estimate, 2024................................... 111,280,000
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 $368,000 is available by transfer
from the Black Lung Disability Trust Fund. 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.
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 continues a provision providing
authority related to the disposition of excess property related
to the training of apprentices.
Section 113. The bill continues a provision related to the
Secretary's security detail.
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 includes a new 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 extending
the period to liquidate obligations for construction of the
Atlanta Job Corps center.
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.
BUREAU OF PRIMARY HEALTH CARE
Appropriations, 2023.................................... $1,858,772,000
Budget estimate, 2024................................... 1,938,772,000
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.
Alzheimer's Disease.--Little is known about people with
Alzheimer's disease and related forms of dementia served by
HRSA funded health centers and look-alikes in the CHC program
due to the lack of available data. Data is essential to
understanding the level of need, resources, training and
challenges needed to keep people currently served in the CHC
programs as they continue to age. The Committee strongly
encourages HRSA to include Alzheimer's and related Dementia
ICD-10 codes in the Uniform Data Collection System.
Brain Health Equity Initiative.--The Committee urges HRSA
to establish a Brain Health Equity initiative to help drive the
integration of brain health services into the workflow of
primary care delivery that reaches underserved populations
served by HRSA funded health centers and look-alikes.
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.
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 Public Health Service [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 Public
Health Service [PHS] Act to increase their capacity to meet the
increasing demand for health services, including mental health
services.
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 its 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 19 and 59 be vaccinated and March 2023 ACIP
recommendation that all adults between 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 2024 of 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.
BUREAU OF HEALTH WORKFORCE
Appropriations, 2023.................................... $1,390,376,000
Budget estimate, 2024................................... 1,747,486,000
Committee recommendation................................ 1,391,376,000
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. Its 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 2025 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], an increase of $3,000,000 above the
fiscal year 2023 enacted level. 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. The Committee
recognizes the importance of the National Health Service Corps
scholarship and loan-repayment programs with Corps members in
all 50 States. Therefore, the Committee encourages HRSA to
ensure that no State has fewer than five National Health
Service Corps awardees in fiscal year 2024 and shall give
preference to individuals working in their home State or the
State in which they received their education.
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 $8,000,000, an increase of $3,000,000
above fiscal year 2023, to support loan repayment and
scholarships for maternity care health services in health
professional shortage areas. The Committee requests that HRSA
provide a briefing for the Senate Committee on Appropriations
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
recommends that HRSA increase the number of scholarships
provided. Providing NHSC 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 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 navigate 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.
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.--Funding of academic
administrative units, such as medical school departments and
divisions, under the PCTE program has been a critical part of
the program both in its role in medical student selection of
primary care training programs and in facilitating scholarly
activity in departments of family medicine. The Committee
directs HRSA to maintain this funding and to continue funding
opportunities to support administrative academic units within
medical schools.
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 $14,000,000
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 quintile of
States projected to have a primary care provider shortage in
2025. 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 $172,000,000 for Behavioral Health
Workforce Education and Training [BHWET] program, $19,000,000
above the fiscal year 2023 enacted level. This program
establishes and expands internships or field placement programs
in behavioral health serving populations in rural and medically
underserved areas.
Addiction Medicine Fellowship Program [AMF].--Within the
total for BHWET, The Committee includes $30,000,000 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 $16,000,000 to fund training, internships, and
national certification for mental health and substance abuse
peer support specialists to create an advanced peer workforce
prepared to work in clinical settings.
Substance Use Disorder Treatment and Recovery [STAR] Loan
Repayment Program.--The Committee also includes $52,000,000 for
this program within the total for BHWET. 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.
Geriatric Workforce Enhancement Program
The Committee provides $48,245,000 for the Geriatric
Workforce Enhancement Program. This program supports training
to integrate geriatrics into primary care delivery and develops
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, underserved 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 new 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.
Health Professions Workforce Information and Analysis
The Committee provides $5,663,000 for health professions
workforce information and analysis. The 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.
U.S. Healthcare Workforce Analysis.--The Committee
recognizes that the U.S. healthcare workforce, including
physicians and nurses, is a critical national resource that
requires up-to-date, accurate analysis of current trends and
projections for future workforce needs. This data may inform
recruiting and training practices to ensure an adequate supply
of medical professionals in medically underserved areas.
However, current data streams do not provide real-time insight
into the health care workforce supply pipeline. The Committee
directs HRSA to submit a report to the Committees of
jurisdiction, not later than 12 months from the date of
enactment of this act, providing data on: how the training and
supply pipeline is matched against health workforce
projections; whether any capability gaps exist; how regional
conditions impact local and regional supply; what information
is needed to implement the use of such data going forward; and
if there are existing resources available to access that data
more expediently.
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 $302,472,000 for Nursing Workforce
Development programs. These programs provide funding to address
all aspects of nursing workforce demand, including education,
practice, recruitment, and retention.
Native Hawaiian and Pacific Islander Recruitment.--The
Committee recognizes the importance of striving to ensure
representation from underrepresented populations in the nursing
workforce for better care and patient outcomes. The Committee
also recognizes that nurses of Native Hawaiian and Pacific
Islander backgrounds represent a far smaller share of
registered nurses and advanced practice registered nurses than
their proportional representation in the United States. The
Committee encourages HRSA to increase efforts to recruit and
retain graduate and undergraduate nursing students and faculty
from Native Hawaiian and Pacific Islander backgrounds.
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.
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 total 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 $60,413,000 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
support 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] recently 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.
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 $29,500,000 for Nurse Faculty Loan
Repayment, an increase of $1,000,000, 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 $385,000,000 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 in-patient 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 Subspecialty 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 is 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.
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. The Committee is aware that
limitations may prevent certain healthcare providers,
especially those who predominantly serve seniors, from
accessing the National Practitioner Data Bank in a timely
manner. HRSA shall evaluate opportunities to expand access to
the National Practitioner Data Bank to all Medicare and
Medicaid providers, with particular emphasis on providers who
serve the senior population.
MATERNAL AND CHILD HEALTH
Appropriations, 2023.................................... $1,171,430,000
Budget estimate, 2024................................... 1,357,830,000
Committee recommendation................................ 1,169,430,000
The mission of the 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.
Stillbirth Prevention Technical Assistance.--Stillbirth
affects one in 175 pregnancies, with more than 21,000 babies
stillborn each year. Despite medical advances, the Committee is
concerned that the rate of early stillbirth has remained
relatively the same over the past 30 years. The Committee
directs HRSA to update its materials and guidance to States to
clarify that stillbirth prevention activities are an allowable
use of funds under title V, Maternal and Child Health Block
Grant program. The Committee also urges HRSA to provide
technical assistance to States and healthcare providers in
carrying out stillbirth prevention activities.
MCH Block Grant-Special Projects of Regional and National Significance
[SPRANS]
Early Childhood Development Expert Grants.--The Committee
provides $10,000,000 expand placements of early childhood
development experts in pediatrician offices 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 for 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.
Maternal and Child Health Programs
Sickle Cell Anemia
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.
Sickle Cell Disease Data Collection.--The Committee
recognizes that more than 100,000 Americans have sickle cell
disease, which disproportionately affects patients of color
and, every year, over 2,000 infants in the United States are
born with this condition. Supporting sickle cell disease
research helps identify and examine barriers to quality care
services for patients living with sickle cell disease,
including transportation barriers for patients seeking trained
specialists in urban and rural communities. The Committee
directs HRSA to submit a report to the Committee within a year
of enactment of this act on current Federal efforts to: expand
data collection through the Sickle Cell Anemia Demonstration
Program and the Data Coordination Center; support existing
programs that provide transition support for sickle cell
disease patients who are aging out of pediatric care and
receiving adult care; provide training, technical assistance,
and educational opportunities; support education and advocacy
programs that engage populations affected by sickle cell
disease; disseminate information on health and community
services; and improve access to care and treatment decision-
making processes. The Committee encourages HRSA, in
collaboration with the National Center for Birth Defects and
Developmental Disabilities at the CDC, to support sickle cell
disease surveillance activities.
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 continued funding 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 LENDs' role in
providing direct clinical assessment and evidence-based
interventions.
Healthy Start
The Committee provides $145,000,000 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 an infant
mortality review, 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.
Newborn Screening for Heritable Disorders
The Committee provides $20,833,000 for the Newborn
Heritable Disorders Screening program, as described in section
1109 of 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.
Newborn Screening for Duchenne Muscular Dystrophy.--The
Committee is aware that at its February 2023 meeting, the
Advisory Committee on Heritable Disorders in Newborns and
Children [ACHDNC] voted not to advance the nomination of
Duchenne muscular dystrophy for evidence-based review for
newborn screening. The Committee recognizes the challenges in
collecting data for rare diseases, particularly in young
children. Duchenne muscular dystrophy typically isn't diagnosed
until age five despite the efforts of CDC and others to move
the age of diagnosis earlier. As a result, it is difficult to
meet the newborn screening criteria despite strong potential
for benefit. The Committee recommends expediting consideration
of Duchenne muscular dystrophy for the Recommended Uniform
Screening Panel for newborn screening, incorporating the
patient community voice in the ACHDNC review, and developing
appropriate flexible criteria.
Universal Newborn Hearing Screening and Early Intervention
The Committee provides $18,818,000 for universal newborn
hearing screening and early intervention activities. This
program awards grants to 53 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 $11,000,000 for the Screening and
Treatment 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 36
States mental health conditions are the leading cause of
maternal mortality, accounting for 22 percent of pregnancy-
related deaths from 2017-2019. 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 6 months of
enactment detailing 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 $13,000,000 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 $26,846,000 for Poison Control
Centers.
Alliance for Maternal Health Safety Bundles
The Committee includes $15,300,000 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.
Pregnancy Medical Home Demonstration
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 $7,000,000 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.
HIV/AIDS BUREAU
Appropriations, 2023.................................... $2,571,041,000
Budget estimate, 2024................................... 2,696,041,000
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 abuse 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 support
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 CARE SYSTEMS
Appropriations, 2023.................................... $99,009,000
Budget estimate, 2024................................... 135,009,000
Committee recommendation................................ 101,009,000
The Committee recommendation for the Health Care Systems
Bureau is $101,009,000.
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 $33,049,000, an increase of
$2,000,000 above the fiscal year 2023 enacted level, for organ
donation and transplantation activities that provide financial
support for living donors and increase public education and
awareness about organ donation.
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
encourages HRSA to implement its stated objectives and requests
a briefing within 90 days of enactment that details the:
actions the Department has or plans to take to improve
oversight of the OPTN contractor(s), and the performance of
duties and responsibilities under said contract(s); actions the
Department will take to increase public and stakeholder trust
in the OPTN organ allocation process; and the plan for tracking
and evaluating the effectiveness and impact of the Initiative.
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, long-term care, as well as training and research in
Baton Rouge, Louisiana; a residential facility at Carville,
Louisiana; 11 outpatient clinic sites in the continental U.S.
and Puerto Rico; repair and maintenance of buildings at the
Gillis W. Long Hansen's Disease Center; and medical care and
treatment of persons with Hansen's disease in hospital and
clinic facilities at Kalaupapa, Molokai, and Honolulu, Hawaii.
RURAL HEALTH
Appropriations, 2023.................................... $352,407,000
Budget estimate, 2024................................... 415,852,000
Committee recommendation................................ 364,407,000
The Committee recommendation for Rural Health programs is
$364,407,000, an increase of $12,000,000 above the fiscal year
2023 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-Urban Commuting Area [RUCA] Codes.--The Committee
recognizes FORHP's use of RUCA codes and the Frontier and
Remote codes, which are developed to define rural populations.
However, neither of these codes sufficiently measure rurality
in mountainous regions, such as the Appalachian Mountains. The
Committee directs FORHP to coordinate with the U.S. Department
of Agriculture's Economic Research Service on reviewing and
implementing the ``Difficult Terrain and Access to Urban Area''
project. The Committee also requests a report on how FORHP
plans to utilize this project to better define rural in
mountainous areas, such as Appalachia.
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 $10,000,000 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 would encourage HRSA to consider how the
centers can expand their outreach into other underserved
communities. Within the total provided for the Rural
Communities Opioid Response program, 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 Maternity and Obstetrics Management Strategies
[RMOMS].--The Committee provides no less than $8,000,000 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 Outreach
The Committee provides $94,975,000 for the Rural Health
Outreach program, an increase of $2,000,000 above the fiscal
year 2023 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 no more
than $22,000,000 for the Delta States Rural Development Network
Grant program and not less than $10,000,000 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 $3,000,000 for
HRSA's collaboration with the Appalachian Regional Commission.
Rural Health Research
The Committee provides $11,076,000 for the Rural Health
Research program. Funds are used for rural health research
centers, the National Advisory Committee on Rural Health, and a
reference and information service. Supported activities focus
on improving the delivery of health services to rural
communities and populations.
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 continues to recognize the importance of
supporting hospitals located in rural or underserved
communities and recommends HRSA give preference in grant awards
to Critical Access Hospitals serving rural communities that
create community health teams to help coordinate care among
rural populations to foster better outcomes in chronic disease
management.
State Offices of Rural Health
The Committee provides $12,500,000 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 $12,500,000 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 $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 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.
FAMILY PLANNING
Appropriations, 2023.................................... $286,479,000
Budget estimate, 2024................................... 512,000,000
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, 2023.................................... $1,735,769,000
Budget estimate, 2024................................... 360,709,000
Committee recommendation................................ 1,112,585,000
The Committee provides $1,112,585,000 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 $891,997,000
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.
Long COVID Centers of Excellence.--The extensive incidence
of individuals suffering from Long COVID (Post-Acute Sequelae
of SARS CoV-2 COVID [PASC]) presents an ongoing challenge to
the healthcare system, patients and their caregivers. The
Committee supports the establishment of a network of Long COVID
Centers of Excellence that can gather, develop and disseminate
data regarding evidence-based treatment; educate and train
providers on best practices; conduct outreach to affected
populations and community organizations; and coordinate access
to care. The Committee provides $5,000,000 to competitively
fund a network of such sites. In making awards, HRSA is
instructed to leverage existing federally funded Long COVID
research efforts, prioritize geographically diverse entities
with experience recruiting, enrolling, and working with Long
COVID patient populations on research and clinical care, and
institutions with the ability to coordinate on data sharing and
the identification of evidence-based treatments.
Telehealth
The Committee provides $38,050,000 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
supports HRSA's use of technology-enabled collaborative
learning and capacity building models, as authorized in Public
Law 116-260, division BB, title III, section 313. The Committee
urges HRSA to explore addressing Alzheimer's disease and other
dementias, including improving Alzheimer's person-centered care
coordination, improving care transitions, evaluating models to
build the evidence-base, increasing advanced care planning and
strengthening quality improvement measures.
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.
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 supports HRSA's continued use of its authorities and
any available measures, including the imposition of civil
penalties, as appropriate, to hold those drug manufacturers in
violation of the law directly accountable. The Committee urges
HRSA to continue to take actions to safeguard covered entities'
lawful access to discounted drugs.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Appropriations, 2023.................................... $15,200,000
Budget estimate, 2024................................... 26,200,000
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 childhood vaccines.
COVERED COUNTERMEASURES PROCESS FUND
Appropriation, fiscal year 2023......................... $7,000,000
Budget request, fiscal year 2024........................ 15,000,000
Committee Recommendation................................ 7,000,000
The Committee includes $7,000,000 for administrative costs
associated with the Countermeasures Injury Compensation Program
[CICP]. The CICP provides benefits to individuals who are
seriously injured as a result of a vaccination, medication,
device, or other item recommended to diagnose, prevent or treat
a declared pandemic, epidemic or security threat.
Centers for Disease Control and Prevention
The Committee recommendation provides a program level of
$9,197,590,000 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, 2023.................................... $919,291,000
Budget estimate, 2024................................... 1,255,930,000
Committee recommendation................................ 919,291,000
The Committee recommendation for the activities of the
National Center for Immunization and Respiratory Diseases is
$919,291,000, which includes $702,250,000 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Section 317 Immunization Program.... 681,933,000 681,933,000
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 directed 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.
Advisory Committee on Immunization Practices [ACIP]
Process.--The Committee recognizes the important work of ACIP
in regularly evaluating and providing informed vaccine
recommendations. Following an ACIP recommendation that the CDC
Director has reviewed and approved, timely publication in the
CDC Morbidity and Mortality Weekly Report [MMWR] is critical to
ensuring health insurance coverage and timely provider
implementation. Given the importance of the review,
recommendation, and publication process, the Committee requests
that CDC provide a report to the Committee outlining the
resources necessary to support both routine and emergency
reviews in real time as well as timely MMWR publication of
recommendations to ensure appropriate patient access. The
report should include recommendations for changes necessary to
improve efficiency in the ACIP process that will result in
expedited communication of recommendations.
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, 2024, 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.
Immunization Data Optimization.--The Committee is aware
that some States that receive resources to support Immunization
Information Systems [IIS] allow providers to opt-into
transmitting vaccination data for some populations to the IIS.
The Committee is concerned that this could lead to gaps in data
and potential outbreaks in VPDs. The Committee requests CDC,
along with the Office of the National Coordinator for Health
Information Technology [ONC], work with States to develop a
plan to encourage all providers who vaccinate to report
immunization data across the life course.
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 requests a report to Congress on current challenges
and barriers to access that are limiting vaccination rates and
preventing vaccine series completion required to achieve full
immunity.
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 routine vaccination across the life
course due to the COVID-19 pandemic, with underserved
populations affected to a greater degree and adolescents
affected disproportionately. If not addressed, these trends
will increasingly expose Americans to VPDs, outbreaks, and
exacerbate existing disparities in care. The Committee urges
CDC to prioritize and to allocate resources to engage
providers, healthcare stakeholders, educators, community
organizations, and families on the importance of ensuring that
all receive routinely recommended vaccinations, ensuring that
resources are allocated to address disparities in vaccination
rates based on race/ethnicity and age. Within 60 days of the
enactment, CDC shall provide the Committee with an update on
the ongoing ``Vaccinate with Confidence'' campaign and the rate
of routine vaccination across all ages, as well as an update on
the forward-looking plan to administer missed doses. CDC should
include updated recommendations about what other tools it could
employ to address this health equity issue.
Protecting Immunization Data.--The Committee encourages CDC
to continue its work with State and local health departments
and affiliated partner organizations toward adoption of and
adherence to nationally accepted privacy and security standards
for immunization data captured across the life course that
includes bi-directional data reporting between public health
authorities and providers at the point of care. The Committee
further asks CDC to provide an update on the status of
immunization work to date in the context of the CDC data
modernization initiative in the fiscal year 2025 CJ.
HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS
PREVENTION
Appropriations, 2023.................................... $1,391,056,000
Budget estimate, 2024................................... 1,544,556,000
Committee recommendation................................ 1,395,056,000
The Committee recommendation for the activities of the
National Center for HIV, Viral Hepatitis, Sexually Transmitted
Diseases [STDs], and Tuberculosis Prevention [TB] is
$1,395,056,000.
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 Center on Global Health.
The Committee recommends funding for the following
activities in the following amounts:
------------------------------------------------------------------------
Fiscal year 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and 1,013,712,000 1,016,712,000
Research...........................
HIV Initiative.................. 220,000,000 223,000,000
School Health................... 38,081,000 38,081,000
Viral Hepatitis..................... 43,000,000 43,000,000
Sexually Transmitted Infections..... 174,310,000 174,310,000
Tuberculosis........................ 137,034,000 137,034,000
Infectious Diseases and Opioid 23,000,000 24,000,000
Epidemic...........................
------------------------------------------------------------------------
Ending the HIV Epidemic [EHE] Initiative.--The Committee
includes $223,000,000 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, increase 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 has included funding to enhance
efforts to eliminate the public health threat of viral
hepatitis and to specifically implement and help fund the HHS
National Viral 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 CDC's recent universal screening guidelines
and urges a coordinated Federal effort to implement these
goals. Therefore, the Committee requests HHS complete a report
before the end of fiscal year 2024 on government-wide
coordinated efforts to make progress to meet this vaccination
goal. Finally, the Committee encourages that funds provided by
the Center be prioritized for jurisdictions with the highest
infection rates.
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 has provided $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.
Self-Testing.--The Committee notes the important role that
self-testing, self-collection, and rapid testing has played for
HIV, COVID-19, and other conditions. The Committee encourages
CDC to continue to advance opportunities to enhance access to
these innovative technologies in order to further promote
interventions that address inequities, including through the
Ending the HIV Epidemic initiative, the Viral Hepatitis
National Plan, the National STI Strategic Plan, and ongoing
activities.
Sexually Transmitted Infections [STIs].--The Committee
includes $174,310,000 to combat and prevent the high incidence
of STIs. The Committee further directs that a portion of these
funds be used to ensure that none of the grantees receives less
than the amount received in fiscal year 2023. 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 each year
for the next 3 years, 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.
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/Native American
communities.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriations, 2023.................................... $750,772,000
Budget estimate, 2024................................... 845,772,000
Committee recommendation................................ 750,772,000
The Committee recommendation for the activities of the
National Center for Emerging and Zoonotic Diseases is
$750,772,000, 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Antibiotic Resistance Initiative.... 197,000,000 197,000,000
Vector-Borne Diseases............... 62,603,000 64,103,000
Lyme Disease........................ 26,000,000 27,500,000
Prion Disease....................... 7,500,000 7,500,000
Chronic Fatigue Syndrome............ 5,400,000 5,400,000
Emerging Infectious Diseases........ 202,997,000 204,997,000
Harmful Algal Blooms................ 3,500,000 3,500,000
Food Safety......................... 71,000,000 71,000,000
National Health Care Safety Network. 24,000,000 24,000,000
Quarantine.......................... 58,772,000 53,772,000
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.
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 continues to encourage CDC to competitively award
research activities that address aspects of AMR related to
``One Health'', including global surveillance and research and
development for new tools to counter AMR.
Lyme Disease and Related Tick-Borne Illnesses.--With recent
2020 CDC data showing that nearly 500,000 Americans contract
Lyme disease every year, especially in rural States across the
United States, an improved understanding of the disease is
essential to the health and wellbeing of Americans. CDC
tracking of Nationally Notifiable Infectious Diseases shows
that Lyme disease is the most common tick-borne disease and the
most common vector-borne disease in the United States. In
patients who suffer from long-term complications associated
with Lyme disease, clear treatment pathways are often missed as
a result of inaccurate and incomplete testing. The Committee
provides $27,500,000, an increase of $1,500,000, 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 directs CDC to develop and implement
methods to improve surveillance to more accurately report the
disease burden, including through the development of real time
data for reporting Lyme disease and other tick-borne diseases
as well as a process for estimating the prevalence of Post-
Treatment Lyme Disease Syndrome. The Committee directs CDC to
direct funding to improve early diagnosis of Lyme and related
tick-borne diseases to prevent the development of late stage
disease and more serious and long-term disability. 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 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.
Mosquito Control Activities.--The Committee continues to
urge CDC to direct funding from within the Vector-Borne
Diseases budget to coordinate with States, mosquito control
districts, universities, and other Federal partners to update
spray drift models used in the pesticide registration process.
The Committee urges CDC to move expeditiously in support of
these activities. The Committee further encourages CDC,
consistent with the provisions of the Strengthening Mosquito
Abatement for Safety and Health Act (Public Law 116-22) to
increase support to State and local mosquito control programs
for mosquito-borne and other vector-borne diseases surveillance
and control.
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 and children. The Committee expects
CDC to strengthen collaboration with 1) interagency partners,
2) disease experts and stakeholders, and 3) the NIH's
Collaborative Research Centers on study design protocol.
Additionally, the Committee urges CDC to conduct a series of
epidemiological studies into the causes, diagnosis, and risk
factors of ME/CFS. Finally, the Committee expects CDC to engage
physicians and patients in an effort to increase awareness of
ME/CFS and disseminate updated clinical guidance.
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 includes
$7,500,000 for surveillance efforts of human prion diseases,
including Creutzfeldt-Jakob Disease, through the National Prion
Disease Pathology Surveillance Center and CDC. Monitoring the
prevalence of prion diseases, including whether a disease was
acquired from animals or other humans, is particularly critical
for Chronic Wasting disease endemic areas.
Sepsis.--The Committee provides $2,000,000 within Emerging
Infectious Diseases to integrate sepsis data from hospitals
into the National Healthcare Safety Network [NHSN] to enable
CDC to assess the impact of policies and programs (including
sepsis `Core Elements') across hospitals and assist in the
improvement of sepsis care. These data will promote awareness
and uptake of CDC's sepsis initiatives including the sepsis
Core Elements through public and private clinical care
partnerships and events based on the successful CDC strategy
employed for antibiotic resistance and stewardship campaign, as
appropriate. CDC, in collaboration with CMS, will use the
quality measure development process to develop new, or identify
existing, hospital quality measures for adult and pediatric
sepsis.
Vector-Borne Diseases [VBDs].--The Committee is concerned
about the risk of a vector-borne infectious disease outbreak in
the U.S. and our readiness to quickly respond to and stop its
spread. The recommendation includes $64,103,000, an increase of
$1,500,000, to support activities like those of the Regional
Centers of Excellence program, including State-level
surveillance and research being conducted by partners in order
to prevent and rapidly respond to emerging VBDs across the
United States. The Committee encourages CDC to examine options
to provide greater coverage of the Northwest region for VBD
resources. Additionally, the Committee recognizes the
importance of strong surveillance data to monitor and forecast
the risk of infectious disease outbreaks in the U.S. The
Committee notes that the pandemic response necessitated the
disruption of mosquito control and abatement efforts by many
State and local health departments and notes the importance of
continuing mosquito prevention efforts. The Committee is aware
of the ongoing challenges faced in the Caribbean and the
Pacific regarding control and management of VBDs, the increased
risk for prevalence and spread of these diseases due to their
tropical climate, and how cases in these islands can impact the
rest of the country. The Committee urges CDC to support the
training and research needs of the U.S. territories and
encourages the use of the Mosquito Abatement for Safety and
Health program to provide grants and technical assistance to
States and political subdivisions to prevent and control
mosquito-borne diseases. In addition, the Committee requests
CDC, in consultation with other appropriate agencies, to
provide information in the fiscal year 2025 CJ on the
ecological structure and epidemiological factors that must be
known and monitored to estimate the mosquito-borne infectious
disease outbreak risk.
Wastewater Surveillance.--The Committee continues to
recognize the important role wastewater surveillance plays for
our Nation's biosecurity. In a January 2023 report, the
National Academies of Sciences, Engineering, and Medicine
highlighted how critical wastewater surveillance has been in
detecting, managing and preventing further spread of the COVID-
19 virus and affirms its continued value for managing
infectious disease outbreaks, including resurgences of known
pathogens and newly emergent pathogens. The Committee shares
the National Academies' vision of a wastewater surveillance
system that is ``flexible, equitable, integrated, actionable
and sustainable.'' This should include a system that would be
able to track multiple pathogens simultaneously, has an open
and transparent process for prioritizing targets, and can pivot
quickly to detect emerging pathogens. The Committee further
underscores the importance of a national wastewater
surveillance system with geographic and temporal design
informed by data and that strategically incorporates sites as a
mechanism for early detection. Additionally, the Committee
encourages CDC to continue working with States and localities
to broaden the scope of wastewater surveillance capabilities to
track COVID-19, additional pathogens, and high-risk substances
such as fentanyl to assist with public health data analysis.
The Committee requests CDC provide information in the
fiscal year 2025 CJ on how the National Wastewater Surveillance
System program, and wastewater surveillance more broadly, can
be leveraged to include analysis of future public health
threats beyond infectious diseases, which may include high-risk
substances such as fentanyl and other natural or manmade
biothreats.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriations, 2023.................................... $1,430,414,000
Budget estimate, 2024................................... 1,813,539,000
Committee recommendation................................ 1,435,414,000
The Committee recommendation for the activities of the
National Center for Chronic Disease Prevention and Health
Promotion is $1,435,414,000, which includes $254,950,000 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Tobacco............................. 246,500,000 246,500,000
Nutrition, Physical Activity, 58,420,000 58,420,000
and Obesity....................
High Obesity Rate Counties.. 16,500,000 16,500,000
School Health....................... 19,400,000 19,400,000
Health Promotion................ 62,600,000 64,100,000
Glaucoma.................... 4,000,000 4,000,000
Vision and Eye Health....... 2,500,000 2,500,000
Alzheimer's Disease......... 38,500,000 40,000,000
Inflammatory Bowel Disease.. 1,500,000 1,500,000
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 4,500,000 4,500,000
and Awareness..............
Prevention Research Centers......... 28,961,000 28,961,000
Heart Disease and Stroke............ 155,105,000 155,105,000
Diabetes............................ 155,129,000 156,129,000
National Diabetes Prevention Program 37,300,000 37,300,000
Cancer Prevention and Control....... 409,549,000 409,549,000
Breast and Cervical Cancer...... 235,500,000 235,500,000
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 44,294,000
Comprehensive Cancer............ 22,425,000 22,425,000
Johanna's Law................... 11,500,000 11,500,000
Ovarian Cancer.................. 14,500,000 14,500,000
Prostate Cancer................. 15,205,000 15,205,000
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....... 108,000,000 110,500,000
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....... 8,000,000 8,000,000
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 is encouraged by
research demonstrating the positive impact of risk reduction on
dementia prevalence and commends the Secretary for updating the
National Alzheimer's Plan to reflect the latest science. To
ensure high burden populations are reached, the Committee
directs CDC to increase capacity to reach populations
disproportionately burdened by Alzheimer's disease, including
Black/African American and Latino/Hispanic population through
public health promotion and workforce development.
Breast and Cervical Cancer.--The Committee includes
$235,500,000 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 Education and Awareness [CDEA] Program.--
The Committee is pleased with the administration of the CDEA
program and includes $4,500,000 for fiscal year 2024 to support
existing and additional grants for chronic health conditions
that do not have 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.
Chronic Disease Research on Children, Adolescents, and
Young Adults.--The Committee recognizes that children,
adolescents, and young adults living with chronic conditions
can be disproportionately affected by barriers to access to
quality healthcare services. An estimated 39.8 million adults
between ages of 18 and 34 years have at least one chronic
condition and about 16.5 million adults in this age group have
more than one condition. Limited access to quality care often
results in a lack of awareness among healthcare providers,
limited treatment options, and adverse health outcomes for
children, adolescents, and young adults living with chronic
conditions. The Committee directs the National Center for
Chronic Disease Prevention and Health Promotion to submit a
report to the Committee within a year of enactment of this act
on the current state of Federal research on children,
adolescents, and young adults living with chronic conditions,
including information on disease prevalence, an evaluation of
existing data collection programs for chronic conditions
affecting this population, barriers to available treatment
options, and related health outcomes. The report should also
identify remaining knowledge gaps among healthcare providers
and patients in understanding of chronic conditions affecting
children, adolescents, and young adults, and recommendations
for filling these gaps. Further, the Committee encourages CDC,
in collaboration with NIH, to continue to support education,
outreach, and awareness to promote early and accurate diagnosis
of chronic conditions among children, adolescents, and young
adults.
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 $156,129,000 to prevent
diabetes and its complications, and to reduce inequities
through prevention strategies, translational research, and
education. In addition, the Committee includes $37,300,000 for
the National Diabetes Prevention Program to expand efforts of
this public-private partnership that provides diabetes
prevention for people with prediabetes. The Committee supports
the continued expansion of CDC-recognized community-based
prevention programs and encourages flexibility for
organizations serving low-income populations to address
barriers these populations face in losing weight.
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.--The Committee remains concerned that
mental health problems among youth are at an all-time high,
with eating disorder-related emergency room admissions for
youth doubling during the pandemic. 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. For 23 years, CDC conducted surveillance of the
signs and symptoms of eating disorders within the Youth Risk
Behavioral Surveillance System but ended that data collection
in 2015. The resulting gap in data collection has left public
health experts and researchers with limited data to address the
current eating disorders crisis among youth. Additionally, the
Committee supports the implementation of public awareness
campaigns for eating disorders including education on proper
prevention strategies.
Epilepsy.--The Committee includes $11,500,000 and commends
CDC for its ongoing leadership of this successful program and
effective community collaborations, and encourages further
efforts to eliminate stigma, improve awareness and education,
and better connect people with epilepsy to health and community
services. Additionally, the Committee recognizes the importance
of surveillance to accurately understand the incidence,
prevalence, and mortality rate of epilepsies and to address the
long-term health outcomes, complications, and healthcare access
needs of people living with epilepsies. The Committee requests
CDC to report to the Committee within 120 days of enactment of
this act 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 includes
$155,105,000 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 116.0 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 remains
concerned about the growing body of evidence suggesting that
obesity is one of the most significant challenges facing the
public health system. The Committee continues to support land
grant universities in partnership with their cooperative
extensions for counties with an obesity prevalence over 40
percent. 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.
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 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. The Committee recognizes
that health literacy is an important factor in an individual's
ability to find, understand, and use information to inform
health-related decisions and actions and that CDC has a leading
role in improving health literacy. As CDC seeks to improve
awareness of and education related to IBD, the Committee
strongly encourages the agency to include health literacy
activities within these activities and to work with multiple
stakeholders to implement them.
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 of [CKD]
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 2025 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
$15,205,000 for CDC's prostate cancer activities, including for
outreach and education initiatives among high-risk men,
especially African American men.
Psoriatic Disease.--The Committee recognizes that psoriatic
disease impacts 8,000,000 Americans and presents a significant
public health burden, including increased risk of co-occurring
conditions such as depression, anxiety, diabetes, and
cardiovascular disease, as well as social isolation, and the
need for costly treatments. The Committee commends CDC for its
work through the CDEA program to raise awareness of psoriatic
disease among underserved populations to improve diagnosis, and
to update epidemiology and surveillance tools. This work, as
well as the addition of a psoriatic disease question in the
National Health Interview Survey, presents new opportunities to
mitigate the public health burden of psoriatic disease. The
Committee encourages CDC to build upon and expand these
activities on psoriatic disease, with a focus on developing and
disseminating public health interventions for those living with
psoriatic disease and other co-occurring conditions.
Racial and Ethnic Approaches to Community Health [REACH].--
The Committee includes $68,950,000 to continue scaling this
program to all States and territories, and to support grantees
in building capacity for collaboration and disseminating
evidence-based strategies in communities. REACH is a vital
initiative to help eliminate healthcare disparities in minority
communities. The Committee's recommended level includes
$24,000,000 for Good Health and Wellness in Indian Country.
Safe Motherhood/Infant Health.--The Committee
recommendation builds upon the commitment made in the fiscal
year 2023 bill by providing an increase of $2,500,000 for this
portfolio of programs to improve health outcomes during and
after pregnancy, including to reduce disparities 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 forty percent increase
from 2020. The Committee continues to direct CDC to expand the
Maternal Mortality Review Committees [MMRCs] and Perinatal
Quality Collaboratives [PQCs] to additional States and
territories and for increased support to current States and
territories, as well as to increase support for other programs,
including Sudden Unexplained Infant Death [SUID]. State MMRCs
are working to collect complete data on pregnancy and delivery-
related deaths, but more must be done to ensure the accuracy
and completeness of the data. The Committee encourages CDC to
prioritize funding to help MMRCs build stronger data systems
and improve data collection at the State level to create
consistency in data collection, analysis and reporting across
State MMRCs. The Committee requests CDC to provide a briefing
to the Committees on Appropriations within 90 days of enactment
of this act on barriers to effective and consistent data
collection and opportunities to improve coordination among
State MMRCs. The Committee requests an update on the expansion
of PQCs beyond the States currently funded, as well as any
barriers to expansion. Finally, the Committee continues to
support the SUID and Sudden Death in the Young Registry to
expand the number of States and jurisdictions participating in
monitoring and surveillance to improve data collection. This
data works to identify, develop, and implement best practices
to prevent infant death, including practices to improve safe
sleep, in coordination with appropriate nonprofits.
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 increase its collaboration and
partnership with local governments, business, health,
education, communities, nonprofit, and faith-based sectors.
Social Determinants of Health [SDOH].--The Committee
recognizes the important impact of SDOH on outcomes and health
inequities in communities. The Committee provides $8,000,000
for SDOH activities. These activities should include expanding
and implementing accelerator plans and providing grants for
implementation of SDOH activities. CDC should award grants to
improve the capacity of governmental and non-governmental
public health organizations and community organizations to
address SDOH in communities; support and conduct research on
best practices; and improve health outcomes and reduce health
inequities by coordinating SDOH activities across CDC. The
Committee encourages CDC to continue efforts that support
action plans and research into best practices that address
SDOH.
Sudden Cardiac Arrest.--The Committee recognizes that
sudden cardiac arrest [SCA] 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. The Committee
requests a report on its progress no later than 180 days after
enactment of this act.
Sudden Cardiac Arrest Registry.--The Committee encourages
CDC to expand the Cardiac Arrest Registry to Enhance Survival
[CARES] program to capture data from additional States.
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 provides $246,500,000 so that CDC,
States and territories can continue efforts to reduce tobacco
use among disparate populations and in areas and regions with
high tobacco prevalence and mortality and expand the highly
successful and cost-effective Tips from Former Smokers media
campaign. The Committee remains concerned that 3,000,000 youth
currently 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.
Vision and Eye Health.--The Committee provides $2,500,000
and encourages CDC to update national prevalence estimates on
vision impairment and eye disease through use of the National
Health and Nutrition Examination Survey. 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 State 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, 2023.................................... $205,560,000
Budget estimate, 2024................................... 222,560,000
Committee recommendation................................ 206,060,000
The Committee recommendation for the activities of the
National Center on Birth Defects, Developmental Disabilities,
Disability and Health [NCBDDD] is $206,060,000.
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 2023 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 85,910,000 86,410,000
with Disabilities..................
Disability and Health........... 45,500,000 45,500,000
Tourette Syndome................ 2,500,000 2,500,000
Early Hearing Detection and 10,760,000 10,760,000
Intervention...................
Muscular Dystrophy.............. 7,500,000 8,000,000
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 10,400,000 10,400,000
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 4,250,000
Surveillance for Emerging Threats to 23,000,000 23,000,000
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.
Diversity and Expansion of Blood Supply.--The current pool
of donors to the Nation's blood supply does not reflect the
diversity of the population at large. To better serve the needs
of those who require blood transfusions, diversifying and
expanding the blood donor pool is crucial. Red blood cells
carry markers that determine blood type beyond the common O, A,
B and AB designation. Some blood types are more common among
people of similar racial or ethnic backgrounds. Diversifying
and expanding the blood supply decreases the chance of
transfusion-related complications, especially among individuals
who require regular transfusion, such as many with thalassemia
or sickle cell disease. The Committee encourages the creation
of strategies and campaigns aimed at creating a blood supply
that more adequately reflects the diverse population of the
United States and better meets the needs of the blood
transfusion population.
Congenital Heart Disease [CHD].--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 $8,000,000 to enhance Muscular Dystrophy research and
disease surveillance initiatives, including the evaluation of
the impact of incorporating the care considerations as
identified in the recent report to the Committee, into the
standards of care for Duchenne Muscular Dystrophy patients. In
addition, the Committee encourages CDC to collaborate with
stakeholders on an initiative to integrate the care
considerations into electronic health records to improve care,
understand disease outcomes, and model disease progression.
Hemophilia Treatment Centers [HTC].--The Committee
recognizes the importance of the Community Counts Hemophilia
Data Collection program and its role in identifying blood-borne
infections and improvements in the care and treatment of
individuals living with Hemophilia.
Neonatal Abstinence Syndrome [NAS] Surveillance.--The
Committee includes $4,250,000 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 includes funding to strengthen existing programs that
address healthy athletes.
Public Health Approach to Blood Disorders.--The Committee
provides $10,400,000 for the Public Health Approach to Blood
Disorders program and encourages CDC to implement innovative
activities dedicated to supporting patients with immune
thrombocytopenia and other rare platelet disorders, in a manner
similar to programming and activities available for sickle cell
and hemophilia.
Sickle Cell Disease [SCD].--The Committee recommendation
includes $6,000,000 for the sickle cell disease data collection
program to allow for data collection and analysis in States
currently participating in the program and encourages expansion
to additional States. 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.
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 $23,000,000 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.
PUBLIC HEALTH AND SCIENTIFIC SERVICES
Appropriations, 2023.................................... $754,497,000
Budget estimate, 2024................................... 961,564,000
Committee recommendation................................ 739,497,000
The Committee recommendation for Public Health Scientific
Services is $739,497,000.
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 2023 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.... 175,000,000 160,000,000
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.
Epidemiology and Laboratory Capacity [ELC] Program.--The
Committee includes $23,000,000 and recognizes the need to
provide flexibility to State, territorial, and large local
[STL] health departments to address gaps that are not funded by
the disease specific sections of the ELC cooperative agreement.
The ELC program provides critical foundational support for STL
health departments to fund epidemiology, surveillance,
laboratory, and data science staff positions that provide the
backbone for STL public health programs. This program allows
STL health departments to build the public health workforce and
infrastructure that will allow them to be better prepared to
respond to emerging threats more quickly.
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 many in
the United States who are affected with FH are completely
unaware of their condition. The Committee encourages the
National Center for Chronic Disease Prevention and Health
Promotion to work collaboratively with CDC's Office of Genomics
and Precision Public Health to address FH as a public health
concern in order to improve diagnosis and care delivery and
prevent heart disease.
Health Data Utilities [HDUs].--The Committee urges CDC to
encourage States to coordinate with ONC to designate existing
neutral, trusted, and nonprofit health information exchange(s)
[HIEs] to be the State's HDU. HDUs will build upon CDC's
current work to create modern, integrated, and real-time public
health infrastructure by building out a highly collaborative
public utility infrastructure to facilitate State-wide
electronic health data sharing across the healthcare ecosystem.
A State-designated HDU will drive better health outcomes and
more informed population health management programs and payment
models. The CDC may use appropriated funding through the Data
Modernization Initiative to support the development of HDUs.
The Committee urges CDC to issue policy guidelines or best
practices to support the establishment of HDUs across the
country.
National Center for Health Statistics.--The Committee
provides $187,397,000 for the National Center on 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. The Committee directs the National
Center for Health Statistics to provide the Committee a report
within 90 days of enactment 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 $160,000,000 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. This
funding level reflects a shift of $15,000,000 to Public Health
Preparedness and Response for the Ready Response Enterprise
Data Integration Platform. The Committee encourages CDC to
create an advisory council or a sub-unit to an existing
advisory council to formalize its engagement with
representatives from State and local public health departments,
healthcare providers, and the private sector toward the
development and implementation of enterprise level public
health data systems that will benefit all public health
programs at all levels of the government for all diseases and
conditions. Electronic birth and death registration systems are
essential tools to monitor public health and fight waste,
fraud, and abuse in Federal programs. 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.
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, 2023.................................... $246,850,000
Budget estimate, 2024................................... 420,850,000
Committee recommendation................................ 246,850,000
The Committee recommendation for the National Center for
Environmental Health is $246,850,000. The Committee
recommendation includes $17,000,000 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Environmental Health Laboratory..... 70,750,000 70,750,000
Newborn Screening Quality 21,000,000 21,000,000
Assurance Program..............
Newborn Screening for SCID...... 1,250,000 1,250,000
Other Environmental Health...... 48,500,000 48,500,000
Environmental Health Activities..... 52,600,000 52,600,000
Safe Water...................... 8,600,000 8,600,000
Amyotrophic Lateral Sclerosis 10,000,000 10,000,000
Registry.......................
Trevor's Law.................... 3,000,000 3,000,000
Climate and Health.............. 10,000,000 10,000,000
All Other Environmental Health.. 21,000,000 21,000,000
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 urges CDC to provide reports to the
public that include State-by-State data on the incidence and
prevalence of ALS. 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. The Committee requests this report
within 1 year of enactment, and requests the inclusion of a
strategy to develop and test risk reduction strategies that
will lower the incidence of ALS among active-duty personnel and
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 directs 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 by building capacity 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.
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 should work expeditiously to update its clinical guidance
to advise clinicians 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 requests a briefing
within 180 days of enactment of this act outlining trends in
human exposure for the 13 phthalates measured in CDC's National
Exposure Report, including CDC's efforts to measure human
exposure to phthalates.
Vessel Sanitation Program.--The Committee includes
$4,000,000 to support the critical public health functions of
the vessel sanitation program. The Committee requests
additional information in the fiscal year 2025 CJ on the
program budget, including user fee and no-year funding
balances, estimated user fee collections, and the anticipated
workload.
INJURY PREVENTION AND CONTROL
Appropriations, 2023.................................... $761,379,000
Budget estimate, 2024................................... 1,351,669,000
Committee recommendation................................ 761,879,000
The Committee recommendation for the National Center for
Injury Prevention and Control is $761,879,000.
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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Intentional Injury.................. 164,550,000 164,550,000
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 30,000,000
Adverse Childhood Experiences... 9,000,000 9,000,000
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 Activities.. 29,950,000 29,950,000
Opioid Overdose Prevention and 505,579,000 506,079,000
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 is aware that the
United States is facing a crisis in adolescent and youth mental
health. The Committee commends CDC for standing up a new
Behavioral Health Coordinating Unit [BHCU] to coordinate and
leverage existing CDC activities related to mental health, with
a particular focus on adolescent mental health activities,
including prevention and early intervention. The BHCU will
identify opportunities for a streamlined, coordinated, and
collaborative approach to CDC's mental health activities to
amplify the impact across the agency. 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 $9,000,000 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, addiction, and violence. The Committee urges CDC to
improve upon its previous ACEs research by focusing on building
a diverse sample of participants, identifying the relative
strength of risk and protective factors as well as community
factors, understanding the impact of social and economic
conditions on well-being, and measuring the intensity and
frequency of specific ACEs and their effect on health outcomes.
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.
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.
Additionally, as incidents of trauma continue to rise, the
Committee urges CDC to develop innovative approaches to reduce
the incidence of re-injury and re-incarceration caused by
intentional violent trauma. Efforts may include facilitating
the creation and expansion of comprehensive hospital-based
violence intervention and prevention programs that focus on
individuals at the highest risk for experiencing community
violence. This may be done through partnerships with trauma
centers and non-profit entities, such as community-based
violence prevention programs, providing technical assistance,
and facilitating or conducting research of hospital-based
violence prevention programs.
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. 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 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.
National Violent Death Reporting System [NVDRS].--The
Committee encourages CDC to support enhanced data linkage
opportunities between NVDRS and emergency department data. The
Committee recognizes the initial Linking ESSENCE and Death
Surveillance initiative piloted across six health departments
proved successful and should be expanded to additional sites to
strengthen violence-related data linkage activities.
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.
Public Safety Officer Suicide Reporting Module.--The
Committee continues funding for CDC to maintain its Public
Safety Officer Suicide Reporting Module to collect data on the
suicide incidence among public safety officers. These data will
inform and aid in the development of prevention efforts to
reduce suicide among public safety officers as described in the
Helping Emergency Responders Overcome Act of 2020.
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 is concerned about data
that show suicide rates increased in 2021 after 2 years of
decline, and that in 2021, suicide was one of the leading
causes of death for people aged 10-14 and 25-34. 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 to expand the Comprehensive Suicide Prevention
program nationwide, and to help tribes and territories build
capacity and implement strategies to prevent suicide.
Traumatic Brain Injury.--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. Gaps still exist in capturing youth sports concussion,
therefore a national concussion surveillance system is needed
to accurately determine the incidence of all concussions among
youth ages 5 to 21. CDC is encouraged to continue efforts to
track traumatic brain injury, concussion mortality, and
morbidity, particularly among youth.
OCCUPATIONAL SAFETY AND HEALTH
Appropriations, 2023.................................... $362,800,000
Budget estimate, 2024................................... 362,800,000
Committee recommendation................................ 362,800,000
The Committee recommendation for the National Institute for
Occupational Safety and Health [NIOSH] programs is
$362,800,000. 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
National Occupational Research 119,500,000 119,500,000
Agenda.............................
Agriculture, Forestry, Fishing (non-- 29,000,000 29,000,000
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 66,500,000
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...........................
------------------------------------------------------------------------
Agriculture, Forestry, and Fishing Program.--The Committee
includes $29,000,000 for efforts to protect workers in this
sector by providing leadership in applied research, disease and
injury surveillance, education, and prevention. NIOSH is
directed to provide a briefing to the Committee not later than
90 days after the date of enactment of this act on the
execution of the Commercial Fishing Safety Research and
Training program and grants since the program's inception 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, the Committee encourages CDC NIOSH to
prioritize funds 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 directs NIOSH to increase support for
new and existing ERCs to support education and training
programs for undergraduate and 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 directs the 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.
Ryan White Act Emergency Responder Notification Compliance
Program.--The Committee encourages CDC to implement Part G of
the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public
Law 111-87), which is intended to establish and facilitate a
notification process for emergency response employees who may
have been exposed to certain potentially life-threatening
infectious diseases while attending, treating, assisting, or
transporting victims of emergencies.
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, 2023.................................... $55,358,000
Budget estimate, 2024................................... 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, 2023.................................... $692,843,000
Budget estimate, 2024................................... 764,843,000
Committee recommendation................................ 692,843,000
The Committee recommends $692,843,000 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 2023 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 29,000,000
Global Public Health Protection..... 293,200,000 293,200,000
------------------------------------------------------------------------
Global Health Protection.--The Committee includes
$293,200,000 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 supports the creation of a deputy
director for global health within the director's office to
oversee and unify CDC's global health activities. CDC is a
leader in global health research on infectious diseases and in
developing and validating tools to detect, prevent, and respond
to infectious diseases that are used in U.S. bilateral and
multilateral global health and global health security programs.
The Committee applauds the global health research and related
partnerships led by the Global Health Center, the National
Center for Immunization and Respiratory Diseases, and the
National Center for Emerging and Zoonotic Infectious Diseases.
In addition, the Committee urges CDC in its international
engagements to emphasize the importance of research and
development to global health security.
Malaria and Parasitic Diseases.--The Committee provides
$29,000,000, recognizing the important role CDC plays in the
fight against malaria and parasitic disease, particularly
providing parasitic lab capabilities for the United States. 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 $1,500,000, for currently
funded CDC projects aimed at surveillance, source remediation
and clinical education to reduce soil transmitted helminth
infection.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriations, 2023.................................... $883,200,000
Budget estimate, 2024................................... 943,200,000
Committee recommendation................................ 898,200,000
The Committee recommendation for CDC's Preparedness and
Response activities is $898,200,000.
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 2023 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.......................
All Other CDC Preparedness.......... 139,000,000 139,000,000
------------------------------------------------------------------------
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.
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 2025 CJ, which should
also include information about how funding is being allocated
to local health departments and how States are determining
these allocations.
Ready Response Enterprise Data Integration [RREDI]
Platform.--The Committee provides $15,000,000 for RREDI and 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 decisionmaking. This platform, the next
generation of HHS Protect, the platform used in the COVID-19
response, has proven vital to allow for a common operating
picture to collect, integrate and analyze enormous amounts of
data for situational awareness and decisionmaking regarding
public health response resources. The Committee recognizes the
investment the U.S. government has made into this platform and
includes funding for CDC to continue to maintain this
capability to ensure preparedness for future public health
emergencies.
BUILDINGS AND FACILITIES
Appropriations, 2023.................................... $40,000,000
Budget estimate, 2024................................... 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 until completion of the
facility.
CDC-WIDE ACTIVITIES
Appropriations, 2023.................................... $723,570,000
Budget estimate, 2024................................... 1,038,570,000
Committee recommendation................................ 693,570,000
The Committee provides $693,570,000 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
Preventive Health and Health 160,000,000 160,000,000
Services Block Grant...............
Public Health Leadership and Support 128,570,000 128,570,000
Infectious Diseases Rapid Response 35,000,000 10,000,000
Reserve Fund.......................
Public Health Infrastructure and 350,000,000 350,000,000
Capacity...........................
Center for Forecasting and Outbreak 50,000,000 45,000,000
Analytics..........................
------------------------------------------------------------------------
Center for Forecasting and Outbreak Analytics [CFA].--The
Committee includes funding for the CFA to facilitate the use of
data, modeling, and analytics to improve preparedness and
response. The Committee urges CDC to continue to work with
schools of public health and other academic institutions to
engage the Nation's expertise in disease modeling, public
health data analysis, research, and training to build workforce
capacity in this emerging field. 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.
Infectious Diseases Rapid Response Reserve Fund [IDRRRF].--
The Committee includes $10,000,000 for 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. CDC is expected
to provide updates to the Committees on Appropriations as
outlined in the Joint Explanatory Statement accompanying Public
Law 117-328.
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 is encouraged
by efforts from the agency to establish the ORH. The Committee
directs the agency to ensure that the established ORH will
guide the CDC's rural health leadership across the entire
agency. This includes developing purposeful public health
guidance for rural health departments, analyzing and developing
initiatives to expand the rural public health workforce,
coordinating 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. The
Committee includes $5,000,000 for the continued efforts to
establish the ORH.
Public Health Infrastructure and Capacity.--The Committee
includes $350,000,000 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 $128,570,000 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. The Committee continues
funding for the John R. Lewis CDC Undergraduate Public Health
Scholars Program.
National Institutes of Health
The Committee provides $49,224,000,000, an increase of
$943,000,000, for the National Institutes of Health [NIH].
Within the total appropriation, the Committee provides
$407,000,000 in budget authority authorized in the 21st Century
Cures Act (Public Law 114-255). Per the Cures Act, $86,000,000
is transferred to the National Institute of Neurological
Disorders and Stroke [NINDS] and $86,000,000 to the National
Institute of Mental Health [NIMH] for the BRAIN Initiative; and
$235,000,000 to the Office of the Director [OD] for the All of
Us precision medicine initiative. The total also includes
$1,412,482,000 in transfers available under section 241 of the
PHS Act (Public Law 78-410 as amended).
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 $100,000,000, provides an increase of
$100,000,000 for research on Alzheimer's disease and
Alzheimer's disease-related dementias research, increases
support for cancer research by $60,000,000, and increases
support for diabetes research by $10,000,000. The bill also
includes an increase of $20,000,000 for the Helping to End
Addiction Long-term or HEAL Initiative, $12,000,000 for a new
palliative care research program, and an increase of
$10,000,000 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
2025 Congressional Justification: metastatic breast cancer;
future goals for each of the deadliest cancers (brain,
esophagus, liver, lung, ovary, pancreas, stomach and
mesothelioma); the link between obesity and endometrial cancer;
melanoma; neuroblastoma; pediatric immunotherapy clinical
trials; congenital heart disease; kidney transplant
disparities; lower urinary tract symptoms; celiac disease;
Maternal-Fetal Medicine Units Network; pelvic organ prolapse;
Usher syndrome; indoor pollutants; amyloidosis; Childhood Post-
Infectious Neuroimmune Disorders/Pediatric Acute-Onset
Neuropsychiatric Syndrome [PANS]/Pediatric Autoimmune
Neuropsychiatric Disorders Associated with Streptococcus
[PANDAS]; Congenital Cytomegalovirus; Native Hawaiian Early
Career Development; Von Hippel-Lindau Disease; NCI's plans to
update the Surveillance, Epidemiology, and End Results
Registry; pulmonary fibrosis; cellular immunity; and
opportunities to enhance childhood cancer research efforts,
including coordinating efforts already underway through the
Trans-NIH Pediatric Research Consortium.
NATIONAL CANCER INSTITUTE
Appropriations, 2023.................................... $7,104,159,000
Budget estimate, 2024................................... 7,820,159,000
Committee recommendation................................ 7,380,159,000
The Committee recommendation includes $7,380,159,000 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.
Alaska Native Colorectal Cancer.--The Committee is
concerned the Alaska Native people are twice as likely to be
diagnosed with colorectal cancer as the White population. A
recent study shows that Alaska Natives have the world's highest
rate of colorectal cancer. Colorectal cancer often has no
symptoms until later stage, but screenings help detect growth
at earlier stages. These high rates have led the Alaska Native
Tribal Health Consortium and the Alaska Native Medical Center
to amend their guidelines to lower the screening age from 45 to
40 in order to detect early onset colorectal cancer. The
Committee encourages NCI to expand research efforts to reduce
Alaska Native cancer disparities and improve outreach.
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
$30,000,000, the same as the fiscal year 2023 enacted level,
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.
Clinical Research Workforce Training.--The Committee is
concerned that a shortage of staff who are qualified to support
and administer cancer clinical trials has reached a crisis
point and is slowing our Nation's progress in developing new
treatments. In some cases, trials have been delayed or even
abandoned because the sponsor or cancer center conducting the
trial could not hire enough staff to run them. The shortage is
especially acute in trials involving cellular therapies, such
as CAR-T, which are customized for each individual patient.
Specialized skills are required to run trials that involve
extracting a patient's cells, re-engineering them in the lab,
and infusing them back into the patient. Therefore, the
Committee urges the NCI to address the shortage of clinical
research staff by working with the academic community to
support the training of highly specialized clinical research
staff, including in the area of cellular therapy.
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. In response, NCI
formed a multi-disciplinary working group of its Clinical
Trials and Translational Research Advisory Committee [CTAC] and
has released a report listing suggested research focus areas.
The Committee appreciates that NCI has transmitted its
framework for gastric and esophageal cancers to Congress,
emphasizing the important research efforts underway, as well as
future opportunities. The Committee requests to be kept
informed of NCI's efforts on the pancreatic, lung,
glioblastoma, esophageal and stomach cancer frameworks and
directs NCI to start a similar process for primary liver
cancer, including cholangiocarcinoma. Finally, given the
devastating toll of all recalcitrant cancers and the lack of
diagnostic and treatment resources currently available, the
Committee urges NCI to identify future goals for each of the
deadliest cancers (brain, esophagus, liver, lung, ovary,
pancreas, stomach and mesothelioma) in the fiscal year 2025 CJ.
Endometrial Cancer and Obesity.--Endometrial cancer is the
most common gynecologic cancer, and the fourth most common
malignancy among women in the United States trailing only
breast, lung, and colorectal. In fact, in 2023, it is estimated
that 66,200 new cases of uterine cancer will be diagnosed, and
about 13,030 women will die from the disease. Obesity is the
strongest known risk factor for the most common type of
endometrial cancer, and the disease is more than three times as
common in people with obesity. The Committee recognizes that
obesity is a growing public health issue, and as rates of
obesity continue to increase, the number of women diagnosed
with endometrial cancer is also expected to rise. Therefore,
the Committee requests an update in the fiscal year 2025 CJ on
collaborative research efforts across NIH, other NIH-supported
extramural research projects, and research efforts focusing on
the link between obesity and endometrial cancer.
Geriatric Cancers.--As our population ages and cancer
treatments improve, more patients with cancer are living long
into their late decades. Adults aged 65 and older currently
account for 67 percent of cancer survivors but are projected to
account for 73 percent by 2040. Survivorship programs, however,
have primarily focused on the late effects of cancer diagnosed
at younger ages rather than supporting older adults. In
addition, older adults with cancer remain significantly
underrepresented in clinical trials, making treatment of these
patients challenging for oncologists. The Committee urges NCI
to continue to support funding opportunities across the
geriatric oncology research continuum. Investments in this area
will allow clinicians to provide a higher quality of care to
this vulnerable and growing cancer patient population.
Glioblastoma [GBM].--GBM is a cancer with less than a 5
percent 5-year relative survival rate. The average survival
time from diagnosis has improved by only 6 months over the last
30 years. To date, only five drugs and one medical device have
been approved by the FDA for treating GBM. With prior
Congressional investment in NCI programs, glioblastomas have
been molecularly characterized, resulting in a new and
promising understanding of these tumors, including identifying
potential clinical strategies and agents, trial designs, and
imaging and pathology technologies. The Committee commends NCI
for its establishment and implementation of the GBM
Therapeutics Network [GTN] and requests an update on the status
of the program's implementation and progress. The GTN's cross-
cutting teams' capabilities to conduct pre-clinical studies and
early-phase clinical trials enable the careful evaluation of
potential treatments, including small molecule drugs,
immunotherapies, radiation, and devices. The overall goal of
the GTN is advancing progress towards future cures and improved
quality of life for GBM patients. The Committee urges NCI to
continue to support the GTN so that this program can rapidly
launch clinical trials that speed access to promising qualified
treatments to patients consistent with NCI's Glioblastoma
Working Group recommendations in 2019.
Helping Cancer Patients Quit Smoking.--The Committee is
concerned that not all cancer patients who smoke and are
treated at NCI designated cancer centers are being offered
tobacco cessation services. Research indicates that smoking
cessation can lead to improved cancer treatment outcomes for
all cancers. The Committee commends NCI for identifying this
gap and launching the Cancer Center Cessation Initiative with
the long-term goal of helping cancer centers and other
hospitals build and implement tobacco cessation treatment
programs for cancer patients. The Committee is eager to read
new findings and publications from the pilot program and urges
NCI's continued support for this initiative to ensure its
sustainability. The Committee also is aware that tobacco use
and lung cancer rates are higher in rural areas. The Committee
encourages NCI to provide input on Agency for Healthcare
Research and Quality efforts to develop model tobacco cessation
programs for cancer patients in rural hospitals to improve
health outcomes.
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
continue to support a robust research portfolio in early
detection, screening, and prevention of liver cancer. The
Committee applauds the NCI for its Early Detection of Liver
Cancer consortia initiatives as a means of fostering progress
and collaboration. The Committee encourages NCI to continue
such programs as well as Program Projects, R01 and U01
Cooperative Research to advance progress against liver cancer.
Also, as hepatitis B is estimated to cause up to 60 percent of
the cases of liver cancer, the Committee applauds NCI for its
collaboration to implement the Strategic Plan for Trans-NIH
Research to Cure Hepatitis B.
Maternal and Child Cancer Risks.--The Committee is
concerned about knowledge gaps regarding the risk and impact of
exposure to environmental carcinogens associated with common
cancers in women and children, particularly in understudied and
highly impacted populations such as communities of color and
low-income populations. Additional research is needed to
understand the windows of exposure and the relationships
between multiple exposures to environmental contaminants and
intermediate cancer risk to develop effective prevention
programs for environmentally mediated cancers and address
health inequities. The Committee encourages NCI to continue to
support research to understand the impact of multiple exposures
to environmental chemicals, pollutants, and social stressors
across a diverse population of pregnant women and children.
Melanoma.--The Committee encourages NCI to continue support
for research on mutagenesis, early detection and treatment.
Continued study of gene expression profiling in melanoma and
its precursors is needed to define patient subsets by their
risk of melanoma and their prognosis, which will be able to
guide management of early-stage disease as has been the case in
breast cancer. Melanoma research over the last decade has
produced groundbreaking advances in targeted therapy and
immunotherapy that have not only led to a decline in melanoma
mortality, but have been the foundation for advances in many
other cancer types. The Committee encourages NCI to continue to
support research on mechanisms of primary and secondary drug
resistance, new drug targets and validation of predictive
biomarkers that will allow selection of optimal therapy. Basic
and translational goals should be facilitated through
development and use of ever-improving models of human melanoma,
including those involving rare subtypes. In addition, the
Committee encourages NCI to explore opportunities for
multicenter trials that will determine whether shorter courses
of therapy will decrease toxicity while maintaining benefit,
refine adjuvant therapies, and continue to develop neoadjuvant
therapies. The Committee also encourages NCI to continue to
further rare melanoma research through the use of patient data
and biospecimen banks where populations are not adequate for
randomized trials. The Committee requests an update on melanoma
research efforts in the fiscal year 2025 CJ.
Neuroblastoma.--The Committee encourages NCI to continue to
support research on high-risk neuroblastoma, including
continued support for an innovative treatment consortium that
tests new therapies for relapsed and refractory patients in
early phase clinical trials. The Committee requests an update
on neuroblastoma research efforts in the fiscal year 2025 CJ.
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. The
Committee requests an update on progress made in ensuring the
continuation of multi-site pediatric immunotherapy clinical
trials in the fiscal year 2025 CJ.
Surveillance, Epidemiology, and End Results [SEER]
Program.--The Committee recognizes NCI for recent 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 2025
CJ.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2023.................................... $3,982,345,000
Budget estimate, 2024................................... 3,985,158,000
Committee recommendation................................ 3,982,345,000
The Committee recommendation includes $3,982,345,000 for
the National Heart, Lung, and Blood Institute [NHLBI].
Community Engagement Alliance Against COVID-19 Disparities
[CEAL] Initiative.--The Committee includes $30,000,000 for the
CEAL initiative, consistent with the fiscal year 2023 enacted
level. CEAL connects researchers with community organizations
to foster trust in science, to conduct research and increase
participation of people from underrepresented communities in
clinical trials for treatments, vaccines, and research on
critical areas of public health need.
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 2025 CJ a report on steps being taken to
close these research gaps.
Lung Health Research.--The burden of chronic lung diseases
continues to rise. In order to accelerate progress in
addressing these challenges for the approximately 15 million
Americans diagnosed with chronic obstructive pulmonary disease
[COPD] and other airway diseases such as non-cystic fibrosis
bronchiectasis, the Committee encourages NHLBI to support
critical research on these conditions including: (1)
development of complex tissue and cellular systems to mimic the
disease process in the lung to help identify molecular pathways
of disease; (2) research to promote earlier diagnosis; (3)
clinical research of early disease to identify appropriate
targets to modulate disease progression before irreversible
tissue damage has occurred; and, (4) proof-of-concept clinical
trials including translational and experimental medicine
studies. The Committee directs NHLBI to provide a report to the
Committee within 180 days of enactment on the current and
planned activities in these areas.
Pulmonary Fibrosis.--Many pulmonary fibrosis [PF] patients
wait more than a year for diagnosis after symptom onset, and
patients with some types of PF have a life expectancy of only
three to 5 years. Therefore, the Committee encourages NHLBI to
support research into biomarkers that can aid in earlier, safer
diagnosis of PF, as well as tools that can help predict which
patients will experience disease progression. The Committee
commends NHLBI for hosting a Pulmonary Fibrosis Stakeholders
Summit in November 2022 to develop a blueprint for PF-related
research priorities over the next 5 years, and requests an
update on the plan's implementation in the fiscal year 2025 CJ.
The plan's priorities include a focus on early disease
detection and improved diagnosis and innovative clinical trial
designs. The Committee urges NHLBI to support the development
of advanced research models and integrate these models into
preclinical studies in order to facilitate faster drug
development. The Committee also hopes the PF plan will lead to
increased support for related research and coordination to
address this deadly disease.
Rare Blood Disorders.--The Committee is encouraged by new
leadership and emerging vision for the Division of Blood
Diseases and Resources. NHLBI is encouraged to sustain its
focus in immune thrombocytopenia, warm autoimmune hemolytic
anemia and other rare blood disorders, including through
community collaborations and partnerships with other Institutes
and Centers, to sustain scientific progress in this important
area.
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 and the
promotion of sleep health. The Committee encourages the
National Center for Sleep Disorders Research [NCSDR] to advance
the blueprint for ongoing and emerging activities outlined
through the recent NIH Sleep Research Plan and to advise the
Committee of any resources, infrastructure, or innovation
needed to facilitate further progress.
Thalassemia.--Donated blood has a relatively short ``shelf
life'' and is generally stored for only 42 days. However,
stored blood begins to degrade before the end of that 42-day
period, with possible stiffening of cell membranes as early as
after 21 days. For patients in need of emergency blood
transfusions, that degradation may not be significant; however,
studies are needed to determine the impact of older red blood
cells on patients who require chronic transfusion, such as
those with thalassemia, especially in terms of iron loading in
the heart and internal organs. The Committee urges NHLBI to
continue to support research initiatives focused on this issue.
Valvular Heart Disease Research.--Many people in the U.S.
have heart valve defects or disease but do not have symptoms.
For some, the condition remains the same throughout their lives
and does not cause significant or life-threatening problems.
Unfortunately, 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 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.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2023.................................... $520,163,000
Budget estimate, 2024................................... 520,138,000
Committee recommendation................................ 520,163,000
The Committee recommendation includes $520,163,000 for the
National Institute of Dental and Craniofacial Research [NIDCR].
Dental Care.--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 improving
medical management and reducing the prevalence of malignant
oral cancers, preventing pneumonia in hospitals, and lowering
hospitalization and emergency department admission rates for
nontraumatic oral conditions.
Dental, Oral and Craniofacial Tissue Regeneration
Consortium.--The Committee commends NIDCR for establishing a
multidisciplinary Dental, Oral and Craniofacial Tissue
Regeneration Consortium [DOCTRC] that will develop effective
clinically-applicable strategies for regeneration of functional
tissues of the human dental, oral and craniofacial complex. The
goal of DOCTRC is to develop technologies based on cells,
biologics, devices, combination products and associated
protocols ready for the initiation of clinical trials and to
prepare them for submission for FDA approval.
Oral Health in America Report.--The Committee commends
NIDCR for publishing its 2021 report Oral Health in America:
Advances and Challenges documenting 20 years of progress since
the first Oral Health Report in 2000. The Committee encourages
NIDCR to prioritize funding the research gaps that were
identified in the report.
Temporomandibular Disorders [TMD].--The Committee
encourages NIDCR to maintain a patient-centered approach in the
implementation of the TMD-IMPACT Concept. The Committee is
encouraged by NIDCR's collaboration with agencies and
institutes, and encourages further collaboration with other
government agencies and Institutes, Centers, and Offices within
NIH with appropriate scientific expertise. The Committee
directs NIH to provide an update within 90 days of enactment on
efforts to implement the next phase of the initiative including
the recruitment of other NIH ICs as partners, the role of the
patient perspective, and NIDCR's use of the National Academies
of Sciences, Engineering, and Medicine [NASEM] Report on TMDs
and the TMJ Patient-led Roundtable.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2023.................................... $2,300,721,000
Budget estimate, 2024................................... 2,303,098,000
Committee recommendation................................ 2,310,721,000
The Committee recommendation includes $2,310,721,000 for
the National Institute of Diabetes and Digestive and Kidney
Diseases [NIDDK].
Diabetes.--The Committee 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 provides an additional
$10,000,000 for diabetes related research. 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, data
bank development and precision medicine approaches. The
Committee further encourages 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 HBV 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.
Kidney Transplant Disparities.--The Committee appreciates
the ongoing efforts of NIDDK's Health Disparities and Health
Equity Working Group, 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. The Committee
requests an update on these efforts in the fiscal year 2025 CJ.
Lower Urinary Tract Symptoms.--Lower urinary tract symptoms
[LUTS] describe symptoms related to the storage and voiding of
urine. Conditions associated with LUTS include overactive
bladder, stress urinary incontinence, as well as neurogenic and
non-neurogenic voiding dysfunction. The effectiveness of
treatment for these conditions varies depending on patient
characteristics and symptoms. Unfortunately, an established
repository of patient phenotypes for LUTS does not exist.
Knowledge in this area would enable the identification of
symptom clusters to advance LUTS treatment. Therefore, the
Committee urges NIDDK to conduct a workshop that will lead to
the development of LUTS precision medicine approaches,
including the characterization of LUTS clusters and their
association to treatment responsiveness, identification of
markers for phenotype clusters, development of functional and
physiologic assessment measures specific to individual
phenotype profiles to objectively correlate symptoms and
treatment outcomes. The Committee requests an update on
research activities to advance LUTS prevention and treatment in
the fiscal year 2025 CJ.
Pancreatitis.--The Committee applauds NIDDK for featuring
research into pancreatitis and conditions of the pancreas
prominently through the 2023 Recent Advances and Emerging
Opportunities report. Due to the lack of effective treatment
options for patients impacted by pancreatitis and a variety of
access challenges, NIDDK is encouraged to facilitate additional
scientific progress in this important area.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2023.................................... $2,813,925,000
Budget estimate, 2024................................... 2,739,418,000
Committee recommendation................................ 2,849,925,000
The Committee recommendation includes $2,849,925,000 for
the National Institute of Neurological Disorders and Stroke
[NINDS].
Alzheimer's Disease and Alzheimer's Disease-Related
Dementias [AD/ADRD].--The Committee includes an increase of
$100,000,000 across NIH for AD/ADRD research, including an
increase of $10,000,000 in NINDS and $90,000,000 in NIA.
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.
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. The
Committee also urges NIH to support efforts to better
understand the social determinants of health that lead to
inequity in 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 continue to advance regulatory science
and develop innovative clinical trial designs that recruit
diverse populations so that potential therapies can be
effectively tested.
Opioids, Stimulants, and Pain Management.--The Committee
provides no less than $290,295,000, an increase of $10,000,000,
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.
Pediatric-Onset Epilepsies Research.--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, there are many different kinds
of epilepsies, and the number of children with one specific
disease type is relatively small. 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 type of epilepsy for clinical trials.
Large numbers of patients are critical to ensuring that study
results are meaningful and result in improved patient outcomes.
Using a collaborative research model and enrolling patients
from many hospitals in the same system greatly increases the
ability to detect meaningful differences due to interventions,
can significantly accelerate therapy development, and expedites
translation of research findings into standard clinical care.
Therefore, the Committee encourages NIH to continue to enable
cooperative research studies, accelerate the development of
knowledge about epilepsies, and rapidly advance therapeutic
options and their implementation to improve treatments and
healthcare outcomes. Additionally, to better facilitate
implementation of translational research, the Committee urges
NINDS to prepare and submit a report to the Committee on
progress and incorporate key findings and planned actions
resulting from convenings of the Curing the Epilepsies
conference.
Undiagnosed Diseases Network [UDN].--The Committee
continues to provide $18,000,000 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, 2023.................................... $6,562,279,000
Budget estimate, 2024................................... 6,561,652,000
Committee recommendation................................ 6,562,279,000
The Committee recommendation includes $6,562,279,000 for
the National Institute of Allergy and Infectious Diseases
[NIAID].
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 NIH 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 2025 CJ.
Centers for Research on Emerging Infectious Diseases
[CREID].--NIAID works with partners in 30 countries to
understand how and where viruses can emerge to develop
diagnostic tests. The Committee urges NIAID to ensure the CREID
Network is sufficiently supported to coordinate and conduct
research on, and active surveillance for, emerging pathogens.
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 supporting a
total of 17 clinical sites for this critical research,
including seven sites as part of the Consortium for Food
Allergy Research [CoFAR]. The Committee encourages CoFAR to
expand its clinical research network, identify new research
centers, and conduct new, larger, and in-depth clinical trials
and observational studies.
Gonorrhea.--The Committee continues to be concerned with
recent reports from the World Health Organization [WHO] and
U.S. public health officials, that antimicrobial resistant
gonorrhea continues to increase, reducing the treatment
options. The Committee commends NIAID for their continued
efforts to develop new antibiotics to combat the bacterium that
causes this disease and encourages NIAID to accelerate work to
find new diagnostic tools and treatments for these new strains
of bacterium.
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 road map 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 2024 and beyond.
The Committee urges NIAID to expand the use of Program
Projects, R01 and U01 Cooperative Research Agreements, as was
successfully used to discover cures for hepatitis C, as well as
cooperative research programs modeled after the Martin Delaney
Collaborations and applauds the success of the point of Care
Technologies Research Network [POCTRN] and Rapid Acceleration
of Diagnostics [RADx] programs and urges more use of these
programs for development of point of care tests for HBV, HDV
and the cancers caused by these viruses. Finally, the Committee
understands that research to enhance the human immune system to
control and cure hepatitis B is promising and the continued use
of animal models is a research tool that needs to be continued.
Metabolism of Infectious Disease.--The Committee recognizes
that research to understand how metabolic responses are altered
by infection and connected with the immune response and
comorbidities is increasingly important due to the prevalence
of emerging and reemerging infectious diseases. As such, the
Committee urges NIAID to fund as many meritorious proposals as
possible.
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
continues to provide $52,000,000 to the 12 RBLs to support core
and shared resources for BSL-3 containment enabling them to
develop and maintain the research resources, facilities and
personnel needed to meet national, regional and local
biodefense and emerging infectious diseases research needs in
the event of a bioterrorism or infectious disease emergency. Of
this amount, the Committee directs that no less than $1,000,000
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, developing and contributing to an organizational
structure to ensure the RBL network is prepared to respond
effectively to national needs, and supporting operations,
facilities, and equipment purchase costs. The Committee directs
that 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.
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.
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.
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. Such vaccines would eliminate the
need to update and administer the seasonal flu vaccine each
year or could provide protection against newly emerging flu
strains, potentially including those that could cause a flu
pandemic.
Viral Pathogen Research.--The Committee supports
investments in research on highly pathogenic zoonotic viruses
with pandemic potential including filoviruses, flaviviruses,
paramyxoviruses, and bunyaviruses. 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.
Warm Autoimmune Hemolytic Anemia [wAIHA].--The Committee
recognizes that wAIHA is a prototypical autoimmune disorder
where the body's immune system attacks healthy red blood cells
and little is known about underlying causes or effective
treatment beyond the use of immunosuppressive therapies. NIH is
encouraged to advance wAIHA research and to consider key
partnerships among Institutes and Centers that have an interest
in or have shown progress in this area, such as NHLBI, NIAID,
and the Office of Autoimmune Disease Research [OADR].
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2023.................................... $3,239,679,000
Budget estimate, 2024................................... 3,239,679,000
Committee recommendation................................ 3,239,679,000
The Committee recommendation includes $3,239,679,000 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).
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
women and racial and ethnic minorities, spend longer periods of
time in postdoctoral positions with lower salaries, receive
inadequate mentorship, and are offered fewer opportunities for
professional advancement, resulting in lower retention rates
for 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
Maximizing Opportunities for Scientific and Academic
Independent Careers [MOSAIC] 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.
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 $425,956,000 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. 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 or to
limit the number of awards per State. 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.
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.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
Appropriations, 2023.................................... $1,749,078,000
Budget estimate, 2024................................... 1,747,784,000
Committee recommendation................................ 1,759,078,000
The Committee recommendation includes $1,759,078,000 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.
Autism Research.--The Committee encourages NICHD to
increase support for and prioritization of collaborations to
build the methodological base and infrastructure for large
scale longitudinal neuroimaging studies of autistic individuals
with linkages to clinical data and outcomes. Projects supported
by this investment could include proof of concept multicenter
approaches to address major challenges for collaborative
groups, such as linking longitudinal neuroimaging data with
measures of behavioral change and outcomes, including
information from clinical records, and to aggregate the
resulting information into usable datasets that are harmonized
across study sites and clinical centers. The Committee further
encourages NICHD to support studies that allow for data to be
collected across wide ranges in age.
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 is aware that endometriosis
is a chronic disease originating in the female reproductive
system affecting 10 percent of women of reproductive age
worldwide and it has been linked to ovarian cancer. The
Committee also recognizes that endometriosis is the third-
leading cause of female infertility in the United States. The
Committee encourages NIH to advance research to increase
earlier detection, develop more accurate diagnostics and for
education to inform healthcare providers and their patients
regarding diagnosis and treatment of endometriosis.
Implementing a Maternal Health and Pregnancy Outcomes
Vision for Everyone [IMPROVE] Initiative.--The Committee
provides no less than $53,400,000 for this activity.
Maternal Fetal Medicine Units.--The Committee appreciates
NICHD's continued support of research focused on improving
maternal and infant health outcomes. A critical part of this
work is the 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. The Committee was
pleased to see NICHD release a request for applications in 2022
for a new funding cycle for the MFMU Network that maintains the
Network's existing infrastructure, ensuring high-quality, high-
impact multi-site clinical studies continue. However, unlike
the prior funding cycles, clinical study proposals for the MFMU
Network will now undergo NIH peer review to assure greater
rigor and transparency. In addition, the Network infrastructure
will now be made available to the entire community of
researchers. The Committee requests an update in the fiscal
year 2025 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 include in the update plans to ensure that NIH will
continue to fund clinical research conducted by the MFMU at the
appropriate levels based on scientific need.
Pelvic Organ Prolapse.--Pelvic organ prolapse [POP] occurs
when the pelvic floor muscles and connective tissue supporting
the pelvic organs no longer support these organs, causing one
or more of the pelvic organs to fall downward into the vagina.
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, sexual dysfunction, deteriorating
physical function and diminished socialization. No effective
preventative strategies for POP have been identified and the
development of novel preventative strategies related to
pregnancy is needed. Therefore, the Committee urges the NICHD
to convene a workshop to assess peripartum, intrapartum, and
postpartum 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 this issue
and on research activities to advance POP prevention and
treatment in the fiscal year 2025 CJ.
Population Research.--The Committee commends NICHD for
fulfilling its statutory authority by supporting a robust
population research portfolio that includes population
representative longitudinal surveys, research centers and
networks, training programs, and grant mechanisms. Over the
decades, these investments have yielded numerous scientific
advances regarding the causes and consequences of population
change on human and child development, maternal health, and the
health and well-being of individuals across the life course.
Most recently, the Baby's First Years Study and Panel Study of
Income Dynamics Child Supplement Survey provided key insights
into the impact of COVID mitigation strategies and economic
relief measures on infant and child development. The Committee
encourages NICHD to enhance its support of these and its other
large-scale longitudinal surveys to help, among other things,
elucidate the pandemic's impacts on child and adolescent
development. In addition, the Committee commends NICHD for
supporting initiatives that facilitate collaborations and
resource sharing between the Population Dynamics Research
Centers and outside institutions and for funding the innovative
Data Sharing for Demographic Research data repository, which
makes high-quality demographic data widely available to the
scientific research community.
Reproductive Medicine Network [RMN].--Infertility, defined
as the inability to conceive within 1 year of unprotected
intercourse, affects an estimated 19 percent of reproductive
aged couples. In addition, about 26 percent of women have
difficulty getting pregnant or carrying a pregnancy to term.
The RMN, which has since been replaced by the Consortia for
Infertility and Reproductive Medicine [ConFIRM] Clinical Trial
Program of linked R01s, had a proven track record of supporting
infertility research by providing a single hub that supported
multiple substudies and secondary analyses. Most importantly,
it informed major changes to clinical practice and supported
the training of young investigators in the field. While the
Committee understands that NICHD has moved away from the U01/
U10 mechanism the RMN utilized, it is noted that the ConFIRM
Clinical Trial Program may not be supporting coordination or a
pipeline of young investigators in this field in the same
manner as the RMN. The Committee urges NICHD to report on its
plans to support clinical trials on infertility within 180 days
of enactment.
Women's Reproductive Health Research [WRHR] Program.--The
Committee encourages NICHD to fund additional 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.
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 ages 17 and under 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
recommendations published by the U.S. Preventive Services Task
Force.
NATIONAL EYE INSTITUTE
Appropriations, 2023.................................... $896,549,000
Budget estimate, 2024................................... 896,136,000
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 2025 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, 2023.................................... $913,979,000
Budget estimate, 2024................................... 938,807,000
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.
Environmental-related Health Conditions.--The Committee
urges NIEHS to expand efforts to support and coordinate
research on the rise in and exacerbation of a wide range of
health conditions related to the environment, which may include
infectious disease, injury and trauma, chronic conditions such
as asthma, mental health, and health disparities. Such research
may include evaluation of both preventative and intervention
strategies for such conditions.
Environmental exposures and Cancer in Firefighters.--The
Committee encourages NIH and CDC/NIOSH to continue their
efforts to better understand the cancer risks firefighters may
experience, including efforts to measure environmental
exposures in firefighters and determine the mechanisms that
lead to increased cancer incidence, morbidity, and mortality.
The Committee also encourages NIH to continue to support
research to improve health equity among firefighters to
evaluate potential differences and exposure risk.
Indoor Air.--Health outcomes from the use of combustion
indoors depend on individual health characteristics, the fuel
used, and mitigations. The Committee encourages NIEHS to
research and collaborate with appropriate partners to
understand effects of indoor emissions on health and the degree
to which mitigation strategies reduce exposures and other
impacts. Research should include the impacts of other indoor
pollutants to fully understand the indoor air landscape. The
Committee requests an update on these activities in the fiscal
year 2025 CJ.
NATIONAL INSTITUTE ON AGING
Appropriations, 2023.................................... $4,407,623,000
Budget estimate, 2024................................... 4,412,090,000
Committee recommendation................................ 4,509,623,000
The Committee recommendation includes $4,509,623,000 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 previously directed NIA to
collaborate with NINDS and NASEM to pinpoint research
priorities for preventing and treating AD/ADRD, including
identifying barriers to advancing large-scale precision
medicine approaches in this space. Of the approximately 6.5
million Americans over age 65 with AD, more than half have
genetic risk variants linked to glial cell function, which
makes them a key target for precision therapeutics. The
Committee encourages NIA to increase support for research
focused on mitigating immune dysfunction with precision
inspired therapeutics for AD/ADRD and directs NIA and NINDS to
provide a joint report to the Committee within 120 days on its
progress in advancing these efforts.
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.
Geroscience.--Recent advances in geroscience suggest it may
be possible to prevent or treat a wide range of adult-onset
health concerns, including functional declines such as frailty
and lost resilience, and overt diseases such as Alzheimer's
Disease, cancer, cardiovascular diseases and many others. This
could be achieved by slowing or reversing certain genetic,
molecular and cellular hallmarks of aging discovered through
research on the basic biology of aging. The Committee strongly
urges NIA to prioritize funding for geroscience research. The
Committee also understands that the enormous promise of this
field is limited by a shortage of investigators with expertise
in the biology of aging and the clinical translation of basic
research findings. Therefore, NIA should increase support for
early career investigators, especially postdoctoral researchers
and junior faculty, to help attract, retain, and develop top
talent in the field of geroscience. Finally, the Committee
encourages NIA to increase funding for basic and translational
research in aging to provide more options and test more
treatments as quickly as possible.
Palliative Care Research.--Palliative care is specialized
medical care for people living with a serious illness and is
focused on treating the discomfort, symptoms, and stress of
such illness. Palliative care has the potential to improve
patient care, patient-clinician communication, and patient-
centered outcomes while decreasing unwanted and/or burdensome
treatments and enhancing quality of life for people with
serious illness, their loved ones, and their care partners. The
Committee provides $12,500,000 for NIA to implement a trans-
Institute, multi-disease strategy to focus, expand, and
intensify national research programs in palliative care. NIH is
directed to establish a comprehensive multi-Institute and
multi-Center initiative aimed at a wide variety of palliative
care research, training, dissemination, and implementation of
projects to intensify the strategic coordination of palliative
care research efforts. Funding is provided to establish an
extramural-based palliative care research consortium with no
less than three sites to provide technical assistance, pilot
and exploratory grant funding, research dissemination, data
repositories, data analytics, and career development support
for interdisciplinary palliative care. NIH shall prioritize
grantees with a recognized expertise and leadership in
palliative care. The Committee encourages NIH to fund several
multi-year, early-career development grants modeled after NIA's
GEMSSTAR program. Appropriations provided in fiscal year 2024
for training are expected to cover 2 years of funding for
career development awards. The Committee requests a briefing
within 120 days of enactment on how this strategy will be
established and implemented, including timelines on when
funding opportunities will be issued and when funding will be
awarded.
Population Research.--NIA supports a rigorous population
aging research portfolio that includes research grants,
centers, networks, and population representative longitudinal
surveys examining how demographic, social, and economic factors
impact the health and well-being of older adults over the life
course. The Committee is pleased to learn that in fiscal year
2024 NIA will be renewing several transdisciplinary research
networks devoted to studying issues such as rural aging,
psychosocial stress measurement, and social genomics. The
Committee encourages the NIA to stimulate additional research
projects addressing high priority areas such as rising midlife
mortality rates, socioeconomic disparities, and the unique
impacts of climate change on older individuals. Further, the
Committee urges the Institute to explore how multidisciplinary
nationally representative studies, such as the Health and
Retirement Study, can improve the representation of Asian
American subpopulations.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2023.................................... $685,465,000
Budget estimate, 2024................................... 687,639,000
Committee recommendation................................ 685,465,000
The Committee recommendation includes $685,465,000 for the
National Institute of Arthritis and Musculoskeletal and Skin
Diseases [NIAMS].
Musculoskeletal Regenerative Medicine.--The Committee
recognizes the increasingly fundamental role that extracellular
vesicles [EVs] play as a mechanism of communication between
cells, organs, organ systems, and organisms in providing a
snapshot of a wide range of disease processes including
musculoskeletal disorders. The Committee also understands that
the field of regenerative medicine is in the early stage of
exploring the potential of EVs to help treat patients,
including veterans, living with significant musculoskeletal
injuries such as osteoarthritis, tendon, and ligament diseases.
The Committee therefore encourages support for research to
optimize regenerative medicine through analyzing EVs and other
approaches through partnerships that bring together scholars,
creators, and entrepreneurs to work in a collaborative space to
discover and deliver solutions that utilize the body's healing
capacity to improve the lives of those living with
musculoskeletal disorders.
Thalassemia.--Individuals with thalassemia frequently
develop low bone mass issues, often several decades earlier
than is typical in the general population. Most currently
recognized treatment options for low bone mass issues have been
developed for populations that develop these issues at an older
age than in thalassemia, and which may not have the same
characteristics as those with thalassemia. More research in
treatments for and prevention of low bone mass for this
population may be warranted.
NATIONAL INSTITUTE OF DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2023.................................... $534,333,000
Budget estimate, 2024................................... 534,330,000
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, 2023.................................... $197,693,000
Budget estimate, 2024................................... 197,671,000
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, 2023.................................... $595,318,000
Budget estimate, 2024................................... 596,616,000
Committee recommendation................................ 595,318,000
The Committee recommendation includes $595,318,000 for the
National Institute on Alcohol Abuse and Alcoholism [NIAAA].
Alcohol and Polysubstance Use.--The Committee is pleased to
see NIH supporting research on alcohol and polysubstance use,
and urges NIH to increase research in this area through more
comprehensive centers across the United States. The Committee
is concerned by the high rates of alcohol misuse and alcohol-
related morbidity and mortality in the United States,
particularly in Indigenous, frontier, and rural communities.
The Committee encourages NIH to support studies, and form
multi-tier prevention programs for R1 Research Centers, that
focus on rural and minority communities with high rates of
alcohol and polysubstance use mortality. These centers could
develop, test, and implement prevention programming to reduce
alcohol misuse, including through social media as well as web-
based and mobile applications. These programs could also train
community health providers in delivering person-centered brief
interventions to help reduce alcohol misuse and alcohol-related
harms.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2023.................................... $1,662,695,000
Budget estimate, 2024................................... 1,663,365,000
Committee recommendation................................ 1,672,695,000
The Committee recommendation includes $1,672,695,000 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.--The Committee remains concerned about the drug
addiction public health crisis 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.
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 be translated directly into improved patient
care, including novel medications, fewer drug-related
fatalities, and science-based methods for preventing addiction.
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.
Medication for Methamphetamine Use Disorder.--The Committee
is concerned with the rise in methamphetamine use and addiction
in the United States. While there are currently approved
medication treatments for alcohol and opioid addiction there
remains no approved medication for methamphetamine addiction.
The Committee urges the Institute to continue their ongoing
trials in order to expeditiously find and approve a medication
for methamphetamine.
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 41 and 40 percent respectively between 2021 and 2022. The
sharp increase has led some to refer to stimulant overdoses as
the ``fourth wave'' of the current drug addiction crisis in
America following the rise of opioid-related deaths involving
prescription opioids, heroin, and fentanyl-related substances.
No FDA-approved medications are available for treating
methamphetamine, cocaine, and other stimulant use disorders.
The Committee continues to support NIDA's efforts to address
the opioid crisis, has provided continued funding for the HEAL
Initiative, and supports NIDA's efforts to combat the growing
problem of methamphetamine and other stimulant use disorders
and related deaths.
Opioid Initiative.--The Committee continues to be concerned
about the high mortality rate due to the opioid overdose
epidemic and appreciates the important role that research plays
in the various Federal initiatives aimed at this crisis.
Approximately 174 people die each day in this country from drug
overdose (over 100 of those are directly from opioids), making
it one of the most common causes on non-disease-related deaths
for adolescents and young adults. The Committee is also aware
of increases in opioid deaths from 2020 to 2021, with the
primary driver being the increased overdose deaths involving
synthetic opioids, primarily fentanyl. More research is needed
to find new and better agents to prevent or reverse the effects
caused by this class of chemicals and to provide improved
access to treatments for those with addiction to these drugs.
To combat this crisis, the Committee has provided within NIDA's
budget no less than $365,295,000, an increase of $10,000,000,
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 support 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 support research on
comprehensive care models in communities nationwide to prevent
opioid misuse, expand treatment capacity, enhance access to
overdose reversal medications, 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 Analogs.--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 and
related analogs. 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 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 support research to develop therapies, including both
pharmacologic and behavioral therapies, to combat nicotine
addiction in pediatric populations.
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2023.................................... $2,337,843,000
Budget estimate, 2024................................... 2,455,653,000
Committee recommendation................................ 2,437,843,000
The Committee recommendation includes $2,437,843,000 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.
Cost of Serious Mental Illness [SMI].--Despite increased
spending on mental health services, the prevalence of SMI has
grown by almost fifty percent since 2008. In response to
Congressional direction included with the Consolidated
Appropriations Act, 2023, NIH developed a professional
judgement budget setting the stage for near- and intermediate-
term improvements in mental healthcare to address the Nation's
growing mental health crisis. The agenda outlines a 15-year
vision for four independent but complementary projects that
will address different needs in the prevention, diagnosis, and
treatment of SMI. To develop this budget, NIMH considered input
from the National Academy of Medicine Fora on Mental Health and
Substance Abuse and Neuroscience; the National Advisory Mental
Health Council; and NIMH-sponsored convenings over the past 3
years. The Committee urges NIMH to launch the four projects
proposed under the initiative, and NIMH is directed to brief
the House and Senate Committees on Appropriations on how these
time-limited, goal-driven investments will accelerate emerging
science and support high-risk/high-reward research.
Mental Health Research.--In recognition of the country's
unprecedented mental health crisis, the Committee provides a
$100,000,000 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; 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.
Suicide Prevention.--The Committee is concerned by alarming
rates of suicide, particularly among youth between the ages of
10 and 24 year old, which climbed to the highest point in more
than 20 years during the pandemic. Data show that the groups
that experience higher rates of suicide or suicide attempts
include veterans, people who live in rural areas, sexual and
gender minorities, middle-aged adults, people of color, and
Tribal populations. Suicide is complex, and multiple factors-
biological, psychological, social, and environmental-play a
role. 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 supporting research in areas that can contribute to
suicide prevention, including NIA, NICHD, NHGRI, NIAAA, NIDA
and NINDS.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2023.................................... $663,200,000
Budget estimate, 2024................................... 660,510,000
Committee recommendation................................ 663,200,000
The Committee recommendation includes $663,200,000 for the
National Human Genome Research Institute [NHGRI].
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, 2023.................................... $440,627,000
Budget estimate, 2024................................... 440,625,000
Committee recommendation................................ 440,627,000
The Committee recommendation includes $440,627,000 for the
National Institute of Biomedical Imaging and Bioengineering
[NIBIB].
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH
Appropriations, 2023.................................... $170,384,000
Budget estimate, 2024................................... 170,277,000
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, 2023.................................... $524,395,000
Budget estimate, 2024................................... 525,138,000
Committee recommendation................................ 524,395,000
The Committee recommendation includes $524,395,000 for the
National Institute on Minority Health and Health Disparities
[NIMHD].
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
has provided $12,000,000 for fiscal year 2024 to implement the
revitalized program. The Committee urges NIMHD to work swiftly
on its implementation 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, 2023.................................... $95,162,000
Budget estimate, 2024................................... 95,130,000
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]. These programs
improve national and global health security and produce health
interventions that can improve public health and reduce costs
in low-resource settings everywhere, including in the United
States. 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.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2023.................................... $497,548,000
Budget estimate, 2024................................... 495,314,000
Committee recommendation................................ 497,548,000
The Committee recommendation includes $497,548,000 for the
National Library of Medicine [NLM].
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES
Appropriations, 2023.................................... $923,323,000
Budget estimate, 2024................................... 923,323,000
Committee recommendation................................ 923,323,000
The Committee recommendation includes $923,323,000 for the
National Center for Advancing Translational Sciences [NCATS].
Addressing All Rare Diseases.--The Committee directs NCATS
to host a public workshop convening rare disease expert
stakeholders including scientists, Federal agency
representatives including FDA, patient advocacy leaders,
clinicians, therapy and diagnostics developers, and regulators.
Developing a therapy for conditions occurring in very small
populations involves overcoming unique regulatory and research
hurdles due to their small patient populations. The workshop
will address current research and treatment efforts for rare
diseases, including focusing on commonalities across diseases
and therapeutic platforms, the outcome of which would also be
applicable for rare diseases with small patient populations,
and rare diseases with no path to commercialization.
Clinical and Translational Science Awards [CTSA] Program.--
The Committee provides $629,560,000 for the CTSA program. The
Committee once again emphasizes that allocated resources shall
be used to provide additional support to CTSA hubs and further
enhance ongoing activities. The Committee maintains its strong
support for the CTSA program and reaffirms previous language
preserving the size, scope, and historic mission of the CTSA
program, including the direction that no competitively funded
hub shall receive less than 95 percent of the resources that
were provided prior to fiscal year 2022. The CTSA program has
helped modernize the Nation's approach to effective and
efficient medical research and will continue to be fully
supported to facilitate further scientific progress through
this critical infrastructure. Finally, the CTSA program is
encouraged 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.
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.
National Clinical Cohort Collaborative [N3C].--The
Committee continues to support NCATS N3C's open-science
privacy-preserved data-sharing platform to accelerate
biomedical research and discovery. N3C combines electronic
health record data with imaging, mortality, viral genome
sequences, and Medicare and Medicaid data from CMS to answer
key research questions on a variety of diseases. The Committee
encourages NCATS to expand use of its virtual data research
infrastructure to accelerate research and cures for a variety
of diseases through re-use of NCATS repositories, other NIH
repositories including clinical trial data, and readily
available real-world data including Federal agency data such as
CMS claims data.
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.
OFFICE OF THE DIRECTOR
Appropriations, 2023.................................... $2,655,514,000
Budget estimate, 2024................................... 2,903,379,000
Committee recommendation................................ 2,834,514,000
The Committee recommendation includes $2,834,514,000 for
the Office of the Director [OD]. Within this total,
$722,401,000 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.
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. The Committee
directs NIH to provide an update in the fiscal year 2025 CJ on
the steps NIH has taken to expand research into the causes of
amyloidosis and the measures taken to improve the diagnosis and
treatment of this devastating group of diseases.
Artificial Intelligence/Machine Learning [AI/ML].--The
Committee provides $135,000,000 to support NIH's efforts to
build capacity to leverage AI, ML and data science to
accelerate the pace of biomedical innovation. The Committee
supports NIH's efforts to build AI-based analytical tools to
help NIH optimize investments in biomedical research by
identifying emerging topics and predicting which ones will
produce transformative breakthroughs. To build upon NIH's
progress in this area, the Committee encourages NIH to continue
expanding the application of AI, ML, and data science across
its research portfolio, with a particular emphasis on
activities that bring together research grants and the Office
of Data Science [ODSS] as it implements the NIH Strategic Plan
for Data Science. To increase AI, ML, and data science
expertise on NIH review panels, the Committee encourages ODSS
to partner with the Center for Scientific Review to increase
outreach to the AI, ML, and data science community. Finally,
the Committee continues to support collaboration between NIH
and the Department of Energy [DOE] to bring together biomedical
scientists with computer scientists, computational scientists
and other data science experts. The Committee directs NIH to be
consistent with the ODSS policies regarding use of AI/ML in
biomedical and behavioral sciences research when carrying out
AI/ML initiatives. The Committee requests an update within 180
days of enactment on NIH-wide ethical standards when biomedical
research utilizes AI/ML.
Autoimmune and Immune Mediated Diseases.--The Committee
recognizes the important role the new Office of Autoimmune
Disease Research within the Office of Research on Women's
Health will play in coordinating and fostering collaborative
research across Institutes and Centers. As the office develops
a strategic research plan, the Committee strongly encourages it
to seek input from external stakeholders particularly patient
advocacy organizations that represent the populations affected
by autoimmune and immune-mediated diseases.
Biosecurity in Synthetic Nucleic Acid Synthesis.--The
Committee urges NIH to develop additional policies to advance
the adoption of strong biosecurity practices for synthetic
biology technologies. Specifically, NIH should explore
approaches to encourage grantees receiving NIH research dollars
to prioritize the purchase of domestically produced synthetic
genetic materials and tools from companies that have
implemented appropriate biosecurity practices, including but
not limited to the 2010 HHS Screening Framework Guidance for
Providers of Synthetic Double-Stranded DNA or when available,
an updated version of this guidance. In creating and
implementing any such approaches, the Committee encourages NIH
to coordinate with the Administration for Strategic
Preparedness and Response.
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 $680,000,000 for the BRAIN Initiative. 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 expand its current research agenda
across its Institutes and Centers, including additional
research on higher potency THC, alternative cannabis
formulations and extracts, and additional minor cannabinoids.
The Committee also encourages NIH to expand 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.
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 acknowledges that other
countries have established oversight requirements for
cephalopods when used in government-funded research. Due to
cephalopods' current exclusion in Federal regulations, there is
limited oversight of their involvement in research. The
Committee recognizes that researchers must still justify their
use and numbers when proposing research seeking NIH funding. As
interest in the welfare of these animals in research is
increasing, the Committee encourages the NIH to consider
developing guidance for the humane care and use of cephalopods
in NIH-supported research, including possibly expanding the
current definition of ``animal'' in the PHS Policy.
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 to fully understand causes, diagnosis, and
treatment of these devastating disorders. Research and
physician education are essential to early identification and
intervention, thereby reducing the risk of chronic illness and
associated costs to families, school systems, healthcare
systems, and insurers. The association between neuropsychiatric
illness and infections has become even more evident because of
SARS CoV-2 and provides increasing opportunities for
breakthroughs in research and treatment. The Committee
encourages NIH to increase prioritization of research in this
area, and report to the Committee in the fiscal year 2025 CJ on
the progress being made on the understanding of the causes,
diagnostic criteria, and treatment of these conditions.
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.
Congenital Cytomegalovirus [cCMV].--cCMV is the most common
viral infection infants are born with in the United States and
the leading non-genetic cause of hearing loss. cCMV can cause
stillbirth or miscarriage, visual impairment, developmental
delays, and other health complications. Current anti-viral and
prevention strategies for cCMV that have been clinically
studied are based on outdated innovations. The Committee
encourages NIH to support research on the development of lower-
cost and high-sensitivity prenatal (fetal) diagnosis and
newborn screening technologies; the design, evaluation, and
acceleration of clinical trials for vaccines; strategies to
prevent CMV-related stillbirth and miscarriages; cCMV
disparities research; effectiveness studies of risk reduction
measures during pregnancy; treatment trials for those who are
pregnant to reduce transmission and fetal disease; and
intervention trials to assist those infants born with CMV. The
Committee directs NIH to submit an update in the fiscal year
2025 CJ on the development of this research.
Common Fund.--The Gabriella Miller Kids First Research Act
authorized $126,000,000 for a 10-year Pediatric Research
Initiative. These funds are used to advance research for
pediatric birth defects and childhood cancer. As authorized by
the act, $12,600,000 is provided to support pediatric research.
Common Data Elements [CDEs].--The Committee recognizes the
continued need to develop CDEs in disease areas where they
currently do not exist, particularly in complex autoimmune and
immune-mediated conditions. The Committee encourages the Office
of Data Science Strategy [ODSS] to collaborate with the Office
of Research on Women's Health and Institutes and Centers that
oversee research on autoimmune and immune-mediated conditions
to prepare a roadmap for developing CDEs for these conditions.
The Committee encourages ODSS to engage outside stakeholders,
including professional societies and patient organizations, in
this work, as appropriate.
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 students to accept positions, particularly in
high-cost areas; areas in which academic medical centers are
located. The Committee is aware of NIH's concerns about
instituting COLAs for postdoctoral students, however, the
Committee believes attracting and retaining New and Early-Stage
Investigators and increasing diversity in biomedical science
are paramount goals. The Committee directs NIH to evaluate the
adequacy of compensation for trainees and early career
researchers, including COLAs, supported through fellowships,
training grants, and research awards. Within 180 days of
enactment, the Committee directs NIH to provide a report on
this analysis, and such a report shall include the estimated
budgetary needs of instituting COLAs for postdoctoral students.
Creutzfeldt-Jakob Disease.--The Committee encourages NIH to
continue to fund projects investigating Creutzfeldt-Jakob
Disease [CJD] and other prion diseases, which are rapidly
progressive and fatal neurodegenerative diseases, including
projects that are also relevant to Alzheimer's Disease and
Related Dementias [ADRD]. CJD is caused by the abnormal folding
of the prion protein in the brain, and closely resembles ADRDs.
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 including 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
recognizes the importance of ongoing activities to better
understand the impact of food and diet on the development of
mucosal immunity and the relevance of this topic to Crohn's
disease and ulcerative colitis and to other digestive and
autoimmune or immune-mediated diseases. The Committee
encourages NIH to convene a scientific workshop, supported by
multiple Institutes, Centers or Offices, including the Office
of Nutrition Research, and to report to the Committee the
outcomes of the workshop, including possible future research
opportunities.
Duchenne and Becker Muscular Dystrophy.--The Committee
supports the research conducted by the Wellstone Muscular
Dystrophy Research Network Centers of Excellence program
established in 2003. The Committee directs NIH to provide a
report to Congress and the public on the key scientific
accomplishments of the Centers to date and their current
activities. The NIH also should use this information to update
its website content regarding the program.
Eating Disorders.--The Committee commends NIH for
supporting multi-Institute research on the chronic, serious,
and fatal mental illness of eating disorders impacting nearly
30 million Americans during their lifetimes. More than seventy
percent of people with eating disorders have comorbid mental
health conditions including anxiety disorders, mood disorders,
and trauma-related symptoms. Lifetime prevalence of comorbid
substance use disorder among individuals with eating disorders
was recently reported as 27.9 percent. The Committee remains
concerned about the lack of research surrounding binge-eating
disorder, the most common eating disorder in the United States
and encourages NIH to increase eating disorder research across
all sub-types to better reflect the U.S population, including
historically underrepresented populations. The Committee
requests an update within 180 days of enactment on steps NIH is
taking to diversify research across all eating disorder sub-
types and resources needed to address gaps in genetics,
prevention, diagnosis, and treatment of eating disorders.
Encouraging Innovation and Experimentation.--The Committee
recognizes that there are many ideas for how NIH could improve
its operations and funding models-such as lotteries for funding
mid-range proposals, funding the person rather than the
project, and more-yet there is not enough evidence to directly
mandate any of these ideas. The Committee urges NIH to examine
how best to create or empower a team that would engage in NIH-
wide experimentation with new ideas regarding peer review,
funding models, and others, so as to enhance NIH's operations
and ultimately to improve biomedical progress. The Committee
directs NIH to provide a report within 1 year on these efforts.
Endotoxemic Septic Shock.--The Committee encourages NIH to
convene a stakeholder workshop to discuss research needs to
inform the development of diagnostic criteria for
characterizing endotoxemic septic shock in recognition of
clinical advances in knowledge and emerging medical
technologies to assess and treat this condition.
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. Finally, to better understand
what is needed to advance these efforts, the Committee directs
NIH to provide a report within 180 days of enactment on its
full range of programs for early career scientists including
the annual cost per program over the last five fiscal years and
the average number of recipients per year by award. Such report
shall include a ``professional judgement'' budget to estimate
the additional funding needed to grow and retain the early
career investigator pool, accelerate earlier research
independence, and ensure the long term sustainability of the
biomedical research enterprise.
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.
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 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
best possible science. At present, only NIGMS uses the R35 to a
significant extent (more than four times as often as the rest
of NIH put together), with its Maximizing Investigators'
Research Award [MIRA] program. The Committee directs NIH to
convene an expert panel on expanding the R35/MIRA grant type
such that is more widely used across NIH Institutes and
Centers, and to report back to the Committee within 1 year on
NIH's plans for expanding the R35 along with its plans for
evaluating the impact on scientific progress.
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 recent 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 recently 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 2024 and
2025.
Genomic Data.--The Committee encourages NIH to support
development of technology that would allow biomedical
researchers to manage and analyze genomic clinical data for
research, in a user-friendly way, independent of
bioinformaticians in an environment for users without coding
skillsets.
Harassment Policies.--The Committee is concerned by recent
reports that despite being disciplined for sexual harassment
against multiple trainees and co-investigators, NIH allowed the
transfer of a principle investigator from one academic
institution to another, where he continued to harass trainees,
and was later awarded an additional $2,500,000 grant from NIH.
The Committee directs NIH to provide a full reporting of this
incident to the Committees, including an update on how NIH will
rectify this particular case. In addition, NIH is directed to
provide an update to the Committees on how it intends to
prevent enabling ``pass the harasser'' in the future, and make
clear to institutions and researchers that harassment is not
acceptable and that both institutions and researchers will be
held accountable, including through the loss of Federal
funding, for such incidents.
HEALing Community Study.--The Committee supports the goals
of the HEALing Communities study to test the integration of
prevention, overdose treatment, and medication-based treatment
to combat the opioid crisis, and encourages NIH to continue
funding the study to completion.
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.
Improving Clinical Trials.--The clinical trial enterprise
has been criticized for conducting too many clinical trials
where small size may lead to the production of limited evidence
relevant to clinical outcomes. The Committee directs NIH to
convene an independent panel (at least 51 of whom must be non-
Federal employees) in order to assess the rate at which NIH-
funded clinical trials are not of sufficient size or quality to
be informative. The panel should randomly sample at least 300
NIH-funded trials from each of the years between 2010 and 2020,
and should make recommendations as to how to fund fewer non-
informative trials in the future. The Committee directs NIH to
provide a report within 1 year as to the independent panel's
findings.
INCLUDE Initiative.--The Committee includes no less than
$90,000,000, the same as the fiscal year 2023 enacted level,
within OD for the INCLUDE Initiative. The Committee encourages
NIH to make further investments in health equity-focused
research and care for African Americans and other
underrepresented groups with Down syndrome. 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 and increase
pipeline research initiatives specific to Down syndrome.
Kleine-Levin Syndrome.--The Committee commends NIH for its
December 2021 publication of the Sleep Research Plan. The
Committee encourages the inclusion of Kleine-Levin Syndrome
[KLS], a complex neurological disorder characterized by long,
recurring episodes of excessive sleep and derealization, as a
sleep disorder requiring attention and study in the next
publication of the Sleep Research Plan. The cause of KLS is
still unknown, and there are no known treatments. Because KLS
shares symptoms with other sleep disorders and mental health
conditions, the Committee encourages NIH to expand its support
for research about KLS, which could provide the KLS community
and many others with critical information and answers.
Low-Code Application Development.--The Committee encourages
NIH to continue to utilize commercially available tools to
expand Low-Code Application Development and that NIH also seek
to bring that increased efficiency and effectiveness to the
entire NIH enterprise with the intent to improve cybersecurity
posture, reduce Operation and Maintenance costs associated with
legacy applications, reduce open-ended reliance upon external
services vendors, and train and empower personnel to create
solutions that can be replicated at lower cost by other users
across the enterprise, utilizing Low-Code Application
development technologies.
Lyme Disease and Related Tick-Borne Illnesses.--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, including vertical transmission. 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
including through the HHS Tick-borne Disease Working Group on
publishing reports that assess diagnostic advancements, methods
for prevention, the state of treatment, and links between tick-
borne disease and psychiatric illnesses.
Mitochondrial Disease Research.--The Committee is aware of
the efforts by NIH to advance research on mitochondrial
disorders and translate advances in mitochondrial research to
therapies for mitochondrial disorders and their secondary
diseases, such as Alzheimer's disease, Parkinson's disease,
muscle myopathies, and cancer. It is noteworthy progress that
the first treatment for a primary mitochondrial disease--
Freidereich's Ataxia--was very recently approved by the FDA.
The Committee is also aware of considerable evidence
implicating the impairment of mitochondrial function resulting
from infection with SARS-CoV-2 in the causation of so-called
``Long COVID'' disease. Accordingly, the Committee encourages
NIH to promote interest in primary mitochondrial disease
research, continue its ongoing outreach and collaboration with
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 fund collaborative
research on mitochondrial disease to centralize a critical mass
of research, clinical care, and provider education.
National Primate Research Centers.--The Committee includes
$30,000,000 in funding to expand, 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.
Native Hawaiian Early Career Development.--The Committee
acknowledges the underrepresentation of Native Hawaiian health
research-related activities across the agency and within the
Native Hawaiian community. The Committee encourages NIH to
continue to explore NIH-wide early career development awards
that provide support for early-career investigators from
populations underrepresented in the U.S. research enterprise,
including Native Hawaiian investigators, and encourages
outreach to entities with a proven track record of working
closely with Native Hawaiian communities. The Committee
requests an update on progress in the fiscal year 2025 CJ.
National Security.--The Committee believes that NIH should
consider relevant national security issues when developing and
executing the NIH-Wide Strategic Plan.
Near-Misses.--The Committee recognizes that in many cases,
top biomedical scientists (even Nobel winners) attest that they
struggled to get NIH funding for the work leading up to their
major discoveries. The failure of the NIH peer review process
to recognize and award groundbreaking science is separate from
the issue of hypercompetition, and warrants investigation. The
Committee urges NIH to fund a major, independent study of how
often this phenomenon happens, the possible reasons behind it,
and potential reforms that could alleviate the problem in the
future.
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 continue to support preclinical research and clinical
trials. Because NF can cause blindness, pain, and hearing loss,
the Committee urges NINDS and NIDCD to continue to support
fundamental basic science research on NF relevant to restoring
normal nerve function. Based on emerging findings from numerous
researchers worldwide demonstrating that children with NF have
a higher chance of developing autism, learning disabilities,
motor delays, and attention deficits, the Committee encourages
NINDS, NIMH, and NICHD to continue their support of research in
these areas. Since NF2 accounts for some genetic forms of
deafness, the Committee encourages NIDCD to expand its
investment in NF2-related research. NF1 can cause vision loss
due to optic gliomas. The Committee encourages NEI to expand
its investment in NF1-focused research on optic gliomas and
vision restoration.
NIH Support for Pediatric Research.--The Committee commends
NIH for its efforts to coordinate pediatric research across its
Institutes and Centers through the recently established Trans-
NIH Pediatric Research Consortium. The Committee understands
NCI participates in the Consortium, and that childhood cancer
research is an important part of the pediatric research
portfolio across NIH. The Committee requests an update in the
fiscal year 2025 CJ on efforts underway through the Trans-NIH
Pediatric Research Consortium to enhance pediatric research
across NIH, including efforts to strengthen the pediatric
research workforce. The Committee desires NIH to maintain a
robust pediatric research portfolio spanning basic,
translational and clinical research, to adequately support
researchers at all career stages, particularly early career
investigators focused in pediatrics, and to ensure pediatric
components are included within larger NIH research priorities.
The Committee includes $1,500,000 for the National Academies of
Science, Engineering, and Medicine to assess the current NIH
pediatric research portfolio and structure, including how
projects are categorized as pediatrics, how pediatric
components have been included or excluded from larger NIH
initiatives, structural or process impediments to pediatric
applicants, how pediatric research priorities are established,
and how pediatric research activity is coordinated across
Institutes and Centers and to make recommendations to address
deficiencies and improve NIH's overall support of child health
research.
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
recognizes that understanding the complex factors that affect
the nutritional needs of older adults is critical to informing
the Dietary Guidelines for Americans, which serves as the
foundation for Federal food assistance and meal programs,
including the Older Americans Act Nutrition Program, which
serves millions of older adults each year. However, there is
limited research examining older adult nutrition. The Committee
encourages ONR and NIA to coordinate and to study the
nutritional needs of older adults, particularly those ages 85
and older. Bolstering older adult nutrition research will
support older adults in adequately meeting their dietary needs,
which can contribute to improved health outcomes and quality of
life and reduce the need for long-term care services and
supports. In addition, the Committee encourages ONR and NIA to
review all research currently underway at the NIH as it
pertains to older adult nutrition and submit a report on the
status of such research, as well as gaps in research, to the
Committees on Appropriations no later than 270 days after
enactment.
Office of Research on Women's Health [ORWH].--The Committee
notes bill language that was included in the Consolidated
Appropriations Act, 2022 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 $76,480,000 for ORWH. This
Office ensures women's health research and research on the
biological and sociocultural influence of sex and gender are
included within the NIH scientific framework. Congress
recognizes ORWH's critical leadership in promoting women's
health research and spearheading research programs like the
Building Interdisciplinary Research Careers in Women's Health
[BIRCWH] program, which aims to increase the number and skills
of investigators who conduct research on sex and gender
influences on health and disease, and the Specialized Centers
of Research Excellence on Sex Differences, a program designed
to expedite the development and application of new knowledge to
human diseases that affect women, to learn more about the
etiology of these diseases, and to foster improved approaches
to treatment and/or prevention. The Committee recognizes
persistent gaps remain in the knowledge of women's health.
Within the total for ORWH, the Committee provides $7,000,000,
an increase of $2,000,000 above the fiscal year 2023 enacted
level, to expand the BIRCWH program. ORWH is encouraged to
support additional researchers focused on women's health and
sex differences, including research focused on cancer and
maternal health.
Osteopathic Medical Schools.--The Committee recognizes that
osteopathic medicine is one of the fastest growing healthcare
professions in the country and osteopathic medical schools
educate 25 percent of all medical students. The Committee
understands that osteopathic medical students receive 200 hours
of additional training in the musculoskeletal system and learn
the value of osteopathic manipulative treatment as a non-
pharmacological alternative to pain management. Over half of
osteopathic physicians' practice in the primary care
specialties of family medicine, internal medicine, and
pediatrics, and a disproportionate share of osteopathic medical
graduates locate in rural and underserved areas. Osteopathic
research is needed to enhance primary care and improve
healthcare for rural and underserved populations. Over the past
5 years, osteopathic medical school applications have seen
similar success rates as seen in NIH overall. The Committee
recognizes that increased access to research funding for the
osteopathic profession will significantly bolster NIH's
capacity to support robust recovery from the COVID-19 pandemic,
address health disparities in rural and medically-underserved
populations, and advance research in primary care, prevention,
and treatment. The Committee urges NIH to consider how best to
incorporate colleges of osteopathic medicine into research
activities and involvement of their researchers on NIH National
Advisory Councils and study sections to have better
representation of the osteopathic medicine field.
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 or recovery from opioid addiction 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 living with
chronic pain.
Peripheral Neuropathy.--The Committee is concerned about
the lack of research funding for peripheral neuropathy, a
condition that affects 30 million Americans and can cause
considerable pain and disability in those diagnosed with the
disease. The Committee encourages NIH to develop a coordinated
approach to better understand the causes of and find potential
new treatments for peripheral neuropathy. Among other things,
research could focus on developing a natural history database,
collecting serial blood biomarkers and creating a tissue bank,
and identifying genetic risk factors and other strategies to
facilitate the diagnosis and treatment of various types of
peripheral neuropathy. The Committee also encourages NIH to
support research on idiopathic peripheral neuropathy, which
affects 10 million Americans.
Polycystic Ovary Syndrome [PCOS].--PCOS is a common female
endocrine disorder that affects women across the lifespan. The
Committee recognizes the significant and pervasive health and
economic burden of PCOS, which may have reproductive,
metabolic, cardiovascular, maternal, and mental health effects.
Therefore, the Committee encourages NIH to continue to
prioritize PCOS research and to devote additional resources to
support research on cardiometabolic, endocrine, and other
comorbidities that impact the health and quality of life of
patients with PCOS such as insulin resistance, hirsutism and
dermatologic conditions, cardiovascular diseases and their risk
factors, mental health disorders, stroke, and cancer; as well
as resources on research focused on ethnic and racial
differences. The Committee directs NIH to submit an update to
the Committee within 180 days of enactment on the findings from
the 2021 NIH workshop on the cardiovascular risks across the
lifespan in PCOS and the recommendations and plans to address
identified gaps.
Postural Orthostatic Tachycardia Syndrome [POTS].--The
Committee requests an update within 90 days of enactment on the
NIH's work to establish a new multi-institute Notice of Special
Interest to spur new research on POTS as directed in fiscal
year 2023.
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.
Research on Enhanced Potential Pandemic Pathogens
[ePPPs].--The Committee supports the recommendations outlined
the March 2023 National Science Advisory Board for Biosecurity
[NSABB] Report on Proposed Biosecurity Oversight Framework for
the Future of Science. Periodic reassessment of NIH's biosafety
and biosecurity oversight ensures that the agency effectively
addresses existing and emerging safety and security concerns
surrounding the research it funds while preserving scientific
progress and innovation. In accordance with the NSABB
recommendations, NIH is directed to articulate specific roles,
responsibilities, and expectations for investigators and
institutions in the identification, review, and evaluation of
research for potential involvement of ePPPs in its terms and
conditions of awards. NIH is urged to prioritize resources for
the independent review of such research identified by
institutions that receive NIH support for life sciences
research either directly or indirectly, and ensure that the
conduct of ePPP research at international institutions
receiving NIH support is subject to oversight requirements that
are equivalent to domestic U.S. policies and procedures.
Finally, in preparation for the Office of Science and
Technology Policy's updated December 2023 Federal policy
governing the review and oversight of ePPP research, the
Committee provides $1,000,000 for NIH to establish an
implementation office to serve as a resource for the research
community. The implementation office shall serve as the main
point of contact within NIH that provides technical assistance
for research institutions regarding the ePPP policy. The office
shall also develop tools and training guidance for the
extramural research community to strengthen risk-assessment,
safety, security, and ethical considerations surrounding
proposed ePPP research at research institutions. NIH is
directed to provide an update on the implementation of these
activities within 120 days of enactment. Finally, NIH is
directed to deliver with the fiscal year 2025 CJ a professional
judgement budget on the funding required to support facilities
and administration costs, including additional inspections and
review of policies and procedures, at its high containment
laboratories in addition to the grant funding it provides. This
budget should estimate additional funding needed to support
biosafety training and safeguard research involving pathogens
to protect laboratory workers, public health, and national
security.
Research with Non-Human Primates.--The Committee recognizes
the critical role of non-human primate [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 costly and emergent
diseases. The Committee is concerned about the condition and
availability of critical Federal research assets outlined in
the 2023 National Academies report on the State of the Science
and Future Needs for Nonhuman Primate Models in Biomedical
Research. In particular, the Committee is alarmed that NIH has
no central data management or reporting structure for tracking
the number of NHPs required to meet current and future research
needs. The Committee directs NIH to develop a strategic
management plan for NHP research resources to bolster
cooperative efforts, data sharing, purposeful planning, and
data-driven care and management methods. The Committee urges
NIH to award funding to meritorious research proposals using
NHPs to study neurological diseases as well as research into
preventing the next pandemic. NIH is also encouraged to
continue the development and validation of new approach
methodologies that reduce the need for, enhance the utility of,
and mitigate shortages and costs of NHP 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. NIH is encouraged to justify, 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.
Sex as a Biological Variable [SABV] Policy.--The
appropriate analysis and reporting of data by sex can enhance
the rigor and applicability of preclinical biomedical research.
The NIH SABV Policy was necessary because historical research
data that only uses one sex has been misleading and
ungeneralizable to another sex. Furthermore, studying only one
sex may lead to false conclusions due to hidden sex-specific
effects that, left unreported, can have serious health
consequences. To track and analyze NIH's progress in
integrating SABV into biomedical research across its Institutes
and Centers, the Committee encourages NIH to explore options
for assessing policy implementation and how well studies are
satisfactorily incorporating SABV into research designs,
analyses, and reporting.
Spinal Muscular Atrophy.--The Committee remains committed
to continued NIH research into spinal muscular atrophy [SMA], a
neuromuscular disease that causes degenerative nerve damage and
results in severe muscle loss and impaired motor function. Past
SMA research at NIH, particularly through NINDS, has led to
disease-modifying SMA treatments and greater knowledge of the
nervous system, which has benefited other neurological and
neuro-muscular disorders. While current SMA treatments slow or
stop future degeneration, they do not cure SMA. Individuals
with SMA, particularly adults, face significant challenges in
muscle weakness and fatigue due to degeneration that occurred
prior to treatment. Individuals treated prior to clinical
symptoms onset may also display unmet needs, such as bulbar
impairment and gait abnormalities. The Committee urges NIH to
address the significant unmet need that exists across all ages
and disease stages of SMA by supporting new SMA research into
the role and function of survival motor neuron [SMN] protein,
investigation into non-SMN pathways and targets capable of
modifying disease, and research into how to best combine SMN-
enhancing and non-SMN approaches for optimal therapeutic
outcomes.
Reducing the Administrative Burden on Researchers.--The
Committee recognizes that according to a national survey by the
Federal Demonstration Partnership, federally-funded researchers
report spending 44 percent of their research time on
bureaucracy, including the time to prepare proposals and
budgets, post-grant reporting of time and effort, ethical
requirements, and other compliance activities. Although NIH and
other agencies tasked with reducing administrative burden
conducted extensive consultations with the research community
that resulted in a 2019 final report on their implementation
plans, the Committee is concerned about the status of the
implementation by NIH and any plans to evaluate the outcome.
The Committee directs NIH to form a Board on reducing
administrative burden, with at least 75 percent representation
from non-Federal organizations and at least 25 percent
representation from early-career researchers (including post-
docs). Within 1 year of enactment, the Board is directed to
provide a report that includes an evaluation of current efforts
to reduce administrative burden and to provide recommendations
aiming to reduce the administrative burden on researchers by 25
percent over the next 3 years. The Committee strongly
encourages NIH to put recommendations into effect as soon as
practicable. The Committee requests a briefing on this effort
90 days from the enactment. The report recommendations shall be
made available to the public on the agency website.
Scientific Management Review Board.--The Committee
recognizes that under the NIH Reform Act of 2006 (Public Law
109-482), a Scientific Management Review Board [SMRB] was
created with the specific mission of reviewing the overall
``research portfolio'' of NIH, and advising on the ``use of
organizational authorities,'' such as abolishing Institutes or
Centers, creating new ones, and reorganizing existing
structures. Yet this Board has not met or issued a report since
2015, despite the obligation to do so every 7 years. The NIH
Advisory Committee to the Director [ACD] does not have the
statutory authority or mandate to serve as a substitute for the
SMRB, and the Committee rejects any efforts to assign the ACD
to undertake these efforts. The Committee directs NIH to
reconvene the SMRB within 1 year of enactment in order to
fulfill its statutory duty to advise Congress, the Secretary,
and the NIH Director on how best to organize biomedical
research funding.
Term Limits.--Congress' decision to limit ARPA-H managers
to a maximum of two 3-year appointments (4 years for the ARPA-H
Director) is a break from NIH's longstanding practice of
allowing its top officials to effectively serve indefinitely.
The Committee believes that a healthy degree of turnover in
leadership is critical for sustaining the vitality of NIH. It
also provides the opportunity for leading scientists across the
Nation to leave their positions for a set period of time and
come to NIH to provide effective leadership to critical
elements of the Nation's biomedical enterprise. The Committee
supports the recommendations outlined in the 2003 Institute of
Medicine report Enhancing the Vitality of the National
Institutes of Health: Organizational Change to Meet New
Challenges. Specifically, the Committee supports Recommendation
10, to set term limits for IC Director appointments to two 5-
year terms. The Committee believes regular replacement of IC
Directors following a maximum of two terms would be an overall
benefit to medical research by ensuring the periodic
introduction of fresh perspectives. The Committee provides
$500,000 and directs NIH to begin the planning process for
implementing this policy, and to report to the Committees
within 180 days of enactment on these efforts.
Thalassemia.--Nutrition can be an important tool in the
management of rare diseases. Currently, there is no guidance on
nutrition approaches for the management of thalassemia, which
occurs most often in people of Mediterranean, Chinese, South
Asian, and Southeast Asian descent. In addition to the
possibility that thalassemia itself creates nutritional
deficits, there is concern that necessary iron chelation
therapy may create additional deficits. Research is needed to
provide practitioners with evidence-based advice for patients,
both on diets that would help improve and manage their
condition, and those that may be harmful. The Committee
encourages NIH to study the impact of nutrition on disease
management and improving clinical understanding.
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 approximately 7,500
participants through 27 sites across the United States,
including regions of the country significantly affected by the
opioid crisis. The study cohort will comprise participants that
reflect the U.S. population but will oversample for individuals
that have used substances sometime during their pregnancy and a
matching cohort with similar characteristics but no substance
exposure during the pregnancy. Multimodal data collection will
include neuroimaging, behavioral and cognitive assessments as
well as collection of biospecimens and brain activity
measurements [EEG]. Knowledge gained will be critical to help
predict and prevent some of the known impacts of pre- and
postnatal exposure to drugs and environmental influences,
including risks for future illicit substance use, mental
disorders, and other behavioral and developmental problems, as
well as identify factors that contribute to resilience and
opportunities for intervention. The Committee recognizes that
the HBCD Study is supported in part by the NIH HEAL Initiative,
and NIH Institutes, Centers, and Offices [ICOs], including
OBSSR, ORWH, NEI, NIMHD, NIBIB, NIEHS, NICHD, NINDS, NIAAA,
NIMH, and NIDA, and encourages additional NIH support for this
important study.
Von Hippel-Lindau [VHL] Disease.--The Committee recognizes
that finding a treatment and cure for VHL disease, in which the
VHL tumor suppressor gene is damaged or nonexistent, is key for
treating and curing not only the rare disease of VHL but also
many other forms of cancer. The role of the VHL gene is central
in how cells sense and adapt to oxygen and nutrient
availability and how this mechanism leads to abnormal cell or
cancer growth. As a result, nearly a dozen medications
currently used to treat various forms of cancer are the direct
result of research in VHL biology. The Committee encourages NIH
to continue to support research on VHL disease and biology,
seeking both pharmacological and gene therapy treatments for
VHL and other cancer patients. The Committee requests an update
on VHL research efforts in the fiscal year 2025 CJ.
Wastewater Surveillance R&D.--The Committee recognizes the
potential and importance of wastewater surveillance in public
health surveillance, including its use during the pandemic to
inform COVID-19 surveillance. The Committee encourages NIH to
continue programs, including the Rapid Acceleration of
Diagnostics [RADx] that support innovation in developing and
improving wastewater surveillance capabilities.
Women's Health Clinical Research Network.--The Committee
directs NIH to expand and more formally coordinate its support
women's health clinical research by leveraging the CTSA
program. The Committee urges NCATS and CTSA awardees to focus
on women's health within its efforts to modernize the
translation of research into health benefits across the full
spectrum of medical research. The Committee directs NCATS to
collaborate with ORWH to evaluate how to better promote
research and collaborations that address the distinctive
medical and health needs of women and advance the dissemination
and implementation of research results. The Committee requests
an update on these activities with 120 days of enactment.
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH
Appropriations, 2023.................................... $1,500,000,000
Budget estimate, 2024................................... 2,500,000,000
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 2023. 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 consider funding ALS research that prioritizes time
to beneficial impacts on people living with ALS and their
families.
Geroscience.--Geroscience research is a revolutionary way
to approach health and aligns well with the mission of ARPA-H
to identify and invest in high-risk, high-reward research
projects that have the potential to transform healthcare and
improve public health. By uncovering new insights into the
underlying causes of age-related diseases, geroscience research
could lead to treatments and therapies that offer the
possibility of improving people's ``healthspan,'' so they
remain healthier longer, and address the growing burden of age-
related diseases on society. The Committee urges ARPA-H to
prioritize two areas of geroscience research that could advance
the field dramatically: biomarkers and epigenetic
reprogramming. Discovering and validating biomarkers for aging
would significantly improve the efficacy of interventions,
while epigenetic reprogramming of cellular age could slow down
or even reverse the aging process and thereby prevent or delay
the entire panoply of age-related diseases.
Mission and Independence.--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] but singularly focused on improving health outcomes,
ARPA-H is expected to pursue transformative advances in health
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
expects 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. While the Committee supports
the structure of ARPA-H as an independent entity within NIH, it
understands that ARPA-H will utilize many of NIH's
administrative functions and will cover its appropriate share
of the cost of these functions, like NIH's Institutes and
Centers. In all other respects, where collaboration with other
parts of NIH may occur, the Committee strongly encourages ARPA-
H and NIH to co-fund the collaboration following precedent of
NIH projects co-funded with other government agencies. The
Committee directs ARPA-H to report to the Committee within 180
days of enactment with details on any scientific collaborations
with NIH, including the allocation of costs.
Recalcitrant Cancers.--Given the toll recalcitrant cancers
exact on society and the lack of diagnostic and treatment
resources currently available to help these patients, the
Committee encourages ARPA-H to work with NIH and NCI to ensure
that approved projects focus on the hardest problems and areas
where medical practice will be dramatically changed, including
the deadliest cancers.
BUILDINGS AND FACILITIES
Appropriations, 2023.................................... $350,000,000
Budget estimate, 2024................................... 350,000,000
Committee recommendation................................ 292,000,000
The Committee includes $292,000,000 for Buildings and
Facilities. For the fourth 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
quarterly 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. The
Committee directs NIH to provide a detailed briefing on the
proposed Center for Pediatric and Adult Diseases, including how
the size and activities in the Center compare to the footprint
and activities in the existing facilities that would be
demolished to make way for it. Finally, the Committee also
directs NIH to describe in its fiscal year 2025 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, 2023.................................... $419,000,000
Budget estimate, 2024................................... 407,000,000
Committee recommendation................................ 235,000,000
The Committee recommendation includes $235,000,000 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.
Substance Abuse and Mental Health Services Administration
The Committee recommends $7,550,268,000 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 [MHBG], 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 2024.
MENTAL HEALTH
Appropriations, 2023.................................... $2,788,546,000
Budget estimate, 2024................................... 4,529,395,000
Committee recommendation................................ 2,850,546,000
The Committee recommends $2,850,546,000 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 $1,077,453,000 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
CAPACITY:
Seclusion & Restraint........... $1,147,000 $1,147,000
Project AWARE................... 140,001,000 140,001,000
Mental Health Awareness Training 27,963,000 27,963,000
Healthy Transitions............. 30,451,000 30,451,000
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.................. 25,605,000 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 28,200,000
Prevention.....................
Zero Suicide................ 26,200,000 26,200,000
American Indian and 3,400,000 3,400,000
Alaska Native Set-Aside
Mental Health Crisis Response 20,000,000 20,000,000
Grants.........................
988 Lifeline.................... 501,618,000 519,618,000
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 3,931,000
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 7,269,000
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 1,991,000 1,991,000
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 [Lifeline].--Suicide is a
leading cause of death in the United States, claiming over
48,000 lives in 2021. Suicide rates among youth and young
adults between the ages of 10-24 reached a 20 year high in
2021. The Committee provides $519,618,000 for the 988 Lifeline
and Behavioral Health Crisis Services. This amount includes
funding to continue to strengthen the National Suicide
Prevention Lifeline [NSPL], which coordinates a network of more
than 180 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.
This funding is intended to support local crisis center
capacity including through partnerships in behavioral health
crisis response and the centralized network functions necessary
to respond to the anticipated increase in contacts in fiscal
year 2024. The Committee encourages SAMHSA to use additional
funding for 988 to expand existing intervention and suicide
prevention hotline and web services, including texts, e-mails,
photos, videos or other digital modes of communications and
focus outreach to youth, teens, young adults and their
families. Additionally, the Committee understands the
importance of peer services, particularly for youth in crisis.
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 Lifeline network, along with highly
coordinated referrals and connections for youth peer-run
support lines that are not formally embedded within the 988
Lifeline.
Behavioral Health Crisis and 988 Coordinating Office.--
Within the total for 988 and Behavioral Health Crisis Services,
the Committee recommendation 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, including CMS and
HRSA, as well as with external stakeholders. The Committee
requests that the Secretary include a multi-year, crisis care
system roadmap in the fiscal year 2025 CJ.
988 Text and Chat-Based Capabilities.--Within the total for
988 Suicide and Crisis Services, the Committee again includes
$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 $33,100,000 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.
Depression.--The Committee notes that depression and
bipolar disorder afflict a growing number of Americans and are
one of the most costly medical conditions in the United States.
The Committee encourages the establishment of a national
Depression Center of Excellence to help translate academic
treatment advances into clinical care. This Center will help
address the need for earlier clinical detection of depression
and new strategies to prevent recurrences of depressive
illnesses, as well as ways of reducing their length and
severity.
Garrett Lee Smith Youth Suicide Prevention.--The Committee
recommends $43,806,000 for Garrett Lee Smith 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. To help meet these growing needs
and address disparities in access to mental health services,
the Committee directs the Secretary to waive the requirement of
matching funds for minority-serving institutions and community
colleges as defined by the Higher Education Act of 1965. 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 $30,451,000
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.
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 continues $20,000,000 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 and requests a report within 1 year
showing the number and type of primary care, physician
specialists and subspecialists, and other mental health
professionals participating in the program and describing how
the program is working to support youth mental health across
communities.
National Strategy for Suicide Prevention.--The Committee
includes $28,200,000 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 $3,931,000 for the AI/AN Suicide Prevention
Initiative.
Outreach in Underserved Communities.--The Committee directs
SAMHSA to conduct outreach, provide technical assistance and
give priority in awarding cooperative agreements and grants to
underserved States and communities. Underserved States and
communities disproportionately suffer from a high prevalence of
substance use disorders, high suicide rates, and high poverty
rates, combined with severe mental health provider shortages of
rates less than half the National benchmark for full-time
equivalent mental health providers, psychologists, and
psychiatrists. The Committee urges SAMHSA to work with these
communities to better develop a mental health workforce. The
Committee requests a report, not later than 180 days of
enactment of this act, on best practices and strategies to
attract healthcare and mental healthcare practitioners to these
underserved communities.
Primary and Behavioral Health Care Integration Grants and
Technical Assistance.--The Committee notes that Congress
recently enacted changes to the Primary and Behavioral Health
Care Integration Grant program, with the goal of improving
patient access to bidirectional integrated care services. The
Committee provides $55,877,000 for the program, and $1,991,000
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.
Project AWARE.--The Committee provides $140,001,000 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 2025
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 2023 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 180 days after enactment of this act.
Trauma Support Services in Educational Settings.--The
Committee recognizes the increased need for school and
community-based trauma services for children, youth, young
adults, and their families. The Committee also recognizes the
need to support school staff with training in trauma-informed
practices. Within the total for Project AWARE, the Committee
directs $12,000,000 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).
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 $93,887,000 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 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 National Child Traumatic Stress
Network 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, an increase of
$15,000,000. The CCBHC expansion program 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).
SUBSTANCE ABUSE TREATMENT
Appropriations, 2023.................................... $4,157,298,000
Budget estimate, 2024................................... 5,463,087,000
Committee recommendation................................ 4,219,298,000
The Committee recommends $4,219,298,000 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 $576,219,000 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 2023 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- 122,416,000 122,416,000
General........................
Medication Assisted 111,000,000 111,000,000
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........ 56,000,000 57,000,000
Rural Focus................. 31,000,000 32,000,000
Pregnant and Postpartum Women... 38,931,000 38,931,000
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 16,000,000 17,000,000
Peer Support Technical 2,000,000 2,000,000
Assistance Center..............
Comprehensive Opioid Recovery 6,000,000 6,000,000
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 2,000,000
Initiatve......................
Science and Service:
Addiction Technology Transfer 9,046,000 9,046,000
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 notes
that peer support networks focus on long-term, sustainable
recovery and incorporate a full range of services such as case
management, counseling, and community supports. To further
support these recovery community organizations, the Committee
provides $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 $6,000,000, to help ensure that people with substance
use disorders can access proper treatment, as authorized by
section 7121 of the SUPPORT Act.
Confidentiality of Substance Use Disorder Patient
Records.--The Committee appreciates SAMHSA and the Office for
Civil Rights [OCR] developing proposed rules updating the
Confidentiality of Substance Use Disorder Patient Records. This
action holds the potential to reduce drug overdose rates and
help coordinate treatment for those with substance use
disorder. The Committee directs SAMHSA and OCR to complete the
rulemaking process as soon as is practicable in order to
improve treatment and save lives.
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
$57,000,000 for First Responder Training grants. Of this
amount, $32,000,000 is set aside for rural communities with
high rates of substance use. In addition, $11,500,000 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.
Medication-Assisted Treatment.--The Committee includes
$111,000,000 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 Overdose Reversal and Treatment.--
The opioid epidemic remains a major concern for the Committee.
Provisional data from CDC's National Center for Health
Statistics indicate that there were an estimated 109,680 drug
overdose deaths in the United States in 2022, the highest level
ever recorded. Among these overdoses, there has been a dramatic
increase of deaths due to illicit fentanyl, which is
increasingly found mixed with xylazine in the illicit drug
supply, putting users at an even higher risk of a fatal
overdose. Opioid overdose reversal agents remain a key tool for
law enforcement, first responders, and other community
intervention organizations. The evolving nature of the epidemic
and the increasing prevalence of synthetic opioids among
overdose deaths have led to substantial innovation in reversing
opioid overdoses. To ensure the availability of opioid overdose
reversal agents throughout the country, including innovative
technologies, the Committee urges the Secretary 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 misuse 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; 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 $38,931,00 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. A provision in the
Comprehensive Addiction and Recovery Act authorizes SAMHSA to
allocate a portion of these resources for a pilot program to
State alcohol and drug agencies to support outpatient,
intensive outpatient, and related services to pregnant and
postpartum women using a family-centered approach. The
Committee again encourages SAMHSA to fund an additional cohort
of States above and beyond the pilots already funded.
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.
State Opioid Response [SOR] Grants
The Committee provides $1,595,000,000 for grants to States
to address the opioid crisis. Bill language provides
$60,000,000 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. Activities funded with this grant may include treatment,
prevention, and recovery support services. States receiving
these grants should ensure that comprehensive, effective,
universal prevention, and recovery strategies are prioritized
to account for comprehensive services to individuals. The
Committee continues to direct SAMHSA to make prevention and
treatment of, and recovery from, stimulant use an allowable use
of these funds. The Committee directs SAMHSA to ensure funds
reach communities and counties with the greatest unmet need.
SAMHSA is also directed to provide State agencies with
technical assistance concerning how to enhance outreach and
direct support to providers and underserved communities. 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 directs SAMHSA to continue funding
technical assistance within the administrative portion of the
appropriated amounts for the State Opioid Response 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 State Opioid Response
grantees, sub-recipients and others addressing opioid use
disorder and stimulant use disorder in their communities.
SOR Funding Cliffs.--The Committee continues to direct
SAMHSA to avoid significant 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. 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. The Assistant Secretary is encouraged to apply
a weighted formula within the set aside based on state ordinal
ranking. 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.
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. 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.
SUBSTANCE ABUSE PREVENTION
Appropriations, 2023.................................... $236,879,000
Budget estimate, 2024................................... 245,738,000
Committee recommendation................................ 236,879,000
The Committee recommends $236,879,000 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 is concerned about SAMHSA's lack of emphasis
and funding for primary substance use prevention to stop use
and delay the age of initiation. SAMHSA has conflated mental
health promotion with substance use prevention, thereby
diluting the already scarce resources for actual substance use
prevention in CSAP. The Committee instructs SAMHSA to ensure
that all the funding provided to the Center for Substance Abuse
Prevention, 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 and not for any other purposes, to
include mental health promotion and harm reduction. The
Committee further requests a report to Congress within 120 days
of enactment that includes 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 $236,879,000 for PRNS within the
Center for Substance Abuse Prevention. 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 2023 Committee
Budget activity appropriation recommendation
------------------------------------------------------------------------
CAPACITY:
Strategic Prevention Framework/ $135,484,000 $135,484,000
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
------------------------------------------------------------------------
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.
Strategic Prevention Framework.--The Committee recommends
$135,484,000 for the Strategic Prevention Framework. Within the
total provided, $125,484,000 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 intends
that this program support comprehensive, multi-sector substance
use prevention strategies to stop or delay the age of
initiation of each State's top substance use issues for high-
risk youth as determined by the State's epidemiological data.
The Committee directs SAMHSA to ensure that State alcohol and
drug agencies remain eligible to apply along with community-
based organizations and coalitions. Finally, the Committee
directs SAMHSA to issue a report to the Committees on
Appropriations assessing the extent to which the work of local
grantees complements and aligns with the primary prevention
efforts led by the corresponding State alcohol and drug agency.
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.
Substance Use Disorder Prevention Workforce Report.--The
Committee appreciates SAMHSA's work to conduct a comprehensive
national study regarding the substance use prevention workforce
as directed in fiscal year 2022. 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, 2023.................................... $333,360,000
Budget estimate, 2024................................... 182,255,000
Committee recommendation................................ 243,545,000
The Committee recommends $243,545,000 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 2023 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.......... 13,000,000 13,000,000
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 is concerned
with the lack of transparency and information that is provided
to Congress and the public about how States are distributing
those funds and what programs or services they are going
toward. The Committee encourages SAMHSA to begin implementing
public reporting on their existing block grants. The Committee
directs SAMHSA to submit a report, 180 days after the enactment
of this act, to identify any staffing, IT infrastructure,
legislative policies, or funding barriers that would prevent
grantees and SAMHSA from collecting and providing outcome data
on their block grant programs.
Congressionally Directed Spending.--Within the funds
included in this account, $70,962,000 are for the projects, and
in the amounts, specified in the table titled ``Congressionally
Directed Spending Items'' at the end of this Committee Report.
Data Collection for SUD Grants to States.--A December 2020
GAO report [GAO 21-58] examining SUD grants to States found
that SAMHSA does not have consistent, relevant, and timely data
on the number of individuals provided treatment and recovery
support through the SUPTRS Block Grant, State Targeted Response
to the Opioid Crisis Grant, and SOR programs. The Committee
recognizes the challenges the lack of data poses in evaluating
the effectiveness of these grants and encourages SAMHSA to
adopt GAO's recommendation to identify and implement changes to
their data collection efforts to improve the consistency,
relevance, and timeliness of data collected on the number of
individuals who receive substance use disorder treatment and
recovery support services with funding from the SUPTRS Block
Grant and SOR programs.
Drug Abuse Warning Network.--The Committee recommends
$13,000,000 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.
Drug Testing.--The Committee recognizes that section 5402
of the Fixing America's Surface Transportation [FAST] Act
(Public Law 114-94) required the Secretary to ``issue
scientific and technical guidelines for hair testing as a
method of detecting the use of a controlled substance for
purposes of section 31306 of title 49, United States Code'',
which is the drug and alcohol testing program for operators of
commercial motor vehicles. While more than seven years have
passed since the enactment of the FAST Act, the Committee
understands that HHS is currently considering hair testing as
an alternative method of drug testing and issued proposed
mandatory guidelines relating to hair testing in September
2020, but has not issued final guidelines, as required by the
FAST Act. Therefore, the Committee calls on HHS to produce
guidelines for the use of hair testing as an alternative drug
testing method for commercial motor vehicle operators, in
accordance with section 5402 of the FAST Act.
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, 2023.................................... $373,500,000
Budget estimate, 2024................................... 447,500,000
Committee recommendation................................ 370,500,000
The Committee provides $370,500,000 for the Agency for
Healthcare Research and Quality [AHRQ]. This funding is
combined with the $116,000,000 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 upon 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 at 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.
Improving Maternal Health.--The Committee supports 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 Research.--The extensive incidence of
individuals suffering from Long COVID (Post-Acute Sequelae of
SARS CoV-2 COVID [PASC]) presents an ongoing challenge to the
healthcare system, patients and their caregivers. The Committee
recommendation includes $10,000,000 to support access to
comprehensive, coordinated, and person-centered care,
particularly for underserved, rural, vulnerable, or minority
populations that are disproportionately impacted by the effects
of Long COVID. This funding supports health-systems research
that develops and implements new or improved care delivery
models, expands access and services offered, and strengthens
care coordination. The Committee expects AHRQ to coordinate
these efforts on Long COVID health-systems research with HRSA
and other Federal healthcare agencies.
Nonalcoholic Fatty Liver Disease [NAFLD] Study.--The
Committee acknowledges the public health burden of NAFLD and
values having a comprehensive understanding of NAFLD.
Therefore, the Committee encourages AHRQ, in collaboration with
other relevant Federal agency stakeholders, to evaluate the
prevalence, diagnoses, treatments, and complications associated
with NAFLD. The Committee requests that such study: (1) assess
the prevalence of NAFLD in the United States; (2) assess the
costs associated with individuals diagnosed with NAFLD,
including the costs to patients, families, and government
programs; (3) assess the costs and impact on patients and the
healthcare system if NAFLD is unaddressed and progresses to
nonalcoholic steatohepatitis [NASH], liver failure, poor liver
function, or liver transplant; (4) identify and address
barriers to preventing, diagnosing, and treating NAFLD and
NASH; and (5) include an analysis of any disparities in access
to care and other outcomes, such as health status, among
minority populations. The Committee requests that AHRQ provide
an interim report on the findings of this study, if applicable,
in the fiscal year 2025 Congressional Justification and to
provide a final report, if applicable, in the fiscal year 2026
Congressional Justification.
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 expects AHRQ to continue its
opioid-related research to include equitable access to
treatment, management of substance use disorders with other co-
occurring chronic conditions, and how changes in service
delivery could improve outcomes.
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.
People with Disabilities.--The Committee continues to
support AHRQ's work with stakeholders to develop a research
agenda and report for dissemination on health promotion,
disease prevention, and intervention strategies for people with
disabilities.
Telehealth.--The Committee notes that telehealth now
represents a significant share of healthcare delivery. The
Committee encourages AHRQ to issue guidance on effective
strategies to engage individuals with disabilities and
individuals with limited English proficiency, and to assess and
publish the effectiveness of beneficiary telehealth readiness
tools commonly used across the health system, such as digital
navigators and provision of technology.
Unites States Preventive Services Task Force [USPSTF]
The Committee recommends $11,542,000 for USPSTF, which
works to improve the health of people nationwide by making
evidence-based recommendations about clinical preventive
services.
Medical Innovations.--The Committee notes concerns 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 Food and Drug Administration that is a preventive strategy
or modality pertaining to, but not included, in a previous
USPSTF recommendation.
USPSTF Public Engagement.--The Committee encourages the
USPSTF to advance open processes that help ensure meaningful
engagement by the public, including underrepresented groups.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee recommends $71,791,000 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, 2023....................................$367,357,090,000
Budget estimate, 2024................................... 406,956,850,000
Committee recommendation................................ 406,956,850,000
The Committee recommends $406,956,850,000 in mandatory
funding for Grants to States for Medicaid.
The fiscal year 2024 recommendation excludes
$197,580,474,000 in fiscal year 2023 advance appropriations for
fiscal year 2024. As requested by the administration,
$245,580,414,000 is provided for the first quarter of fiscal
year 2025.
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, 2023....................................$548,130,000,000
Budget estimate, 2024................................... 476,725,000,000
Committee recommendation................................ 476,725,000,000
The Committee recommends $476,725,000,000 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, 2023.................................... $3,669,744,000
Budget estimate, 2024................................... 4,550,070,000
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.
Alzheimer's Disease [AD].--The Committee remains
disappointed about CMS' decision to restrict coverage of an
FDA-approved monoclonal antibody treatment for Alzheimer's
disease. That decision set a dangerous precedent that
undermines FDA decision-making and may have far reaching
consequences that extend well beyond Alzheimer's treatments.
Even now that FDA has granted traditional approval for such a
treatment, the Committee is concerned that CMS continues to
create barriers to care by requiring Medicare patients be
enrolled in a qualifying registry. Given the substantial new
clinical evidence published since the national coverage
decision was issued and the FDA's confirmation of clinical
benefit in keeping with its traditional approval of a treatment
in this class, the Committee expects CMS to reconsider the
National Coverage Determination policy to provide full access
for Medicare beneficiaries to these FDA-approved Alzheimer's
treatments.
AD Diagnostics.--AD is among the top 10 causes of death in
the United States and disproportionately affects racial and
ethnic minorities. CMS' rate-setting policies may discourage
the use of advance diagnostics for AD in certain care settings.
The Committee notes that CMS' bundled payment policy for
advance radiopharmaceuticals in the hospital outpatient setting
makes these diagnostic imaging services cost prohibitive for
many hospitals and doctors, especially those providing care to
racial and ethnic minorities, who already face more significant
delays in obtaining a timely diagnosis. The Committee
encourages CMS to review these rate-setting policies and the
impacts these payment rules have on utilization of AD
diagnostics among racial and ethnic minority groups.
Furthermore, the Committee directs CMS to review the
utilization of AD diagnostics and consider potential
modifications that could make access to advanced imaging for AD
more equitable.
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 prioritize policies that
accelerate the adoption of all biosimilars on Medicare
Advantage and Part D formularies. In doing so, CMS should
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.
Birthing-Friendly Hospitals.--The Committee supports CMS'
new Birthing-Friendly Hospital designation to assist consumers
in choosing hospitals that have demonstrated a commitment to
maternal health through the implementation of best practices
that advance healthcare quality, safety, and equity for
pregnant and postpartum patients. The Committee encourages CMS
to explore expanding the criteria for which this designation
would be awarded in the future and requests a briefing on
additional steps to address maternal health outcomes and
improve patient care within 120 days of enactment of this act.
Cardiac Computed Tomography [CT].--The Committee notes that
unstable and low Medicare payments for cardiac CT services
contribute to significant disparities in access to services
among minority and underserved populations. The Committee
encourages CMS to review the reimbursement structure and to
make appropriate adjustments.
Cardiovascular Disease [CVD].--The Committee notes the
economic and public health burden of CVD, including
atherosclerotic CVD [ASCVD], which can lead to heart attack or
stroke. More than 200 studies with over 2.0 million patients
have broadly established that elevated low-density lipoprotein
cholesterol [LDL-C] levels can cause ASCVD. The Committee
encourages CMS to evaluate whether to add a quality measure of
appropriate LDL-C testing as part of its Universal Foundation
initiative.
Certified Registered Nurse Anesthetists [CRNAs].--The
Committee notes concerns about patient access to anesthesia
services, particularly in rural areas, and is encouraged by
some positive outcomes resulting from the suspended physician
supervision requirements for CRNAs during the COVID-19 Public
Health Emergency. The Committee urges CMS to use empirical data
analysis and stakeholder input to consider whether permanently
waiving the physician supervision requirement for CRNAs under
Medicare Part A Conditions of Participation can increase access
to safe and effective anesthesia services.
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 the 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.
Expanding Support for Screening and Diagnostic Testing in
Cancer Treatment.--The Committee understands that the use of
pre-treatment interventions, such as screening for signs of
cancer or testing with a companion diagnostic to determine a
specific cancer type, can help healthcare providers select
treatment options with a greater probability of better outcomes
for patients. The Committee also recognizes that the use of
these interventions can reduce unnecessary costs in the
healthcare system by avoiding ineffective treatments and that
awareness of genetic risk factors can encourage preventive care
and early diagnosis. The Committee urges CMS to identify ways
to expand access to such screening and testing.
Healthcare for People with Mobility Disabilities.--The
Committee encourages CMS to require disability clinical care
training and the availability of accessible medical and
diagnostic equipment into its conditions of participation for
Part A and Part B providers and suppliers.
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 2025.
Home and Community Based Services.--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.
Hospice Respite Care.--The Committee requests an update in
the fiscal year 2025 CJ on the current capacity and best
practices for the provision of hospice respite care, including
in the home. The update should assess and provide
recommendations on what would be needed to ensure greater
access to home respite care for hospice beneficiaries and their
caregivers, including but not limited to changes to the current
benefit to expand access to in-home respite. It should also
evaluate the adequacy of the current five-day inpatient respite
limit and make recommendations on parameters and situations in
which an expanded eligibility definition and benefit duration
might be appropriate.
Hospital Wage Index.--The Committee encourages CMS to
continue its low wage index policy, as established in the
Fiscal Year 2020 Medicare Hospital Inpatient Prospective
Payment System Final Rule, which helps many rural, low-wage
hospitals attract and maintain a skilled workforce. This policy
increases reimbursements for many vulnerable, rural hospitals
while ensuring overall budget neutrality in order to avoid
further depleting the already strained Medicare Hospital
Insurance Trust Fund.
Non-Emergency Medical Transportation [NEMT].--The Committee
continues to monitor patient outcomes resulting from changes to
NEMT policies. The Committee encourages CMS to evaluate
existing State Medicaid NEMT access for beneficiaries and
timeliness of services, and if appropriate, pursue alternative
options to provide NEMT for partial dual eligible beneficiaries
and to establish a data exchange between the Medicare
Administrative Contractors and State Medicaid agencies to
identify affected beneficiaries.
Nursing Home Medical Directors.--The Committee continues to
be concerned that post-acute and long-term care setting
facility medical directors remain underutilized and invisible
to most patients, families and others in the healthcare field.
The Committee requests that CMS and the Secretary identify
better ways for public health agencies to contact nursing
facility medical directors with mechanisms like Care Compare or
on data.cms.gov. This effort aligns with recent HHS proposed
rule to increase the transparency of nursing home ownership and
management through the administrative process.
Nurse Staffing Levels for Patient Safety.--The Committee
recognizes high-quality nursing staff are essential to patient
safety and outcomes. As part of its accrediting oversight
function, CMS is charged with ensuring that Medicare-
participating hospitals meet important patient safety
standards, including meeting appropriate nurse staffing
requirements. The Committee encourages CMS to work with
stakeholders to support the post-acute workforce, including by
ensuring burdensome requirements do not result in decreased
access for patients.
Osteoporosis.--The Committee notes that current Medicare
payment policies may not be adequate to encourage comprehensive
care to reduce osteoporosis-related bone fractures. As such,
the Committee is pleased that CMS is considering implementing a
care coordination payment mechanism for secondary prevention of
osteoporotic fractures through future rulemaking. These
services have the potential to reduce the rates of costly
secondary fractures through improved screening, treatment and
adherence, patient and caregiver education and counseling, and
comprehensive fall prevention strategies.
Pediatric Oral Health.--The Committee appreciates CMS'
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.
Prescription Digital Therapeutics.--The Committee is
encouraged that a new cutting-edge medical modality of
software-based, FDA-cleared products called prescription
digital therapeutics [PDTs] is beginning to improve the lives
of Americans living with serious diseases and conditions like
substance use disorder, attention-deficit/hyperactivity
disorder, insomnia, major depression, diabetes, stroke,
schizophrenia, and cancer. The Committee directs CMS to explore
coverage of PDTs in the Medicare and Medicaid programs under
existing benefit categories until a distinct benefit category
can be created for these products through legislation.
Rare Disorders.--The Committee notes the limitations of
bundled payments for rare and ultra- rare diseases. The
Committee urges the HHS Inspector General to review bundled
payment systems and quality reporting methodologies across care
settings. The review should evaluate barriers to accessing
treatments, diagnostics, clinicians, and specialists, as
appropriate.
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
stereotactic radiosurgery and robotic stereotactic body
radiation therapy [SBRT] may threaten patient access to this
important treatment option for many types of cancer in both the
hospital and freestanding cancer settings. CMS' statement in
the 2023 Medicare Physician Fee Schedule Final Rule that the
agency intends to review coding and payment policies for
radiation therapy services, including possible adoption of
revised CPT codes established in 2015. The Committee urges CMS
and contractors to maintain existing G codes describing robotic
SRS and robotic SBRT in order to protect Medicare beneficiary
access to these services which 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 Emergency Hospitals.--The Committee is encouraged by
CMS' timely implementation of the Rural Emergency Hospital
[REH] designation, as created by Public Law 116-260. The
Committee urges CMS to continue working with stakeholders to
ensure the regulatory geographic requirements for the REH
designation are clear for interested parties, especially rural
hospitals located in or near metropolitan statistical areas.
Rural Hospital Closures.--The Committee notes that 135
rural hospitals have closed in the past decade and many others
are vulnerable to closure. The Committee continues to direct
CMS to provide information to the Committees on Appropriations,
Energy and Commerce, and Ways and Means of the House of
Representatives and the Committees on Appropriations and
Finance of the Senate on existing policies that provide support
for struggling hospitals in rural and under-served communities.
Tribal Health Care Reimbursements.--The 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 unsustainable for Medicare patients and damages
the ability of American Indians to access local cancer
treatment. The Committee urges CMS to clarify reimbursement
procedures and amounts for Part B oncology drugs dispensed at
IHS facilities to ensure parity among IHS and non-IHS
facilities.
Whole Child Health Model.--The Committee is aware that
social determinants of health influence health outcomes,
particularly for children and youth. The Committee commends CMS
for establishing the Integrated Care for Kids Model and for
supporting State flexibility to address social drivers of
health through recent guidance and waivers. The Committee
encourages CMS to issue a report on options for a whole child
health demonstration centered in primary care settings that
would build state capacity to address youth mental health
through sustainable payment and delivery models. Options
included in such report would address the mental, developmental
and social factors affecting children served by Medicaid and
CHIP through pediatric value-based care models and locally
driven strategies, to align financial incentives and resources
across Medicaid and other programs. The Committee directs CMS
to provide an update to the Committees on Energy and Commerce
and Appropriations of the House of Representatives and the
Committees on Finance and Appropriations of the Senate within
180 days of enactment of this act on options for benefit
designs, including cost estimates for implementation.
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 directs CMS to provide, in
the fiscal year 2025 Congressional Justification, 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 78
and 80 of the fiscal year 2024 Congressional Justification,
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' 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, 2023.................................... $893,000,000
Budget estimate, 2024................................... 937,000,000
Committee recommendation................................ 915,000,000
The Committee recommends $915,000,000, 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
$604,000,000 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 ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2023.................................... $2,883,000,000
Budget estimate, 2024................................... 3,309,000,000
Committee recommendation................................ 3,309,000,000
The Committee recommendation includes $3,309,000,000 in
fiscal year 2024 mandatory funds for Child Support Enforcement
and Family Support programs. In addition, the Committee
recommends $1,400,000,000 in advance funding for the first
quarter of fiscal year 2025.
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, 2023.................................... $4,000,000,000
Budget estimate, 2024................................... 4,111,000,000
Committee recommendation................................ 4,075,000,000
The Committee recommendation includes $4,075,000,000 for
the Low Income Home Energy Assistance Program [LIHEAP], which
is $75,000,000 over the fiscal year 2023 enacted level. LIHEAP
provides home heating and cooling assistance to low-income
households. In addition to funding made available in this bill,
the Infrastructure Investment and Jobs Act (Public Law 117-58)
provided $500,000,000 in LIHEAP funding, with $100,000,000
available each fiscal year through September 30, 2026, for home
energy assistance.
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 continues to include up
to $9,600,000 for program integrity and oversight efforts. A
portion of this funding is intended to support ongoing efforts
to implement a formula system, which will allow ACF to provide
estimates more readily when requested by the Committee. Once
such a system is in place, the Committee instructs HHS to work
collaboratively with the Committee to promptly respond to
requests for estimates and to ensure no request shall be
outstanding for longer than 10 calendar days. The Committee
requests a briefing on the progress that has been made on a
formula system within 90 days of enactment of this act.
REFUGEE AND ENTRANT ASSISTANCE
Appropriations, 2023.................................... $6,427,214,000
Budget estimate, 2024................................... 7,258,755,000
Committee recommendation................................ 6,427,214,000
The Committee recommends $6,427,214,000 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 Committee will continue
to work closely with HHS to evaluate and address fiscal year
2024 funding needs.
The Committee believes that the U.S. Refugee Admissions
Program [USRAP] serves as a reflection of U.S. humanitarianism
as well as the Nation's strategic interests. In times of
changes in the pace and projections of refugee arrivals, the
Committee encourages HHS, to the extent practicable, to ensure
that resettlement agencies are able to maintain their
infrastructure and capacity at a level to continue to serve new
refugees, previously arrived refugees, and other populations of
concern who remain statutorily eligible for integration
services, and to ensure that there is capacity for future
arrivals to be adequately served.
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 DOJ.--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 the Department
of Justice to improve the referral process for eligible
arrivals.
Mental Health and Trauma Informed Care.--The Committee
recognizes that mental health is an important component of
ORR's work. Many of the individuals that ORR serves have
endured torture, war, loss of homes and loved ones, and other
traumatic events. The Committee encourages ORR to partner with
an outside organization 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 address any
gaps and for ensuring that mental health services are trauma-
informed and culturally appropriate. The Committee also
encourages ORR to assess the need for training for ORR staff
who regularly engage with potential trauma survivors,
including: training on recognizing signs of trauma exposure,
understanding culturally specific behaviors of people exposed
to trauma, and sensitive or trauma-informed principles for
interacting; and secondary trauma and resilience training and
support.
Transitional and Medical Services
The Committee recommendation includes $564,000,000 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 encourages HHS to
create a plan to expand case management for MG enrollees.
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 allocate RSS funding based on 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 2025 CJ on what flexibilities
ORR has applied in allocating funding to better reflect needs,
and any ongoing limitations in doing so.
Preferred Communities.--The Committee recognizes that the
increase in refugee arrivals projected for fiscal year 2024
requires expanded capacity among the resettlement network and
the Preferred Communities program is an important part of that.
The Committee directs HHS to include information in its fiscal
year 2025 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.
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
2025 CJ on such efforts, including an assessment of the use of
virtual ICM services.
Victims of Trafficking
The Committee recommendation includes $30,755,000 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 $5,000,000 for the National human trafficking
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 national
trafficking hotline is authorized to assist victims of severe
forms of trafficking in persons in communicating with service
providers. It is critical that that the hotline maintain a
person-centered approach focused on the victim's well-being.
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 National trafficking 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.
Unaccompanied Children
The Committee recommendation includes $5,506,258,000 for
the Unaccompanied Children [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 expects
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 ICFs in fiscal
year 2023, but has significant concerns that the administration
has not been aggressive enough in reducing capacity in ICFs and
closing them when they are no longer needed. The Committee
expects that ICFs will only be used in the future when
absolutely necessary and directs ORR to include in its fiscal
year 2025 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 expects 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 expects 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 expects 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 2025 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 Committee strongly
encourages HHS to establish the Office of the Ombudsperson as
soon as possible. 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 2023 funding level for post-release
services; legal services and access to counsel; and child
advocates. The Committee expects that HHS will continue 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 expects these funds will be used 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 expects 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 expects 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 2025 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. Finally, the Committee directs ORR
to include information in its fiscal year 2025 CJ on its actual
and planned capacity by program type and a review of past
funding opportunity announcements. This review should include
any challenges or barriers with expanding capacity in such
programs, including detailed explanations of why applicants
were unsuccessful and what ORR has done to address such
barriers and challenges as well as steps taken to improve
technical assistance for and communication with both current
and potential new providers.
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.
Spend Plan.--The Committee directs ORR to continue to
provide quarterly spend plans with actual and estimated
obligations by major category, at the same level of detail has
been provided in previous years. The Committee further expects
at least this level of detail to be included in future budget
justifications.
Sponsor Suitability Determination Policies.--The Committee
directs 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 2023 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
requests a briefing within 180 days of enactment on these
reviews.
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 2025 CJ on any such efforts.
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, 2023.................................... $8,021,387,000
Budget estimate, 2024................................... 9,000,000,000
Committee recommendation................................ 8,721,387,000
The Committee recommends $8,721,387,000, an increase of
$700,000,000 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.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2023.................................... $1,700,000,000
Budget estimate, 2024................................... 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 continues to note that SSBG funding can be
used for a wide-range of activities and encourages HHS to
ensure that States are aware that funding can be used to
support child support programs by providing job training and
employment services for non-custodial parents.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriations, 2023.................................... $14,618,437,000
Budget estimate, 2024................................... 16,139,665,000
Committee recommendation................................ 14,801,100,000
The Committee recommends $14,801,100,000 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 $12,271,820,000 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
$275,000,000 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.
American Indian and Alaska Native [AIAN] and Migrant and
Seasonal Head Start [MSHS] Eligibility.--The Committee
recognizes the efforts OHS has made to ensure AIAN and MSHS
programs are aware of the flexibilities that exist for
determining eligibility under these programs. Nevertheless,
AIAN and MSHS programs continue to face difficulty enrolling
families who are functionally very low income due to high costs
and wage inflation in some parts of the country. To address
this issue, the Committee includes bill language allowing
flexibility for AIAN and MSHS providers to enroll families at
their discretion.
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.
Tribal Colleges and Universities-Head Start Partnership
Program.--The Committee recommendation continues $8,000,000 for
the Tribal Colleges and Universities-Head Start Partnership
Program.
Preschool Development Grants
The Committee recommendation includes $310,000,000 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 recommends ACF encourage States to consider
how providing access to kindergarten preparedness services,
including those that are innovative, technology-enabled for use
in the home, and focused on parent engagement, could improve
their birth through five systems.
Duel 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 directs ACF to provide a report to Congress outlining
progress on these efforts not later than 1 year after the date
of enactment of this act.
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 $105,091,000 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 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 supports ongoing
efforts to address and support youth and families impacted by
child abuse and neglect. Within the total, the Committee
includes $2,000,000 for broad, ongoing support for the existing
national child abuse hotline in order to provide resources and
intervention through multiple modalities, including chat, text,
and call, to respond to the urgent needs of youth and concerned
adults facing these challenges.
Community-based Child Abuse Prevention
The Committee recommendation includes $70,660,000 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.
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.
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.
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.
Emergency Relief for Foster Youth.--The Committee urges ACF
to establish a demonstration program to provide emergency
relief, including clothes and basic necessities, to youth
entering the foster care system and improve pre-placement
services offered by foster care stabilization agencies.
Additionally, the Committee continues to be concerned by the
high rates of homelessness among children who age-out of the
foster care system. The Committee encourages HHS to support the
development, implementation, and evaluation of innovative
programs that effectively serve vulnerable populations of youth
transitioning out of the foster care system.
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 provides
$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 $51,000,000 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 $70,000,000 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 $70,523,000 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, $40,011,000 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.
Preventing Youth Homelessness.--The Committee includes
$3,000,000 for a 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. Funds shall be made available to State agencies,
tribes, counties, cities, or other unit of local government for
demonstration grants to provide primary prevention services for
youth at risk of homelessness and implement or improve cross-
system collaboration with key partners within the community
that serve youth at risk of homelessness. Grantees shall show
collaboration with youth with lived expertise in project design
and implementation, including establishment of local youth
advisory boards. The Committee requests a briefing 1 year after
award of such grants on the initial findings of this
demonstration program. Further, the Committee notes that this
demonstration program is in addition to other, ongoing Family
and Youth Services Bureau initiatives.
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).
Community Services Block Grant
The Committee recommendation includes $765,000,000, 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 $235,000,000 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.
Native Hawaiian Resource Center on Domestic Violence.--The
Committee includes $2,000,000 for the Native Hawaiian Resource
Center on Domestic Violence. This Resource Center will continue
to build capacity to engage Native Hawaiian communities in
developing local responses to domestic violence and support
critical networking and coalition building between Native
Hawaiian advocates across the State and the Nation.
Chafee Education and Training Vouchers
The Committee recommendation includes $43,257,000 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 $218,500,000 for the
Federal costs of administering ACF programs.
PROMOTING SAFE AND STABLE FAMILIES
Appropriations, 2023.................................... $431,515,000
Budget estimate, 2024................................... 451,000,000
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, 2023.................................... $7,606,000,000
Budget estimate, 2024................................... 8,594,000,000
Committee recommendation................................ 8,594,000,000
The Committee recommends $8,594,000,000 in mandatory funds
for Payments for Foster Care and Permanency. In addition, the
Committee recommends $3,400,000,000 in advance mandatory
funding for the first quarter of fiscal year 2025. 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, 2023.................................... $2,565,487,000
Budget estimate, 2024................................... 3,055,322,000
Committee recommendation................................ 2,524,592,000
The Committee recommends $2,524,592,000 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 Older
Americans Act 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
consultation, 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 $210,000,000 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 notes
the publication of the 2022 National Strategy to Support Family
Caregivers [National Strategy], as required by the RAISE Family
Caregivers Act. The National Strategy includes nearly 350
commitments from over a dozen Federal agencies for actions to
support family caregivers. It also includes more than 150
recommended actions for State and local governments and the
private sector to begin to build a system that ensures family
caregivers have the resources they need to maintain their own
health, well-being, and financial security while providing
crucial support for those in their care. The Committee includes
$5,000,000 to support demonstration grants that develop, test,
and scale models that implement commitments and recommended
actions from the National Strategy. The Committee directs ACL
to provide a briefing for the Committee on Appropriations no
later than 180 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, including wages,
established workplace benefits and protections, increased
prevalence of workplace violence, and competition from other
employment sectors. These factors can make it difficult to
recruit and retain qualified workers. The Committee is further
concerned with the potential effects of worker shortages on
increasing healthcare costs, such as emergency room visits and
re-hospitalizations, as well as the costs to employers that
need to hire and train new 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.
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 directs
ACL, in coordination with DOL and CMS, to examine data on the
potential impacts of worker shortages on long-term care
affordability and accessibility. The agencies shall submit a
report analyzing the above-mentioned data to the Committees on
Appropriations not later than 120 days after enactment of this
act.
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.
Nutrition Services Incentives Program [NSIP].--The
Committee recommends $112,000,000 for NSIP, consistent with the
budget request level. ACL expects that the reduction will be
offset by State and private funding, as well as the Committee's
recommended increases for the two primary nutrition programs.
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.
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.
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.
Alzheimer's Disease Program
The Committee recommends $16,800,000, 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 $11,500,000, an increase of
$1,500,000, 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 to
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
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 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
[NDSC].
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 last Congress, 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 $47,813,000 for program
administration at ACL. These funds support salaries and related
expenses for program management and oversight activities.
Congressionally Directed Spending.--The Committee includes
$29,268,000 for aging and disability services projects, as
specified in the explanatory statement accompanying this act.
Administration for Strategic Preparedness and Response
The Committee recommends $3,673,677,000 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.
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. Finally, in accordance
with the recommendations outlined in the National Academies of
Sciences, Engineering and Medicine November 2021 report,
Ensuring an Effective PHEMCE, the Committee encourages ASPR to
create an advisory committee to the PHEMCE of rotating private
sector and non-Federal partners and stakeholders. 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 vaccines
and therapeutics, as well as the deployment of these vaccines
and therapeutics during the previous month as reported by
States and other jurisdictions until the inventory is expended.
RESEARCH, DEVELOPMENT, AND PROCUREMENT
Appropriations, 2023.................................... $3,062,991,000
Budget estimate, 2024................................... 3,215,123,000
Committee recommendation................................ 3,056,991,000
The Committee recommends $3,056,991,000 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 $970,000,000, an
increase of $20,000,000, 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.
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
rapidly 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.
CBRN Threats.--The Committee notes with concern the
elevated risks posed by CBRN weapons across the globe and
provides robust funding for BARDA's core national security
mission to protect Americans against these deliberate, man-made
or naturally occurring threats. The Committee urges ASPR to
prioritize the development and stockpiling of critical CBRN
vaccines, treatments, and diagnostics to ensure there is no
disruption in the availability of these life-saving MCMs in 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 United
States and globally that lack advanced health infrastructure.
The Committee encourages ASPR to project it's spending on
emerging infectious diseases, pandemic influenza, and AMR in
its annual 5-year budget plan. The Committee requests that
BARDA continue publicly updating its research portfolios and 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 support advanced
research and development of innovative platform technologies
and medical countermeasures focused on (but not limited to)
vaccines, therapeutics, diagnostics, and other MCMs for
emerging infectious diseases, including novel pathogens and
priority viral families with pandemic potential. The Committee
encourages ASPR to collaborate with the heads of other
appropriate Federal departments, agencies, and offices as well
as the private sector and other stakeholders to identify
promising MCMs and platform technologies that can be leveraged.
The Committee directs BARDA to prioritize expeditious
development of such MCMs and innovative platform technologies.
The Committee directs BARDA to allocate no less than
$10,000,000 in fiscal year 2024 to create a Disease X Medical
Countermeasure Program at BARDA for expeditious development of
MCMs against priority viral families, including those effective
against novel pandemic pathogens. The Committee requests a
briefing within 90 days of enactment to provide an update on
such efforts.
Valley Fever.--The Committee is concerned by projections of
the growing geographic spread of coccidioidomycosis, commonly
known as Valley fever, throughout the western United States.
The Committee is encouraged by recent progress toward a canine
vaccine to prevent Valley fever and urges close collaboration
between NIAID and BARDA to identify, facilitate, and engage in
translational research and opportunities for public-private
partnerships to advance a Valley fever vaccine for humans.
Project Bioshield Special Reserve Fund
The Committee recommendation includes $820,000,000 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 $965,000,000, 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 55 percent of their
requirement to protect Americans from ARS. Considering the
risks associated with international supply chains and recent
geopolitical developments, the Committee urges ASPR/SNS to
enter into agreements that will allow them to achieve the
requirements for FDA-approved MCMs for ARS that reflect the
expected conditions for their deployment and use. 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 and secure the continued availability of a diverse
set of domestically manufactured ARS countermeasures that will
be effective under expected conditions of deployment and use.
Improving Testing Protocols for Auto-Injectors.--The
Committee is concerned shelf-life extension protocols for auto-
injector delivered drugs in the SNS only verify the life-cycle
of the active pharmaceutical ingredients inside the auto-
injector, but there is no protocol to verify the mechanical and
functional efficacy of the auto-injector's delivery device. The
Committee requests a report within 120 days of enactment on the
agency's plans, in coordination with FDA, to commence routine
testing of auto-injector mechanisms for continued viability,
along with active pharmaceutical viability.
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.
Nerve Agent Countermeasures.--The Committee is concerned
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 received previous shelf-
life extensions that are set to expire in October 2023. The
Committee is concerned the existing anti-convulsants will soon
expire and no plan is in place to resupply the stockpile. The
Committee directs ASPR to provide a report within 45 days of
enactment on the agency's plans to begin the replacement of
expiring diazepam auto-injectors with FDA approved anti-
convulsant medicines.
Poxvirus Vaccine.--The Committee commends ASPR for their
role in the successful campaign to stop the 2022 Mpox outbreak
by deploying MCMs 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 in the
stockpile, especially in light of the continued national
security threat of an intentional or accidental release of
smallpox. The Committee requests ASPR prioritize replenishment
of medical countermeasures used during the Mpox outbreak and
requests a briefing within 60 days of enactment on the
stockpiling requirements for poxvirus vaccine as determined by
the PHEMCE.
Replenishing Influenza Antivirals.--The Committee remains
concerned about the perennial threat of pandemic influenza. In
addition to vaccines, antivirals are a critical medical
countermeasure. The Committee supports the Department's multi-
year strategic initiative to supplement shelf-life extended flu
antivirals in the stockpile with therapeutics that have not
undergone extensions, in order to meet the full requirements.
ASPR is encouraged to prioritize acquiring influenza antivirals
to the full requirements that can be safely used during
pregnancy and in children under 5. The Committee also 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.--The Joint Explanatory
Statement accompanying the fiscal year 2023 Consolidated
Appropriations Act (Public Law 117-328) expressed concern that
efforts to achieve cost savings through the Shelf-Life
Extension Program [SLEP] could negatively impact the
distribution of, patient adherence to, and ultimately consumer
confidence in certain products in the SNS, particularly aged
antivirals. It also required an audit of SLEP for antivirals in
the SNS as well as inclusion of recommendations to safeguard
SNS's ability to effectively respond to future severe influenza
outbreaks, and the Committee expects delivery of those
materials expeditiously. Moreover, additional MCMs in the SNS,
which have been procured to support domestic readiness in the
event of a biological event, are expired or approaching expiry
but are not currently included in the SLEP. The Committee
directs ASPR, in coordination with FDA, to develop an
appropriate strategy to evaluate the potency and utility of
these products in a public health emergency. ASPR is directed
to update the Committee on these activities within 120 days of
enactment.
Supply Chain Risk Assessment.--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. 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 product of Active Pharmaceutical
Ingredients [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.
Domestic Supply Chain of Essential Medicines.--The
Committee urges ASPR, in coordination with FDA, to identify
opportunities to support the development of capabilities to
produce essential medicines in the United States. Particular
attention should be paid to the production of antibiotics,
which are experiencing drug shortages and are found on FDA's
List of Essential Medicines.
Pandemic Influenza Preparedness
The Committee recommendation includes $327,991,000, for
Pandemic Influenza Preparedness, which includes $26,000,000 in
unobligated balances from pandemic influenza supplemental
appropriations. 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. Of the total, $27,991,000 is
provided in annual funding and $274,000,000 in no-year funding.
The Committee expects the $26,000,000 in unobligated balances
from pandemic influenza supplemental appropriations shall be
provided to BARDA for pandemic influenza activities.
OPERATIONS, PREPAREDNESS, AND EMERGENCY RESPONSE
Appropriations, 2023.................................... $566,686,000
Budget estimate, 2024................................... 656,790,000
Committee recommendation................................ 541,686,000
The Committee recommends $541,686,000 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 $50,000,000 to ensure the
operational coordination and logistical support for the COVID-
19 response and other threats, as they arise.
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 $96,904,000, 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
continues to include $20,000,000 for ASPR to invest in next
generation air mobility solutions that will ensure more cost-
effective health delivery systems. The Committee supports the
establishment of a federally-funded research and development
center, led by an academic medical center, to improve far-
forward medical response, training and innovation, specifically
utilizing health information technology, unmanned aerial
systems, countermeasure delivery, and remote patient assessment
and triage.
Health Care Readiness and Recovery
The Committee's recommendation includes $305,055,000 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.
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.
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.
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.
MANUFACTURING AND PRODUCTION
Appropriations, 2023....................................................
Budget estimate, 2024................................... $400,000,000
Committee recommendation................................ 75,000,000
The Committee recommends $75,000,000 for ASPR's
Manufacturing and Production and 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 new
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.
Industrial Based Management and Supply Chain [IBMSC]
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.
Active Pharmaceutical Ingredients.--The Committee is
concerned with the National security risk of our increased
reliance on foreign-based sources of APIs, their chemical
components, and drug production. Key identified vulnerabilities
in the essential medicine supply chain include the current lack
of the ability to manufacture high-quality products for the
U.S. market, need for diversification of the drug supply chain,
and establishing redundancy in the supply chain, such as
incentivizing the existence of multiple manufacturers for each
product and its precursors. The Committee recognizes the
importance of domestic drug manufacturing and onshore
production of medicine and provided supplemental emergency
funding in pandemic relief legislation to support increased
U.S. based manufacturing capabilities. The Committee urges
IBMSC to engage in public-private partnerships for U.S. based
advanced manufacturing for APIs including their chemical
precursors for the SNS. The Committee directs IBMSC to provide
a report within 180 days of enactment detailing their efforts
to promote domestic drug manufacturing, including efforts
during the COVID-19 public health emergency, and
recommendations for Congress to support onshore pharmaceutical
production.
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.
Warm-Base Manufacturing for Diagnostics.--The Committee
remains concerned the COVID-19 pandemic has demonstrated the
need for warm-base manufacturing for U.S. domestic diagnostic
companies. Warm-base manufacturing programs for diagnostics,
like those established for vaccines, would be a significant
benefit to the United States and global health. In addition,
the pandemic highlighted the expansion and success of Over-the-
Counter [OTC] testing as a pivotal part of the Administration's
Test-to-Treat program to address the public health emergency.
The Committee encourages ASPR to continue to support the
investments made during the pandemic for testing, supply chain,
and surge capacity for U.S. diagnostic manufacturing to
maintain U.S. readiness and future preparedness. Further, the
Committee urges ASPR to promote policies for flexible
contracting and the expansion of OTC tests, and tests
appropriate for use in low resource settings, to improve public
health surveillance beyond COVID-19.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriations, 2023.................................... $601,972,000
Budget estimate, 2024................................... 704,566,000
Committee recommendation................................ 601,972,000
The Committee recommends $601,972,000 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 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.
Addressing Factors Related to Improving Health Outcomes.--
The Committee encourages the Secretary to support efforts to
coordinate health and social services, enable information
sharing on health and social services, and provide technical
assistance and related support for entities engaging in efforts
to better coordinate health and social services as authorized
in Public Law 117-328.
Adult Cellular Therapies.--The Committee encourages the
Department to support collaborative evidence development in
coordination with FDA, NIH, and HRSA, to fully operationalize
an outcomes database for adult cellular therapies that are FDA-
approved or being administered under FDA Investigational New
Drug or Investigational Device Exemption protocols. The
Committee also encourages engagement of experts and
stakeholders to define data types and standards necessary for
such a database.
Alzheimer's Advisory Council.--The Committee directs ASPE
to fulfill the legislative objectives for the Advisory Council
on Alzheimer's Research, Care, and Services, as created by the
National Alzheimer's Project Act (Public Law 111-375).
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 directs OASH, NIH, ASPR, CDC, and AHRQ
to jointly brief the Committee no later than 60 days after the
enactment of this act detailing how HHS and its agencies are
coordinating their AMR-related efforts, as well as domestic and
international AMR trends.
Artificial DNA Synthesis.--The Committee remains concerned
about the potential for state actors or terrorist organizations
to modify existing pathogens using DNA synthesis technologies
to create dangerous biological agents that could be used as
bioweapons. HHS, in collaboration with the Department of
Homeland Security [DHS], is currently required to establish and
regulate the list of biological agents and toxins that have the
potential to pose a severe threat to public health and safety,
referred to as ``Select Agents and Toxins.'' Current DNA
synthesis technologies are enabling the production of Select
Agents, as well as nontraditional Agents, that could pose a
significant risk to National Security and may not be covered by
current HHS select agent review or regulations. The Committee
is concerned by the potential for commercial DNA synthesis
providers to manufacture and distribute synthetic genetic
material (directly or indirectly through providing synthesizing
instruments) that could enable the production of infectious
forms of agents with potential to cause serious intentional or
unintentional harm. The Committee encourages the Secretary of
HHS to consult with DHS on the current threat landscape and for
the Secretary to evaluate the need for a regulatory framework
for screening synthetic genetic material to prevent the
mistaken or malicious production of biological agents.
Barriers to Behavioral Health Care for Students.--The
Committee encourages the Secretary to investigate barriers to
continuity of behavioral healthcare due to State licensing
agreements, particularly for students in higher education. The
Committee is concerned that students who move or reside out-of-
State from their primary behavioral health provider may not be
able to maintain access to their provider via telehealth. The
Committee directs the Secretary to submit a report within 1
year of enactment of this act on the circumstances under which
providers may be eligible to deliver telehealth services to
patients located out-of-State, with their informed consent,
including follow up care for patients in higher education with
an established therapeutic (patient-provider) relationship. The
report should also provide recommendations on how to alleviate
such barriers to care.
Bio-Attribution.--The Committee is aware that there is a
need to improve U.S. capacity to determine the origins of
serious future epidemics or pandemics, referred to as bio-
attribution whether they come from a natural, accidental, or
deliberate source. Having strong national bio-attribution
capabilities to allow the identification of a pandemic could
help to prevent further events. Developments in the
complementary fields of genomics, proteomics, metabolomics, and
data analytics provide opportunities for development of
improved bio-attribution capabilities. The Committee encourages
HHS to work with other government agencies towards the
development, maturation, and implementation of new bio-
attribution technologies through both internal government
scientific development programs, grants or contracts, as
appropriate.
Brain Aneurysm.--The Committee directs the Secretary to
develop best practices on brain aneurysm detection and rupture
for first responders, emergency room physicians, primary care
physicians, nurses, and advanced practice providers.
Breast Cancer Diagnostics.--The Committee remains concerned
about access to breast cancer diagnostic and supplemental
imaging for individuals with commercial insurance, including
financial barriers to care, and the financial costs associated
with delayed care. The Committee urges the Secretary to work
with Congress, and stakeholders to ensure adequate access to
diagnostic and supplemental breast imaging, which are integral
services of breast cancer screening and early detection. The
Committee also requests a report to Congress on existing
barriers to breast cancer diagnostic and supplemental imaging,
financial costs associated with delayed care relative to breast
cancer screenings, actions the Secretary could take to address
this issue, and recommendations to Congress on how to alleviate
such barriers within 180 days of enactment of this act.
Broadband Deployment.--The Committee notes that HHS has not
submitted the report on broadband deployment as requested in
the joint explanatory statement that accompanied Public Law
117-328. HHS is directed to submit the report to the Committees
on Appropriations detailing the progress it has made to date to
coordinate with the Federal Communications Commission and carry
outs its responsibilities to populate the Deployment Locations
Map pursuant to section 60105 of the Infrastructure and Jobs
Act (Public Law 117-58), including responsibilities not yet
fulfilled.
Children's Interagency Coordinating Council.--The
Consolidated Appropriations Act of 2023 provided HHS with
$3,000,000 to create a Children's Interagency Coordinating
Council to foster greater coordination and transparency on
child policy across agencies. The Committee requests that the
Department provide a briefing for the House and Senate
Committees on Appropriations on this effort within 90 days of
enactment of this act.
Continuous Manufacturing.--The Committee is concerned that
the lack of clear standards and realistic quality assessment
methods for continuous pharmaceutical manufacturing are
creating unnecessary risk for capital investments in advanced
manufacturing equipment. The Committee urges the Secretary to
issue updated guidance that provides clear standards and
realistic quality assessment methods for continuous
pharmaceutical manufacturing, such as by creating a monitoring
system for finished drug quality performance. Furthermore, the
Committee urges the Secretary to hold industry forums with
domestic pharmaceutical manufacturers and to make dedicated
staff available to assist innovators and drug manufacturers in
navigating the regulatory process for new and emerging advanced
manufacturing practices and technologies.
Dietary Guidelines.--The Committee notes that section 772
of division A of the Consolidated Appropriations Act, 2023
(Public Law 117-328) includes funding for the Secretary of
Agriculture, in consultation with the Secretary of HHS, to
enter into an agreement with the National Academies of
Sciences, Engineering, and Medicine [NASEM] to conduct a study
of the eight topics and scientific questions related to alcohol
previously published by USDA and HHS, and other relevant
topics. Section 772 further directs the Secretary of
Agriculture to ensure 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 United States Code, and
that it is fully transparent and includes a balanced
representation of individuals who are unbiased and free from
conflicts of interest. The Committee expects the Secretary of
HHS will ensure the same, and requests a briefing within 120
days of enactment on how HHS will incorporate the findings and
recommendations of the NASEM study into the process for
developing the 2025 Dietary Guidelines.
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.
Grants.gov.--Grants.gov, operated by HHS for all Federal
agencies, allows Indian tribes, Tribal organizations, and
Native Hawaiian organizations to search for Federal grants for
which they are eligible. Alaska Native Corporations [ANCs],
created by Congress, are not able to search for the funding
opportunities for which they are eligible in the same manner.
The Committee directs HHS to report within 120 days of
enactment on how the Department is ensuring ANCs are aware of
their eligibility through search functions on grants.gov.
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 2024 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.
Evaluation of 211 Hotlines.--The Committee directs ASPE, in
collaboration with ACF and ACL, and in consultation with State,
local, and Tribal governments, to conduct a study on the usage,
quality, shortcomings, and best practices of the 211 hotline
and submit a report to the Committee within 1 year of enactment
of this act on the findings of such study. The report shall
include findings on the prevalence of 211 hotline usage,
effectiveness of 211 referrals, any gaps in service coverage,
modes of communication used to disseminate information,
accuracy, timeliness, data protections, and satisfaction of 211
users. The report should also provide recommendations for the
improvement to the 211 hotline, including funding, technology,
accessibility, quality of social service information, and
measurement of outcomes.
Global Health Research.--The Committee requests an update
in the fiscal year 2025 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 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
between 19 and 59 be vaccinated for hepatitis B. The Committee
requests a report, in partnership with CDC, to be prepared
before the end of fiscal year 2024 on a government-wide
coordinated effort needed to make progress to meet this
vaccination goal. The Committee also urges HHS to take action
on its Viral Hepatitis National Strategic Plan.
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, CMS, SAMHSA, ACL,
and ASPE to provide direct technical assistance to communities
leveraging 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.
Impairment after Mastectomy.--The Committee is aware of
research demonstrating that long-term impacts after mastectomy
can lead to both functional impairment and quality of life
issues in breast cancer survivors. Impairment due to numbness,
muscle weakness, and chronic swelling may occur. The Committee
is aware that technological procedure advancements are now
available to shift the focus of reconstructive breast surgery
beyond cosmetic-only results to include the restoration of
typical breast functions, such as sensation. The Committee
requests that the Secretary, in collaboration with other
relevant HHS agencies, explore technological advances impacting
health outcomes after mastectomy. The Committee requests an
update in the fiscal year 2025 CJ about this issue.
Maternal Health.--The CDC recently released a new study on
the maternal mortality crisis in the United States, finding
that the rate has risen 40 percent since 2020, the highest
numbers in almost 60 years. The Committee is concerned with
these alarming statistics, and directs HHS to prioritize
efforts to improve maternal health outcomes and reduce maternal
mortality. The Committee directs HHS to focus on efforts to
improve coordination across maternal health programs, expand
the maternity care workforce, advance equity through the
development of a maternal health quality outcomes measure, and
enhance postpartum social supports for families.
Mental Health Grants.--The Committee supports the continued
efforts of the Federal Government in addressing the growing
mental health crisis across the country. The Committee
encourages the Secretary, in coordination with other Federal
agencies, to establish an interactive online dashboard to allow
the public to review information for Federal grant funding
related to mental health programs across agencies in order to
promote increased accessibility of Federal funding to
effectively address mental health.
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.
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.
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.
Polycystic Ovary Syndrome [PCOS].--Research shows that the
prevalence of PCOS, one of the most common endocrine disorders
in women-reported in health systems data is significantly less
than the population prevalence of PCOS. One potential factor in
underdiagnoses is a lack of education and awareness about the
disorder by healthcare professionals and patients. The
Committee urges HHS to increase education about PCOS among
medical and allied health providers within health systems and
insurers and work in partnership with PCOS patient
organizations to increase education and awareness among
patients. The Committee urges HHS to investigate and report on
gaps in care for PCOS patients regarding metabolic,
cardiovascular, cerebrovascular, mental, reproductive,
oncologic, maternal, and adolescent health, and any other
identified care gaps.
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] have been 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 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 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 2025 CJ.
Rural Media.--The Committee recognizes 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 the Federal public health advertising campaigns. To
further this goal, the Committee directs the Secretary, in
coordination with the Assistant Secretary for Public Affairs
and their media buyer contractors, to prioritize local news
media in rural areas for HHS Federal advertising campaigns to
reach citizens in these communities with key health messages.
Local media should include newspapers, including non-daily
newspapers, television, and radio. The Committee directs the
Office of the Secretary to provide to the Committee within 90
days of enactment an update on the efforts of the Department to
ensure that local media in rural areas are part of the
Department's public health advertising campaigns, including a
breakdown of money allocated to local media in rural areas for
each of the health focused public affairs campaigns for fiscal
year 2023.
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.
Stillbirth Working Group.--The Committee continues funding
for implementation of the Stillbirth Working Group's
recommendations across HHS, including at NIH and CDC.
Voting-Related Activities.--The Committee directs the
Secretary 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.
Wuhan Institute of Virology.--The Committee is encouraged
with the action Referral Memorandum issued on July 17, 2023,
with respect to the suspension and debarment of Wuhan Institute
of Virology, Chinese Academy of Sciences Capital Construction
from participating in the United States Federal Government
programs. The Committee directs the Department to provide a
report to the Committee within 30 days of enactment regarding
compliance with the Memorandum and ways the Department is
ensuring that Federal funds are not awarded to entities that
are likely to have failed to comply with Federal biosafety
requirements based on evidence that provides cause for
suspension under 2 C.F.R Sec. 180.700(a)-(c).
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 $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.
Center for Indigenous Innovation and Health Equity.--The
Committee continues $4,000,000 to support 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 and
policy among American Indians and Alaska Natives, as well as
institutions of higher education with a focus on Indigenous
health policy and innovation among Native Hawaiians/Pacific
Islanders. The Committee encourages the Center to both continue
and expand these efforts.
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. However, 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
supports 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 Committee notes that the Consolidated Appropriations
Act of 2023 (Public Law 117-328) included funding for HHS to
enter into an agreement with NASEM 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.
Women's Health Research Study.--To address the persistent
gaps of 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.
OFFICE OF MEDICARE HEARINGS AND APPEALS
Appropriations, 2023.................................... $196,000,000
Budget estimate, 2024................................... 199,000,000
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, 2023.................................... $66,238,000
Budget estimate, 2024................................... 103,614,000
Committee recommendation................................ 71,238,000
The Committee makes available $71,238,000, in transfers
available under section 241 of the PHS, 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 the ONC's rule to implement the interoperability and
information blocking provisions of the 21st Century Cures Act
took significant steps forward to give patients greater access
to and improve the electronic flow of electronic health
information across care settings. Given the significant
penalties and other consequences for information blocking, the
Committee urges ONC to provide regulated entities and other
affected stakeholders with clear, practical guidance regarding
foundational concepts in the rule. Guidance should clearly
outline how regulated entities can evaluate their particular
circumstances and scenarios against the rule's provisions,
including how to identify and apply relevant exceptions to the
information blocking definition.
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. An 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 an HIE or HIEs to be a State's HDU.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2023.................................... $87,000,000
Budget estimate, 2024................................... 116,801,000
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, 2023.................................... $39,798,000
Budget estimate, 2024................................... 78,000,000
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, 2023.................................... $710,327,000
Budget estimate, 2024................................... 792,691,000
Committee recommendation................................ 792,691,000
The Committee provides an estimated $792,691,000 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, 2023.................................... $137,892,000
Budget estimate, 2024................................... 278,318,000
Committee recommendation................................ 115,992,000
The Committee recommends $115,992,000 for the Public Health
and Social Services Emergency Fund [PHSSEF]. This appropriation
supports the activities to prepare for, respond to, and recover
from the consequences of a wide range of natural and man-made
medical and public health security threats and includes the HHS
Office of the Chief Information Officer Cybersecurity Program,
the Office of National Security [ONS], the Office of Global
Affairs [OGA], pandemic programs, and other HHS-wide
preparedness activities.
Cybersecurity
The Committee recommends $100,000,000 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.
PREVENTION AND PUBLIC HEALTH FUND
In fiscal year 2024, the level transferred from the PPH
Fund after accounting for sequestration is $1,225,900,000. The
Committee includes bill language in section 221 of this act
that requires that funds be transferred within 45 days of
enactment of this act to the following accounts, for the
following activities, and in the following amounts:
[In thousands of dollars]
------------------------------------------------------------------------
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 317 702,250,000
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 125,850,000
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.
Environmental Health............. Lead Poisoning 17,000,000
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 modifies a provision authorizing the
transfer of up to 2.8 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 includes a new provision related to
eligibility criteria for certain Head Start enrollees.
Section 237. The bill includes a new provision related to
eligibility criteria for certain Head Start enrollees.
Section 238. The bill includes a provision rescinding
funding from the Nonrecurring Expenses Fund.
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, 2023.................................... $19,087,790,000
Budget estimate, 2024................................... 21,254,551,000
Committee recommendation................................ 19,262,790,000
The Committee recommends $19,262,790,000 for programs in
the Education for the Disadvantaged account. Funds appropriated
in this account primarily support activities in the 2024-2025
school year.
Grants to Local Educational Agencies
The Committee recommends $18,561,802,000 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, 2023, for transfer
to the Census Bureau for poverty updates; $7,715,625,000 will
become available on July 1, 2024; and $10,841,177,000 will
become available on October 1, 2024. The funds that become
available on July 1, 2024, and October 1, 2024, will remain
available for obligation through September 30, 2025.
The fiscal year 2024 President's budget also proposes to
reserve up to $100,000,000 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 Improvement and Support.--The Committee appreciates
the Department's targeted monitoring of implementation of ESEA
requirements related to resource allocation reviews and
resource inequities. The Committee also appreciates this
summer's release of a dear colleague letter that shares
recommendations for effectively implementing these
requirements. The Department also must continue efforts to
assist SEAs and LEAs with implementing all of the school
improvement requirements of ESEA. The Committee is concerned
the Department has not identified any actions or plans to
implement direction in the explanatory statement accompanying
last year's appropriations act which directed the Department to
increase transparency on the amount reserved by each State for
the school improvement set aside, method of distribution to
eligible LEAs, and uses of such funds. The Committee directs
the Department to provide a briefing on actions taken and
planned to be taken to provide transparency for school
improvement investments, including information required to be
reported in State report cards.
Students Experiencing Homelessness.--The Committee
continues to be concerned by the challenges faced by students
experiencing homelessness and the continued lack of compliance
by LEAs with requirements intended to ensure such students
receive necessary amounts required to be reserved under section
1113(c)(3)(A) of the ESEA for a wide variety of services,
including 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. The Department has taken
important steps by recently revising its monitoring protocol
and planning to work with SEAs to ensure they provide guidance
on coordination between the LEA's title I and McKinney-Vento
staff and provide training on methods for determining required
set-aside amounts. 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 2025 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 last year's 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 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.
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. The fiscal year 2024 appropriation will support
approximately 12 new and continuation State grant awards and
funding reservations for Bureau of Indian Education schools,
the outlying areas, and national activities, including
evaluation.
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. In developing the
notice inviting applications for this program consistent with
the requirements of the ESEA, the Committee encourages the
Department to consider applications that include 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. In addition,
the Committee directs the Department to ensure that grants are
distributed among eligible entities that will serve
geographically diverse areas, including rural areas.
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.
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 urges the Department to increase its
direct and technical assistance support to further assist
grantees in their efforts to improve and report on program
outcomes.
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, 2023.................................... $1,618,112,000
Budget estimate, 2024................................... 1,618,112,000
Committee recommendation................................ 1,628,151,000
The Committee recommends $1,628,151,000 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 $1,477,000,000 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.
Student Weighting.--The Committee understands that this
year one LEA benefitting from increased student weighting for
serving a large total student and on-base military and civilian
connected student population has experienced a decline in total
student population that jeopardizes their eligibility for such
student weighting. Such a change could cause a significant
reduction in Impact Aid payment. The Committee notes there are
other changes impacting LEAs eligibility for Impact Aid and
understands the need for continued work to address these issues
in a comprehensive manner that reflects the input of all
stakeholders. The Department should be prepared to engage in
these discussions and seamlessly implement changes.
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 $19,000,000 for eligible LEAs for
school construction activities allocated through the authority
for formula grants to LEAs under section 7007(a) of the ESEA.
Payments for Federal Property
The Committee recommends $79,000,000 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, 2023.................................... $5,810,642,000
Budget estimate, 2024................................... 5,890,278,000
Committee recommendation................................ 5,820,642,000
The Committee recommendation includes $5,820,642,000 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 2024-2025 academic year. Of the
funds provided, $508,639,000 will become available on July 1,
2024, and $1,681,441,000 will become available on October 1,
2024. These funds will remain available for obligation through
September 30, 2025.
The Committee notes that title II, part A funds can be
targeted toward effective preparation and professional
development designs that enable teachers and school leaders to
expand their knowledge and skills regarding the sciences of
child and adolescent learning and development, including
teaching challenging content, teaching diverse learners, and
supporting social-emotional and academic development in
culturally and linguistically responsive ways.
Supplemental Education Grants
The Committee recommendation includes $24,464,000 for
supplemental education grants to the Republic of Marshall
Islands [RMI] and the Federated States of Micronesia [FSM].
This grant program was authorized by the Compact of Free
Association Amendments Act of 2003 (Public Law 99-239). Under
the Compact, funds were transferred from the Department to the
Secretary of the Interior for grants to these entities. The
Committee bill continues language requested in the budget and
contained in previous appropriations acts that allows the
Secretary of Education to reserve 5 percent of these funds to
provide FSM and RMI with technical assistance.
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. 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. 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.
The Committee recommendation does not include language
proposed in the President's budget that would provide up to
$100,000,000 in grants to LEAs for a new demonstration program
that would develop, improve, or scale-up diagnostic and
formative assessments.
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 recommendation includes new language
providing an additional 12 months for educational agencies and
institutions to obligate and expend EHCY funds provided last
year and in this year's act.
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 recommendation provides $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 recommendation continues the set-aside
established last year 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. The Committee intends increased funds
above the prior year be used for this purpose, which shall be
made competitively available to organizations in need of
assistance with infrastructure improvement for increased
capacity to serve 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.
Use of Funds.--The Committee continues language that allows
funding provided by this program to be used for construction
and overriding the authorizing statute's requirement to make
noncompetitive awards to certain organizations.
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 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.
Rural Education
The Committee recommends $220,000,000 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 continue to fall this
fiscal year through fiscal year 2027. The Committee has also
increased funding for the Rural Education Achievement Program
in the fiscal year 2021 through 2023 bills and recommends an
increase of $5,000,000 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 includes bill language that will hold the affected
LEAs harmless 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 understands the Department is considering
changes for the scheduled 2024 competition for regional and
content centers. The Committee requests a briefing not later
than 14 days prior to issuance of a notice of proposed
priorities or notice inviting applications on how the
assessments of the Regional Advisory Committees and other
regional surveys are reflected in these notices.
Student Support and Academic Enrichment Grants
The Committee recommendation includes $1,400,000,000 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.
Report on Use of Funds.--The Committee understands the
Department is conducting an implementation study that will
gather information on how LEAs determined the uses of SSAE
grant funds, the primary services and activities implemented
with such funds and the support from SEAs for implementation of
the program. The Committee looks forward to the publication of
the report in early 2024. In addition, the Department should
continue to analyze and report on expenditures by statutory
program areas and the percentage of LEAs spending funds in each
of these areas.
Technical Assistance and Capacity Building.--The Committee
appreciates the information provided in the fiscal year 2024 CJ
on expenditures for the 2 percent set-aside for technical
assistance and capacity building from the fiscal year 2022
appropriation. The reservation for technical assistance [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 such 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.
School Readiness
Appropriations, 2023....................................................
Budget estimate, 2024................................... $500,000,000
Committee recommendation................................................
The Committee does not include funds for a newly proposed
School Readiness account.
Preschool Incentive Demonstration Program
The Committee recommendation does not includes 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, 2023.................................... $194,746,000
Budget estimate, 2024................................... 201,746,000
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 continues support for the Indian
Education Professional Development Program to effectively
prepare and address the need for American Indian/Alaska Native
teachers and administrators.
In addition, the Department shall continue support for the
teacher retention-initiative established in fiscal year 2023 to
address the shortage of Native American educators and expand
their impact on Native American students' education. The
initiative should support teacher leadership models to increase
the retention of effective, experienced Native American
teachers.
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 President's budget includes
appropriations language overriding the authorized funding level
for this program. The Committee bill continues language, 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 $2,885,000 for Native
American Language Immersion Programs. If the Department makes
new awards in fiscal year 2024, 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 most
extensive 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 notes that Hawaiian is a Native American
language defined under the Native American Language Act, and
that the Department website specifically lists Native Hawaiian
organizations as eligible for funding under the Native American
Language program. The Committee further notes that while almost
half of the Native students enrolled in Native American
language immersion schools or programs are taught in the medium
of Hawaiian, there has not been a single Hawaiian language
school or program grantee in the years the Department has
administered this program. Therefore, the Committee is
concerned the Department has failed to provide adequate notice
of Native American Language program funding opportunities or to
seek meaningful engagement with the Native Hawaiian community.
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 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 elementary schools, secondary schools,
and institutions of higher education to include Native American
languages in the curriculum 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. To that end, the Committee provides $2,965,000
to carry out the policy set forth in Public Law 117-335 and
direction provided in fiscal years 2022 and 2023 to establish
Native American Language Resource Centers. Furthermore, the
Committee directs the Office of Indian Education to continue
consulting with the Office of English Language Acquisition on
the continued development, implementation, and support of the
centers.
Innovation and Improvement
Appropriations, 2023.................................... $1,453,443,000
Budget estimate, 2024................................... 1,604,000,000
Committee recommendation................................ 1,236,844,000
The Committee recommends $1,236,844,000 for programs within
the Innovation and Improvement account. This amount includes an
additional $87,344,000 provided by a general provision at the
end of this title of the bill.
Education Innovation and Research
The Committee recommendation includes $240,000,000 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. The Committee
recommendation supports a robust competition for new awards of
approximately $225,000,000.
Briefing Requirement.--The Committee requests the
Department brief the Committees on the fiscal year 2024 funding
opportunities available under this program, including any
proposed priorities, not less than 14 days prior to publication
in the Federal Register.
Data Science Education.--The Committee encourages the
Department to invite eligible applications that propose the
development and implementation of effective interventions to
support 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.
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.
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.
School Leader Recruitment and Support
The Committee recommendation does not include funding for
the School Leader Recruitment and Support [SLRS] program. The
President's budget proposed $40,000,000 for SLRS. This program
is authorized to provide competitive grants for improving the
recruitment, preparation, placement, support and retention of
effective principals and other school leaders in high-need
schools.
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 bill includes new
language modified from last year's enacted bill to increase
flexibility within the program to effectively respond to the
changing needs of the sector and 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 and earlier in the fiscal year. The new language allows
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 Committee bill provides extended
availability through March 31, 2025 for continuation grants for
existing CMO grantees making substantial progress on their
awards. 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.
In addition, 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.
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.
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.
Fiscal Year 2024 Priorities.--The Committee requests a
briefing not later than 14 days prior to the publication of a
notice of proposed priorities or notice inviting applications
for fiscal year 2024 funds.
Teacher and School Leader Incentive Grants
The Committee recommendation includes $120,000,000 for
Teacher and School Leader Incentive Grants. At this level, the
Department would have sufficient funding for all non-
competitive continuation awards and approximately $20,000,000
for renewal awards. The Committee requests a briefing not later
than 14 days prior to obligating funds for new activities,
including renewal awards expected to be made at this funding
level. 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 $30,000,000 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.
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 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.
The Committee recommendation only includes sufficient funds
for continuation grants and does not include proposed language
for Civics Participatory Learning and Engagement Grants.
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.
Parental and Family Engagement.--The Committee
recommendation sustains the increased resources provided the
past 2 years that has enabled the Department to support 20
centers providing technical assistance to SEAs, LEAs and
relevant organizations to increase parental and family
engagement to improve educational outcomes. The Committee urges
the Department to continue to support educators, principals,
school leaders, specialized instructional support personnel,
and other school staff in implementing evidence-based parental
and family engagement activities to address chronic absenteeism
and other urgent issues facing students, parents, and families,
such as home visitation programs, effective professional
development, afterschool and summer activities, and the
provision of resources in the home languages of families.
Fostering Diverse Schools
The budget includes $100,000,000 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 $87,344,000 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, 2023.................................... $457,000,000
Budget estimate, 2024................................... 1,075,000,000
Committee recommendation................................ 437,000,000
The Committee recommends a total of $437,000,000 for
activities to promote safe schools, healthy students, and
citizenship education.
Promise Neighborhoods
The Committee recommendation includes $91,000,000 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.
School Safety National Activities
The Committee recommendation includes $196,000,000 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 $60,000,000 is available for new awards. 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 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 $44,000,000 for continuation awards for the 2022
cohort of grantees under the Mental Health Services
Professional Demonstration Grant Program and $56,000,000 for
continuation awards for the 2022, 2021, and 2020 cohorts of
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 2024.
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.
Project Prevent.--The Committee recommendation includes
just more than $8,000,000 to continue existing Project Prevent
grants. These grants are helping increase the capacity of LEAs
in communities with high rates of violence to address the needs
of students, including by supporting trauma-informed practices,
and help break the cycle of violence.
GAO Study of Substance Misuse Prevention.--The Committee is
concerned about the increase of K-12 students using and abusing
substances like opioids, tobacco, and vaping. The Committee
appreciates GAO's work to evaluate and improve the Federal
effort to improve drug prevention efforts. The Committee
directs GAO to report on the extent to which States require the
use of evidence-based drug education and prevention programs in
schools. GAO shall also report on how the Federal Government
helps address challenges schools face in implementing such
programs, especially in rural areas, and make recommendations
on best practices for incorporating educational materials on
the harmful impacts of substance misuse and abuse. The
Committee requests GAO provide a preliminary briefing not later
than 200 days after the date of enactment of this act and to
provide a full report on the findings of the review as
determined at the briefing.
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. The Committee appreciates
the Department adopted a priority for State scaling grants for
implementation of the program in fiscal year 2023. The
Committee believes prioritizing commitments by States to
sustain the Federal investment made by this program is a
powerful way to leverage these funds and support the growing
evidence base that this approach improves student outcomes and
school performance.
The Committee recommendation does not include language
proposed in the President's budget allowing up to $10,000,000
to be awarded as planning grants, $25,000,000 to be used for
grants to LEAs to provide integrated student supports language,
and up to 2 percent of Full-Service Community Schools funds to
provide technical assistance to grantees.
English Language Acquisition
Appropriations, 2023.................................... $890,000,000
Budget estimate, 2024................................... 1,195,000,000
Committee recommendation................................ 897,000,000
The Committee recommends an appropriation of $897,000,000
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. National activities funds
shall be 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, 2023.................................... $15,453,264,000
Budget estimate, 2024................................... 18,179,373,000
Committee recommendation................................ 15,661,764,000
The Committee recommends an appropriation of
$15,661,764,000 for special education programs.
Grants to States
The Committee recommendation includes $14,368,704,000 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 2024-2025 academic
year. Of the funds available for this program, $5,085,321,000
will become available on July 1, 2024, and $9,283,383,000 will
become available on October 1, 2024. These funds will remain
available for obligation through September 30, 2025.
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 $560,000,000 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 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 $75,345,000 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 $36,000,000 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 $134,500,000 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. The Committee
notes the critical role the Personnel Preparation program plays
in helping to address the Nation's shortage of teachers for
students with disabilities. Given the critical shortage of
special education teachers, including the higher education
special education faculty who prepare them, the Committee
recommends that the Office of Special Education Programs
prioritize additional investments in doctoral level personnel
preparation in special education.
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.
Education Materials in Accessible Formats for Students with
Visual Impairments.--The Committee recognizes the ongoing
progress made with the tools and services provided under the
Educational Technology, Media and Materials program that have
allowed more than 900,000 students with disabilities free
access to more than 1.0 million books in digitally accessible
formats while creating systemic change in the publishing
industry by equipping publishers with tools and processes to
make their products ``Born Accessible,'' ensuring all students
can use the same educational materials.
The Committee recognizes that to meet the educational needs
of more students with print disabilities, new investments are
required to develop technology and expand capacity so that the
growing diversity of educational materials, such as teacher
curated educational materials not included in standard
textbooks, are also available to eligible students in a timely
manner. Additionally, the Committee recognizes the benefit of
making more accessible educational materials available to pre-K
and postsecondary students in addition to the K-12 student
population, which requires additional resources and greater
capacity to process and convert a larger volume of educational
materials into accessible formats. The Committee recommendation
continues to include funding to make a broader range of
educational materials available to students and to meet the
needs of all eligible students, including pre-K and
postsecondary students.
Rehabilitation Services
Appropriations, 2023.................................... $4,092,906,000
Budget estimate, 2024................................... 4,405,533,000
Committee recommendation................................ 4,397,033,000
Vocational Rehabilitation State Grants
The Committee recommends $4,253,834,000 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.
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.
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, 2023.................................... $43,431,000
Budget estimate, 2024................................... 43,431,000
Committee recommendation................................ 43,431,000
The Committee recommends $43,431,000 to help support
American Printing House for the Blind [APH].
APH provides educational materials to students who are
legally blind and enrolled in programs below the college level.
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 textbooks 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 expand assistive
technology training resources and regional partnerships into
additional States to assist schools, teachers, parents, and
students throughout the Nation. In addition, within amounts
provided for APH, the Committee includes up to $5,000,000 to
support additional field testing and initial production and
distribution of an innovative braille and tactile display
product developed by the Printing House and its partners.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2023.................................... $92,500,000
Budget estimate, 2024................................... 92,500,000
Committee recommendation................................ 92,500,000
The Committee recommends $92,500,000 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 for NTID's Regional STEM Center
[NRSC] program. The NRSC 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, 2023.................................... $165,361,000
Budget estimate, 2024................................... 165,361,000
Committee recommendation................................ 165,361,000
The Committee recommends $165,361,000 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 up to $8,500,000
for ELAP, which supports early language acquisition for
children from birth through age three who are deaf or hard of
hearing. This program 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, 2023.................................... $2,191,436,000
Budget estimate, 2024................................... 2,447,900,000
Committee recommendation................................ 2,211,436,000
Career and Technical Education
The Committee recommends $1,482,269,000 for Career and
Technical Education [CTE] programs.
State Grants.--The Committee recommends $1,469,848,000 for
CTE State grants. Funds provided under the State grant program
assist States, localities, and outlying areas to expand and
improve their CTE program and help 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 109-270).
Of the funds available for this program, $678,848,000 will
become available July 1, 2024, and $791,000,000 will become
available on October 1, 2024. These funds will remain available
for obligation until September 30, 2025.
National Activities.--The Committee recommendation includes
$12,421,000 for national activities, including up to $6,100,000
for Innovation and Modernization grants.
The Committee encourages 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,
career and technical education programs related to the skills
needed for new submarine construction.
The Committee encourages the Department to support
Innovation and Modernization grants for evidence-based school-
based mentoring programs focused on providing students with
social-emotional and other skills and experiences needed to be
successful in the workplace.
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.
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.
Student Financial Assistance
Appropriations, 2023.................................... $24,615,352,000
Budget estimate, 2024................................... 26,415,352,000
Committee recommendation................................ 24,595,352,000
The Committee recommends an appropriation of
$24,595,352,000 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 $6,585 for the
discretionary portion of the maximum Pell grant award, an
increase of $250. Combined with mandatory funding, under
current law, this would provide a total maximum award of $7,645
for the 2024-2025 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. Given that regulations for the new Prison
Education Program are expected to be finalized during fiscal
year 2024, 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 $900,000,000 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 $1,220,000,000 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 (Public Law 89-
329), as amended.
Student Aid Administration
Appropriations, 2023.................................... $2,033,943,000
Budget estimate, 2024................................... 2,654,034,000
Committee recommendation................................ 2,183,943,000
The Committee recommends $2,183,943,000 for the Student Aid
Administration account. These funds are available until
September 30, 2025, 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, largely related to the resumption of
Federal student loan payments starting in September 2023 and
helping borrowers to reenter repayment. The Committee
recommendation also includes an increase because it reflects
the annualized costs of administering Federal student aid
programs in fiscal year 2024. In fiscal year 2023 the
Department shortened the length of contracts to limit the
effect of level funding on students and borrowers. This created
one-time savings in fiscal year 2023 but only by shifting costs
to and significantly increasing funding needs in fiscal year
2024.
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 provide
notification to the Committees not later than 7 days after
issuing a student loan servicing contract Change Request [CR],
including a summary of any new requirements, adjustments to
existing requirements, or removal of requirements in the CR.
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
urges the Department to conduct a study to thoroughly
understand the impact of the new requirement for students to
report the farms their families live on as assets for purposes
of applying for Federal student aid.
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 to the Committees on
Appropriations 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 progress
related to implementation of title IV of division B of the
Fiscal Responsibility Act of 2023 (Public Law 118-5) for
Federal student loans during fiscal year 2024. The briefings
should include information on borrower status, including the
percentage of borrowers in repayment by repayment plan and the
percentage of borrowers who are delinquent or not making
payments, metrics on communications with borrowers, such as
open rates for emails, and any changes to communications with
borrowers based on data or behavioral economics assumptions.
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 to ensure such
organizations have a role in any new Federal student loan
servicing environment. With the resumption of student loan
payments, it is more important than ever that student borrowers
are supported by mission-based organizations, like these State-
based and non-profit organizations, that have longstanding
experience in providing proactive borrower advocacy services.
The Committee strongly encourages the Department to explore
incentives for Federal student loan servicers to subcontract
with such organizations.
Higher Education
Appropriations, 2023.................................... $3,526,037,000
Budget estimate, 2024................................... 3,986,621,000
Committee recommendation................................ 3,260,429,000
The Committee recommends an appropriation of $3,260,429,000
for higher education programs.
Aid for Institutional Development
The Committee recommends $1,027,116,000 for Aid for
Institutional Development. These totals do not include
separately authorized and appropriated mandatory funding.
Strengthening Institutions.--The Committee recommends
$112,070,000 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 $231,547,000 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 supports funding for programs that promote
and support collaboration between Hispanic-serving institutions
and local educational agencies 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 $27,769,000 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 encourages the Department to prioritize
awards for projects that support consortiums of Hispanic-
Serving Institutions 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 $402,585,000 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 $102,462,000 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 $22,672,000 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 $18,899,000 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 $24,840,000 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.
Strengthening Native American-Serving Non-Tribal
Institutions.--The Committee recommends $11,595,000 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.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $52,408,000 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.
Strengthening Master's Degree Programs at Historically
Black Colleges and Universities.--The Committee recommends
$20,269,000 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 $73,353,000
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.
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 $1,191,000,000 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 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 Educational Opportunity Centers [EOC] have a
long history of helping justice-impacted adults to enroll in
college. The upcoming 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 $388,000,000 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, 2024, 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 $83,000,000 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 creating model
teacher preparation and residency programs.
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 encourages the Department to work with
CCAMPIS grantees to conduct direct outreach to student parents
regarding State and Federal public benefits, the Child Tax
Credit, and education tax benefits for which the student parent
may be eligible.
Fund for the Improvement of Post-Secondary Education
The Committee recommendation includes $324,979,000 for the
Fund for the Improvement of Post-Secondary Education.
Basic Needs Systems Grants.--The Committee includes
$10,000,000 for competitive grants to IHEs, consortia of IHEs,
or a system of higher education, that enroll a significant
population of low-income students to advance systemic solutions
to student basic needs security. These grants shall prioritize
strengthening strategic integrations of student supports which
could include improving data infrastructure to facilitate data
matching and streamlining student eligibility determinations,
and other innovative solutions to better connect students to
supports. The Committee strongly encourages the Department to
include connecting students to mental health resources as a key
element of addressing student's basic needs. The Committee also
strongly encourages the Department to prioritize IHEs with a
significant percentage of Pell-eligible students, including
community colleges, HBCUs, and other MSIs.
Open Textbook Pilot.--The Committee recommendation includes
$7,000,000 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.
Postsecondary Student Success Grants.--The Committee
recommendation includes $45,000,000 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.
Research and Development Infrastructure Investments at
HBCUs, TCCUs, and MSIs.--The Committee recommendation includes
$25,000,000 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 $35,000,000 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.
Congressionally Directed Spending.--The Committee
recommendation includes $202,979,000 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.
Howard University
Appropriations, 2023.................................... $354,018,000
Budget estimate, 2024................................... 347,018,000
Committee recommendation................................ 304,018,000
The Committee recommends an appropriation of $304,018,000
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 $77,325,000 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.
In addition to ongoing support for operations of Howard
University Hospital, the Committee recommendation includes
$50,000,000 to support 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 assumes the remaining
planned Federal contribution would be provided in fiscal year
2025.
College Housing and Academic Facilities Loans Program
Appropriations, 2023.................................... $298,000
Budget estimate, 2024................................... 321,000
Committee recommendation................................ 298,000
Federal Administration.--The Committee bill includes
$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, 2023.................................... $20,678,000
Budget estimate, 2024................................... 20,750,000
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 $377,340,824 in new loan volume
in fiscal year 2024. In addition, the Committee recommendations
includes $528,000 for administrative expenses.
Institute of Education Sciences
Appropriations, 2023.................................... $807,605,000
Budget estimate, 2024................................... 870,868,000
Committee recommendation................................ 793,106,000
The Committee recommends $793,106,000 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 objective and valid
research-driven knowledge that was free of political influence
or bias so as to better inform effective education practices at
the State and local levels. 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 2025 and future CJs, as well as the
fiscal year 2024 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 full-time equivalent
employment [FTE] by national center, and an explanation by
national center for FTE changes from the preceding quarter.
Reports providing sufficient information on each of these
required elements will satisfy the Committee's staffing report
directive under the Program Administration account.
Collaborative Education Research.--The Committee recognizes
the ongoing collaborative efforts between IES and the National
Science Foundation, 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, which may include support for
Centers for Transformative Education Research and Translation.
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
last year's publication of the ``The Future of Education
Research at IES''. This report provides recommendations to
build on the research supported by IES over the past 20 years.
The Committee encourages IES to continue implementation of
recommendations made in the report and requests the fiscal year
2024 operating plan include a discussion of actions taken and
planned.
Methods Training in Data Science for Education
Researchers.--The Committee is aware IES invited applications
for proposals that would support training in applying data
science methods within education research and expects to
announce awards later this year. The Committee looks forward to
receiving more information about these awards and requests IES
describe additional data science-related actions in its fiscal
year 2024 operating plan.
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.
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 2024 operating plan include a
discussion of actions taken and planned.
REGIONAL EDUCATIONAL LABORATORIES
The Committee recommends $53,733,000 to continue support
for the Regional Educational Laboratories [REL] program. Given
the 2-year availability of funding, REL annual contract costs
of the 10 laboratories of approximately $55,000,000 are paid
for out of the fiscal year 2023 appropriation and resources
provided by this act. The Committee intends to sustain the
programs of research the laboratories have developed for the
current 2022-2027 contract cycle.
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
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 $28,500,000 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;
improve data access and use for research and evidence-based
policy- and decision-making; 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.
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.
Additional funds are provided to help carry out an assessment
framework update and increased communications efforts ahead of
the 2024 Nation's Report Card.
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
2025 CJ and fiscal year 2024 operating plan describe
implemented and planned strategies for cost efficiencies and
necessary research and development projects.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2023.................................... $426,907,000
Budget estimate, 2024................................... 527,609,000
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.
The budget requests $19,250,000, to remain available until
expended, to relocate staff and renovate and repair Department-
occupied buildings. The act does not include funding
specifically for building modernization, but notes that the
Department may use the Nonrecurring Expenses Fund for this
purpose, as it has this year.
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.
Cybersecurity.--The Committee is aware that elementary and
secondary schools have faced significant impacts resulting from
cybersecurity incidents. Last year, GAO made three
recommendations for the Department intended to better
coordinate cybersecurity efforts between government agencies
and the elementary and secondary school community, measure the
effectiveness of cybersecurity-related products and services
available and, in coordination with Federal and non-Federal
stakeholders, determine how to best help LEAs overcome
challenges for addressing cyber threats. The Committee requests
an update in the fiscal year 2025 CJ on the Departments actions
and plans (and associated timeline) for implementing these
recommendations.
Education Department General Administrative Regulations.--
The Committee notes with approval that the Department plans to
revise and update the Education Department General
Administrative Regulations [EDGAR] including amending areas
that are outdated. The Committee is concerned that these plans
were announced in the Regulatory Agenda for Fall 2021 but the
Department has not yet issued a notice of proposed rulemaking.
The Committee urges the Department to modernize and updateo the
construction provisions starting at 34 CFR 76.600. Given this
delay, the Committee expects the Department has used this time
to conduct stakeholder engagement and public input processes to
inform the development of proposed revisions.
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 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 its planned
actions and associated timeline for implementing this
directive.
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.
Such disclosures increase transparency and are in support of
national security and academic integrity. The Department makes
such information publicly available on its website. The
Committee notes the Department provides on its website a
repository of guidance and other resources related to section
117 reporting. The Committee strongly urges the Department to
work with IHEs to ensure they are fully complying with this
statutory requirement and requests an update in the fiscal year
2025 congressional justification on these efforts.
Additionally, the Department shall report to the Committee on
the presence and influence of Confucius Institutes and any
steps it has taken to address undue influence within
institutions of higher education.
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 2025 and future CJs updates on the
implementation and planned implementation of such act for the
current and future budget years.
GAO Study Holocaust Education.--The Committee directs the
GAO to conduct a study on the use of K-12 educational resources
devoted to Holocaust education. The review should describe
State mandates about the Holocaust, and other relevant
information, such as associated funding levels, standards, and
methods for ensuring school compliance with State requirements
and standards; as well as Federal resources available to
support Holocaust education.
``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 particularly among underserved
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 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 1 to not more than 4
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 on how to protect 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 Department should announce its policy
and process as soon and transparently as possible to grant
ESSER liquidation extensions for ARP. The Department's revised
policy should be released as soon as possible but no later than
September 30, 2023. The Department shall ensure that its
process for ARP ESSER late liquidation requests minimizes the
administrative burden on SEAs and LEAs to the extent
practicable, including by not requiring excessive
documentation. The Committee appreciates the Department's
frequently asked questions, June 26, 2023 clarification, and
availability to speak with State or other auditors about the
late liquidation process. The Department must also provide
explicit clarity outlining how its guidance can be implemented
consistent with 2 CFR 200.403(h). 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.
Micro-Credentialing.--The Committee recognizes the unique
educational and workforce challenges in rural and underserved
areas and encourages the Department to support colleges and
universities serving rural and underserved communities
implementing micro-credentials.
National Advisory Council on Indian Education [NACIE].--The
Committee is aware of the GAO recommendation to the Department
to develop a formal process for incorporating the input of its
Tribal advisory council, NACIE, into its annual budget request.
The Committee directs the Department to implement this
recommendation as soon as possible and ensure Tribal officials
are able to provide meaningful and timely input on annual
budget requests for programs serving tribes and their members.
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 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.
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
colleges and universities 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 fiscal year 2023 explanatory
statement raised concerns with the Department's prioritization
of staff resources and directed the Department to begin
rebalancing the agency's ratio of career staff to non-career
staff, out of concern with the agency's prioritization of staff
resources and to ensure adequate career staff for executing
core programs, such as in grants offices and the Budget
Service. To ensure this rebalancing occurred, the fiscal year
2023 explanatory statement also directed the Department not to
expand its non-career staff on-board above December 2022
levels. While the Committee is pleased to see that the
Department has begun to fill key career staff positions and
understands some non-career hires may have already been
advanced in the hiring process, the Committee is extremely
concerned that the number of non-career staff has gone up
contrary to the directive in the fiscal year 2023 explanatory
statement. This is even more important with nondefense
discretionary spending limits recently established under the
Fiscal Responsibility Act of 2023. The Committee directs the
Department to reduce non-career FTE on-board to December 2022
levels or below, and it reiterates the fiscal year 2023
directive to continue rebalancing career and non-career staff.
Not later than 30 days after enactment, the Department is
directed to provide the Committee with a briefing and a written
plan on how the Department will comply with these directives.
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.
Reorganization Plans.--The Committee recommendation
continues all directives included in the Consolidated
Appropriations Act, 2021 (Public Law 116-94) and the
accompanying explanatory statement.
Reports to Congress.--The Department is directed to provide
5 business days' notice to the Committee before release of any
congressionally directed report.
Staffing Report.--Consistent with the fiscal year 2023
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 appreciates
the Department's planned targeted monitoring effort this year
on a sample of SEAs and LEAs with respect to applicable report
card requirements of ESEA. The Committee requests an update in
the fiscal year 2025 CJ on the findings from this targeted
monitoring effort and the Department's planned actions to
support SEAs and LEAs in achieving compliance with these
requirements and improving the quality, accessibility
(including language and data visualization) and utility of
report card information available to parents, educators, and
policymakers. This update should also provide steps the
Department will take to support the inclusion of available
information on postsecondary enrollment under section
1111(h)(1)(C)(xiii), which could include enrollment information
with and without remediation at the discretion of a State.
Strengthening Data Capacity and Infrastructure.--The
Committee urges the Secretary to clarify for grantees when
improving data capacity, including integrated data
infrastructure, analysis activities, and human capacity, is a
permissible use of grant funds. Further, for grantees of
programs where this is an eligible use of funds, the Secretary
should provide technical assistance, highlight best practices,
and take other steps to encourage State and local grantees to
build this capacity, which is essential to understanding
student needs, improving coordination across programs,
measuring results, and evaluating which strategies and
interventions are most effective while maintaining the privacy
of individuals' data.
Suicide Prevention Resources.--The Committee encourages the
Department to pursue policies that will increase student
awareness of mental health resources, such as urging
institutions of higher education to prominently include phone
numbers for the National Suicide Prevention Lifeline and campus
resources in materials and documents routinely provided to
students.
Teacher and School Leader Diversity Guidance.--The
Committee recognizes that increasing educator diversity can
help build a strong educator workforce that supports students
and educators from all backgrounds and is aligned with the
Department's commitment to equitable impact of Federal
education funding. The Committee looks forward to the
Department's planned release of guidance on how formula funds
across various programs, including Title I-A, Title II-A, Title
III, Title V-B, and Title VI of the ESEA, Title III of the HEA,
and Part B of the IDEA may be used by SEAs, LEAs and IHEs to
increase teacher and school leader diversity, including through
pre-service support, enhancing preparation, providing on-the-
job support, and strengthening retention and promotion
policies.
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.
Voting-Related Activities.--The Committee directs the
Secretary 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.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2023.................................... $140,000,000
Budget estimate, 2024................................... 177,600,000
Committee recommendation................................ 140,000,000
The Committee recommends $140,000,000 for the Office of
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. The Committee urges continued efforts,
including timely processing of all complaints, including those
relating to antisemitism. Within available resources, OCR
should also consider appropriate funding for the work of the
Outreach, Prevention, Education & Nondiscrimination Center.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2023.................................... $67,500,000
Budget estimate, 2024................................... 87,497,000
Committee recommendation................................ 67,500,000
The Committee recommends $67,500,000 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.
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 modifies a provision rescinding
fiscal year 2024 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.
Section 313. The bill modifies a provision rescinding
unobligated balances available for the Pell Grant program.
TITLE IV
RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriations, 2023.................................... $13,124,000
Budget estimate, 2024................................... 15,400,000
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 117-328.
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 $1,262,806,000.
Grantee Match Requirements.--The Committee notes that CNCS
opened a request for comment on grantee match requirements on
May 5, 2023. The Committee recognizes the value of the unique
Federal-State and public-private partnership model embodied in
CNCS programs and is aware of concerns about the impact of
existing matching requirements. The Committee encourages CNCS
to thoroughly review stakeholder comments and asks that it
submit to the Committees on Appropriations a report outlining
action CNCS may undertake using its existing authorities and
resources as a result of that review and recommendations for
any appropriate changes to those requirements that may fall
outside the scope of CNCS' current authorities.
OPERATING EXPENSES
Appropriations, 2023.................................... $975,525,000
Budget estimate, 2024................................... 1,138,618,000
Committee recommendation................................ 975,525,000
The Committee recommends $975,525,000 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 $557,094,000 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 encourages 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.
Commission Investment Fund [CIF].--The Committee
recommendation includes no less than the fiscal year 2023 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 2025 Congressional
Justification, on the modifications CNCS may make and if any
congressional action is required to authorize or help implement
the changes.
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, 2023.................................... $230,000,000
Budget estimate, 2024................................... 213,000,000
Committee recommendation................................ 180,000,000
The Committee recommends an appropriation of $180,000,000
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.
The Committee also recommends a rescission of $243,000,000 from
the surplus unobligated balances in the Trust, which is
$33,000,000 above the budget request level.
SALARIES AND EXPENSES
Appropriations, 2023.................................... $99,686,000
Budget estimate, 2024................................... 118,434,000
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, 2023.................................... $7,595,000
Budget estimate, 2024................................... 8,572,000
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, Prior act............................... $595,000,000
Budget estimate, This act............................... 635,000,000
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 2026 for CPB to
carry out its statutory mission of sustaining the public-
private partnership underpinning public media and $60,000,000
for fiscal year 2024 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.
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.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriations, 2023.................................... $53,705,000
Budget estimate, 2024................................... 55,815,000
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, 2023.................................... $18,012,000
Budget estimate, 2024................................... 18,657,000
Committee recommendation................................ 18,012,000
The Committee recommends $18,012,000 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, 2023.................................... $294,800,000
Budget estimate, 2024................................... 294,800,000
Committee recommendation................................ 289,800,000
The Committee recommends $289,800,000 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 no less than $3,000,000 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 directs IMLS to submit a report to the
Committees on information literacy activities implemented,
including website development and support for locally-driven,
pilot projects established, and future plans, within 1 year of
the date of enactment of this act.
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 recognizes 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.
Matching Funds Requirements.--The Committee is aware of the
challenge faced by museums during the COVID-19 pandemic. The
Committee requests IMLS provide in its fiscal year 2025 CJ
information on statutory and administrative barriers to IMLS
grant support of eligible museum's programs and activities and
unmatched museum grant funding opportunities; and steps IMLS
has taken to assist the museum community with understanding
cost-share requirements and accessing Federal support needed to
operate effective museum programs.
Tribal Consortia Eligibility.--The Committee instructs the
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 directs the
GAO to conduct a study on the physical condition of library and
museum facilities in the United States and report preliminary
findings to the Committee within 18 months of the date of
enactment. The GAO's study shall examine the availability and
condition of library and museum facilities, separated by
geographic region including non-contiguous States, urban,
rural, and frontier areas, and economically disadvantaged and
underserved communities; the physical accessibility of such
facilities for individuals with disabilities; the condition of
such facilities affected by natural disasters and extreme
weather; the condition of such facilities affecting employee
and patron health and safety; and what is known about the cost
to bring such facilities to a State of good repair.
Within the total for IMLS, the Committee recommendation
includes the amounts below:
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2023 Fiscal year Committee
appropriation 2024 request recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act [LSTA]:
Grants to States............................................ 180,000,000 180,000,000 183,250,000
Native American Library Services............................ 5,763,000 5,763,000 5,763,000
National Leadership: Libraries.............................. 15,287,000 15,287,000 13,787,000
Laura Bush 21st Century Librarian........................... 10,000,000 10,000,000 8,000,000
-----------------------------------------------
Subtotal, LSTA............................................ 211,050,000 211,050,000 210,800,000
===============================================
Museum Services Act:
Museums for America......................................... 30,330,000 27,330,000 30,330,000
21st Century Museum Professional............................ .............. 2,000,000 ..............
Native American/Hawaiian Museum Services.................... 3,772,000 3,772,000 3,772,000
National Leadership: Museums................................ 9,348,000 10,348,000 8,848,000
-----------------------------------------------
Subtotal, MSA............................................. 43,450,000 43,450,000 42,950,000
===============================================
African American History and Culture Act.................... 6,000,000 6,000,000 5,250,000
National Museum of the American Latino Act.................. 6,000,000 6,000,000 4,000,000
Research, Analysis and Data Collection...................... 5,650,000 5,650,000 5,150,000
Administration.............................................. 22,650,000 22,650,000 21,650,000
-----------------------------------------------
IMLS, Total............................................. 294,800,000 294,800,000 289,800,000
----------------------------------------------------------------------------------------------------------------
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
Appropriations, 2023.................................... $9,405,000
Budget estimate, 2024................................... 10,053,000
Committee recommendation................................ 9,405,000
The Committee recommends $9,405,000 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, 2023.................................... $13,824,000
Budget estimate, 2024................................... 13,824,000
Committee recommendation................................ 13,824,000
The Committee recommends $13,824,000 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, 2023.................................... $3,850,000
Budget estimate, 2024................................... 4,000,000
Committee recommendation................................ 3,850,000
The Committee recommends $3,850,000 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 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, 2023.................................... $299,224,000
Budget estimate, 2024................................... 376,163,000
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, 2023.................................... $15,113,000
Budget estimate, 2024................................... 15,601,000
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, 2023.................................... $15,449,000
Budget estimate, 2024................................... 16,179,000
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, 2023.................................... $9,000,000
Budget estimate, 2024................................... 8,000,000
Committee recommendation................................ 8,000,000
The Committee recommends $8,000,000 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, 2023.................................... $150,000
Budget estimate, 2024................................... 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, 2023.................................... $128,000,000
Budget estimate, 2024................................... 138,575,000
Committee recommendation................................ 128,000,000
The Committee recommends $128,000,000 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, 2023.................................... $14,000,000
Budget estimate, 2024................................... 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, 2023.................................... $11,000,000
Budget estimate, 2024................................... 10,000,000
Committee recommendation................................ 10,000,000
The Committee recommends $10,000,000 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, 2023.................................... $48,609,338,000
Budget estimate, 2024................................... 45,717,853,000
Committee recommendation................................ 45,561,145,000
The Committee recommends $45,561,145,000 in fiscal year
2024 mandatory funds for the SSI program. This is in addition
to the $15,800,000,000 provided in the fiscal year 2023
appropriations act for the first quarter of fiscal year 2024.
In addition, the Committee recommends $21,700,000,000 in
advance funding for the first quarter of fiscal year 2025. 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 2024
program level of $56,328,000,000 for Federal benefit payments.
Beneficiary Services
The Committee recommendation includes $137,000,000 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 $4,805,145,000 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, 2023.................................... $14,125,978,000
Budget estimate, 2024................................... 15,488,200,000
Committee recommendation................................ 14,417,978,000
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 $1,851,000,000 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 $1,578,000,000 in cap adjustment funding, as
authorized and specified in the Fiscal Responsibility Act of
2023.
The Committee recommendation also includes up to
$151,000,000 for administrative activities funded from user
fees. This includes up to $150,000,000 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
$2,700,000 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 2025 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 Backlogs.--The Committee recognizes the pandemic
created significant challenges for SSA, which has contributed
to a significant increase in processing times for initial
disability claims. The Committee is deeply concerned that
staffing challenges will make it difficult for SSA to address
growing backlogs but expects SSA will, to the greatest extent
possible, prioritize funding to reduce the initial disability
claims backlog. The Committee directs SSA to continue to
provide monthly reports to the Committee on key agency
performance metrics and to provide quarterly briefings to the
Committees on its progress towards reducing the initial
disability claims and hearings backlogs, as well as addressing
other service delivery challenges.
Express Appointments.--The Committee commends SSA for the
creation of innovative service delivery improvements
implemented during the pandemic. Given SSA's stated plans to
expand the number of visitors that are served at field offices
since the pandemic, the Committee directs SSA to provide an
update in the 2025 CJ detailing the agency's plans for
expansion of Express Services, including the expected timeline
of such expansion, mechanisms for providing such services, and
planned national availability and capacity. Such update shall
also include any substantial progress made or plans to
implement other significant service delivery changes in field
offices.
IT Modernization Procurement Policies.--According to the
SSA's OIG report titled Agile Software Development at the
Social Security Administration, SSA implemented some
appropriate control and practices to manage its Agile software
development projects, but is not using Agile consistently
across all of its software development projects. The OIG's
analysis 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 encourages SSA to
implement OIG's recommendations and requests a briefing within
90 days of enactment on its progress in doing so.
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 2025 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 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 directs
SSA to submit a report to the House and Senate Committee on
Appropriations, the House Committee on Ways and Means, and the
Senate Committee on Finance within 180 days of enactment on the
list of proposed policy reforms to improve customer experience,
as well as a project timeline on implementing the online portal
allowing individuals submitting documents electronically.
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, within 90 days of enactment of this act
and quarterly thereafter, provide a 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 application process 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. Therefore, within 120 days of enactment, SSA shall
submit a report to the Committees on Appropriations and Ways
and Means of the House of Representatives and the Committees on
Appropriations and Finance of the Senate regarding the agency's
efforts to simplify the SSI application and program, including
a list of proposed legislative changes aimed at simplifying the
SSI application for claimants.
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 2023 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, 2023.................................... $114,665,000
Budget estimate, 2024................................... 120,400,000
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.--According
to the SSA OIG, reports of the Social Security Impersonation
Scam increased rapidly from 2018 to 2020. Since this time,
reports of this scam have declined but still number in the tens
of thousands each year. The Committee commends the work that
SSA OIG has done thus far to combat these scams, encourages SSA
OIG to continue to prioritize working with the SSA to increase
awareness of this scam, and urges SSA OIG 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 includes a new provision providing an
additional $10,000,000 available for obligation through
September 30, 2028 solely for costs necessary to achieve rent
reductions through the expiration and replacement of leases for
NLRB's headquarters and several regional offices. The Committee
directs NLRB to submit an operating plan for this capital
investment not later than 30 days after enactment of this act
and quarterly updates on its execution. Further, the Committee
expects future CJs to describe prior year rent costs, current
year rent costs and projected rent costs for the next 5 years.
Section 528. The bill continues a provision requiring
questions for the record be submitted within 45 days of
receipt.
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 Performance Bonus
Fund.
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
funds available in this act designated as an emergency).
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 July 27, 2023,
the Committee ordered favorably reported an original bill (S.
2624) making appropriations for the Departments of Labor,
Health and Human Services, and Education, and related agencies
for the fiscal year ending September 30, 2024, 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 Chairman of the Committee or his 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 26-2, a quorum being
present. The vote was as follows:
Yeas Nays
Chair Murray Mr. Hagerty
Mrs. Feinstein Mrs. Fischer
Mr. Reed
Mr. Tester
Mrs. Shaheen
Mr. Merkley
Mr. Coons
Mr. Schatz
Ms. Baldwin
Mr. Murphy
Mr. Manchin
Mr. Van Hollen
Mr. Heinrich
Mr. Peters
Ms. Collins
Mr. McConnell
Ms. Murkowski
Mr. Graham
Mr. Moran
Mr. Hoeven
Mr. Boozman
Mrs. Capito
Mr. Kennedy
Mrs. Hyde-Smith
Mrs. Britt
Mr. Rubio
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] 2024.
* * * * * * *
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] 2024,
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).
------
NATIONAL AND COMMUNITY SERVICE ACT OF 1990, PUBLIC LAW 101-610
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 2024.-- * * *
* * * * * * *
(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, 2028);
* * * * * * *
(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,
2028.
------
BUDGETARY IMPACT OF BILL
PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO PSEC. 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 2024: Subcommittee on Labor, HHS, Education,
and Related Agencies:
Mandatory............................................... 1,064,077 1,064,077 1,062,276 \1\1,062,27
6
Discretionary........................................... 195,231 202,178 263,863 \1\256,369
Defense............................................. ........... ........... NA NA
Non-defense......................................... 195,231 202,178 NA NA
Projections of outlays associated with the recommendation:
2024.................................................... ........... ........... ........... \2\1,132,40
6
2025.................................................... ........... ........... ........... 113,468
2026.................................................... ........... ........... ........... 32,122
2027.................................................... ........... ........... ........... 6,594
2028 and future years................................... ........... ........... ........... 1,653
Financial assistance to State and local governments for NA 492,271 NA \2\578,195
P2024......................................................
----------------------------------------------------------------------------------------------------------------
\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 $6,947,000,000 in budget authority plus the associated outlays. Pursuant to section
1001(b)(3)(B) of the 21st Century Cures Act (Public Law 114-255), $407,000,000 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 A Precious Child, Inc., CO, for workforce 400,000 Hickenlooper
Administration. development programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Advocate Christ Medical Center, IL, for a career 500,000 Durbin
Administration. pipeline program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training African Alliance of Rhode Island, RI, for 200,000 Reed, Whitehouse
Administration. workforce training and apprenticeship programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Alaska Joint Electrical Apprenticeship and 1,600,000 Murkowski
Administration. Training Trust, AK, for an apprenticeship
program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Alaska Joint Electrical Apprenticeship and 350,000 Murkowski
Administration. Training Trust, AK, for an apprenticeship
program, including the purchase of equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Alaska Legal Services Corporation, AK, for a 500,000 Murkowski
Administration. workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Alaska Operating Engineers Employers Training 1,999,000 Murkowski
Administration. Trust Fund, AK, for the purchase of equipment
for an apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Alaska Works Partnership, Inc., AK, for a 1,000,000 Murkowski
Administration. workforce training program, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training arc Thrift Stores, CO, for workforce development 51,000 Bennet, Hickenlooper
Administration. activities, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Arizona Commerce Authority, AZ, for the 2,000,000 Kelly, Sinema
Administration. semiconductor workforce accelerator project,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training AS220, RI, for a workforce training program...... 870,000 Reed, Whitehouse
Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Automotive Training Center, Inc., GA, for 250,000 Ossoff, Warnock
Administration. equipment for a workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Best Buddies International, Inc., WA, for 250,000 Murray
Administration. workforce development activities for individuals
with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Beyond Literacy, PA, for an education and 395,000 Casey
Administration. training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Big Brothers Big Sisters of Flint and Genesee 75,000 Stabenow
Administration. County, MI, for a youth workforce opportunity
initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Blue Ridge Community & Technical College 492,000 Capito
Administration. Foundation Inc., WV, for advanced manufacturing
training programs, including the purchase of
equipment, technology, and curriculum design.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Boys & Girls Clubs of the Chattahoochee Valley, 500,000 Warnock
Administration. Inc., GA, for college preparation, career
training, and workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Capital Workforce Partners, Inc. (CWP), CT, for 876,000 Blumenthal, Murphy
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Center for Community Health Alignment, University 112,000 Graham
Administration. of South Carolina Arnold School of Public
Health, SC, for a workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Children's Health Care, MN, for workforce 875,000 Klobuchar, Smith
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training City of Elkins, WV, for an apprenticeship program 60,000 Capito, Manchin
Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training CitySeed, Inc., CT, for a culinary training 150,000 Blumenthal, Murphy
Administration. program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Civic Works, Inc., MD, for workforce development 788,000 Cardin, Van Hollen
Administration. services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Clark College, WA, for the purchase and 1,000,000 Cantwell, Murray
Administration. installation of equipment and development of
curriculum for a clean energy technical
education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Coalfield Development, WV, for workforce 1,200,000 Manchin
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training College of Staten Island of the City University 1,720,000 Gillibrand, Schumer
Administration. of New York, NY, for a wind energy workforce
education and training initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Colorado State University--Pueblo, CO, for a 949,000 Bennet, Hickenlooper
Administration. transportation technology workforce development
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Connecticut NAACP, CT, for workforce development 350,000 Blumenthal, Murphy
Administration. activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Cook Inlet Tribal Council Inc., AK, for a 1,000,000 Murkowski
Administration. workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training County of Middlesex, NJ, for a healthcare 1,400,000 Booker, Menendez
Administration. workforce training project, including curriculum
development and the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Cowley Community College, KS, for welding 264,000 Moran
Administration. education, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Dartmouth Hitchcock Nashua, NH, for a behavioral 1,292,000 Shaheen
Administration. workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Delaware Bioscience Association, DE, for 2,168,000 Carper, Coons
Administration. workforce development activities, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Delaware Department of Safety and Homeland 1,800,000 Coons
Administration. Security--State Fire School, DE, for the
purchase of workforce training equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Detroit Health Department, MI, for training and 900,000 Peters, Stabenow
Administration. certification programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Doddridge County Day Report Center, WV, for the 10,000 Manchin
Administration. purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training East River Development Alliance Inc, NY, for 912,000 Schumer
Administration. youth development and training services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Eastern Shore Foundation Inc, VA, for a 197,000 Kaine, Warner
Administration. prototyping and training center for advanced
manufacturing, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Foundation Health LLC, AK, for a workforce 1,000,000 Murkowski
Administration. training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fox Valley Workforce Development Board, WI, for 4,675,000 Baldwin
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Fremont Multidistrict Initiative, CO, for 450,000 Bennet, Hickenlooper
Administration. workforce development programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Game On Upstate, NY, for workforce development 1,500,000 Schumer
Administration. programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training George Mason University, VA, for health workforce 921,000 Kaine, Warner
Administration. programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hartford Promise, CT, for a student internship 116,000 Blumenthal, Murphy
Administration. support program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hawaii Pacific University, HI, for a physician 1,843,000 Hirono, Schatz
Administration. assistant program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Henry Ford College, MI, for workforce development 3,000,000 Peters
Administration. activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hinds Community College, MS, for a STEM program, 2,847,000 Hyde-Smith
Administration. including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hinds Community College, MS, for a workforce 1,200,000 Wicker
Administration. training program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Hispanic Center Lehigh Valley, PA, for workforce 350,000 Casey
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Homeboy Industries, CA, for workforce development 2,000,000 Padilla
Administration. activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Housing Authority of the City of Providence, 150,000 Reed, Whitehouse
Administration. Rhode Island (dba Providence Housing Authority),
RI, for workforce development services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Ibero-American Action League Inc., NY, for a 800,000 Schumer
Administration. community health workers apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Illinois Central College, IL, for the purchase of 547,000 Duckworth
Administration. workforce training equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Itasca Economic Development Corporation, MN, for 339,000 Klobuchar, Smith
Administration. workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training IYRS School of Technology and Trades, RI, for 550,000 Whitehouse
Administration. robotics enabled workforce development programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Kawerak, Inc., AK, for a workforce training 568,000 Murkowski
Administration. program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training La Colaborativa, MA, for a workforce development 630,000 Markey, Warren
Administration. program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Leeward Community College, HI, for special 175,000 Schatz
Administration. education educator apprenticeship programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Living Classrooms Foundation, MD, for a maritime 883,000 Cardin, Van Hollen
Administration. skills workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Machinists Institute, WA, for the purchase of 4,500,000 Murray
Administration. equipment and program development for a
manufacturing workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Maine Development Foundation, ME, for a workforce 535,000 Collins, King
Administration. development program, including the purchase of
equipment and curriculum development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Manchester School District, NH, for an education 105,000 Shaheen
Administration. leadership training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Mary Hitchcock Memorial Hospital, NH, for an 400,000 Shaheen
Administration. early childhood workforce program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Maryland Reentry Resource Center Inc., MD, for 200,000 Cardin, Van Hollen
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Michigan Health & Hospital Association Keystone 756,000 Stabenow
Administration. Center, MI, for workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Midlands Technical College, SC, for a workforce 6,000,000 Graham
Administration. development program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Minnesota Assistance Council for Veterans, MN, 420,000 Klobuchar, Smith
Administration. for an employment services program for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Moraine Park Tech College, WI, for the purchase 150,000 Baldwin
Administration. of equipment for a fire training center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Multi-Service Center, WA, for workforce training. 772,000 Murray
Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Neighborhood, VA, for the career and community 275,000 Kaine, Warner
Administration. development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Castle County Vocational Technical School 1,702,000 Carper, Coons
Administration. District, DE, for nursing, commercial driving,
and biopharmaceutical manufacturing programs,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training New Immigrant Community Empowerment, NY, for a 500,000 Gillibrand, Schumer
Administration. workforce development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Newport County Community Mental Health Center, 200,000 Reed, Whitehouse
Administration. Inc. d/b/a Newport Mental Health, RI, for
behavioral healthcare workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Oregon Native American Chamber, OR, for a 426,000 Merkley, Wyden
Administration. semiconductor industry workforce development
program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Outreach Services, PA, for workforce development 250,000 Casey
Administration. services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pacific Mountain Workforce Development Council, 1,500,000 Murray
Administration. WA, for workforce development services for
veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pacific Northwest Ironworkers Training Program 1,000,000 Murkowski
Administration. d.b.a. Alaska Ironworkers Training Program, AK,
for a workforce training program, including the
purchase of equipment..
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Philadelphia Area Project on Occupational Safety 100,000 Casey
Administration. & Health, PA, for workforce development
activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Pittsburgh Film Office, PA, for workforce 765,000 Fetterman
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Polaris MEP, RI, for a workforce training 271,000 Reed, Whitehouse
Administration. program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's Community College, MD, for the 874,000 Cardin, Van Hollen
Administration. commercial drivers licensure program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince George's County, MD, for a summer youth 1,500,000 Cardin, Van Hollen
Administration. employment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Prince of Wales Vocational and Technical 500,000 Murkowski
Administration. Education Center, AK, for a workforce
development program, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Providence Public Library (PPL), RI, for 200,000 Reed
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Quincy Asian Resources, Inc., MA, for a workforce 627,000 Markey, Warren
Administration. initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Re-use Hawaii, HI, for workforce development 500,000 Schatz
Administration. training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Rhode Island Manufacturers Association, RI, for a 250,000 Whitehouse
Administration. workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Rhode Island Office of the Postsecondary 900,000 Reed, Whitehouse
Administration. Commissioner, RI, for healthcare workforce
development programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training SC Emergency Medical Services Association, SC, 1,650,000 Graham
Administration. for a workforce development program, including
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Seward County Community College, KS, for the 1,200,000 Moran
Administration. purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training SMART 33 Wheeling District JATC, WV, for 400,000 Capito, Manchin
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training So All May Eat, Inc., CO, for a culinary 157,000 Hickenlooper
Administration. workforce training program, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Southwest Piping Institute, NM, for workforce 1,350,000 Heinrich
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training SpringForward, MD, for workforce development 307,000 Cardin, Van Hollen
Administration. services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Starr Commonwealth, MI, for a youth career 500,000 Stabenow
Administration. development project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training State of New Mexico Office of Broadband Access 1,993,000 Heinrich, Lujan
Administration. and Expansion, NM, for workforce development
including purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Steamfitters Workforce Training Program, PA, for 322,000 Casey
Administration. workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Sunflower Bakery, MD, for workforce development 75,000 Van Hollen
Administration. services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Arc of Hilo, HI, for a school-to-work 297,000 Schatz
Administration. transition program for individuals with
disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Avery Center, CO, for workforce development 109,000 Bennet, Hickenlooper
Administration. programs for survivors of sex exploitation and
sex trafficking.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Black Fire Brigade Org, IL, for an EMT and 500,000 Duckworth
Administration. paramedic training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Challenge Program, DE, for workforce 465,000 Carper, Coons
Administration. development activities, including the purchase
of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Klamath Tribes, OR, for a workforce training 1,000,000 Merkley, Wyden
Administration. program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Mental Health Center of Greater Manchester, 408,000 Shaheen
Administration. NH, for mental health workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Peale Center for Baltimore History and 420,000 Cardin, Van Hollen
Administration. Architecture, Inc., MD, for historic
preservation workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The Skills Foundation of Mississippi, MS, for a 450,000 Hyde-Smith, Wicker
Administration. workforce training program, including curriculum
development and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training The West Virginia Chamber Foundation Corporation, 300,000 Capito, Manchin
Administration. WV, for workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Toledo Area Sheet Metal JATC, OH, for the 715,000 Brown
Administration. purchase of equipment for a sheet metal
apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Trade Institute of Pittsburgh, PA, for workforce 450,000 Casey
Administration. development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Turing School of Software & Design, CO, for a 575,000 Bennet, Hickenlooper
Administration. software development training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United Community Ministries, VA, for a workforce 326,000 Kaine, Warner
Administration. development program and English conversation
classes.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training United Mine Workers of America Career Centers, 1,500,000 Casey, Fetterman
Administration. Inc. (UMWA Career Centers, Inc. UMWACC), PA, for
workforce development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of Alaska Anchorage, AK, for an 1,000,000 Murkowski
Administration. apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training University of Rhode Island, RI, for biomedical 1,200,000 Reed
Administration. workforce development training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban Affairs Coalition, PA, for a summer youth 500,000 Casey
Administration. employment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Urban League of Greater Southwestern Ohio, OH, 670,000 Brown
Administration. for the Building Futures pre-apprenticeship
Program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Vermont Healthcare Information Technology 996,000 Welch
Administration. Education Center, Inc., VT, for apprenticeship
programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Veterans Life Center, NC, for a workforce 750,000 Tillis
Administration. training program for veterans.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Virginia Wesleyan University, VA, for career 625,000 Kaine, Warner
Administration. development services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training WaterFire Providence, RI, for workforce 250,000 Reed
Administration. development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Wesley Dayton, OH, for a workforce development 250,000 Brown
Administration. program for unemployed and underemployed
Montgomery County residents.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training West Virginia Higher Education Policy Commission, 1,800,000 Capito, Manchin
Administration. WV, for a paramedic training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training West Virginia Office of Miners' Health, Safety 300,000 Capito, Manchin
Administration. and Training, WV, for workforce development
activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training West Virginia Sheet Metal Workers Joint 751,000 Brown
Administration. Apprenticeship Training Fund, WV, for sheet
metal workers apprenticeship training, including
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Western Slope Schools Career Collaborative, CO, 600,000 Bennet, Hickenlooper
Administration. for the implementation of new industry
development pathways.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Western States College of Construction, CO, for 1,018,000 Bennet, Hickenlooper
Administration. apprenticeship programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Women's Resource Center, MI, for workforce 95,000 Stabenow
Administration. development services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Woonasquatucket Valley Community Build Inc. dba 300,000 Reed
Administration. The Steel Yard, RI, for workforce training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Labor Employment and Training Workforce Alliance, CT, for a health workforce 1,188,000 Blumenthal, Murphy
Administration. training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Adventist Health Castle, HI, for equipment....... 700,000 Hirono, Schatz
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Agnes Scott College, GA, for facilities and 1,001,000 Ossoff, Warnock
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Aiken Technical College, SC, for facilities and 1,000,000 Graham
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Alaska Addiction Rehabilitation Services, AK, for 3,000,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Alaska Native Tribal Health Consortium, AK, for 2,000,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Albany Med Health System, NY, for equipment...... 500,000 Gillibrand, Schumer
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Alcona Citizens for Health, Inc., MI, for 305,000 Stabenow
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Alivio Medical Center, IL, for facilities and 498,000 Durbin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services ALS Association, AK, for equipment............... 413,000 Murkowski
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Amador Health Center, NM, for facilities and 780,000 Heinrich
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services American Red Cross of Hawaii, HI, for a rural 50,000 Schatz
Services Administration. training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Anchorage Community Mental Health Services Inc. 1,987,000 Murkowski
Services Administration. d.b.a. Alaska Behavioral Health, AK, for
facilities and equipment, including information
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Anderson Regional Medical Center, MS, for 4,300,000 Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services AnMed Health, SC, for facilities and equipment... 11,176,000 Graham
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Apicha Community Health Center, NY, for 146,000 Gillibrand
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Apple Tree Dental, MN, for facilities and 3,690,000 Klobuchar, Smith
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Applied Research Foundation of WV, WV, for 7,415,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Arab Community Center for Economic and Social 4,000,000 Stabenow
Services Administration. Services, MI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Arcadia University, PA, for facilities and 342,000 Casey
Services Administration. 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--Mountain Home, AR, for 6,000,000 Boozman
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Aroostook Mental Health Services, Inc., ME, for 4,300,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Ashland Ambulance Service, ME, for equipment..... 431,000 Collins
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Asian Health Services, CA, for facilities and 1,000,000 Feinstein, Padilla
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Aunt Martha's Health and Wellness, IL, for 450,000 Duckworth, Durbin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Avera McKennan, SD, for facilities and equipment, 997,000 Rounds
Services Administration. including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Axis Health System, CO, for facilities and 1,107,000 Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Baltimore County Government, MD, for facilities 500,000 Cardin, Van Hollen
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Bangor Nursing and Rehabilitation Center, ME, for 366,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Bangor Young Men's Christian Association, ME, for 5,000,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Barnes-Kasson County Hospital, PA, for equipment. 600,000 Casey
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Barrow Neurological Foundation, AZ, for equipment 1,053,000 Sinema
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Bartlett Regional Hospital, AK, for facilities 4,000,000 Murkowski
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Beebe Medical Center, Inc. d/b/a Beebe 1,500,000 Carper
Services Administration. Healthcare, DE, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Berks Community Health Center, PA, for facilities 1,001,000 Casey, Fetterman
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Bethel Family Clinic, AK, for facilities and 2,000,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Blue Ridge Hospice, VA, to expand access to high- 561,000 Kaine, Warner
Services Administration. quality preventive, primary, acute and long term
care under its Program of All-Inclusive Care for
the Elderly.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Blue Sky Bridge, CO, for facilities and equipment 807,000 Bennet, Hickenlooper
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Boone Memorial Hospital Inc., WV, for facilities 2,202,000 Capito, Manchin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Borough of Waynesboro, PA, for facilities and 1,114,000 Casey
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Braxton County, WV, for equipment................ 400,000 Capito, Manchin
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Broaddus Hospital Association Incorporation, WV, 529,000 Capito, Manchin
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Brooks Ambulance, Inc., ME, for facilities and 1,650,000 Collins
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Bryant University, RI, for facilities and 1,500,000 Reed
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Calais Community Hospital, ME, for facilities and 1,354,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Camden-on-Gauley Medical Center, Inc., WV, for 5,000,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Camp Kita Inc., ME, for facilities and equipment. 3,330,000 Collins, King
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Cancer Can't, WA, for facilities and equipment... 1,500,000 Cantwell
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Canyonlands Community Health Care, AZ, for 2,500,000 Kelly, Sinema
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Cape Fear Valley Health, NC, for facilities and 903,000 Tillis
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Capital Health System, Inc., NJ, for facilities 1,500,000 Booker, Menendez
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Caring Hands Healthcare Centers Inc., OK, for 3,000,000 Mullin
Services Administration. facilities and equipment, including information
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Catholic Medical Center, NH, for facilities and 407,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services CCI Health Services, MD, for facilities and 940,000 Cardin, Van Hollen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Centra Health, VA, for facilities and equipment.. 190,000 Kaine, Warner
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Central Maine Community College, ME, for 3,325,000 Collins
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Central Maine Medical Center, ME, for facilities 2,100,000 Collins
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Central Virginia Health Services, Inc., VA, for 355,000 Kaine, Warner
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Centreville Clinics, Inc., PA, for facilities and 500,000 Casey
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Charleston Area Medical Center Inc., WV, for 7,516,000 Capito, Manchin
Services Administration. facilities and equipment for a multispecialty
facility.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Charleston Area Medical Center Inc., WV, for 15,000,000 Capito, Manchin
Services Administration. facilities and equipment to improve neurological
care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services CHI Memorial Hospital-Georgia, Inc. d/b/a CHI 1,500,000 Ossoff, Warnock
Services Administration. Memorial Hospital Georgia, GA, for facilities
and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Chicago Family Health Center, Inc. (CFHC), IL, 122,000 Duckworth
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Children's Hospital of Colorado, CO, to support a 421,000 Bennet, Hickenlooper
Services Administration. rural nurse training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Chiricahua Community Health Centers, Inc., AZ, 789,000 Kelly, Sinema
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Choptank Community Health Systems, MD, for 892,000 Cardin, Van Hollen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services CIL Community Resources Inc, CT, for facilities 1,403,000 Blumenthal, Murphy
Services Administration. and construction.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Circle the City, AZ, for facilities and equipment 500,000 Sinema
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Citizens Foundation, KS, for facilities and 3,000,000 Moran
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services City and County of San Francisco, CA, for 1,000,000 Feinstein, Padilla
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services City of Caribou Cary Medical Center, ME, for 9,800,000 Collins
Services Administration. facilities and equipment, including information
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services City of Hobbs Fire Department, NM, for equipment. 400,000 Lujan
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services City of Talladega, AL, for rural emergency 3,980,000 Britt
Services Administration. medical services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services City of Waterbury, CT, for facilities and 5,000,000 Blumenthal, Murphy
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Claflin University, SC, for facilities and 3,563,000 Graham
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Clearfield Educational Foundation--Future, PA, 900,000 Fetterman
Services Administration. for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Clemson University, SC, for facilities and 6,000,000 Graham
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Cleveland Clinic Akron General, OH, for 856,000 Brown
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services CODAC Behavioral Health, RI, for facilities and 1,200,000 Reed, Whitehouse
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Codman Square Health Center, MA, for facilities 179,000 Markey, Warren
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Colorado Mountain College, CO, for facilities and 3,000,000 Bennet, Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Columbia County Health & Human Services, WI, for 1,000,000 Baldwin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Columbus Consolidated Government, GA, for 139,000 Ossoff
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Columbus Neighborhood Health Center, Inc., dba/ 1,200,000 Brown
Services Administration. PrimaryOne Health, OH, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Community College of Allegheny County, PA, for 500,000 Casey
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Community Health and Wellness Center of Greater 232,000 Blumenthal, Murphy
Services Administration. Torrington, Inc., CT, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Community Health Care Systems, Inc., GA, for 132,000 Ossoff
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Community Health Centers of Burlington, Inc, VT, 3,000,000 Sanders
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Community Housing of Maine, Inc., ME, for 15,000,000 Collins
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services CommunityHealth, IL, for facilities and equipment 516,000 Duckworth
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services COMPASS Family and Community Services, OH, for 750,000 Brown
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Comprehensive Community Action Inc. (CCAP), RI, 1,000,000 Reed, Whitehouse
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Comprehensive Life Resources, WA, for facilities 1,500,000 Cantwell
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Connections for Abused Women and their Children, 500,000 Durbin
Services Administration. IL, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Copper River Native Association, AK, for 300,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services County of Los Angeles, CA, for facilities and 1,500,000 Feinstein, Padilla
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services County of San Diego, CA, for equipment........... 2,500,000 Feinstein, Padilla
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Crisp Regional Hospital, Inc., GA, for facilities 580,000 Ossoff, Warnock
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Critical Care Services, Inc. (D.B.A. Life Link 1,500,000 Klobuchar, Smith
Services Administration. III), MN, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Cuba Independent Schools, NM, for facilities and 680,000 Lujan
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Curry Health Network, OR, for facilities and 2,000,000 Merkley, Wyden
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Dakota Child and Family Clinic, MN, for 350,000 Klobuchar, Smith
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Dartmouth Health, NH, for facilities and 650,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Day One, RI, for facilities and equipment........ 273,000 Whitehouse
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Deborah Heart and Lung Center, NJ, for equipment. 1,500,000 Booker, Menendez
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Delaware Health Information Network, DE, for 1,430,000 Carper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Delta Health, CO, for facilities and equipment... 158,000 Hickenlooper
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services DuPagePads, IL, for facilities and equipment..... 280,000 Duckworth
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services East Bay Community Action Program, RI, for 1,500,000 Whitehouse
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Eastern Maine Healthcare Systems, Acadia Hospital 1,330,000 Collins
Services Administration. Corporation d.b.a. Northern Light Acadia
Hospital, ME, for a rural health training
program to improve dementia care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Eastern Maine Healthcare Systems, Eastern Maine 1,097,000 Collins, King
Services Administration. Medical Center, ME, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Eastern Maine Healthcare Systems, The Aroostook 3,016,000 Collins, King
Services Administration. Medical Center d.b.a. Northern Light A.R. Gould
Hospital, ME, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Eastern Shore Rural Health System, Inc., VA, to 159,000 Kaine, Warner
Services Administration. support rural pediatric health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Eastport Health Care, Inc., ME, for facilities 5,061,000 Collins
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Education Health and Research International, DE, 1,501,000 Carper
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Elliot Health System, NH, for facilities and 577,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Ellis Hospital, NY, for facilities and equipment. 500,000 Gillibrand, Schumer
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Emory University, GA, for facilities and 536,000 Ossoff
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Entre Hermanos, WA, for facilities and equipment. 706,000 Murray
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Erie Family Health Center, Inc., IL, for 3,000,000 Durbin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Escambia County Alabama Community Hospitals, Inc. 2,000,000 Britt
Services Administration. dba Atmore Community Hospital, AL, for
facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Esperanza Health Center, PA, for facilities and 464,000 Casey
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Fairbanks Native Association, AK, for facilities 5,000,000 Murkowski
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Fairmont State University, WV, for facilities and 3,059,000 Capito, Manchin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services FaithHealth Appalachia Inc., WV, for facilities 470,000 Capito, Manchin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Fallon Paiute-Shoshone Tribe, NV, for equipment.. 210,000 Cortez Masto, Rosen
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Family Health Centers, WA, for facilities and 1,633,000 Cantwell
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Family Service of Rhode Island, RI, for 1,000,000 Reed, Whitehouse
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Florence Crittenton Programs Inc., WV, for 3,042,000 Capito
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Forsyth Community Clinic, GA, for equipment...... 11,000 Warnock
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Frankford Community Development Corporation, PA, 1,000,000 Casey
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Free Clinic of the New River Valley DBA Community 1,250,000 Kaine, Warner
Services Administration. Health Center of the New River Valley, VA, for
facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Fresno County, CA, for facilities and equipment.. 1,000,000 Feinstein
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Gallup Community Health, NM, for rural healthcare 750,000 Lujan
Services Administration. services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Gila Regional Medical Center, NM, for equipment.. 1,000,000 Heinrich, Lujan
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Gilmer County Ambulance Authority, WV, for 157,000 Capito
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Grafton County Nursing Home, NH, for facilities 750,000 Shaheen
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Grant County Commission, WV, for facilities and 700,000 Capito, Manchin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Grays Harbor County Public Hospital District No. 2,500,000 Cantwell
Services Administration. 1 dba. Summit Pacific Medical Center, WA, for
facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Great Bay Services, NH, for facilities and 272,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Greater Health Now Accountable Community of 563,000 Murray
Services Administration. Health, WA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Greater Seacoast Community Health, NH, for 750,000 Shaheen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Guadalupe County Hospital, NM, for equipment..... 650,000 Lujan
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hampton University School of Nursing, VA, for 1,000,000 Kaine, Warner
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hana Health, HI, for facilities and equipment.... 1,440,000 Hirono, Schatz
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Harbor Hall Foundation, MI, for facilities and 1,000,000 Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Harrington Memorial Hospital, Inc., MA, for 498,000 Markey, Warren
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hartford Gay & Lesbian Health Collective, CT, for 156,000 Blumenthal, Murphy
Services Administration. facilities and construction.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hayward Memorial Hospital, WI, for facilities and 2,000,000 Baldwin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services HealthFirst Family Care Center, NH, for 250,000 Shaheen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services HealthPoint, WA, for facilities and equipment.... 4,000,000 Murray
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hennepin County, MN, for facilities and equipment 2,700,000 Klobuchar, Smith
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services HH Health System--Shoals LLC dba Helen Keller 2,600,000 Britt
Services Administration. Hospital, AL, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hodgeman County Health Center, KS, for facilities 4,000,000 Moran
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Holyoke Health Center, Inc., MA, for facilities 1,000,000 Markey, Warren
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services HopeHealth Hospice & Palliative Care, RI, for 41,000 Reed, Whitehouse
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services HopeSparks, WA, for facilities and equipment..... 2,000,000 Murray
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Horizon Health Services, Inc., VA, to upgrade its 2,000,000 Kaine, Warner
Services Administration. Waverly Medical Center location to enhance and
expand services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hospice of Hilo dba Hawaii Care Choices, HI, for 1,217,000 Schatz
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hospice of Michigan, MI, for facilities and 1,000,000 Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hospital Authority of Randolph County, GA, for 5,500,000 Ossoff, Warnock
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hospital Authority of Valdosta & Lowndes, Ga. dba 1,871,000 Ossoff, Warnock
Services Administration. SGMC Berrien Campus, GA, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hospital Development Co., WV, for facilities and 500,000 Capito, Manchin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Hyndman Area Health Center, PA, for facilities 885,000 Fetterman
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Illinois College, IL, for facilities and 911,000 Durbin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Illinois Medical District (IMD) Guest House 168,000 Duckworth
Services Administration. Foundation, IL, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Increase Access to Care Initiative, PA, for 875,000 Casey, Fetterman
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Inner-City Muslim Action Network, IL, for 1,000,000 Durbin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Island Hospital, WA, for facilities and equipment 2,500,000 Murray
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services J Sargeant Reynolds Community College, VA, to 924,000 Kaine, Warner
Services Administration. renovate laboratories and purchase equipment to
increase enrollment in programs with high-demand
health care occupations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Jackson Laboratory, ME, for facilities and 8,000,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Jacksonville State University Foundation, AL, for 1,760,000 Britt
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Jefferson County Community Ministries, WV, for 300,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Jefferson County Public Hospital District 2, 2,000,000 Cantwell, Murray
Services Administration. Jefferson Healthcare, WA, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services John A Logan College, IL, for facilities and 1,235,000 Duckworth
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Johns Hopkins Community Physicians, MD, for 750,000 Cardin, Van Hollen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Johnston Memorial Hospital (Ballad Health), VA, 613,000 Kaine, Warner
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Journey Forward, MA, for facilities and equipment 500,000 Markey, Warren
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kahuku Medical Center, HI, for facilities and 812,000 Schatz
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kanawha Hospice Care Inc., WV, for facilities and 426,000 Capito
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kansas State University, KS, for facilities and 3,000,000 Moran
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kansas State University, KS, for facilities and 4,000,000 Moran
Services Administration. equipment to support biomanufacturing training
and education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kenai Peninsula Borough, AK, for facilities and 5,000,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kennebec Valley Community College, ME, for 513,000 Collins
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Ketchikan Indian Community, AK, for facilities 2,000,000 Murkowski
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services KidsTLC, Inc., KS, for facilities and equipment.. 3,000,000 Moran
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Kodiak Area Native Association, AK, for 5,000,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services KVC Health Systems Inc., KS, for facilities and 2,000,000 Moran
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services La Clinica De Los Campesinos, dba Family Health 2,000,000 Baldwin
Services Administration. La Clinica, WI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services La Clinica del Valle Family Health Care Center, 2,000,000 Merkley, Wyden
Services Administration. Inc. (dba La Clinica), OR, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services LaGrange College, GA, for facilities and 214,000 Ossoff, Warnock
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lakes Region Mental Health Center, NH, for an 630,000 Shaheen
Services Administration. electronic health records system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lamoille Health Partners, Inc., VT, for 1,500,000 Sanders
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lanai Kinaole Inc, HI, for facilities and 1,150,000 Schatz
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lander University, SC, for facilities and 2,400,000 Graham
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lane County, OR, for facilities and equipment.... 1,500,000 Merkley, Wyden
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Larry Labonte Recovery Center, ME, for facilities 178,000 Collins, King
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lawrence County Hospital, MS, for facilities and 8,600,000 Hyde-Smith
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lawrence General Hospital, MA, for facilities and 2,975,000 Markey, Warren
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Leg Up Farm, Inc., PA, for facilities and 500,000 Casey, Fetterman
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services LifeFlight of Maine, LLC, ME, for equipment...... 1,920,000 Collins, King
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lifeways, Inc., OR, for facilities and equipment. 978,000 Merkley, Wyden
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lily's Place, WV, for facilities and equipment... 1,085,000 Capito
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lorain County Health and Dentistry, OH, for 2,000,000 Brown
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Loudoun County Community Health Center dba 359,000 Kaine, Warner
Services Administration. HealthWorks, VA, to purchase radiology equipment
and to renovate imaging room.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Louisiana State University and A&M College, LA, 3,000,000 Cassidy
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Loyola University of Chicago, IL, for facilities 1,000,000 Durbin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services LSU Health Sciences Center, LA, for facilities 1,735,000 Cassidy
Services Administration. and equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Lyon College, AR, for facilities and equipment... 15,000,000 Boozman
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Madera County, CA, for equipment................. 940,000 Feinstein, Padilla
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Magnolia Regional Health Center, MS, for 500,000 Hyde-Smith, Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Maine Veterans' Homes, ME, for facilities and 3,680,000 Collins, King
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services MaineGeneral Medical Center, ME, for facilities 2,000,000 Collins, King
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services MaineHealth, ME, for LincolnHealth facilities and 4,500,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services MaineHealth, ME, for Maine Behavioral Healthcare 1,350,000 Collins, King
Services Administration. Knox County facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services MaineHealth, ME, for Maine Behavioral Healthcare 2,825,000 Collins, King
Services Administration. York County facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Maniilaq Association, AK, for facilities and 750,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Marathon County Government, WI, for facilities 2,000,000 Baldwin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Marion Township Volunteer Fire Company, PA, for 13,000 Fetterman
Services Administration. 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 Martha's Vineyard Hospital, MA, for equipment.... 1,070,000 Markey, Warren
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mary's Center for Maternal & Child Care, Inc., 5,000,000 Cardin, Van Hollen
Services Administration. MD, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mascoma Community Healthcare, Inc., NH, for a 189,000 Shaheen
Services Administration. rural public health initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mazzoni Center, PA, for facilities and equipment. 400,000 Casey
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services McLaren Oakland Hospital, MI, for facilities and 500,000 Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Memorial Medical Center, WI, for facilities and 2,000,000 Baldwin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Memorial Sloan Kettering Cancer Center, NY, for 1,200,000 Gillibrand, Schumer
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mercy Health Foundation Ada, OK, for facilities 10,000,000 Mullin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Meta House, WI, for facilities and equipment..... 3,000,000 Baldwin
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Michigan State University, MI, for facilities and 572,000 Peters, Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mid-Maine Homeless Shelter Inc., ME, for 75,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mid-Michigan Recovery Services, MI, for 500,000 Stabenow
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mid-State Health Center, NH, for facilities and 2,200,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Millinocket Regional Hospital, ME, for facilities 9,893,000 Collins, King
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mineral County Health Department, WV, for 1,260,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Minneola District Hospital NBR2, KS, for 1,000,000 Moran
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Minnie Hamilton Health Care Center, WV, for 5,000,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mississippi Children's Home Society d.b.a. Canopy 5,000,000 Hyde-Smith, Wicker
Services Administration. Children's Solutions, MS, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mississippi State University, MS, for facilities 600,000 Hyde-Smith
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Monroe County Health Center, WV, for facilities 98,000 Capito
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mora County Ambulance Services, NM, for equipment 900,000 Heinrich
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Morgantown Community Resources Inc., WV, for 500,000 Capito, Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Morton County Health System, KS, for facilities 470,000 Moran
Services Administration. and equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mother Nation, WA, for facilities and equipment.. 1,148,000 Murray
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mothers' Milk Bank of the Western Great Lakes, 850,000 Duckworth
Services Administration. IL, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mount Desert Island Biological Laboratory, ME, 1,607,000 Collins, King
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mount Desert Island Hospital, ME, for facilities 5,000,000 Collins, King
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mount Graham Regional Medical Center, AZ, for 500,000 Kelly, Sinema
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Mount Washington Valley Adult Day Center, NH, for 71,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Multnomah County, OR, for facilities and 1,970,000 Merkley, Wyden
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services MUSC Health Orangeburg, SC, for facilities and 4,300,000 Graham
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Native Village of Eyak, AK, for facilities and 5,000,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Nemaha Valley Community Hospital, KS, for 415,000 Moran
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Niagara University, NY, for facilities and 1,000,000 Gillibrand, Schumer
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Nisqually Indian Tribe, WA, for facilities and 5,000,000 Murray
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services North Country HealthCare, Inc., AZ, for 1,733,000 Kelly, Sinema
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services North Country Home Health & Hospice Agency, NH, 155,000 Shaheen
Services Administration. to support a rural health initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services North Sunflower Medical Center, MS, for 1,034,000 Hyde-Smith
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Northwest Technical Institute Education 10,000,000 Boozman
Services Administration. Foundation, AR, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Nottawaseppi Huron Band of the Potawatomi, MI, 1,500,000 Peters
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Noxubee General Critical Access Hospital, MS, for 5,000,000 Hyde-Smith, Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services NYC Health + Hospitals/Elmhurst, NY, for 2,000,000 Gillibrand, Schumer
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services NYU Langone Hospitals, NY, for facilities and 1,500,000 Gillibrand, Schumer
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Oakland University, MI, for facilities and 350,000 Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Ohio University, OH, for facilities and equipment 2,352,000 Brown
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Oktibbeha County Hospital (OCH) Regional Medical 9,500,000 Wicker
Services Administration. Center, MS, for facilities and equipment,
including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services OU Medicine, Inc. d.b.a. OU Health, OK, for 1,300,000 Mullin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Paden City Development Authority, WV, for 200,000 Manchin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pali Momi Foundation, HI, for equipment.......... 500,000 Schatz
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Park West Health System, MD, for facilities and 1,500,000 Cardin, Van Hollen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Parrott Creek Child & Family Services, OR, for 2,000,000 Merkley, Wyden
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services PeaceHealth Southwest Medical Center, WA, for 1,000,000 Murray
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Peninsula Community Health Services of Alaska, 500,000 Murkowski
Services Administration. Inc., AK, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Penobscot Community Health Center, ME, for 1,322,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Philadelphia Midwife Collective (PMC), PA, for 550,000 Casey
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pikes Peak State College, CO, for facilities and 1,000,000 Bennet, Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pinckneyville Community Hospital, IL, for 192,000 Duckworth
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pioneers Medical Center, CO, for facilities and 371,000 Bennet, Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pocahontas Memorial Hospital, WV, for facilities 6,000,000 Capito, Manchin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Portland Community Health Center dba Greater 775,000 King
Services Administration. Portland Health, ME, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Potomac Valley Hospital Inc., WV, for facilities 1,000,000 Capito, Manchin
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Presbyterian Healthcare Service's Espanola 1,800,000 Heinrich
Services Administration. Hospital, NM, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Prestera Center for Mental Health Services, WV, 350,000 Capito, Manchin
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Prisma Health--Upstate, SC, for facilities and 10,700,000 Graham
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Providence Community Health Centers, Inc., RI, 500,000 Reed
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Pushing Boundaries, WA, for facilities and 1,367,000 Murray
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Recovery Point of Huntington d.b.a. Recovery 600,000 Capito, Manchin
Services Administration. Point West Virginia, WV, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Rector and Visitors of the University of 367,000 Kaine, Warner
Services Administration. Virginia, VA, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Regional Hospice and Home Care of Western 2,000,000 Blumenthal, Murphy
Services Administration. Connecticut, Inc., CT, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Regional Medical Center at Lubec, ME, for 5,000,000 Collins
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Richford Health Center, Inc. d/b/a Northern Tier 2,500,000 Sanders
Services Administration. Center for Health (Notch), VT, for facilities
and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Richland Hospital, WI, for facilities and 4,640,000 Baldwin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Rivier University, NH, for facilities and 2,000,000 Shaheen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Rochester General Hospital, NY, for facilities 1,000,000 Gillibrand, Schumer
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Roper St. Francis Hospital, SC, for facilities 8,000,000 Graham
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Rutgers University-New Brunswick, NJ, for 2,000,000 Booker, Menendez
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services RWJ Barnabas Health, NJ, for facilities and 981,000 Menendez
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Saint Antoine Residence, RI, for facilities and 250,000 Reed
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Saint Joseph's Mercy Care Services, Inc., GA, for 540,000 Warnock
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Santa Clara Pueblo, NM, for facilities and 350,000 Heinrich, Lujan
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Save a Life, Inc., ME, for facilities and 167,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Scenic Bluffs Community Health Center, WI, for 1,600,000 Baldwin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Scranton Primary Health Care Center, Inc., PA, 441,000 Casey
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Self Help Movement, Inc., PA, for facilities and 1,500,000 Fetterman
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Sinai Hospital of Baltimore, MD, for facilities 1,500,000 Cardin, Van Hollen
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Sokaogon Chippewa Health Clinic, WI, for 3,000,000 Baldwin
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services South Central Regional Medical Center, MS, for 7,500,000 Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services South Routt Medical Center, CO, for facilities 2,300,000 Bennet, Hickenlooper
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Southcentral Foundation, AK, for facilities and 1,000,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Southeast Colorado Hospital District, CO, for 205,000 Bennet, Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Southern Maine Community College, ME, for 4,100,000 Collins
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Southern New Hampshire Health, NH, for facilities 453,000 Shaheen
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Southwestern Vermont Medical Center, VT, for 2,000,000 Sanders, Welch
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Spanish Peaks Regional Health Center, CO, for 1,100,000 Bennet, Hickenlooper
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Sparrow Carson Hospital, MI, for facilities and 559,000 Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Spoon River College, IL, for facilities and 1,000,000 Durbin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services St. Andre Health Care Facility, ME, for 1,328,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services St. Dominic--Jackson Memorial Hospital, MS, for 500,000 Hyde-Smith, Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services St. Francis Medical Center--Allina Health, MN, 1,000,000 Klobuchar, Smith
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services St. Joseph Hospital, ME, for facilities and 1,550,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services St. Mary's Regional Medical Center, ME, for 3,989,000 Collins, King
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Stamford Health, CT, for facilities and equipment 750,000 Blumenthal, Murphy
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Stanton County Hospital, KS, for facilities and 1,500,000 Moran
Services Administration. equipment, including information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Star Community Health, Inc., PA, for equipment... 500,000 Fetterman
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services STAT (Southern Tier Alternative Therapies, Inc.) 250,000 Casey
Services Administration. Ligonier Therapeutic Center, PA, for facilities
and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services State of Alaska Department of Health, AK, for 1,200,000 Murkowski
Services Administration. equipment, including information technology for
information management.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services State of Alaska Department of Health, AK, for 500,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services State of Alaska Department of Health, AK, for 1,000,000 Murkowski
Services Administration. facilities and equipment, including information
technology for health records.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Stephens County Hospital, GA, for facilities and 1,270,000 Warnock
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Sturdy Memorial Hospital, MA, for facilities and 2,835,000 Markey, Warren
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Summers County Commission, WV, for facilities and 3,000,000 Capito, Manchin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services SUNY Downstate Health Sciences University, NY, 2,758,000 Gillibrand, Schumer
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Susanville Indian Rancheria, CA, for facilities 2,500,000 Feinstein
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Tapestry 360 Health, IL, for facilities and 415,000 Durbin
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Tate County Hospital, MS, for facilities and 8,500,000 Hyde-Smith, Wicker
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Aliveness Project, MN, for facilities and 1,000,000 Klobuchar, Smith
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Board of Trustees of The University of 550,000 Britt
Services Administration. Alabama, for and on behalf of The University of
Alabama in Huntsville, AL, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Cheshire Medical Center, NH, for facilities 750,000 Shaheen
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Children's Place, AK, for facilities and 2,000,000 Murkowski
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Health Care Authority of the City of 2,500,000 Britt
Services Administration. Huntsville DBA Huntsville Hospital Health
System, AL, for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Jackson Laboratory, CT, for facilities and 449,000 Blumenthal, Murphy
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Medical Center of Baldwin County, Inc., GA, 558,000 Ossoff, Warnock
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Providence Center, RI, for facilities and 1,320,000 Reed, Whitehouse
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The University of Cincinnati Medical Center 3,000,000 Brown
Services Administration. (UCMC), OH, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services The Valley Hospital, NJ, for facilities and 3,100,000 Booker, Menendez
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services ThedaCare Regional Medical Center--Neenah, Inc, 1,500,000 Baldwin
Services Administration. WI, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Tift Regional Health System, Inc., GA, for 600,000 Ossoff
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Town of Islesboro, ME, for facilities and 845,000 Collins, King
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Town of Milbridge, ME, for facilities and 370,000 Collins
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Trillium Health, Inc., NY, for facilities and 1,673,000 Gillibrand, Schumer
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Troy University, AL, for facilities and equipment 2,200,000 Britt
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Turner House Clinic, Inc. DBA Vibrant Health, KS, 4,000,000 Moran
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Tuscarawas County General Health Department dba 750,000 Brown
Services Administration. Tuscarawas County Health Department (TCHD), OH,
for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Tyler Holmes Memorial Hospital, MS, for 4,300,000 Wicker
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services UC Davis Health, CA, for facilities and equipment 1,800,000 Feinstein
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Umpqua Community College, OR, for facilities and 2,034,000 Merkley, Wyden
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University Hospital, NJ, for emergency response 4,000,000 Booker, Menendez
Services Administration. vehicles and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Alaska Anchorage, AK, for 500,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Alaska Anchorage, AK, for 2,000,000 Murkowski
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Arkansas--Rich Mountain, AR, for 12,000,000 Boozman
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Arkansas at Pine Bluff, 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, 5,000,000 Boozman
Services Administration. for a rural maternal and child health program,
including equipment and information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Arkansas for Medical Sciences, AR, 3,000,000 Boozman
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Arkansas for Medical Sciences, AR, 4,000,000 Boozman
Services Administration. for facilities and equipment to improve cancer
care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Arkansas for Medical Sciences, AR, 8,000,000 Boozman
Services Administration. for facilities and equipment to improve
digestive disease care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Colorado Colorado Springs, CO, for 374,000 Bennet, Hickenlooper
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Delaware, DE, for facilities and 5,000,000 Coons
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Kansas Cancer Center, KS, for 10,000,000 Moran
Services Administration. facilities 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 Maine System, ME, for facilities 4,500,000 Collins, King
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Michigan, MI, for facilities and 2,263,000 Peters, Stabenow
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Mississippi Medical Center, MS, for 3,200,000 Hyde-Smith
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Mississippi Medical Center, MS, for 4,300,000 Wicker
Services Administration. facilities and equipment for the Mississippi
Burn Center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Mississippi Medical Center, MS, for 1,090,000 Wicker
Services Administration. rural telehealth and other services to address
congenital syphilis.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Mississippi, MS, for equipment..... 4,500,000 Hyde-Smith
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Mississippi, MS, for facilities and 1,350,000 Hyde-Smith, Wicker
Services Administration. equipment for medical device innovation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Nevada Las Vegas, NV, for 400,000 Cortez Masto, Rosen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Oklahoma Health Sciences Center, 1,200,000 Mullin
Services Administration. OK, for facilities and equipment, including
information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of South Carolina, SC, for facilities 3,010,000 Graham
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of South Carolina Lancaster, SC, for 2,800,000 Graham
Services Administration. facilities and equipment, including information
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of South Carolina Upstate, SC, for 1,331,000 Graham
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of South Dakota, SD, for facilities 1,100,000 Rounds
Services Administration. and equipment, including telehealth and
information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services University of Washington, WA, for facilities and 3,500,000 Cantwell
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Uwchlan Ambulance Corps, PA, for equipment....... 121,000 Fetterman
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Valley Health Systems, Inc., WV, for a rural 1,000,000 Manchin
Services Administration. healthcare outreach initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Vermont State Colleges System, VT, for facilities 5,982,000 Welch
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services VNA Home & Hospice d.b.a. Northern Light Home 1,000,000 Collins, King
Services Administration. Care & Hospice, ME, for rural telehealth and
information technology, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Volunteers in Medicine Berkshires, Inc., MA, for 441,000 Markey, Warren
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Volunteers of America Southeast Louisiana Inc. 4,500,000 Cassidy
Services Administration. and Subsidiaries, LA, for facilities and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Wahiawa Center for Community Health, HI, for 1,500,000 Schatz
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Washington County, OR, for facilities and 2,500,000 Merkley, Wyden
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Washington State University, WA, for facilities 1,470,000 Murray
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Wayne Memorial Hospital, PA, for equipment....... 1,000,000 Casey
Services Administration.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services West Hawaii Region of the Hawaii Health Systems 2,500,000 Hirono, Schatz
Services Administration. Corporation, HI, for electronic medical records
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services West Side Community Health Services (dba 3,700,000 Klobuchar, Smith
Services Administration. Minnesota Community Care), MN, for facilities
and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services West Virginia School of Osteopathic Medicine 6,000,000 Capito
Services Administration. Clinic Inc., WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services West Virginia University Hospitals, Inc., WV, for 6,428,000 Capito, Manchin
Services Administration. WVU Medicine Children's Hospital for facilities
and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services West Virginia University Research Corporation, 12,600,000 Capito, Manchin
Services Administration. WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services WestCare Arizona, Inc., AZ, for facilities and 303,000 Sinema
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Western Nevada College, NV, for facilities and 4,392,000 Cortez Masto, Rosen
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Westside Family Healthcare, DE, for facilities 5,000,000 Carper, Coons
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services WhidbeyHealth Medical Center, WA, for facilities 2,500,000 Murray
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services White Mountain Regional Medical Center, f.k.a. 3,000,000 Kelly, Sinema
Services Administration. White Mountain Communities Hospital, Inc., AZ,
for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services William S. Baer School Partnership Board, MD, for 300,000 Cardin, Van Hollen
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Williams County Health Department, OH, for 1,000,000 Brown
Services Administration. facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Women and Infants Hospital, RI, for facilities 1,808,000 Reed, Whitehouse
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Wood County Parks and Recreation Commission/ 300,000 Capito, Manchin
Services Administration. Mountwood Park, WV, for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Wood River Health, RI, for facilities and 100,000 Reed
Services Administration. equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Yalobusha General Hospital and Nursing Home, MS, 591,000 Wicker
Services Administration. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Health Resources and Services Yuma Regional Medical Center, AZ, for facilities 1,500,000 Kelly, Sinema
Services Administration. and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental A Place to Belong, MN, for services for adults 75,000 Klobuchar, Smith
Services Health Services Administration. diagnosed with a serious mental illness.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Addiction Recovery Coalition of New Hampshire, 308,000 Shaheen
Services Health Services Administration. NH, for substance use disorder treatment and
recovery services, including peer support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental AIDS Service Center of Lower Manhattan, Inc. dba 500,000 Gillibrand, Schumer
Services Health Services Administration. Alliance for Positive Change, NY, for substance
use and mental health treatment services,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Allegheny-Singer Research Institute D/B/A AHN 900,000 Casey
Services Health Services Administration. Research Institute, PA, for mental health
programming, including through the creation of a
digital application.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Appalachian Children Coalition, OH, for substance 1,220,000 Brown
Services Health Services Administration. use prevention, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Axiom Community of Recovery, AZ, for recovery 638,000 Sinema
Services Health Services Administration. services, including peer-based support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Board of Trustees of the University of Illinois, 1,500,000 Durbin
Services Health Services Administration. IL, for school-based mental health services,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Boys & Girls Clubs of Southern Maine, ME, for 508,000 Collins
Services Health Services Administration. youth mental and behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Briarpatch Youth Services, WI, for counseling 400,000 Baldwin
Services Health Services Administration. services for at-risk youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Cambria County Drug Coalition, PA, for a mobile 115,000 Casey, Fetterman
Services Health Services Administration. crisis response unit, including supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Carlsbad LifeHouse, NM, for mental and behavioral 1,000,000 Heinrich
Services Health Services Administration. health care services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Cathedral Square Corporation, VT, for mental 1,776,000 Welch
Services Health Services Administration. health services, including technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Catholic Charities, Inc.-Archdiocese of Hartford, 616,000 Blumenthal, Murphy
Services Health Services Administration. CT, for a substance use disorder treatment
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Children's Hospital and Health Systems Inc., WI, 1,000,000 Baldwin
Services Health Services Administration. to help children and families access mental
health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Chinese-American Planning Council, Inc., NY, for 500,000 Gillibrand, Schumer
Services Health Services Administration. mental health support services, including
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental City of Everett, WA, for an alternative response 4,500,000 Murray
Services Health Services Administration. team for individuals experiencing behavioral and
mental health crises.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Clark County, NV, for behavioral health training 934,000 Cortez Masto, Rosen
Services Health Services Administration. and peer support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Clark County, NV, for crisis response services, 535,000 Cortez Masto, Rosen
Services Health Services Administration. including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Clark County, NV, for substance use treatment 942,000 Cortez Masto, Rosen
Services Health Services Administration. services in detention facilities including
medication assisted treatment, counseling, and
referral services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Cohen Veterans Network Inc., AK, for mental and 1,315,000 Murkowski
Services Health Services Administration. behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Colorado Meth Project Inc./DBA Rise Above 500,000 Bennet, Hickenlooper
Services Health Services Administration. Colorado, CO, for a substance use and overdose
prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Communities United, IL, for mental health and 450,000 Durbin
Services Health Services Administration. wellness services for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Community Mental Health Authority of Clinton, 1,972,000 Peters
Services Health Services Administration. Eaton, and Ingham Counties, MI, for a mental
health crisis stabilization center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental County of Orange, CA, to increase opioid 872,000 Feinstein, Padilla
Services Health Services Administration. prevention, education, and intervention
services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Cowlitz Indian Tribe, WA, for a mobile health 700,000 Cantwell, Murray
Services Health Services Administration. unit for substance use disorder treatment,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Division of Indian Work, MN, for services to 200,000 Klobuchar, Smith
Services Health Services Administration. mothers and infants to improve outcomes for
infants with prenatal exposure to drugs or
alcohol.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Envision:You, CO, to expand access to mental 845,000 Bennet
Services Health Services Administration. health services for at-risk communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Families Reaching Into Each New Day (FRIENDS 50,000 Reed
Services Health Services Administration. WAY), RI, for mental health services for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Gallup Community Health, NM, for mental health 516,000 Heinrich
Services Health Services Administration. and substance use treatment services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Garrett County Lighthouse, Inc., MD, for mental 85,000 Cardin, Van Hollen
Services Health Services Administration. health crisis services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Gateways Hospital and Mental Health Center, CA, 500,000 Padilla
Services Health Services Administration. for mental health services for youth, including
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Hawaii Health & Harm Reduction Center, HI, for 550,000 Schatz
Services Health Services Administration. behavioral health services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental HopeHealth Hospice & Palliative Care, RI, for 80,000 Reed
Services Health Services Administration. mental health services for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Jacob's Ladder Assistance Fund Inc., WV, for 127,000 Capito
Services Health Services Administration. behavioral health and support services to
address adverse childhood experiences, including
training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Kauai Planning and Action Alliance, HI, for youth 200,000 Hirono, Schatz
Services Health Services Administration. mental health and suicide prevention services,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Kennebec Behavioral Health (KBH), ME, for mental 750,000 King
Services Health Services Administration. and behavioral services, including crisis
support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Kent County, MI, for a behavioral health crisis 750,000 Peters, Stabenow
Services Health Services Administration. stabilization unit.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Kettle Moraine YMCA, WI, for youth mental health 150,000 Baldwin
Services Health Services Administration. programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Lauren's Wish Addiction Triage Center Inc., WV, 838,000 Capito, Manchin
Services Health Services Administration. for substance use disorder treatment and support
services, including supplies and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Libera, Inc, WV, for a mental health program, 200,000 Capito, Manchin
Services Health Services Administration. including the purchase of vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Lily's Place, WV, for substance use disorder 395,000 Capito
Services Health Services Administration. treatment and other support services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Lines for Life, OR, for suicide prevention 1,163,000 Merkley, Wyden
Services Health Services Administration. services, including expansion of a peer-to-peer
program for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Lyon County Department of Human Services, NV, for 673,000 Cortez Masto, Rosen
Services Health Services Administration. a youth mobile crisis team, including a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Marshall University Research Corporation, WV, for 1,000,000 Capito, Manchin
Services Health Services Administration. services for youth affected by parental
substance use.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Marshall University Research Corporation, WV, to 500,000 Manchin
Services Health Services Administration. support psychology graduate students to increase
access to mental health services in schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Mercy Family Center, LA, for mental health and 1,000,000 Cassidy
Services Health Services Administration. support services, including case management and
information technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Mid Fairfield Child Guidance Center, Inc., CT, 1,398,000 Blumenthal, Murphy
Services Health Services Administration. for school-based mental health services and care
coordinators.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Minnesota State University, Mankato, MN, for a 1,000,000 Klobuchar, Smith
Services Health Services Administration. mental health training clinic, including
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Mississippi State University, MS, for mental and 2,557,000 Hyde-Smith
Services Health Services Administration. behavioral health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Morgan County Partnership, Inc., WV, for 500,000 Capito, Manchin
Services Health Services Administration. behavioral health and support services to
address adverse childhood experiences, including
training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Mothers United Against Violence Inc., CT, for 500,000 Blumenthal, Murphy
Services Health Services Administration. trauma support and mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental NAMI New Hampshire (National Alliance on Mental 128,000 Shaheen
Services Health Services Administration. Illness), NH, for mental health and substance
use disorder services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental National Alliance on Mental Illness of New York 750,000 Schumer
Services Health Services Administration. City, Inc. (NAMI-NYC), NY, for mental health
services including peer-based support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Native American LifeLines, Inc, MA, for a 600,000 Markey, Warren
Services Health Services Administration. substance use and behavioral health education
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Nazareth College of Rochester, NY, for mental 250,000 Gillibrand, Schumer
Services Health Services Administration. health care including therapy and wellness
services for underserved children and adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental New Mexico Department of Health, NM, to improve 700,000 Heinrich, Lujan
Services Health Services Administration. care coordination through a community hub,
including through integrating mental and
behavioral healthcare with primary care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Oregon Health Authority, OR, for a public 3,000,000 Merkley, Wyden
Services Health Services Administration. awareness campaign to prevent suicide.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Out Boulder County, CO, for mental health 223,000 Hickenlooper
Services Health Services Administration. services for youth, including buses.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Pediatric Resource Center of Alaska, AK, for 74,000 Murkowski
Services Health Services Administration. behavioral health services training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Portage Recovery Center, WI, for recovery 100,000 Baldwin
Services Health Services Administration. services including peer support.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Preventing Tobacco Addiction Foundation, OH, for 961,000 Brown
Services Health Services Administration. a tobacco education program, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Pueblo of Laguna, NM, for an overdose prevention 35,000 Heinrich
Services Health Services Administration. program, including supplies and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Red Oak Behavioral Health, OH, for school-based 750,000 Brown
Services Health Services Administration. mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Rise Above, WA, for a youth mental health and 755,000 Murray
Services Health Services Administration. wellness program for indigenous adolescents.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Sinai Health System, IL, for mental health 1,250,000 Durbin
Services Health Services Administration. services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Socorro County Options Prevention and Education 81,000 Lujan
Services Health Services Administration. (SCOPE), NM, for mental health and suicide
prevention.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental St. Charles Health System, Inc., OR, to improve 1,142,000 Merkley, Wyden
Services Health Services Administration. access to mental and behavioral health services,
including equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental StayWell Health Care, Inc., CT, for a mental 330,000 Blumenthal, Murphy
Services Health Services Administration. health program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Stratis Health, MN, for a substance use treatment 550,000 Klobuchar, Smith
Services Health Services Administration. and overdose prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Taos Whole Community Health, NM, for a substance 700,000 Heinrich
Services Health Services Administration. use disorder treatment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental The Alliance for Community Wellness, CA, for a 357,000 Padilla
Services Health Services Administration. mobile mental health clinic, including a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental The Martinsburg Initiative, Inc., WV, for 500,000 Capito
Services Health Services Administration. behavioral health and support services to
address adverse childhood experiences, including
training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental The Martinsburg Initiative, Inc., WV, for 201,000 Capito
Services Health Services Administration. substance use prevention and treatment services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental The University of New Hampshire (UNH), NH, for a 112,000 Shaheen
Services Health Services Administration. youth mental health first aid program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Tides Family Services, RI, for mental and 150,000 Whitehouse
Services Health Services Administration. behavioral health care and supportive services,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental United Community and Family Servicers, Inc., CT, 335,000 Blumenthal, Murphy
Services Health Services Administration. for a medication assisted treatment program,
including equipment and the purchase of a van.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental United Way of Matanuska-Susitna Borough, AK, for 38,000 Murkowski
Services Health Services Administration. youth substance use prevention services,
including training and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental University of Chicago Medical Center, IL, for 1,100,000 Durbin
Services Health Services Administration. mental health and trauma recovery services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental University of Mississippi, MS, for substance use 3,230,000 Hyde-Smith, Wicker
Services Health Services Administration. prevention and treatment services, including
training and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental University of New Mexico, NM, for training and 600,000 Lujan
Services Health Services Administration. technical assistance for school-based health
centers to prevent and treat adolescent
substance use.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental University of New Mexico, NM, to expand a 3,905,000 Heinrich
Services Health Services Administration. training program for providers to better treat
babies exposed to opioids.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental University of Oregon Ballmer Institute for 1,304,000 Merkley, Wyden
Services Health Services Administration. Children's Behavioral Health, OR, for mental and
behavioral health care for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental UW Madison, WI, to establish a regional center to 2,000,000 Baldwin
Services Health Services Administration. combat the opioid and fentanyl crisis and
increase access to treatment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Virginia Hospital & Healthcare Association 969,000 Kaine, Warner
Services Health Services Administration. Foundation, VA, to improve access to treatment
for individuals with substance use disorder.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental W.A.R.M. Inc., NY, for mental health and trauma- 588,000 Gillibrand, Schumer
Services Health Services Administration. related therapy.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Walker, Inc. (dba Walker Therapeutic and 400,000 Markey, Warren
Services Health Services Administration. Educational Programs), MA, for mental health and
therapeutic programming for children, including
training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Wellspring Inc., ME, for substance use disorder 467,000 King
Services Health Services Administration. treatment services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental West Liberty University, WV, for a therapy and 80,000 Manchin
Services Health Services Administration. counseling program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental Women In Leadership, NM, for a substance use and 530,000 Heinrich
Services Health Services Administration. overdose prevention program, including supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental WV Game Changers Inc., WV, for youth substance 50,000 Capito, Manchin
Services Health Services Administration. use prevention education, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental YMCA of Honolulu, HI, for programming to support 864,000 Hirono, Schatz
Services Health Services Administration. youth mental health.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Substance Abuse and Mental YWCA Alaska, AK, for youth mental and behavioral 500,000 Murkowski
Services Health Services Administration. health services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and 4MYCITY INC, MD, for a program to improve food 1,000,000 Van Hollen
Services Families. security among low income individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and A Wider Circle, MD, for a donation program for 500,000 Cardin, Van Hollen
Services Families. low income individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Adoptive and Foster Families of Maine, Inc., ME, 100,000 Collins
Services Families. for a kinship caregiver program, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Alaska Children's Trust, AK, for child abuse 250,000 Murkowski
Services Families. prevention.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Annie C. Courtney Foundation, Inc., CT, for job 150,000 Blumenthal, Murphy
Services Families. training and employment opportunities for foster
youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Bean's Cafe Inc., AK, for dependency prevention 1,000,000 Murkowski
Services Families. programming, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Bethel Winter Shelter Lions Club, AK, for case 300,000 Murkowski
Services Families. management services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Big Brothers Big Sisters of New Hampshire, NH, 260,000 Shaheen
Services Families. for a mentoring program for at-risk youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Brigid's Path, OH, for services to support Title 500,000 Brown
Services Families. IV-E prevention services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Brown County United Way, WI, to expand access to 450,000 Baldwin
Services Families. childcare services for immigrant and refugee
families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and CASA Youth Advocates Inc., PA, to connect 161,000 Fetterman
Services Families. vulnerable children and families to community
services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and CASA, MD, to increase access to services for 1,000,000 Cardin, Van Hollen
Services Families. vulnerable communities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Centro Hispano Daniel Torres Inc., PA, for a 235,000 Casey
Services Families. family support and skill-building program for
parents.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Centro Romero, IL, for programming and support 150,000 Duckworth
Services Families. for vulnerable communities and to support
financial self-sufficiency.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Child and Family Charities, MI, for supportive 1,500,000 Stabenow
Services Families. services for low income families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Children Unlimited, Inc., NH, for quality 115,000 Shaheen
Services Families. improvement for early learning programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and City of Dearborn, MI, for supportive services to 1,000,000 Peters
Services Families. families to reduce poverty.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Clark County, NV, to support foster youth through 949,000 Cortez Masto, Rosen
Services Families. outreach and recruitment of quality caregivers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Colorado Food Cluster Inc., CO, to reduce food 903,000 Hickenlooper
Services Families. insecurity, including food, supplies, and
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Community Action Organization of Western New 310,000 Gillibrand, Schumer
Services Families. York, NY, for a support program for at-risk
youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Consejo Counseling and Referral Service, WA, for 750,000 Murray
Services Families. a trauma-informed domestic violence therapy and
recovery services program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and County of Union, New Jersey, NJ, to improve 1,880,000 Booker, Menendez
Services Families. access to human services, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Court Appointed Special Advocates of New 175,000 Shaheen
Services Families. Hampshire, NH, for child abuse prevention.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Covenant House Alaska, AK, for youth homelessness 2,000,000 Murkowski
Services Families. prevention and response.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Cradles to Crayons, Inc., MA, to support a 270,000 Markey, Warren
Services Families. donation program for low income children,
including equipment and the purchase of a truck.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Cradles to Crayons, Inc., PA, to expand a diaper 363,000 Casey
Services Families. distribution program and to study its impact,
including the purchase of diapers and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Digital NEST, CA, for supportive services for 840,000 Feinstein, Padilla
Services Families. families to improve career opportunities and
economic mobility.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and F.A.I.T.H., Inc., GA, for supportive services to 400,000 Warnock
Services Families. survivors of child abuse and their non-offending
caregiver(s).
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Feeding America Eastern Wisconsin, WI, to reduce 500,000 Baldwin
Services Families. food insecurity including through the purchase
of food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Food Link, Inc., MA, to support low income 100,000 Markey, Warren
Services Families. families through a food distribution program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Franklin County and North Quabbin Children's 194,000 Markey, Warren
Services Families. Advocacy Center, Inc., MA, MA, to provide
services to children and families affected by
child sexual abuse.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Hale Kipa, HI, to improve economic mobility for 521,000 Schatz
Services Families. at-risk youth, including supplies.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Hampton Roads Community Action Program, Inc., VA, 498,000 Kaine, Warner
Services Families. for supportive services for families, including
equipment and transportation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Hawaii Children's Action Network, HI, for 150,000 Schatz
Services Families. programming to support low income populations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Hazleton Integration Project, PA, for a pilot to 419,000 Casey
Services Families. increase access to healthy food for low income
individuals, including equipment and a van.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Heart of Maine United Way, ME, for an early 370,000 Collins, King
Services Families. childhood program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Hispanic Federation, NY, to provide assistance to 1,000,000 Gillibrand, Schumer
Services Families. low income individuals, including food and
hygiene products.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Illuminate Colorado, CO, for services including 670,000 Bennet, Hickenlooper
Services Families. home visitation to reduce child maltreatment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and International Rescue Committee in Denver, CO, for 93,000 Bennet, Hickenlooper
Services Families. services and a community navigation program for
immigrants and refugees.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and L.E.A.D., Inc., GA, for programming for middle 400,000 Ossoff
Services Families. and high school aged girls, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Latin American Association, GA, for supportive 200,000 Ossoff
Services Families. programming for students and their families to
enhance college and career opportunities,
including technology and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Marshfield Area United Way, WI, to reduce 10,000 Baldwin
Services Families. childhood hunger, including through the purchase
of food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and McAuley Ministries, RI, for programs and services 110,000 Reed
Services Families. for the unhoused, including equipment and food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Mitzvah Circle Foundation, PA, to support low 500,000 Casey
Services Families. income families, including through the purchase
of basic essential items including hygiene
products.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Nine Star Enterprises Inc., AK, for dependency 1,650,000 Murkowski
Services Families. prevention programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Pacific Resources for Education and Learning 84,000 Hirono
Services Families. (PREL), HI, to examine the root causes of
absenteeism to improve financial outcomes and
reduce poverty.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Pacific Survivor Center, HI, for resiliency 75,000 Schatz
Services Families. trainings to prevent adverse childhood
experiences.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Pennsylvania CASA Association, PA, for a training 456,000 Casey
Services Families. program to support vulnerable children.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and R Kids, Inc., CT, to improve outcomes for 355,000 Blumenthal, Murphy
Services Families. children exposed to trauma.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Refugee Women's Alliance, WA, to provide child 2,000,000 Murray
Services Families. care and early childhood education to under-
resourced populations.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Residential Youth Services and Empowerment 850,000 Hirono
Services Families. (RYSE), HI, for education, outreach, programming
and services to support at-risk individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Rhode Island Coalition to End Homelessness, RI, 750,000 Reed
Services Families. for supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Rural Alaska Community Action Program, Inc., AK, 99,000 Murkowski
Services Families. for child care services, including scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Saint Francis Hospital and Medical Center, CT, 1,274,000 Blumenthal, Murphy
Services Families. for a community health worker program and to
provide wrap-around services to low income
patients.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Ser Familia, GA, for a culturally proficient 500,000 Ossoff, Warnock
Services Families. family resource center for Latino families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and TEAM for West Virginia Children, Inc., WV, for 100,000 Capito, Manchin
Services Families. child abuse prevention.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and TEAM, Inc., CT, for a healthy food access program 230,000 Blumenthal, Murphy
Services Families. for low income individuals, including food.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Giving Kitchen Initiative, GA, to improve 250,000 Ossoff
Services Families. economic outcomes and financial stability for
low income workers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The National Runaway Safeline, IL, to support 425,000 Duckworth
Services Families. youth experiencing homelessness through an
evaluation of crisis intervention and prevention
programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Northern Lighthouse, Inc., ME, for services 510,000 King
Services Families. and education for homeless youth, including the
purchase of a van.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Open Door Network, CA, for services and 1,500,000 Padilla
Services Families. support to individuals at risk of experiencing
homelessness.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Peche Hen DBA Over the Moon, GA, for a diaper 381,000 Ossoff, Warnock
Services Families. distribution program, including diapers and
vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Spirit Horse Ranch, HI, for youth trauma 541,000 Schatz
Services Families. support services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and The Zero Abuse Project, MN, for a child abuse 1,200,000 Klobuchar, Smith
Services Families. prevention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and United Jewish Organizations of Williamsburg Inc, 750,000 Schumer
Services Families. NY, to provide assistance to low income
individuals and families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and University of New Mexico, NM, to measure the 500,000 Heinrich, Lujan
Services Families. prevalence of child abuse and neglect.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Vicksburg Family Development Service, MS, for 247,000 Hyde-Smith
Services Families. child abuse prevention, including the purchase
of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Warroad Community Childcare Center, MN, for child 322,000 Klobuchar, Smith
Services Families. care services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and West Virginia Food and Farm Coalition, Inc., WV, 200,000 Manchin
Services Families. for a food assistance program for low income
individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and Young Fathers dba; Fathers New Mexico, NM, for 213,000 Heinrich
Services Families. family support services for young fathers to
improve outcomes for children.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and YWCA Clark County, WA, for a therapeutic 475,000 Cantwell, Murray
Services Families. preschool program that increases resiliency
among children and families, including
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Children and YWCA Tri-County Area, PA, to provide services to 828,000 Fetterman
Services Families. reduce poverty.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... African American Museum of Bucks County, PA, for 260,000 Casey
support of educational programs of the African
American Education Center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Alaska Humanities Forum, AK, for an Alaska 150,000 Murkowski
studies program, including curriculum
development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Alaska Library Network, AK, for a reading 250,000 Murkowski
program, including the purchase of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Amigos del Museo del Barrio, Inc., NY, to expand 500,000 Gillibrand, Schumer
bilingual, arts-based educational programming
and support education initiatives.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Anchorage School District, AK, for the purchase 301,000 Murkowski
of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Arctic Slope Community Foundation, AK, for a 1,000,000 Murkowski
teacher recruitment and preparation program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Art with a Heart, MD, for arts education and out 506,000 Cardin, Van Hollen
of school time programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... ArtsQuest, PA, for youth enrichment, education 1,000,000 Casey
and arts-based learning.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Baltimore Symphony Orchestra, MD, for music 249,000 Cardin, Van Hollen
education, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Bernice Pauahi Bishop Museum, HI, for curriculum 500,000 Hirono, Schatz
and website development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Best Buddies International, Inc., IL, for the 250,000 Duckworth
Best Buddies in Illinois Inclusion Project for
Students with Intellectual and Developmental
Disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Best Buddies International, Inc., PA, for the 125,000 Casey
Pennsylvania Best Buddies inclusion project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Big Brothers Big Sisters of Greater Pittsburgh, 275,000 Fetterman
PA, for mentoring programs at Woodland Hills and
Clairton City School Districts.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Big Brothers Big Sisters of Metro Atlanta, Inc., 250,000 Ossoff, Warnock
GA, for youth mentoring.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Big Brothers Big Sisters of Southwest Washington, 750,000 Murray
WA, for a career exploration program for high
school students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Blueprint for Change, HI, for family resource 1,150,000 Hirono, Schatz
centers, including the purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Books Are Wings, RI, for an early literacy 20,000 Reed
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Boys & Girls Club of Greater Milwaukee, WI, for 930,000 Baldwin
high school completion and transition support
for postsecondary education and the workforce.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Boys & Girls Club of Northeast Mississippi Inc., 1,000,000 Hyde-Smith, Wicker
MS, for an out of school time program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Boys & Girls Club of Pawtucket, RI, to expand 642,000 Reed, Whitehouse
access to youth programs and transition supports.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Boys & Girls Club of Rochester, MN, for out-of- 250,000 Klobuchar, Smith
school time program expansion.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Boys & Girls Clubs of Newport County, RI, for 300,000 Reed, Whitehouse
afterschool programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... BPE Inc., MA, for STEM career pathways........... 400,000 Markey, Warren
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Bridgeport Public Schools, CT, for social- 706,000 Blumenthal, Murphy
emotional and mental health support for students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Bright Lights Book Project, AK, for a reading 25,000 Murkowski
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Bristol Virginia Public Schools, VA, to acquire 567,000 Kaine, Warner
and install an inclusive and accessible
playground.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Building One Community, Inc., CT, for afterschool 200,000 Blumenthal, Murphy
and summer programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... California State University East Bay, CA, for the 1,200,000 Feinstein, Padilla
California Promise Neighborhood program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Carden Academy of Maui, HI, for STEM education, 184,000 Hirono, Schatz
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Center for the Innovative Training of Youth, 3,000,000 Cassidy
Inc., LA, for a STEM program, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Cherokee By Choice, Inc., GA, for mobile workshop 83,000 Ossoff
for skilled trades career, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... City of Lynn, MA, for early childhood education.. 1,658,000 Markey, Warren
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... City of New Haven, CT, for a bioscience academic 1,500,000 Blumenthal, Murphy
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Clifford W. Beers Guidance Clinic, Inc., CT, to 1,162,000 Blumenthal, Murphy
improve mental health services at Hamden Public
Schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Colorado River BOCES, CO, for a regional career 1,021,000 Bennet
pathway education and training initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Community Education Commission, MI, for 800,000 Stabenow
afterschool programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Community Libraries of Providence, RI, for 100,000 Reed
library materials for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Creative Nomads, MD, for arts education and youth 80,000 Cardin, Van Hollen
development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Danbury Public Schools, CT, for curriculum 1,875,000 Blumenthal, Murphy
redesign.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... DAY ONE Early Learning Community, NY, for early 1,200,000 Gillibrand, Schumer
childhood education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Delaware Division of Libraries, DE, to acquire 1,938,000 Carper, Coons
school library books.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Desert Research Institute, NV, for STEM education 2,800,000 Cortez Masto, Rosen
and career development, including scholarships
for postsecondary education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Dual Language Education of New Mexico, NM, for 250,000 Heinrich
culturally and linguistically responsive
education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... East Bay Educational Collaborative, RI, for 565,000 Reed
science education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Eastern Rhode Island Conservation District 50,000 Reed
(ERICD), RI, for science-based learning.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Eaton Regional Education Service Agency, MI, for 340,000 Peters
equipment for an aviation-focused career and
technical education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Educate Maine, ME, for the Maine Center for 525,000 King
Teaching and learning to strengthen, grow, and
diversify Maine's educator workforce.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... EXCEL Alaska, Inc., AK, for a rural outreach 750,000 Murkowski
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Fairbanks North Star Borough School District, AK, 100,000 Murkowski
for farming education, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Fine Arts Work Center in Provincetown, MA, for 750,000 Markey, Warren
arts education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... FIRST Washington Robotics, WA, to expand access 511,000 Murray
to STEM education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Flint River Fresh, Inc., GA, to expand farm to 269,000 Ossoff
school programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... ForKids, inc., VA, for afterschool programming... 170,000 Kaine, Warner
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Friends of the Future, HI, to expand the health 235,000 Hirono, Schatz
and wellness program, including the purchase of
a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Garden State Equality Education Fund, Inc., NJ, 400,000 Booker, Menendez
for trauma-informed strategies to support LGBTQ+
youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Grand Rapids African American Health Institute, 800,000 Stabenow
MI, for healthcare career education and training
pathways.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Greater Providence YMCA, RI, for physical 600,000 Reed, Whitehouse
education and water safety programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Greenbrier Valley Theatre, WV, for education 350,000 Capito, Manchin
programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Harriet Tubman Museum of Cape May, NJ, for 421,000 Booker
educational programming, curriculum development,
and arts education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Hawaii Agriculture Foundation, HI, for 949,000 Hirono, Schatz
agricultural-focused education programs,
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Hawaii Literacy, HI, for literacy programs....... 252,000 Schatz
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Hawaii Teach for America, HI, for tutoring, 174,000 Hirono, Schatz
including stipends for tutors.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Heartlinks Grief Center at Family Hospice of 120,000 Duckworth
Belleville Area, IL, for grief support
curriculum for elementary and secondary
education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Honolulu First Church of the Nazarene, HI, for 40,000 Hirono
the Waolani Judd Nazarene School Hawaiian
cultural enrichment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Hydaburg City School District, AK, for the 100,000 Murkowski
purchase of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Illinois State Alliance of YMCAs, IL, for youth 400,000 Duckworth
development, physical education and water safety.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Imua Family Services, HI, for an outdoor 91,000 Schatz
inclusion preschool, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Itawamba Agricultural High School, MS, for 94,000 Hyde-Smith
agricultural education, including the purchase
of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... KID Museum, MD, for STEM education and youth 704,000 Cardin, Van Hollen
development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Las Cruces Public Schools, NM, to support the 427,000 Heinrich
career ready toolbox program including stipends,
supplies and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Lincoln Center for the Performing Arts, Inc., NY, 1,000,000 Gillibrand, Schumer
for arts programming for youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Make the Road States, Inc., DBA Make the Road CT, 155,000 Blumenthal, Murphy
CT, for student success centers to improve
college access for youth from historically
underserved communities, including stipends for
college ambassadors.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Maui Academy of Performing Arts, HI, for arts 375,000 Schatz
education programming, including scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Maui Economic Opportunity (MEO), HI, for early 105,000 Hirono, Schatz
childhood education workforce training,
including student stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... McDuffie County School System, GA, for STEM 105,000 Ossoff
education and outdoor learning, including
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Michigan Science Center, MI, for science 987,000 Stabenow
education programs, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Milwaukee Public Schools, WI, for the Success 1,600,000 Baldwin
Center and support of social and emotional
learning and mental health services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Mission Economic Development Agency, CA, for the 750,000 Feinstein, Padilla
California Promise Neighborhood program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Mission West Virginia, WV, for a mentoring 225,000 Capito, Manchin
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Mississippi Charter School Authorizer Board, MS, 510,000 Hyde-Smith
for immersive education technology and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Mount Vernon School District, WA, to improve 436,000 Murray
student safety and provide outreach for drug
impacted and gang involved youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Mystic Seaport Museum, CT, for mentoring, STEM 570,000 Blumenthal, Murphy
education, and enrichment, including student
stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Nashua PAL, NH, for youth development programs, 108,000 Shaheen
including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Native Village of Kotzebue, AK, for native 50,000 Murkowski
language and culture education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Navajo Preparatory School, NM, for a student 500,000 Heinrich
leadership development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Neighborhood Housing Services of Greater 264,000 Blumenthal, Murphy
Waterbury, CT, for the pathways to success
initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... New England Institute of Technology, RI, for 100,000 Reed
career exposure for high school students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... New Hampshire Learning Initiative, NH, to improve 424,000 Shaheen
math teaching and learning, including through
subgrants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Newark Mentoring Movement, NJ, for a school-based 135,000 Booker
mentoring initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Newport Public Schools, RI, for equipment for 500,000 Reed
career and technical education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... North Light Community Center, PA, for the Teen 90,000 Casey
Services Program, including student stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... North Slope Borough School District, AK, for 580,000 Murkowski
native language and culture education, including
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... OH WOW! Center for Science & Technology, OH, for 1,450,000 Brown
STEM education and workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Oregon Department of Education, OR, to revitalize 450,000 Merkley, Wyden
rural public school libraries.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Our Piece of the Pie, CT, for youth development, 750,000 Blumenthal, Murphy
postsecondary education preparation and
workforce readiness training for youth and young
adults in foster care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Pacific Historic Parks, HI, for an interactive 341,000 Schatz
education project, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Phoenixville Area School District, PA, for 75,000 Casey
education and curriculum for a greenhouse
learning initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Pocono Mountains United Way, PA, to develop and 397,000 Casey
expand community schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Prevention of Blindness Society of Metropolitan 200,000 Cardin, Van Hollen
Washington, MD, for school-based vision health
services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Project GOAL Inc., RI, for academic programming.. 146,000 Reed
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Project Vision Hawaii, HI, for equipment and a 300,000 Schatz
vehicle for hearing health care in schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Quaker Valley School District, PA, for life 100,000 Casey
skills curriculum and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Reach Out and Read Rhode Island, RI, for a 50,000 Reed
literacy program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Read Alliance, Inc., NY, to expand tutoring 300,000 Gillibrand, Schumer
programs, include stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Reading Is Fundamental, Inc., DC, for a literacy 1,500,000 Wicker
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Reading is Fundamental, MD, for childhood 500,000 Cardin, Van Hollen
literacy in pre-K through middle school in
Baltimore City Public Schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Rhode Island Black Heritage Society, RI, for 400,000 Reed, Whitehouse
educational programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Rhode Island Center for the Book, RI, for writing 20,000 Reed
programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Rhode Island School of Design, RI, for 60,000 Reed
professional development curriculum for
elementary and secondary educators.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... RSU 13, ME, for mentoring, education and support 450,000 King
services for at-risk and system-involved youth.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Rural Alaska Community Action Program, Inc., AK, 261,000 Murkowski
for early childhood education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... San Diego Zoo Wildlife Alliance, CA, for the 500,000 Feinstein
Native Biodiversity Corps program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... San Miguel Education Center, RI, for a Student 50,000 Whitehouse
Sponsorship Program to provide year-round
educational opportunities to middle school
students in the Providence community.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Save the Children Federation, Inc., CA, to 1,000,000 Feinstein, Padilla
improve food security and access to educational
resources for underserved children and families,
including purchase of three vehicles.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Save the Children Federation, Inc., MS, for a 997,000 Wicker
literacy program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Save the Children Federation, Inc., WV, to 750,000 Capito, Manchin
improve early childhood education and education
programs including through food security and
nutrition education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Sealaska Heritage Institute, AK, for a literacy 250,000 Murkowski
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... SEE Science Center, NH, for STEM education, 200,000 Shaheen
including exhibits and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Siembra Leadership High School, NM, for dual 113,000 Heinrich
enrollment and college transition programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... South Bay Community Services, CA, for the 876,000 Feinstein, Padilla
California Promise Neighborhood program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Southern West Virginia Community College 800,000 Capito, Manchin
Foundation, WV, for an early college program,
including the purchase of technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Stamford Public Education Foundation, CT, for an 200,000 Blumenthal, Murphy
early childhood education summer program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Summer Search Philadelphia, PA, for mentoring 200,000 Casey
programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The African Alliance of Rhode Island, RI, for 180,000 Reed, Whitehouse
agricultural education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Agoge Project, MD, for out-of-school time 75,000 Cardin, Van Hollen
programs, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Carnegie Hall Corporation, NY, for an 1,000,000 Gillibrand, Schumer
orchestral education program, with a special
emphasis on recruiting students from communities
historically underrepresented in the field of
classical music, and for culminating concerts
and associated travel.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Center for Holocaust & Humanity Education, 237,000 Brown
DBA: Nancy & David Wolf Holocaust & Humanity
Center, OH, to address antisemitism through
school district partnerships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Education Alliance--Business and Community 400,000 Capito, Manchin
for Public Schools, Inc., WV, for a work-based
learning program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Ethan Miller Song Foundation, CT, for firearm 59,000 Blumenthal, Murphy
safety curriculum for middle and high schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Viscardi Center, Inc., NY, for disabilities 150,000 Gillibrand, Schumer
history education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... The Water Council, WI, for academic and career 300,000 Baldwin
development in the water sector.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Tree of Life, Inc., PA, for elementary and 1,000,000 Casey
secondary education curriculum and programming
on preventing antisemitism and identity-based
hate.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... U.S. Olympic & Paralympic Museum (USOPM), CO, for 889,000 Bennet
social-emotional learning through Team STRONG
program expansion in Colorado.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... United Way of Erie County, PA, for a community 350,000 Casey
schools initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
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 Alaska Anchorage, AK, for a STEM 1,000,000 Murkowski
education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... University of Maine System, ME, for a teacher 3,300,000 Collins, King
retention program, including for teacher
stipends and the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... University of Mississippi, MS, for a family 600,000 Hyde-Smith, Wicker
engagement program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... University of Mississippi, MS, for 700,000 Hyde-Smith, Wicker
interdisciplinary Autism Spectrum Disorder
evaluation services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... University of Nebraska Board of Regents, NE, for 2,000,000 Fischer
an early childhood education workforce network
and training initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... USS Constitution Museum, MA, for education 125,000 Markey, Warren
programs, including exhibits.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Vermont Agency of Education, VT, to expand the 1,895,000 Sanders
global leadership program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Vermont Student Assistance Corporation, VT, for a 296,000 Welch
career and education pathway initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Very Merry Theatre, VT, for arts-based summer 118,000 Sanders
education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Virginia Department of Education, VA, for the 1,028,000 Kaine, Warner
Virginia STEM ecosystem.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Vision to Learn, GA, for a mobile vision clinic 400,000 Ossoff
for student vision care, including equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Vision to Learn, MI, for a vision care program 1,100,000 Stabenow
for students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Washington Middle School, HI, for STEM education, 380,000 Schatz
including student fellowships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Washoe County School District, NV, for a school 2,000,000 Cortez Masto, Rosen
leadership pathway project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Waterbury School District, CT, to increase 85,000 Blumenthal, Murphy
student attendance.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Waterville School System, ME, for the purchase of 718,000 Collins
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Weitzman National Museum of American Jewish 250,000 Casey
History, PA, for educational programming on the
history and present-day impact of antisemitism.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... West End Neighborhood House, DE, for youth 600,000 Carper, Coons
programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... West Virginia Coding Club, WV, for training in 30,000 Manchin
computer coding.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... Western Museum Of Mining & Industry, CO, for a 87,000 Bennet, Hickenlooper
mobile STEM education program, including
purchase of a vehicle.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Innovation and Improvement..... YMCA of Snohomish County, WA, to expand access to 943,000 Murray
early childhood education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Alaska Pacific University, AK, for a teacher 985,000 Murkowski
apprenticeship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Alcorn State University and Alcorn Extension 1,366,000 Hyde-Smith
Program, MS, for agricultural education,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Allan Hancock Joint Community College District, 1,500,000 Padilla
CA, for a nursing program, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Alma College, MI, for equipment for the Great 850,000 Stabenow
Lakes Watershed Institute.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Averett University, VA, for a center for 670,000 Kaine, Warner
continuing education.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Bard College, NY, for prison education and 4,500,000 Schumer
reentry programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Bellin College, WI, for a mental health nurse 400,000 Baldwin
practitioner program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Benedictine College, KS, for the purchase of 1,000,000 Moran
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Bethany College, WV, for online education, 1,000,000 Capito, Manchin
including the purchase of equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Blue Mountain College, MS, for nursing education, 1,530,000 Hyde-Smith, Wicker
including scholarships and the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Blue Ridge Community and Technical College, WV, 254,000 Capito, Manchin
for veterinary technician training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... BridgeValley Community & Technical College 1,586,000 Capito, Manchin
Foundation Inc., WV, for a nursing program,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... BridgeValley Community & Technical College 212,000 Capito, Manchin
Foundation Inc., WV, for a medical laboratory
technology program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Building Futures, RI, for educator workforce 360,000 Reed
development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Central Arizona College, AZ, for a 1,024,000 Kelly, Sinema
telecommunications training initiative,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Central New Mexico Community College, NM, for a 500,000 Heinrich
teacher training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Central New Mexico Community College, NM, for 862,000 Lujan
quantum and STEM-related programs, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Chaminade University of Honolulu, HI, for a 1,500,000 Schatz
prison education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Clark Atlanta University, GA, for cybersecurity 500,000 Ossoff, Warnock
and critical infrastructure programs, including
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Coker University, SC, for a healthcare education 2,000,000 Graham
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... College of Southern Nevada, NV, for the nursing 2,300,000 Cortez Masto, Rosen
simulation lab project, including the purchase
of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... College Unbound, RI, for college completion and 900,000 Reed
workforce development services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... College Visions, RI, for a college access program 300,000 Reed, Whitehouse
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Colorado Mountain College, CO, for bilingual 300,000 Bennet, Hickenlooper
workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Columbia University in the City of New York, NY, 388,000 Gillibrand, Schumer
for Project Start Right.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Columbus State University, GA, for the Curricula 550,000 Ossoff, Warnock
for CHIPS Education project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Commonwealth of Virginia, VA, for a scholarship 500,000 Kaine, Warner
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Community College of Rhode Island, RI, for 814,000 Reed, Whitehouse
education and workforce programs, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Community College System of New Hampshire, NH, 280,000 Shaheen
for a dual and concurrent enrollment program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Complete College America (CCA), NM, for a college 900,000 Lujan
retention and completion program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Creighton University Health Sciences-- Phoenix 1,450,000 Sinema
Campus, Phoenix AZ, Maricopa County, AZ, for the
purchase of equipment for a medical virtual
reality training room.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Delaware State University, DE, for the purchase 2,346,000 Carper, Coons
of equipment for the aviation program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Delta College, MI, for development of 284,000 Peters, Stabenow
semiconductor curriculum and apprenticeship
programming.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Delta State University, MS, for the purchase of 500,000 Hyde-Smith, Wicker
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Delta State University, MS, for the purchase of 1,000,000 Hyde-Smith
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Desert Research Institute, NV, for the purchase 1,800,000 Cortez Masto, Rosen
of equipment for the environmental studies
project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Dominican University, IL, for a masters in 1,000,000 Durbin
nursing program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Eastern Maine Community College, ME, for 1,648,000 Collins
workforce training, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Eastern West Virginia Community and Technical 150,000 Capito, Manchin
College Foundation Inc., WV, for an aviation
program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Edison State Community College, OH, for the 900,000 Brown
purchase of equipment for a new respiratory care
degree program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... El Puente de Encuentros, NM, for a behavioral 247,000 Heinrich, Lujan
health professionals programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Fort Hays State University, KS, for the purchase 3,000,000 Moran
of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Francis Marion University, SC, for the purchase 1,200,000 Graham
of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Glenville State College Research Corporation, WV, 2,120,000 Capito, Manchin
for the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Goucher College, MD, for the Prison Education 355,000 Cardin, Van Hollen
Partnership.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Grand Valley State University, MI, for the Blue 2,500,000 Peters, Stabenow
Dot Center for Talent, Technology and
Transformation, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Great Basin College, NV, for a health science 760,000 Cortez Masto, Rosen
program, including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Great Basin College, NV, for workforce 1,422,000 Cortez Masto, Rosen
preparedness training systems.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Greenville Technical College, SC, for the 2,980,000 Graham
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Greenville University, IL, for the purchase of 665,000 Durbin
equipment for science facilities and building a
nursing pipeline.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Higher Education Regional Alliance--Greater 1,500,000 Baldwin
Milwaukee Committee, WI, for microcredentials
project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hispanic Federation, IL, for a college readiness, 700,000 Duckworth
achievement, and retention program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hostos Community College, City University of New 1,000,000 Gillibrand, Schumer
York, NY, for student mentorship and research
assistant programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hudson County Community College (HCCC), NJ, for 1,000,000 Booker, Menendez
the Hudson Scholars Program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Hudson Valley Community College, NY, for an 500,000 Gillibrand, Schumer
aircraft mechanic training program, including
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Husson University, ME, for the purchase of 999,000 Collins, King
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... I Know I Can, OH, for programs to increase 994,000 Brown
college and career enrollment and graduation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Inver Hills Community College, MN, for the 250,000 Klobuchar, Smith
purchase of equipment for a health sciences
center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Jackson State University, MS, for a journalism 1,172,000 Wicker
program, including the purchase of equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Jackson State University, MS, for cyber security 1,500,000 Wicker
education, including for scholarships and the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... James Madison University, VA, for early 1,000,000 Kaine, Warner
healthcare workforce development programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Journey into Education & Teaching (JET), MA, for 300,000 Markey, Warren
educator workforce programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Juniata College, PA, for a nursing program....... 500,000 Casey
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Kansas State University--Salina Aerospace and 4,000,000 Moran
Technology Campus, KS, for the purchase of
aviation equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Kawerak, Inc., AK, for a teacher training program 484,000 Murkowski
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Keene State College, NH, for education and 3,000,000 Shaheen
training programs in ultra-precision
manufacturing, optics, and thin film coatings.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... King's College, PA, for an occupational therapy 450,000 Casey
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Laurel Ridge Community College Educational 305,000 Kaine, Warner
Foundation on behalf of Laurel Ridge Community
College, VA, for the purchase of a virtual
reality training system for prospective surgical
technologists and assistants.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Long Island University--Roc Nation School of 1,000,000 Gillibrand, Schumer
Music, Sports & Entertainment, NY, for the early
scholars program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Lourdes University, OH, for an educator workforce 374,000 Brown
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Maine Maritime Academy, ME, for the development 3,000,000 Collins
of training programs, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Malcolm X College, IL, for the purchase of 355,000 Duckworth
equipment for the child development program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Marian University, WI, for the purchase of 1,049,000 Baldwin
equipment of health and STEM education programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Maricopa Community Colleges, AZ, for a 2,500,000 Kelly
semiconductor workforce training program,
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Marquette University, WI, for the purchase of 1,611,000 Baldwin
equipment for a simulation center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Marshall University Research Corporation, WV, for 1,500,000 Capito, Manchin
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Maryland Association of Community Colleges, MD, 2,000,000 Cardin, Van Hollen
for the purchase of equipment for a
cybersecurity workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Massachusetts Women of Color Coalition, Inc, MA, 655,000 Markey, Warren
for a leadership academy, including a data
collection system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... MATC Fast Fund, WI, for supporting students' 500,000 Baldwin
basic needs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... McHenry County College, IL, for the purchase of 1,060,000 Durbin
equipment for Foglia Center for Advanced
Technology and Innovation.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... McKendree University, IL, for a rural nurse 980,000 Durbin
educator workforce program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... McPherson College, KS, for health care education, 2,100,000 Moran
including the purchase of equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Medgar Evers College, NY, for an environmental 500,000 Schumer
health program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Medical College of Wisconsin, WI, for workforce 500,000 Baldwin
development in biomedical sciences, healthcare,
and STEM fields, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mercyhurst University, PA, for a program for 250,000 Casey
students with autism.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Miami University, OH, to support educator 415,000 Brown
workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Michigan State University, MI, for cybercrimes 1,000,000 Peters
investigations and training programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Minnesota State Community and Technical College, 1,650,000 Klobuchar, Smith
MN, for the purchase of equipment for healthcare
simulation labs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Monroe Community College, NY, for a semiconductor 259,000 Schumer
training initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mount Marty College, SD, for the purchase of 370,000 Rounds
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mountwest Foundation Inc., WV, for workforce 195,000 Capito, Manchin
development programs, including faculty stipends.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Mt. San Antonio Community College District, CA, 534,000 Feinstein, Padilla
for the purchase of equipment for the Wildland
Fire Training Program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nevada State College, NV, for a speech-language 938,000 Cortez Masto, Rosen
pathologist educational and training project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Nevada State College, NV, for the mental health 1,650,000 Cortez Masto, Rosen
workforce development project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... New York University, NY, for the Institute of 1,150,000 Gillibrand, Schumer
Public Knowledge.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Newberry College, SC, for the purchase of 506,000 Graham
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Newman University Inc., KS, for agribusiness 1,200,000 Moran
education, including the purchase of equipment
and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northeastern Illinois University, IL, for a 145,000 Duckworth
veterans resource center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Illinois University, IL, for the LEAP 1,660,000 Durbin
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Maine Community College Foundation, ME, 550,000 Collins, King
for the purchase of communications equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northern Maine Community College Foundation, ME, 410,000 Collins, King
for the purchase of equipment and technology for
a diesel hydraulic program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northwest Indian College, WA, for the purchase of 1,200,000 Cantwell
science education equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Northwestern Michigan College, MI, for the 550,000 Stabenow
purchase of student aviation equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... O.S. Johnson Technical Institute, PA, for 806,000 Fetterman
technology and equipment for a Johnson College
satellite campus.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Oakton College, IL, for education and 800,000 Duckworth
experiential learning for students entering the
medical field, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Oregon Coast Community College, OR, for a 896,000 Merkley, Wyden
maritime construction and technician training
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Oregon Health & Science University, OR, for a 2,000,000 Merkley, Wyden
nursing education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Ottawa University, KS, for the purchase of 900,000 Moran
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Paul D. Camp Community College, VA, to establish 293,000 Kaine, Warner
and expand nursing and allied health programs
and purchase equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Peninsula College, WA, for a dental school 1,936,000 Murray
training clinic, including the purchase of
equipment and retrofitting.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pennsylvania College of Art & Design, PA, for a 725,000 Casey
live-experience design and production degree
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Pierpont Foundation Inc., WV, for the purchase of 1,496,000 Capito, Manchin
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Portland Community College, OR, for a program to 1,675,000 Merkley, Wyden
expand the healthcare workforce.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Prisma Health, SC, for a nursing program, 500,000 Graham
including scholarships and the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Providence College, RI, for mental health nursing 600,000 Reed, Whitehouse
education and workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Providence Promise, RI, for a postsecondary 50,000 Reed
access program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rensselaer Polytechnic Institute, NY, for the 1,000,000 Gillibrand, Schumer
purchase of equipment for the Center for Robotic
Manufacturing Systems.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rhode Island College, RI, for a financial aid 1,020,000 Reed
management system.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rhode Island College, RI, for technology for a 1,270,000 Reed
continuing education program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rhode Island College, RI, for the purchase of 340,000 Whitehouse
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Richland Community College, IL, for an EV 1,100,000 Duckworth
innovation hub.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rockford Public Schools, IL, for an education 300,000 Duckworth
pathway partnership.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rowan University, NJ, for a regenerative food 1,000,000 Booker, Menendez
systems program, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Rust College, MS, for a communications degree 695,000 Wicker
program, including the purchase of equipment and
technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Shawnee Community College, IL, for the welding 336,000 Duckworth
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Shepherd University Foundation Inc., WV, for the 2,235,000 Capito, Manchin
purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Shepherd University, WV, for the Stubblefied 250,000 Manchin
Institute's WV Emerging Project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Shorter College, AR, for a STEAM center, 2,000,000 Boozman
including the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Siena College, NY, for the purchase of equipment 1,000,000 Gillibrand, Schumer
for a new science complex.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Skills for Rhode Island's Future, RI, for an 730,000 Reed, Whitehouse
experiential learning program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Southern Oregon University, OR, to support 500,000 Merkley, Wyden
educational opportunities for college students.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Southern University and A&M College, LA, for 2,100,000 Cassidy
legal education, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Southern University and A&M College, LA, for 365,000 Cassidy
technology education, including the purchase of
equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... St. Bonaventure University, NY, for the purchase 750,000 Gillibrand, Schumer
of equipment for the School of Communications.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Sterling College, VT, for workforce readiness and 695,000 Welch
experiential learning programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... SUNY Geneseo, NY, for the purchase of equipment.. 500,000 Schumer
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Sussex County Community College, NJ, for the 546,000 Booker
Public Safety Training Academy, including the
purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The City College of New York, NY, for skills- 1,500,000 Gillibrand, Schumer
based workforce development.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The Research Foundation for SUNY at Binghamton 1,000,000 Gillibrand, Schumer
University, NY, for the purchase of equipment
for a cleanroom.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... The University of Vermont and State Agricultural 1,999,000 Sanders
College, VT, for a university assisted community
schools collaborative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Tuskegee University, AL, for an aviation and aero 6,724,000 Britt
technology program, including scholarships and
the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Alaska Anchorage, AK, for 750,000 Murkowski
development of a graduate degree program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Alaska Anchorage, AK, for expanding 295,000 Murkowski
social workers in schools.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of California, San Diego, CA, for the 1,656,000 Padilla
PATHS Scholars Program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Delaware, DE, for workforce 1,000,000 Carper
education and development in battery
manufacturing, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Hartford, CT, for teacher 300,000 Blumenthal, Murphy
certification programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Hawaii System, HI, for the purchase 900,000 Hirono, Schatz
of equipment for a medical education, residency,
and fellowship expansion initiative.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Maine System, ME, for the 3,057,000 Collins, King
development of a doctoral nursing program,
including scholarships.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Maine System, ME, for the purchase 463,000 Collins, King
of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Maryland Eastern Shore, MD, for the 1,071,000 Cardin, Van Hollen
veterinary medicine program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Nevada Las Vegas, NV, for the 4,000,000 Cortez Masto, Rosen
purchase of high-performance computing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Nevada Reno, NV, for the purchase 2,406,000 Cortez Masto, Rosen
of a Nuclear Magnetic Resonance Spectrometer.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Nevada Reno, NV, for the purchase 1,800,000 Cortez Masto, Rosen
of research and educational platform equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of North Alabama, AL, for the purchase 500,000 Britt
of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of North Carolina System, NC, for the 7,800,000 Tillis
purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of South Dakota, SD, for biomedical 6,500,000 Rounds
computation education, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Southern Mississippi, MS, for a 3,000,000 Hyde-Smith, Wicker
teacher resident program, including scholarships
and the purchase of equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... University of Virginia, VA, for the Youth 900,000 Kaine, Warner
Leadership Initiative, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia Foundation for Community College 1,500,000 Kaine, Warner
Education, VA, for the purchase of equipment for
skilled trades training programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Virginia Polytechnic Institute and State 2,000,000 Kaine, Warner
University, VA, for the purchase of
semiconductor automatic testing equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Viterbo University, WI, for a healthcare 150,000 Baldwin
workforce training program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Warren Community College, NJ, for a precision 699,000 Booker, Menendez
agriculture technology project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Washington County Community College, ME, for the 1,629,000 Collins, King
purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Wayne State University, MI, for equipment for a 1,000,000 Stabenow
school of public health.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... West Virginia Higher Education Policy Commission, 250,000 Capito, Manchin
WV, for the development and implementation of
career pathways.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... West Virginia University Research Corporation, 1,100,000 Capito, Manchin
WV, for the purchase of equipment and training.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Westminster College, PA, an exercise science 376,000 Casey
program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... Wichita State University Campus of Applied 1,000,000 Moran
Sciences and Technology, KS, for aviation
education, including the purchase of equipment
and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... William & Mary (W&M), VA, for a national security 500,000 Kaine, Warner
internship program.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... William James College, MA, for educator workforce 496,000 Markey, Warren
development activities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... William Rainey Harper College, IL, for a 500,000 Duckworth
semiconductor and nanotechnology technician
project.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... William Rainey Harper College, IL, for the 1,000,000 Durbin
purchase of equipment for the emergency services
training center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... YMCA of Greater Providence (GPYMCA), RI, for out- 635,000 Reed, Whitehouse
of-school time programs.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Education Higher Education............... York County Community College, ME, for the 986,000 Collins, King
purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Albuquerque Community Foundation, NM, to support 208,000 Lujan
Services Living. services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Albuquerque Sign Language Academy, NM, to support 300,000 Heinrich
Services Living. services for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Alzheimer's Family Caregiver Support Center, 994,000 Markey, Warren
Services Living. Inc., MA, to support services for families,
individuals, and communities living with
Alzheimer's and other dementia-related disease.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Arc Massachusetts Inc., MA, to support services 1,635,000 Markey, Warren
Services Living. for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Autism Society Northwestern Pennsylvania, PA, to 350,000 Casey
Services Living. support services for individuals on the Autism
Spectrum.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Blackstone Valley Community Action Program, Inc. 85,000 Reed
Services Living. (BVCAP), RI, for supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Cape Abilities, MA, for vehicles and equipment... 1,618,000 Markey, Warren
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Challenge Aspen, CO, for equipment............... 94,000 Bennet, Hickenlooper
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Community Health Centers of America, CA, for 125,000 Padilla
Services Living. geriatric health and supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Direction Home of Eastern Ohio, OH, to expand 239,000 Brown
Services Living. kinship care.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Eastern Area Agency on Aging, ME, for expanding 270,000 Collins, King
Services Living. access to services for older adults, including
the purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Give Comfort, Inc., WV, for supportive services.. 10,000 Manchin
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community JASA, NY, for supportive services for older 750,000 Schumer
Services Living. adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Jefferson Area Board for Aging (JABA), Inc., VA, 100,000 Kaine, Warner
Services Living. for supportive services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Jewish Community Center on the Palisades (DBA: 965,000 Menendez
Services Living. Kaplen JCC on the Palisades), NJ, to expand
services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Las Cumbres Community Services, NM, to expand 944,000 Heinrich
Services Living. services for individual with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Laura Baker Services Association, MN, to support 500,000 Klobuchar, Smith
Services Living. services for individuals with disabilities and
their families.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Lehigh Valley Center for Independent Living 150,000 Casey
Services Living. (LVCIL), PA, for supportive services for
individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community LGBTQ Senior Housing, Inc., MA, for services for 850,000 Markey, Warren
Services Living. older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Liberty Resources Inc., PA, to support services 1,516,000 Fetterman
Services Living. for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Lyon County Human Services, NV, for respite and 411,000 Cortez Masto, Rosen
Services Living. supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community McDowell County Commission on Aging, Inc., WV, 554,000 Manchin
Services Living. for equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Mississippi State University, MS, for enhancing 882,000 Hyde-Smith, Wicker
Services Living. college accessibility for students with
disabilities, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Northwest Colorado Health, CO, for equipment..... 105,000 Bennet, Hickenlooper
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Partners In Care Maryland, Inc., MD, to support 1,000,000 Cardin, Van Hollen
Services Living. services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Pathways Community HUB Institute, OH, to support 640,000 Brown
Services Living. integrated services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Port Resources, ME, for enhancing community 100,000 Collins, King
Services Living. access for individuals with developmental
disabilities, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Queen's Health System, HI, for a training program 300,000 Schatz
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Rural Alaska Community Action Program, Inc., AK, 138,000 Murkowski
Services Living. for expanding access to supports, services, and
activities for older individuals.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community SAGE, NY, for supportive services................ 1,000,000 Gillibrand, Schumer
Services Living.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Sounding Joy Music Therapy, Inc., HI, for 125,000 Schatz
Services Living. supportive services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Southern Maine Agency on Aging, ME, for expanding 600,000 Collins
Services Living. access to services for older adults, including
the purchase of equipment and technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Special Education Center of Hawaii (SECOH), HI, 250,000 Hirono
Services Living. for facilities and equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Specially Adapted Resource Clubs (SPARC), VA, to 763,000 Kaine, Warner
Services Living. expand services for individuals with
disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Summit County Combined General Health District, 504,000 Brown
Services Living. OH, to support services for at risk older adults
and family caregivers..
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Taylor County Senior Citizens, Inc., WV, to 18,000 Manchin
Services Living. support renovations for a senior center.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Team Gleason Foundation, LA, for addressing the 6,000,000 Cassidy
Services Living. needs of individuals with ALS, including the
purchase of equipment and assistive technology.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community The Disability Action Center, WV, for facilities, 500,000 Capito, Manchin
Services Living. equipment and to expand services for individuals
with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community United Way of the Greater Lehigh Valley, PA, for 423,000 Casey
Services Living. supportive services for older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community University of Southern Mississippi, MS, for 200,000 Hyde-Smith, Wicker
Services Living. enhancing networks and supports for students
with disabilities, including the purchase of
equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community Voices for Independence, PA, to support services 99,000 Fetterman
Services Living. for individuals with disabilities.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community WV Bureau of Senior Services, WV, for facilities, 2,565,000 Manchin
Services Living. equipment and services that support senior
centers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Department of Health & Human Administration for Community YMCA of Honolulu, HI, to expand services for 388,000 Hirono, Schatz
Services Living. older adults.
--------------------------------------------------------------------------------------------------------------------------------------------------------
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2023 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2024
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2023 Budget estimate Committee -----------------------------------
appropriation recommendation 2023
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I--DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
Training and Employment Services
Grants to States:
Adult Training, current year appropriations............... 173,649 187,987 173,649 ................ -14,338
Available from prior year appropriations.............. 712,000 712,000 712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, available this fiscal year.............. 885,649 899,987 885,649 ................ -14,338
Advance appropriation FY 2025......................... 712,000 712,000 712,000 ................ ................
less prior year appropriations........................ -712,000 -712,000 -712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, appropriated in this bill............... 885,649 899,987 885,649 ................ -14,338
Youth Training............................................ 948,130 963,837 948,130 ................ -15,707
Dislocated Worker Assistance, current year appropriations. 235,553 295,278 235,553 ................ -59,725
Available from prior year appropriations.............. 860,000 860,000 860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, available this fiscal year.............. 1,095,553 1,155,278 1,095,553 ................ -59,725
Advance appropriation FY 2025......................... 860,000 860,000 860,000 ................ ................
less prior year appropriations........................ -860,000 -860,000 -860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, appropriated in this bill............... 1,095,553 1,155,278 1,095,553 ................ -59,725
-----------------------------------------------------------------------------------------
Subtotal, Grants to States............................ 2,929,332 3,019,102 2,929,332 ................ -89,770
Current year appropriations....................... (1,357,332) (1,447,102) (1,357,332) ................ (-89,770)
Advance appropriations............................ (1,572,000) (1,572,000) (1,572,000) ................ ................
National Programs:
Dislocated Worker Assistance National Reserve:
Current year appropriations........................... 125,859 164,386 105,859 -20,000 -58,527
Available from prior year appropriations.............. 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, available this fiscal year.............. 325,859 364,386 305,859 -20,000 -58,527
Advance appropriations FY 2025........................ 200,000 200,000 200,000 ................ ................
less prior year appropriations........................ -200,000 -200,000 -200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, appropriated in this bill............... 325,859 364,386 305,859 -20,000 -58,527
-----------------------------------------------------------------------------------------
Subtotal, Dislocated Worker Assistance................ 1,421,412 1,519,664 1,401,412 -20,000 -118,252
Indian and Native American programs....................... 60,000 63,800 60,000 ................ -3,800
Migrant and Seasonal Farmworker programs.................. 97,396 97,396 97,396 ................ ................
YouthBuild activities..................................... 105,000 145,000 105,000 ................ -40,000
Reintegration of Ex-Offenders............................. 115,000 170,000 115,000 ................ -55,000
Workforce Data Quality Initiative......................... 6,000 11,000 6,000 ................ -5,000
Apprenticeship programs................................... 285,000 335,000 290,000 +5,000 -45,000
Congressionally Directed Spending/Community Project 217,324 ................ 107,939 -109,385 +107,939
Funding..................................................
Climate Corps............................................. ................ 15,000 ................ ................ -15,000
SECTOR.................................................... ................ 200,000 ................ ................ -200,000
-----------------------------------------------------------------------------------------
Subtotal, National Programs........................... 1,211,579 1,401,582 1,087,194 -124,385 -314,388
Current year appropriations....................... 1,011,579 1,201,582 887,194 -124,385 -314,388
Advance appropriations............................ 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Training and Employment Services............... 4,140,911 4,420,684 4,016,526 -124,385 -404,158
=========================================================================================
Current year appropriations....................... (2,368,911) (2,648,684) (2,244,526) (-124,385) (-404,158)
Advance appropriations............................ (1,772,000) (1,772,000) (1,772,000) ................ ................
Job Corps
Operations.................................................... 1,603,325 1,603,133 1,603,325 ................ +192
Construction, Rehabilitation and Acquisition.................. 123,000 183,000 123,000 ................ -60,000
Administration................................................ 33,830 49,334 33,830 ................ -15,504
-----------------------------------------------------------------------------------------
Total, Job Corps.......................................... 1,760,155 1,835,467 1,760,155 ................ -75,312
=========================================================================================
Community Service Employment For Older Americans.............. 405,000 405,000 405,000 ................ ................
Federal Unemployment Benefits and Allowances (indefinite)..... 494,400 30,700 30,700 -463,700 ................
State Unemployment Insurance and Employment Service Operations
Unemployment Compensation (trust fund)........................ ................ ................ ................ ................ ................
State Administration...................................... 2,750,635 2,947,318 2,815,635 +65,000 -131,683
Reemployment Services and Eligibility Assessments--UI 117,000 117,000 117,000 ................ ................
integrity................................................
RESEA cap adjustment...................................... 258,000 433,000 265,000 +7,000 -168,000
UI Integrity Center of Excellence......................... 9,000 9,000 9,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation................... 3,134,635 3,506,318 3,206,635 +72,000 -299,683
Federal-State UI National Activities (trust fund)......... 23,000 173,255 18,000 -5,000 -155,255
Employment Service [ES]:
Grants to States:
Federal Funds......................................... 21,413 21,413 21,413 ................ ................
Trust Funds........................................... 658,639 677,449 653,639 -5,000 -23,810
-----------------------------------------------------------------------------------------
Subtotal, Grants to States........................ 680,052 698,862 675,052 -5,000 -23,810
ES National Activities (trust fund)....................... 25,000 25,000 25,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Employment Service.......................... 705,052 723,862 700,052 -5,000 -23,810
Federal Funds..................................... (21,413) (21,413) (21,413) ................ ................
Trust Funds....................................... (683,639) (702,449) (678,639) (-5,000) (-23,810)
Foreign Labor Certifications:
Federal Administration.................................... 60,528 75,044 61,528 +1,000 -13,516
Grants to States.......................................... 23,282 28,282 23,282 ................ -5,000
-----------------------------------------------------------------------------------------
Subtotal, Foreign Labor Certification................. 83,810 103,326 84,810 +1,000 -18,516
One-Stop Career Centers/Labor Market Information.............. 62,653 85,653 62,653 ................ -23,000
-----------------------------------------------------------------------------------------
Total, State Unemployment Insurance and Employment Service 4,009,150 4,592,414 4,072,150 +63,000 -520,264
Operations...............................................
=========================================================================================
Federal Funds......................................... (84,066) (107,066) (84,066) ................ (-23,000)
Trust Funds........................................... (3,925,084) (4,485,348) (3,988,084) (+63,000) (-497,264)
Program Administration
Training and Employment....................................... 68,919 93,485 68,919 ................ -24,566
Trust Funds............................................... 9,253 10,430 9,253 ................ -1,177
Employment Security........................................... 3,621 4,181 3,621 ................ -560
Trust Funds............................................... 42,574 55,006 42,574 ................ -12,432
Apprenticeship Services....................................... 38,913 50,397 38,913 ................ -11,484
Executive Direction........................................... 7,447 9,281 7,447 ................ -1,834
Trust Funds............................................... 2,188 2,686 2,188 ................ -498
-----------------------------------------------------------------------------------------
Total, Program Administration......................... 172,915 225,466 172,915 ................ -52,551
=========================================================================================
Federal Funds..................................... (118,900) (157,344) (118,900) ................ (-38,444)
Trust Funds....................................... (54,015) (68,122) (54,015) ................ (-14,107)
-----------------------------------------------------------------------------------------
Total, Employment and Training Administration......... 10,982,531 11,509,731 10,457,446 -525,085 -1,052,285
=========================================================================================
Federal Funds..................................... 7,003,432 6,956,261 6,415,347 -588,085 -540,914
Current year appropriations................... (5,231,432) (5,184,261) (4,643,347) (-588,085) (-540,914)
Advance appropriations........................ (1,772,000) (1,772,000) (1,772,000) ................ ................
Trust Funds....................................... 3,979,099 4,553,470 4,042,099 +63,000 -511,371
Employee Benefits Security Administration [EBSA]
Salaries and Expenses
Enforcement and Participant Assistance........................ ................ 202,596 ................ ................ -202,596
Policy and Compliance Assistance.............................. ................ 37,045 ................ ................ -37,045
Executive Leadership, Program Oversight and Administration.... ................ 9,318 ................ ................ -9,318
Employee benefits security programs........................... 191,100 ................ 191,100 ................ +191,100
-----------------------------------------------------------------------------------------
Total, Employee Benefits Security Administration.......... 191,100 248,959 191,100 ................ -57,859
=========================================================================================
Pension Benefit Guaranty Corporation Fund
Consolidated Administrative Activities........................ (493,314) (512,900) (512,900) (+19,586) ................
Wage and Hour Division
Salaries and Expenses......................................... 260,000 340,953 264,500 +4,500 -76,453
Office of Labor-Management Standards
Salaries and Expenses......................................... 48,515 53,469 48,515 ................ -4,954
Office of Federal Contract Compliance Programs
Salaries and Expenses......................................... 110,976 151,462 110,976 ................ -40,486
Office of Workers' Compensation Programs
Salaries and Expenses......................................... 120,500 149,675 120,500 ................ -29,175
Trust Funds............................................... 2,205 2,271 2,205 ................ -66
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses.......................... 122,705 151,946 122,705 ................ -29,241
=========================================================================================
Special Benefits
Federal Employees' Compensation Benefits...................... 248,000 698,000 698,000 +450,000 ................
Longshore and Harbor Workers' Benefits........................ 2,000 2,000 2,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Benefits................................... 250,000 700,000 700,000 +450,000 ................
=========================================================================================
Special Benefits for Disabled Coal Miners
Benefit Payments.............................................. 42,000 28,000 28,000 -14,000 ................
Administration................................................ 5,031 5,140 5,140 +109 ................
-----------------------------------------------------------------------------------------
Subtotal, available this fiscal year...................... 47,031 33,140 33,140 -13,891 ................
Advance appropriations, FY 2025, 1st quarter.................. 10,250 7,000 7,000 -3,250 ................
Less prior year advance appropriations........................ -11,000 -10,250 -10,250 +750 ................
-----------------------------------------------------------------------------------------
Total, appropriated in this bill.......................... 46,281 29,890 29,890 -16,391 ................
=========================================================================================
Energy Employees Occupational Illness Compensation Fund
Administrative Expenses....................................... 64,564 66,532 66,532 +1,968 ................
Black Lung Disability Trust Fund
Benefit Payments and Interest on Advances..................... 313,586 366,906 366,906 +53,320 ................
Workers' Compensation Programs, Salaries and Expenses......... 42,194 44,059 44,059 +1,865 ................
Departmental Management, Salaries and Expenses................ 38,407 41,178 41,178 +2,771 ................
Departmental Management, Inspector General.................... 353 368 368 +15 ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability Trust Fund................ 394,540 452,511 452,511 +57,971 ................
Treasury Department Administrative Costs...................... 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................... 394,896 452,867 452,867 +57,971 ................
=========================================================================================
Total, Office of Workers' Compensation Programs........... 878,446 1,401,235 1,371,994 +493,548 -29,241
=========================================================================================
Federal Funds......................................... 876,241 1,398,964 1,369,789 +493,548 -29,175
Current year appropriations....................... (865,991) (1,391,964) (1,362,789) (+496,798) (-29,175)
Advance appropriations............................ (10,250) (7,000) (7,000) (-3,250) ................
Trust Funds........................................... 2,205 2,271 2,205 ................ -66
Occupational Safety and Health Administration (OSHA)
Salaries and Expenses
Safety and Health Standards................................... 21,000 31,214 21,000 ................ -10,214
Federal Enforcement........................................... 243,000 286,429 243,000 ................ -43,429
Whistleblower enforcement..................................... 22,500 29,158 22,500 ................ -6,658
State Programs................................................ 120,000 127,115 120,000 ................ -7,115
Technical Support............................................. 26,000 30,623 26,000 ................ -4,623
Compliance Assistance:
Federal Assistance........................................ 78,262 101,073 77,262 -1,000 -23,811
State Consultation Grants................................. 63,160 64,160 63,160 ................ -1,000
Training Grants........................................... 12,787 13,787 10,000 -2,787 -3,787
-----------------------------------------------------------------------------------------
Subtotal, Compliance Assistance....................... 154,209 179,020 150,422 -3,787 -28,598
Safety and Health Statistics.................................. 35,500 43,896 35,500 ................ -8,396
Executive Direction and Administration........................ 10,100 11,213 10,100 ................ -1,113
-----------------------------------------------------------------------------------------
Total, Occupational Safety and Health Administration...... 632,309 738,668 628,522 -3,787 -110,146
=========================================================================================
Mine Safety and Health Administration
Salaries and Expenses
Mine Safety and Health Enforcement............................ 265,774 301,528 265,774 ................ -35,754
Standards Development......................................... 5,000 5,583 5,000 ................ -583
Assessments................................................... 7,191 9,093 7,191 ................ -1,902
Educational Policy and Development............................ 39,820 43,642 39,820 ................ -3,822
Technical Support............................................. 36,041 39,755 36,041 ................ -3,714
Program Evaluation and Information Resources [PEIR]........... 17,990 ................ 17,990 ................ +17,990
Program Administration........................................ 16,000 ................ 16,000 ................ +16,000
Program Administration, Evaluation, and Information Resources. ................ 38,493 ................ ................ -38,493
-----------------------------------------------------------------------------------------
Total, Mine Safety and Health Administration.............. 387,816 438,094 387,816 ................ -50,278
=========================================================================================
Total, Labor Enforcement Agencies......................... 1,753,421 2,123,551 1,754,134 +713 -369,417
=========================================================================================
Federal Funds......................................... (1,751,216) (2,121,280) (1,751,929) (+713) (-369,351)
Trust Funds........................................... (2,205) (2,271) (2,205) ................ (-66)
Bureau of Labor Statistics
Salaries and Expenses
Employment and Unemployment Statistics........................ 243,952 278,649 243,952 ................ -34,697
Labor Market Information (trust fund)......................... 68,000 68,000 68,000 ................ ................
Prices and Cost of Living..................................... 246,000 264,782 246,000 ................ -18,782
Compensation and Working Conditions........................... 91,000 94,929 91,000 ................ -3,929
Productivity and Technology................................... 12,000 13,184 12,000 ................ -1,184
Executive Direction and Staff Services........................ 37,000 38,826 37,000 ................ -1,826
-----------------------------------------------------------------------------------------
Total, Bureau of Labor Statistics......................... 697,952 758,370 697,952 ................ -60,418
=========================================================================================
Federal Funds......................................... 629,952 690,370 629,952 ................ -60,418
Trust Funds........................................... 68,000 68,000 68,000 ................ ................
Office of Disability Employment Policy
Salaries and Expenses......................................... 43,000 60,549 37,000 -6,000 -23,549
Department Management
Salaries and Expenses
Executive Direction........................................... 32,658 48,778 32,658 ................ -16,120
Departmental Program Evaluation............................... 8,281 11,540 4,281 -4,000 -7,259
Legal Services................................................ 130,754 190,553 135,254 +4,500 -55,299
Trust Funds............................................... 308 308 308 ................ ................
International Labor Affairs................................... 116,125 130,525 116,125 ................ -14,400
Administration and Management................................. 30,804 63,148 30,804 ................ -32,344
Adjudication.................................................. 37,000 45,885 37,000 ................ -8,885
Women's Bureau................................................ 23,000 32,426 23,000 ................ -9,426
Civil Rights Activities....................................... 7,586 11,911 7,586 ................ -4,325
Chief Financial Officer....................................... 5,681 6,268 5,681 ................ -587
GSA Technology Transformation................................. ................ 4,182 ................ ................ -4,182
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses.............................. 392,197 545,524 392,697 +500 -152,827
=========================================================================================
Federal Funds......................................... (391,889) (545,216) (392,389) (+500) (-152,827)
Trust Funds........................................... (308) (308) (308) ................ ................
Veterans' Employment and Training
State Administration, Grants.................................. 185,000 185,000 185,000 ................ ................
Transition Assistance Program................................. 34,379 34,379 34,379 ................ ................
Federal Administration........................................ 47,048 59,334 47,048 ................ -12,286
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.................. 335,341 347,627 335,341 ................ -12,286
=========================================================================================
Federal Funds......................................... 65,500 65,500 65,500 ................ ................
Trust Funds........................................... (269,841) (282,127) (269,841) ................ (-12,286)
IT Modernization
Departmental support systems.................................. 6,889 51,689 6,889 ................ -44,800
Infrastructure technology modernization....................... 27,380 27,504 22,380 -5,000 -5,124
-----------------------------------------------------------------------------------------
Total, IT Modernization................................... 34,269 79,193 29,269 -5,000 -49,924
=========================================================================================
Office of Inspector General
Program Activities............................................ 91,187 105,439 91,187 ................ -14,252
Trust Funds............................................... 5,841 5,841 5,841 ................ ................
-----------------------------------------------------------------------------------------
Total, Office of Inspector General.................... 97,028 111,280 97,028 ................ -14,252
=========================================================================================
Federal funds..................................... (91,187) (105,439) (91,187) ................ (-14,252)
Trust funds....................................... (5,841) (5,841) (5,841) ................ ................
-----------------------------------------------------------------------------------------
Total, Departmental Management........................ 858,835 1,083,624 854,335 -4,500 -229,289
=========================================================================================
Federal Funds..................................... (582,845) (795,348) (578,345) (-4,500) (-217,003)
Trust Funds....................................... (275,990) (288,276) (275,990) ................ (-12,286)
-----------------------------------------------------------------------------------------
Total, Workforce Innovation and Opportunity Act 5,901,066 6,256,151 5,776,681 -124,385 -479,470
Programs.............................................
=========================================================================================
Current year appropriations....................... (4,129,066) (4,484,151) (4,004,681) (-124,385) (-479,470)
Advance appropriations............................ (1,772,000) (1,772,000) (1,772,000) ................ ................
-----------------------------------------------------------------------------------------
Total, Title I, Department of Labor................... 15,091,480 16,785,114 15,050,156 -41,324 -1,734,958
=========================================================================================
Federal Funds..................................... (10,766,186) (11,873,097) (10,661,862) (-104,324) (-1,211,235)
Current year appropriations................... (8,983,936) (10,094,097) (8,882,862) (-101,074) (-1,211,235)
Advance appropriations........................ (1,782,250) (1,779,000) (1,779,000) (-3,250) ................
Trust Funds....................................... (4,325,294) (4,912,017) (4,388,294) (+63,000) (-523,723)
-----------------------------------------------------------------------------------------
Total, title I discretionary appropriations........... 13,841,339 15,505,125 13,770,167 -71,172 -1,734,958
=========================================================================================
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 1,937,772 1,857,772 ................ -80,000
Free Clinics Medical Malpractice.............................. 1,000 1,000 1,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Primary Health Care................................ 1,858,772 1,938,772 1,858,772 ................ -80,000
=========================================================================================
Health Workforce
National Health Service Corps................................. 125,600 175,600 128,600 +3,000 -47,000
Training for Diversity:
Centers of Excellence..................................... 28,422 36,711 28,422 ................ -8,289
Health Careers Opportunity Program........................ 16,000 18,500 16,000 ................ -2,500
Faculty Loan Repayment.................................... 2,310 2,310 2,310 ................ ................
Scholarships for Disadvantaged Students................... 55,014 55,014 55,014 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Training for Diversity...................... 101,746 112,535 101,746 ................ -10,789
Primary Care Training and Enhancement......................... 49,924 53,924 49,924 ................ -4,000
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................... 47,245 47,245 48,245 +1,000 +1,000
Mental and Behavioral Health.............................. 44,053 50,000 44,053 ................ -5,947
Behavioral Health Workforce Education and Training........ 153,000 337,374 172,000 +19,000 -165,374
Substance Use Disorder Treatment and Recovery Loan ................ ................ ................ ................ ................
Repayment Program........................................
-----------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Community Linkages........ 291,298 481,619 311,298 +20,000 -170,321
Workforce Information and Analysis............................ 5,663 5,663 5,663 ................ ................
Public Health and Preventive Medicine programs................ 18,000 18,000 18,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Title VII Health Professions Education and 509,304 714,414 529,304 +20,000 -185,110
Training.................................................
Nursing Workforce Development Programs:
Advanced Nursing Education................................ 89,581 106,581 89,581 ................ -17,000
Nurse Education, Practice, and Retention.................. 59,413 91,873 60,413 +1,000 -31,460
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 29,500 +1,000 +1,000
-----------------------------------------------------------------------------------------
Subtotal, Title VIII Nursing Workforce Development 300,472 349,932 302,472 +2,000 -47,460
Programs.............................................
-----------------------------------------------------------------------------------------
Subtotal, Health Professions (Titles VII and VIII).... 809,776 1,064,346 831,776 +22,000 -232,570
Children's Hospitals Graduate Medical Education............... 385,000 385,000 385,000 ................ ................
Medical Student Education..................................... 60,000 60,000 36,000 -24,000 -24,000
Pediatric Subspecialty Loan Repayment Program................. 10,000 10,000 10,000 ................ ................
Supporting the Mental Health of the Health Professions ................ 25,000 ................ ................ -25,000
Workforce....................................................
Health Care Workforce Innovation Program...................... ................ 27,540 ................ ................ -27,540
National Practitioner Data Bank............................... 18,814 18,814 18,814 ................ ................
User Fees................................................. -18,814 -18,814 -18,814 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Health Workforce............................ 1,390,376 1,747,486 1,391,376 +1,000 -356,110
Maternal and Child Health
Maternal and Child Health Block Grant:
Maternal and Child Health Block Grant..................... 603,584 603,584 603,584 ................ ................
Special Projects of National Significance................. 219,116 333,716 209,116 -10,000 -124,600
-----------------------------------------------------------------------------------------
Subtotal, MCH Block Grant............................. 822,700 937,300 812,700 -10,000 -124,600
Sickle Cell Disease Treatment Program......................... 8,205 8,205 8,205 ................ ................
Autism and Other Developmental Disabilities................... 56,344 57,344 56,344 ................ -1,000
Heritable Disorders in Newborns and Children.................. 20,883 20,883 20,883 ................ ................
Healthy Start................................................. 145,000 185,000 145,000 ................ -40,000
Early Hearing Detection and Intervention...................... 18,818 18,818 18,818 ................ ................
Emergency Medical Services for Children....................... 24,334 28,134 24,334 ................ -3,800
Screening and Treatment for Maternal Depression............... 10,000 10,000 11,000 +1,000 +1,000
Pediatric Mental Health Care Access........................... 13,000 13,000 13,000 ................ ................
Innovation for Maternal Health................................ 15,300 15,300 15,300 ................ ................
Maternal Mental Health Hotline................................ ................ 7,000 7,000 +7,000 ................
Training for Health Care Professionals........................ ................ 5,000 ................ ................ -5,000
Poison Control Centers........................................ 26,846 26,846 26,846 ................ ................
Integrated Services for Pregnant and Postpartum Women......... 10,000 25,000 10,000 ................ -15,000
-----------------------------------------------------------------------------------------
Subtotal, Maternal and Child Health....................... 1,171,430 1,357,830 1,169,430 -2,000 -188,400
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....................... 165,000 290,000 165,000 ................ -125,000
-----------------------------------------------------------------------------------------
Subtotal, Ryan White HIV/AIDS program..................... 2,571,041 2,696,041 2,571,041 ................ -125,000
Health Systems
Organ Transplantation......................................... 31,049 67,049 33,049 +2,000 -34,000
Blood Stem Cell Transplantation Program....................... ................ 52,275 ................ ................ -52,275
National Cord Blood Inventory................................. 19,266 ................ 19,266 ................ +19,266
CW Bill Young Cell Transplantation............................ 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.................................. 99,009 135,009 101,009 +2,000 -34,000
Rural Health
Rural Outreach Grants......................................... 92,975 95,375 94,975 +2,000 -400
Rural Health Research/Policy Development...................... 11,076 11,076 11,076 ................ ................
Rural Hospital Flexibility Grants............................. 64,277 64,277 64,277 ................ ................
State Offices of Rural Health................................. 12,500 12,500 12,500 ................ ................
Black Lung Clinics............................................ 12,190 12,190 12,190 ................ ................
Radiation Exposure Screening and Education Program............ 1,889 2,734 1,889 ................ -845
Rural Communities Opioid Response............................. 145,000 165,000 155,000 +10,000 -10,000
Rural Residency Program....................................... 12,500 12,700 12,500 ................ -200
Rural Health Clinic Behavioral Health Initiative.............. ................ 10,000 ................ ................ -10,000
Financial and Community Sustainability for At-Risk Rural ................ 10,000 ................ ................ -10,000
Hospitals....................................................
Rural Hospital Stabilization Pilot Program.................... ................ 20,000 ................ ................ -20,000
-----------------------------------------------------------------------------------------
Subtotal, Rural Health.................................... 352,407 415,852 364,407 +12,000 -51,445
Family Planning............................................... 286,479 512,000 286,479 ................ -225,521
HRSA-Wide Activities and Program Support
Program Management............................................ 163,800 168,971 165,300 +1,500 -3,671
Congressionally Directed Spending/Community Project Funding... 1,521,681 ................ 891,997 -629,684 +891,997
340B Drug Pricing/Office of Pharmacy Affairs.................. 12,238 17,238 12,238 ................ -5,000
Telehealth.................................................... 38,050 44,500 38,050 ................ -6,450
Long COVID.................................................... ................ 130,000 5,000 +5,000 -125,000
-----------------------------------------------------------------------------------------
Subtotal, HRSA-Wide Activities and Program Support........ 1,735,769 360,709 1,112,585 -623,184 +751,876
-----------------------------------------------------------------------------------------
Total, Health Resources and Services (HRS)................ 9,465,283 9,163,699 8,855,099 -610,184 -308,600
=========================================================================================
Vaccine Injury Compensation Program Trust Fund
Post-FY 1988 Claims........................................... 256,370 261,497 261,497 +5,127 ................
HRSA Administrative expenses.................................. 15,200 26,200 15,200 ................ -11,000
-----------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund............. 271,570 287,697 276,697 +5,127 -11,000
=========================================================================================
Countermeasures Injury Compensation Trust Fund................ 7,000 15,000 7,000 ................ -8,000
-----------------------------------------------------------------------------------------
Total, Health Resources and Services Administration....... 9,743,853 9,466,396 9,138,796 -605,057 -327,600
=========================================================================================
Discretionary......................................... 9,487,483 9,204,899 8,877,299 -610,184 -327,600
CENTERS FOR DISEASE CONTROL AND PREVENTION
Immunization and Respiratory Diseases......................... 499,941 750,930 217,041 -282,900 -533,889
Prevention and Public Health Fund......................... (419,350) (505,000) (702,250) (+282,900) (+197,250)
-----------------------------------------------------------------------------------------
Subtotal.............................................. 919,291 1,255,930 919,291 ................ -336,639
HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and 1,391,056 1,544,556 1,395,056 +4,000 -149,500
Tuberculosis Prevention......................................
Emerging and Zoonotic Infectious Diseases..................... 698,772 793,772 698,772 ................ -95,000
Prevention and Public Health Fund......................... (52,000) (52,000) (52,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, EZID program level.......................... 750,772 845,772 750,772 ................ -95,000
Chronic Disease Prevention and Health Promotion............... 1,175,464 1,551,339 1,180,464 +5,000 -370,875
Prevention and Public Health Fund......................... (254,950) (262,200) (254,950) ................ (-7,250)
-----------------------------------------------------------------------------------------
Subtotal, Chronic Disease Prevention and Health 1,430,414 1,813,539 1,435,414 +5,000 -378,125
Promotion, program level.............................
Birth Defects, Developmental Disabilities, Disabilities and 205,560 222,560 206,060 +500 -16,500
Health.......................................................
Public Health Scientific Services............................. 754,497 651,222 495,167 -259,330 -156,055
Evaluation Tap Funding.................................... ................ (170,342) (244,330) (+244,330) (+73,988)
Prevention and Public Health Fund......................... ................ (140,000) ................ ................ (-140,000)
-----------------------------------------------------------------------------------------
Subtotal, Public Health Scientific Services, program 754,497 961,564 739,497 -15,000 -222,067
level................................................
Environmental Health.......................................... 229,850 396,850 229,850 ................ -167,000
Prevention and Public Health Fund......................... (17,000) (17,000) (17,000) ................ ................
Evaluation Tap Funding.................................... ................ (7,000) ................ ................ (-7,000)
-----------------------------------------------------------------------------------------
Subtotal, Environmental Health, program level......... 246,850 420,850 246,850 ................ -174,000
Injury Prevention and Control................................. 761,379 1,351,669 761,879 +500 -589,790
National Institute for Occupational Safety and Health......... 362,800 362,800 362,800 ................ ................
Energy Employees Occupational Illness Compensation Program.... 55,358 55,358 55,358 ................ ................
Global Health................................................. 692,843 764,843 692,843 ................ -72,000
Public Health Preparedness and Response....................... 883,200 943,200 898,200 +15,000 -45,000
Buildings and Facilities...................................... 40,000 55,000 40,000 ................ -15,000
CDC-Wide Activities and Program Support....................... ................ ................ ................ ................ ................
Prevention and Public Health Fund......................... (160,000) (160,000) (160,000) ................ ................
Office of the Director.................................... 128,570 143,570 128,570 ................ -15,000
Infectious Diseases Rapid Response Reserve Fund........... 35,000 35,000 10,000 -25,000 -25,000
Public Health Infrastructure and Capacity................. 350,000 600,000 350,000 ................ -250,000
Prevention and Public Health Fund..................... ................ ................ ................ ................ ................
Center for Forecasting and Outbreak Analytics............. 50,000 50,000 45,000 -5,000 -5,000
Prevention and Public Health Fund..................... ................ (50,000) ................ ................ (-50,000)
-----------------------------------------------------------------------------------------
Subtotal.......................................... 50,000 100,000 45,000 -5,000 -55,000
-----------------------------------------------------------------------------------------
Subtotal, CDC-Wide Activities......................... 563,570 828,570 533,570 -30,000 -295,000
-----------------------------------------------------------------------------------------
Total, Centers for Disease Control and Prevention..... 8,314,290 10,272,669 7,767,060 -547,230 -2,505,609
=========================================================================================
Discretionary..................................... (8,258,932) (10,217,311) (7,711,702) (-547,230) (-2,505,609)
Mandatory......................................... (55,358) (55,358) (55,358) ................ ................
(Evaluation Tap Funding).............................. ................ (177,342) (244,330) (+244,330) (+66,988)
(Prevention and Public Health Fund)................... (903,300) (1,186,200) (1,186,200) (+282,900) ................
-----------------------------------------------------------------------------------------
Total, Centers for Disease Control program level...... (9,217,590) (11,636,211) (9,197,590) (-20,000) (-2,438,621)
=========================================================================================
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute (NCI)............................... 7,104,159 7,820,159 7,164,159 +60,000 -656,000
NIH Innovation Account, CURES Act......................... (216,000) ................ ................ (-216,000) ................
National Cancer Institute (NCI) (emergency)............... ................ ................ 216,000 +216,000 +216,000
-----------------------------------------------------------------------------------------
Subtotal, NCI, program level.......................... 7,320,159 7,820,159 7,380,159 +60,000 -440,000
National Heart, Lung, and Blood Institute (NHLBI)............. 3,982,345 3,985,158 3,982,345 ................ -2,813
National Institute of Dental and Craniofacial Research (NIDCR) 520,163 520,138 520,163 ................ +25
National Institute of Diabetes and Digestive and Kidney 2,300,721 2,303,098 2,310,721 +10,000 +7,623
Diseases [NIDDK].............................................
National Institute of Neurological Disorders and Stroke 2,588,925 2,739,418 2,624,925 +36,000 -114,493
(NINDS)......................................................
NIH Innovation Account, CURES Act......................... (225,000) (86,000) (86,000) (-139,000) ................
National Institute of Neurological Disorders and Stroke ................ ................ 139,000 +139,000 +139,000
(NINDS) (emergency)......................................
-----------------------------------------------------------------------------------------
Subtotal, NINDS, program level........................ 2,813,925 2,825,418 2,849,925 +36,000 +24,507
National Institute of Allergy and Infectious Diseases (NIAID). 6,562,279 6,561,652 6,562,279 ................ +627
National Institute of General Medical Sciences (NIGMS)........ 1,827,197 1,291,570 1,827,197 ................ +535,627
Evaluation Tap Funding.................................... (1,412,482) (1,948,109) (1,412,482) ................ (-535,627)
-----------------------------------------------------------------------------------------
Subtotal, NIGMS, program level........................ 3,239,679 3,239,679 3,239,679 ................ ................
Eunice Kennedy Shriver National Institute of Child Health and 1,749,078 1,747,784 1,759,078 +10,000 +11,294
Human Development (NICHD)....................................
National Eye Institute (NEI).................................. 896,549 896,136 896,549 ................ +413
National Institute of Environmental Health Sciences (NIEHS)... 913,979 938,807 913,979 ................ -24,828
National Institute on Aging (NIA)............................. 4,407,623 4,412,090 4,509,623 +102,000 +97,533
National Institute of Arthritis and Musculoskeletal and Skin 685,465 687,639 685,465 ................ -2,174
Diseases (NIAMS).............................................
National Institute on Deafness and Other Communication 534,333 534,330 534,333 ................ +3
Disorders (NIDCD)............................................
National Institute of Nursing Research (NINR)................. 197,693 197,671 197,693 ................ +22
National Institute on Alcohol Abuse and Alcoholism (NIAAA).... 595,318 596,616 595,318 ................ -1,298
National Institute on Drug Abuse (NIDA)....................... 1,662,695 1,663,365 1,672,695 +10,000 +9,330
National Institute of Mental Health (NIMH).................... 2,112,843 2,455,653 2,212,843 +100,000 -242,810
NIH Innovation Account, CURES Act......................... (225,000) (86,000) (86,000) (-139,000) ................
National Institute of Mental Health (NIMH) (emergency).... ................ ................ 139,000 +139,000 +139,000
-----------------------------------------------------------------------------------------
Subtotal, NIMH, program level......................... 2,337,843 2,541,653 2,437,843 +100,000 -103,810
National Human Genome Research Institute (NHGRI).............. 663,200 660,510 663,200 ................ +2,690
National Institute of Biomedical Imaging and Bioengineering 440,627 440,625 440,627 ................ +2
(NIBIB)......................................................
National Center for Complementary and Integrative Health 170,384 170,277 170,384 ................ +107
(NCCIH)......................................................
National Institute on Minority Health and Health Disparities 524,395 525,138 524,395 ................ -743
(NIMHD)......................................................
John E Fogarty International Center (FIC)..................... 95,162 95,130 95,162 ................ +32
National Library of Medicine (NLM)............................ 497,548 495,314 497,548 ................ +2,234
National Center for Advancing Translational Sciences (NCATS).. 923,323 923,323 923,323 ................ ................
Office of the Director........................................ 2,642,914 2,890,779 2,637,914 -5,000 -252,865
Common Fund............................................... (722,401) (722,401) (722,401) ................ ................
Gabriella Miller Kids First Research Act.................. 12,600 12,600 12,600 ................ ................
Office of the Director (emergency)........................ ................ ................ 184,000 +184,000 +184,000
-----------------------------------------------------------------------------------------
Subtotal, Office of the Director...................... 2,655,514 2,903,379 2,650,514 -5,000 -252,865
NIH Innovation Account, CURES Act............................. (419,000) (235,000) (235,000) (-184,000) ................
Buildings and Facilities...................................... 350,000 350,000 292,000 -58,000 -58,000
Advanced Research Projects Agency for Health (ARPA-H)......... 1,500,000 2,500,000 1,500,000 ................ -1,000,000
-----------------------------------------------------------------------------------------
Total, National Institutes of Health (NIH) with CURES Act 47,546,518 48,821,980 47,811,518 +265,000 -1,010,462
funding..................................................
=========================================================================================
(Evaluation Tap Funding).................................. (1,412,482) (1,948,109) (1,412,482) ................ (-535,627)
-----------------------------------------------------------------------------------------
Total, National Institutes of Health program level........ 48,959,000 50,770,089 49,224,000 +265,000 -1,546,089
=========================================================================================
Total, NIH program level (excluding ARPA-H)............... 47,459,000 48,270,089 47,724,000 +265,000 -546,089
=========================================================================================
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
(SAMHSA)
Mental Health
Programs of Regional and National Significance................ 991,453 1,787,689 1,065,453 +74,000 -722,236
Prevention and Public Health Fund......................... (12,000) (12,000) (12,000) ................ ................
CR Funding--Public Law 117-180 Suicide Lifeline........... 62,000 ................ ................ -62,000 ................
-----------------------------------------------------------------------------------------
Subtotal.............................................. 1,065,453 1,799,689 1,077,453 +12,000 -722,236
Mental Health Block Grant (MHBG).............................. 986,532 1,631,532 1,021,532 +35,000 -610,000
Evaluation Tap Funding.................................... (21,039) (21,039) (21,039) ................ ................
-----------------------------------------------------------------------------------------
Subtotal.............................................. 1,007,571 1,652,571 1,042,571 +35,000 -610,000
Certified Community Behavioral Health Clinics................. 385,000 552,500 400,000 +15,000 -152,500
National Child Traumatic Stress Initiative.................... 93,887 150,000 93,887 ................ -56,113
Children's Mental Health Services............................. 130,000 225,000 130,000 ................ -95,000
Projects for Assistance in Transition from Homelessness (PATH) 66,635 109,635 66,635 ................ -43,000
Protection and Advocacy for Individuals with Mental Illness 40,000 40,000 40,000 ................ ................
(PAIMI)......................................................
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................... 2,755,507 4,496,356 2,817,507 +62,000 -1,678,849
(Evaluation Tap Funding).................................. (21,039) (21,039) (21,039) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Mental Health program level..................... 2,788,546 4,529,395 2,850,546 +62,000 -1,678,849
Substance Abuse Treatment
Programs of Regional and National Significance................ 572,219 753,008 574,219 +2,000 -178,789
Evaluation Tap Funding.................................... (2,000) (2,000) (2,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal.............................................. 574,219 755,008 576,219 +2,000 -178,789
Substance Abuse Prevention and Treatment Block Grant.......... 1,928,879 2,628,879 1,968,879 +40,000 -660,000
Evaluation Tap Funding.................................... (79,200) (79,200) (79,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal Substance Abuse Prevention and Treatment 2,008,079 2,708,079 2,048,079 +40,000 -660,000
Block Grant, program level...........................
State Opioid Response grants.................................. 1,575,000 2,000,000 1,378,000 -197,000 -622,000
State Opioid Response grants (emergency)...................... ................ ................ 217,000 +217,000 +217,000
-----------------------------------------------------------------------------------------
Subtotal, State Opioid Response grants.................... 1,575,000 2,000,000 1,595,000 +20,000 -405,000
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment....................... 4,076,098 5,381,887 4,138,098 +62,000 -1,243,789
(Evaluation Tap Funding).................................. (81,200) (81,200) (81,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment, program level........ 4,157,298 5,463,087 4,219,298 +62,000 -1,243,789
Substance Abuse Prevention
Programs of Regional and National Significance................ 236,879 245,738 236,879 ................ -8,859
Health Surveillance and Program Support
Health Surveillance and Program Support....................... 301,932 150,827 212,117 -89,815 +61,290
Congressionally Directed Spending/Community Project (160,777) ................ (70,962) (-89,815) (+70,962)
Funding (non-add)........................................
Bipartisan Safer Communities Act (PL 117-159) (prior (162,500) (162,500) (162,500) ................ ................
year emergency advance)..............................
Evaluation Tap Funding................................ (31,428) (31,428) (31,428) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Health Surveillance and Program Support 495,860 344,755 406,045 -89,815 +61,290
program level....................................
-----------------------------------------------------------------------------------------
Total, SAMHSA..................................... 7,370,416 10,274,808 7,404,601 +34,185 -2,870,207
=========================================================================================
(Evaluation Tap Funding).......................... (133,667) (133,667) (133,667) ................ ................
(Prevention and Public Health Fund)............... (12,000) (12,000) (12,000) ................ ................
-----------------------------------------------------------------------------------------
Total, SAMHSA, program level, including 7,678,583 10,582,975 7,712,768 +34,185 -2,870,207
emergencies......................................
=========================================================================================
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)
Healthcare Research and Quality
Research on Health Costs, Quality, and Outcomes:
Federal Funds............................................. 228,609 251,924 225,609 -3,000 -26,315
Evaluation Tap funding................................ ................ (45,000) ................ ................ (-45,000)
-----------------------------------------------------------------------------------------
Subtotal, Research on Health Costs, Quality, and 228,609 296,924 225,609 -3,000 -71,315
Outcomes, program level..........................
Medical Expenditures Panel Surveys:
Federal Funds............................................. 71,791 71,791 71,791 ................ ................
Program Support:
Appropriation............................................. 73,100 78,785 73,100 ................ -5,685
-----------------------------------------------------------------------------------------
Total, AHRQ........................................... 373,500 402,500 370,500 -3,000 -32,000
=========================================================================================
(Evaluation Tap Funding).............................. ................ (45,000) ................ ................ (-45,000)
-----------------------------------------------------------------------------------------
Total, AHRQ, program level............................ 373,500 447,500 370,500 -3,000 -77,000
=========================================================================================
Total, Public Health Service with CURES Act funding... 73,348,577 79,238,353 72,492,475 -856,102 -6,745,878
=========================================================================================
Total, Public Health Service, program level........... 75,810,026 82,740,671 75,481,154 -328,872 -7,259,517
=========================================================================================
CENTERS FOR MEDICARE AND MEDICAID SERVICES
Grants to States for Medicaid
Medicaid Current Law Benefits................................. 503,821,443 574,100,474 574,100,474 +70,279,031 ................
State and Local Administration................................ 23,649,059 24,622,000 24,622,000 +972,941 ................
Vaccines for Children......................................... 5,608,606 5,814,850 5,814,850 +206,244 ................
-----------------------------------------------------------------------------------------
Total, Medicaid program level, available this fiscal year. 533,079,108 604,537,324 604,537,324 +71,458,216 ................
=========================================================================================
New advance, 1st quarter, FY 2025..................... 197,580,474 245,580,414 245,580,414 +47,999,940 ................
Less appropriations provided in prior years........... -165,722,018 -197,580,474 -197,580,474 -31,858,456 ................
-----------------------------------------------------------------------------------------
Total, Grants to States for Medicaid, appropriated in this 564,937,564 652,537,264 652,537,264 +87,599,700 ................
bill.....................................................
=========================================================================================
Payments to Health Care Trust Funds
Supplemental Medical Insurance................................ 434,349,000 373,973,000 373,973,000 -60,376,000 ................
Federal Uninsured Payment..................................... 52,000 44,000 44,000 -8,000 ................
Program Management............................................ 1,000,000 1,000,000 1,000,000 ................ ................
General Revenue for Part D Benefit............................ 111,800,000 100,805,000 100,805,000 -10,995,000 ................
General Revenue for Part D Administration..................... 600,000 523,000 523,000 -77,000 ................
HCFAC Reimbursement........................................... 324,000 375,000 375,000 +51,000 ................
State Low-Income Determination for Part D..................... 5,000 5,000 5,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to Trust Funds............................ 548,130,000 476,725,000 476,725,000 -71,405,000 ................
=========================================================================================
Program Management
Research, Demonstration, and Evaluation....................... 20,054 ................ 20,054 ................ +20,054
Program Operations............................................ 2,479,823 3,130,183 2,479,823 ................ -650,360
State Survey and Certification................................ 397,334 565,860 397,334 ................ -168,526
Federal Administration........................................ 772,533 854,027 772,533 ................ -81,494
-----------------------------------------------------------------------------------------
Total, Program Management................................. 3,669,744 4,550,070 3,669,744 ................ -880,326
=========================================================================================
Health Care Fraud and Abuse Control Account
Centers for Medicare and Medicaid Services.................... 665,648 667,359 682,048 +16,400 +14,689
HHS Office of Inspector General............................... 105,145 112,434 107,735 +2,590 -4,699
Senior Medicare Patrol........................................ ................ 35,000 ................ ................ -35,000
Department of Justice......................................... 122,207 122,207 125,217 +3,010 +3,010
-----------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control................ 893,000 937,000 915,000 +22,000 -22,000
=========================================================================================
Program integrity (cap adjustment).................... (576,000) (612,000) (604,000) (+28,000) (-8,000)
-----------------------------------------------------------------------------------------
Total, Centers for Medicare and Medicaid Services......... 1,117,630,308 1,134,749,334 1,133,847,008 +16,216,700 -902,326
=========================================================================================
Federal funds......................................... (1,113,067,564) (1,129,262,264) (1,129,262,264) (+16,194,700) ................
Current year appropriations....................... (915,487,090) (883,681,850) (883,681,850) (-31,805,240) ................
Advance appropriations............................ (197,580,474) (245,580,414) (245,580,414) (+47,999,940) ................
Trust Funds........................................... (4,562,744) (5,487,070) (4,584,744) (+22,000) (-902,326)
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.................................................. 10,177 18,199 18,199 +8,022 ................
-----------------------------------------------------------------------------------------
Subtotal.................................................. 43,177 51,199 51,199 +8,022 ................
Child Support Enforcement:
State and Local Administration............................ 3,474,868 3,840,888 3,840,888 +366,020 ................
Federal Incentive Payments................................ 654,955 706,913 706,913 +51,958 ................
Access and Visitation..................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement................... 4,139,823 4,557,801 4,557,801 +417,978 ................
-----------------------------------------------------------------------------------------
Total, Child Support Enforcement and Family Support 4,183,000 4,609,000 4,609,000 +426,000 ................
Payments, program level available this fiscal year.......
=========================================================================================
Less appropriations provided in prior years........... -1,300,000 -1,300,000 -1,300,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Child Support Enforcement and Family Support 2,883,000 3,309,000 3,309,000 +426,000 ................
Payments, available in this bill.........................
=========================================================================================
New advance, 1st quarter, FY 2025..................... 1,300,000 1,400,000 1,400,000 +100,000 ................
Low Income Home Energy Assistance Program (LIHEAP)
Formula Grants................................................ 1,500,000 4,111,000 1,500,000 ................ -2,611,000
Formula Grants (emergency).................................... 2,500,000 ................ 2,575,000 +75,000 +2,575,000
-----------------------------------------------------------------------------------------
Total, LIHEAP............................................. 4,000,000 4,111,000 4,075,000 +75,000 -36,000
=========================================================================================
C R funding (Public Law 117-180) (Sec 146) (emergency)........ 1,000,000 ................ ................ -1,000,000 ................
Appropriation from prior year advances (PL 117-58 Div (100,000) (100,000) (100,000) ................ ................
J)(emergency)................................................
Refugee and Entrant Assistance
Transitional and Medical Services............................. 564,000 1,000,000 564,000 ................ -436,000
Refugee Support Services...................................... 307,201 686,000 307,201 ................ -378,799
Victims of Trafficking........................................ 30,755 39,497 30,755 ................ -8,742
Unaccompanied Children........................................ 5,506,258 5,506,258 5,506,258 ................ ................
Survivors of Torture.......................................... 19,000 27,000 19,000 ................ -8,000
-----------------------------------------------------------------------------------------
Total, Refugee and Entrant Assistance..................... 6,427,214 7,258,755 6,427,214 ................ -831,541
=========================================================================================
C R Funding--Public Law 117-180 (emergency)................... 1,775,000 ................ ................ -1,775,000 ................
Payments to States for the Child Care and Development Block 8,021,387 9,000,000 8,721,387 +700,000 -278,613
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................................................ 11,996,820 13,111,586 11,996,820 ................ -1,114,766
Head Start (emergency).................................... ................ ................ 275,000 +275,000 +275,000
-----------------------------------------------------------------------------------------
Total, Head Start..................................... 11,996,820 13,111,586 12,271,820 +275,000 -839,766
=========================================================================================
Preschool Development Grants.............................. 315,000 360,000 310,000 -5,000 -50,000
Consolidated Runaway and Homeless Youth Program........... 125,283 136,803 125,283 ................ -11,520
Prevention Grants to Reduce Abuse of Runaway Youth........ 21,000 22,000 21,000 ................ -1,000
Child Abuse State Grants.................................. 105,091 125,000 105,091 ................ -19,909
Child Abuse Discretionary Activities...................... 38,000 42,000 36,000 -2,000 -6,000
Community Based Child Abuse Prevention.................... 70,660 90,000 70,660 ................ -19,340
Child Welfare Services.................................... 268,735 278,900 268,735 ................ -10,165
Child Welfare Training, Research, or Demonstration 18,984 101,000 21,984 +3,000 -79,016
projects.................................................
Adoption Opportunities.................................... 51,000 51,000 51,000 ................ ................
Adoption Incentive Grants................................. 75,000 75,000 70,000 -5,000 -5,000
Social Services and Income Maintenance Research........... 142,860 37,512 70,523 -72,337 +33,011
Congressionally Directed Spending/Community Project (107,848) ................ (40,011) (-67,837) (+40,011)
Funding (non-add)........................................
Native American Programs...................................... 60,500 87,499 60,500 ................ -26,999
Community Services:
Community Services Block Grant Act programs:
Grants to States for Community Services............... 770,000 770,000 765,000 -5,000 -5,000
Economic Development.................................. 22,383 23,615 22,383 ................ -1,232
-----------------------------------------------------------------------------------------
Subtotal, Community Services Block Grant Act 804,383 805,891 799,383 -5,000 -6,508
programs.........................................
Domestic Violence Hotline..................................... 20,500 27,360 20,500 ................ -6,860
Family Violence Prevention and Services....................... 240,000 491,869 235,000 -5,000 -256,869
Chafee Education and Training Vouchers........................ 44,257 48,257 43,257 -1,000 -5,000
Disaster Human Services Case Management....................... 1,864 8,000 1,864 ................ -6,136
Program Direction............................................. 218,500 239,988 218,500 ................ -21,488
-----------------------------------------------------------------------------------------
Total, Children and Families Services Programs............ 14,618,437 16,139,665 14,801,100 +182,663 -1,338,565
=========================================================================================
Promoting Safe and Stable Families
Promoting Safe and Stable Families............................ 345,000 345,000 345,000 ................ ................
Discretionary Funds....................................... 86,515 106,000 72,515 -14,000 -33,485
-----------------------------------------------------------------------------------------
Total, Promoting Safe and Stable Families............. 431,515 451,000 417,515 -14,000 -33,485
=========================================================================================
Payments for Foster Care and Permanency
Foster Care................................................... 6,190,000 6,615,000 6,615,000 +425,000 ................
Adoption Assistance........................................... 4,128,000 4,706,000 4,706,000 +578,000 ................
Guardianship.................................................. 345,000 330,000 330,000 -15,000 ................
Independent Living............................................ 143,000 143,000 143,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States available this fiscal year...... 10,806,000 11,794,000 11,794,000 +988,000 ................
=========================================================================================
Advance appropriations, 1st quarter, FY 2025.............. 3,200,000 3,400,000 3,400,000 +200,000 ................
less appropriations provided in prior years............... -3,200,000 -3,200,000 -3,200,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States available in this bill...... 10,806,000 11,994,000 11,994,000 +1,188,000 ................
=========================================================================================
Total, Administration for Children and Families........... 52,962,553 55,363,420 52,845,216 -117,337 -2,518,204
=========================================================================================
Current year appropriations........................... (48,462,553) (50,563,420) (48,045,216) (-417,337) (-2,518,204)
Advance appropriations................................ (4,500,000) (4,800,000) (4,800,000) (+300,000) ................
-----------------------------------------------------------------------------------------
Total, Administration for Children and Families, (35,928,553) (36,615,420) (34,097,216) (-1,831,337) (-2,518,204)
discretionary............................................
=========================================================================================
Total, ACF (excluding emergencies)........................ 47,687,553 55,363,420 49,995,216 +2,307,663 -5,368,204
=========================================================================================
ADMINISTRATION FOR COMMUNITY LIVING
Aging and Disability Services Programs
Grants to States:
Home and Community-based Supportive Services.............. 410,000 500,000 410,000 ................ -90,000
Preventive Health......................................... 26,339 26,399 26,339 ................ -60
Protection of Vulnerable Older Americans-Title VII........ 26,658 32,059 26,658 ................ -5,401
-----------------------------------------------------------------------------------------
Subtotal.............................................. 462,997 558,458 462,997 ................ -95,461
Family Caregivers......................................... 205,000 249,936 210,000 +5,000 -39,936
Native American Caregivers Support........................ 12,000 15,806 12,000 ................ -3,806
-----------------------------------------------------------------------------------------
Subtotal, Caregivers.................................. 217,000 265,742 222,000 +5,000 -43,742
Nutrition:
Congregate Meals...................................... 540,342 762,050 565,342 +25,000 -196,708
Home Delivered Meals.................................. 366,342 410,335 381,342 +15,000 -28,993
Nutrition Services Incentive Program.................. 160,069 112,000 112,000 -48,069 ................
-----------------------------------------------------------------------------------------
Subtotal, Nutrition............................... 1,066,753 1,284,385 1,058,684 -8,069 -225,701
-----------------------------------------------------------------------------------------
Subtotal, Grants to States............................ 1,746,750 2,108,585 1,743,681 -3,069 -364,904
Grants for Native Americans................................... 38,264 70,208 38,264 ................ -31,944
Aging Network Support Activities.............................. 30,461 40,000 30,461 ................ -9,539
Alzheimer's Disease Demonstrations:
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 14,220 11,500 +1,500 -2,720
Chronic Disease Self-Management:
Prevention and Public Health Fund......................... (8,000) (8,000) (8,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Chronic Self-Management, program level...... 8,000 8,000 8,000 ................ ................
Elder Falls Prevention:
Appropriation............................................. 2,500 5,000 2,500 ................ -2,500
Prevention and Public Health Fund......................... (5,000) (5,000) (5,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Elder Falls Prevention, program level....... 7,500 10,000 7,500 ................ -2,500
Elder Rights Support Activities............................... 33,874 77,400 33,874 ................ -43,526
Aging and Disability Resources................................ 8,619 10,000 8,619 ................ -1,381
State Health Insurance 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 82,000 81,000 ................ -1,000
Protection and Advocacy................................... 45,000 59,659 45,000 ................ -14,659
Voting Access for Individuals with Disabilities........... 10,000 10,000 10,000 ................ ................
Developmental Disabilities Projects of National 12,250 16,000 12,250 ................ -3,750
Significance.............................................
University Centers for Excellence in Developmental 43,119 46,173 43,119 ................ -3,054
Disabilities.............................................
-----------------------------------------------------------------------------------------
Subtotal, Developmental Disabilities Programs......... 191,369 213,832 191,369 ................ -22,463
Workforce Innovation and Opportunity Act:
Independent Living........................................ 128,183 161,458 128,183 ................ -33,275
National Institute on Disability, Independent Living, and 119,000 119,000 119,000 ................ ................
Rehabilitation Research..................................
Assistive Technology...................................... 40,000 44,000 40,000 ................ -4,000
-----------------------------------------------------------------------------------------
Subtotal, Workforce Innovation and Opportunity Act.... 287,183 324,458 287,183 ................ -37,275
Congressionally Directed Spending/Community Project Funding... 41,644 ................ 29,268 -12,376 +29,268
Program Administration........................................ 47,063 63,859 47,813 +750 -16,046
-----------------------------------------------------------------------------------------
Total, Administration for Community Living................ 2,537,787 3,027,622 2,524,592 -13,195 -503,030
=========================================================================================
Federal funds......................................... (2,482,545) (2,972,380) (2,469,350) (-13,195) (-503,030)
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. 2,565,487 3,055,322 2,552,292 -13,195 -503,030
=========================================================================================
ADMINISTRATION FOR STRATEGIC PREPAREDNESS AND RESPONSE
Research, Development, and Procurement
Biomedical Advanced Research and Development Authority (BARDA) 950,000 1,015,132 820,000 -130,000 -195,132
Biomedical Advanced Research and Development Authority (BARDA) ................ ................ 150,000 +150,000 +150,000
(emergency)..................................................
-----------------------------------------------------------------------------------------
Subtotal, BARDA........................................... 950,000 1,015,132 970,000 +20,000 -45,132
Project BioShield............................................. 820,000 830,000 670,000 -150,000 -160,000
Project BioShield (emergency)................................. ................ ................ 150,000 +150,000 +150,000
-----------------------------------------------------------------------------------------
Subtotal, Project BioShield............................... 820,000 830,000 820,000 ................ -10,000
Strategic National Stockpile.................................. 965,000 995,000 965,000 ................ -30,000
Pandemic Influenza Preparedness:
Pandemic Influenza Preparedness........................... 327,991 374,991 301,991 -26,000 -73,000
-----------------------------------------------------------------------------------------
Subtotal Research, Development, and Procurement....... 3,062,991 3,215,123 3,056,991 -6,000 -158,132
Operations, Preparedness, and Emergency Response
Operations.................................................... 34,376 69,867 34,376 ................ -35,491
H-Core........................................................ 75,000 82,801 50,000 -25,000 -32,801
Preparedness and Emergency Operations......................... 31,154 31,300 31,154 ................ -146
National Disaster Medical System.............................. 96,904 130,030 96,904 ................ -33,126
Hospital Preparedness Program:
Formula Grants............................................ 305,055 312,055 305,055 ................ -7,000
Policy and Planning........................................... 14,877 21,417 14,877 ................ -6,540
Medical Reserve Corps......................................... 6,240 6,240 6,240 ................ ................
Preparedness and Response Innovation.......................... 3,080 3,080 3,080 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Operations and Emergency Response............... 566,686 656,790 541,686 -25,000 -115,104
Manufacturing and Production
Pandemic Preparedness and Biodefense.......................... ................ 400,000 ................ ................ -400,000
Pandemic Preparedness and Biodefense (emergency).............. ................ ................ 75,000 +75,000 +75,000
-----------------------------------------------------------------------------------------
Subtotal, Manufacturing and Production.................... ................ 400,000 75,000 +75,000 -325,000
-----------------------------------------------------------------------------------------
Total, Administration for Strategic Preparedness and 3,629,677 4,271,913 3,673,677 +44,000 -598,236
Response.................................................
=========================================================================================
OFFICE OF THE SECRETARY
General Departmental Management
General Departmental Management, Federal Funds................ 221,169 287,345 221,169 ................ -66,176
Teen Pregnancy Prevention Community Grants.................... 101,000 111,000 101,000 ................ -10,000
Evaluation Tap Funding.................................... (6,800) (7,892) (6,800) ................ (-1,092)
-----------------------------------------------------------------------------------------
Subtotal, Teen Pregnancy Prevention Community Grants, 107,800 118,892 107,800 ................ -11,092
program level........................................
Sexual Risk Avoidance......................................... 35,000 ................ 35,000 ................ +35,000
Office of Minority Health..................................... 74,835 85,835 74,835 ................ -11,000
Office on Women's Health...................................... 44,140 44,140 44,140 ................ ................
Minority HIV/AIDS Fund........................................ 60,000 60,000 60,000 ................ ................
Embryo Adoption Awareness Campaign............................ 1,000 1,000 1,000 ................ ................
Electric Vehicle Program...................................... ................ 22,000 ................ ................ -22,000
Planning and Evaluation, Evaluation Tap Funding............... (58,028) (85,354) (58,028) ................ (-27,326)
-----------------------------------------------------------------------------------------
Total, General Departmental Management.................... 537,144 611,320 537,144 ................ -74,176
=========================================================================================
(Evaluation Tap Funding).................................. (64,828) (93,246) (64,828) ................ (-28,418)
-----------------------------------------------------------------------------------------
Total, General Departmental Management fiscal year program 601,972 704,566 601,972 ................ -102,594
level....................................................
=========================================================================================
Medicare Hearings and Appeals................................. 196,000 199,000 196,000 ................ -3,000
Office of the National Coordinator for Health Information ................ ................ ................ ................ ................
Technology...................................................
Evaluation Tap Funding.................................... (66,238) (103,614) (71,238) (+5,000) (-32,376)
-----------------------------------------------------------------------------------------
Total, Program Level.................................. 66,238 103,614 71,238 +5,000 -32,376
=========================================================================================
Office of Inspector General
Inspector General Federal Funds............................... 87,000 116,801 87,000 ................ -29,801
Office for Civil Rights
Federal Funds................................................. 39,798 78,000 39,798 ................ -38,202
Customer Experience........................................... ................ 20,000 ................ ................ -20,000
Retirement Pay and Medical Benefits for Commissioned Officers
Retirement Payments........................................... 573,441 657,647 657,647 +84,206 ................
Survivors Benefits............................................ 35,964 37,681 37,681 +1,717 ................
Dependents' Medical Care...................................... 100,922 97,363 97,363 -3,559 ................
-----------------------------------------------------------------------------------------
Total, Medical benefits for commissioned officers......... 710,327 792,691 792,691 +82,364 ................
=========================================================================================
Public Health and Social Services Emergency Fund (PHSSEF)
Assistant Secretary for Administration:
Cybersecurity............................................. 100,000 188,326 100,000 ................ -88,326
Other PHSSEF--Cybersecurity............................... 21,900 ................ ................ -21,900 ................
Office of National Security............................... 8,983 11,983 8,983 ................ -3,000
Office of the Assistant Secretary of Health................... ................ 20,000 ................ ................ -20,000
Public Health Emergency Fund.................................. ................ 50,000 ................ ................ -50,000
Office of Global Affairs Pandemic Preparedness................ 7,009 8,009 7,009 ................ -1,000
-----------------------------------------------------------------------------------------
Total, PHSSEF............................................. 137,892 278,318 115,992 -21,900 -162,326
=========================================================================================
Total, Office of the Secretary............................ 1,708,161 2,096,130 1,768,625 +60,464 -327,505
=========================================================================================
Federal Funds......................................... (1,512,161) (1,897,130) (1,572,625) (+60,464) (-324,505)
Trust Funds........................................... (196,000) (199,000) (196,000) ................ (-3,000)
(Evaluation Tap Funding).................................. (131,066) (196,860) (136,066) (+5,000) (-60,794)
-----------------------------------------------------------------------------------------
Total, Office of the Secretary Program Level.............. 1,839,227 2,292,990 1,904,691 +65,464 -388,299
=========================================================================================
Total, Title II, Department of Health and Human Services.. 1,250,732,063 1,278,339,772 1,266,744,593 +16,012,530 -11,595,179
=========================================================================================
Federal Funds......................................... 1,245,902,877 1,272,572,260 1,261,893,407 +15,990,530 -10,678,853
Appropriations.................................... (1,038,547,403) (1,022,191,846) (1,007,392,993) (-31,154,410) (-14,798,853)
Emergency appropriations.......................... (5,275,000) ................ (4,120,000) (-1,155,000) (+4,120,000)
Advance appropriations, FY 2025................... (202,080,474) (250,380,414) (250,380,414) (+48,299,940) ................
Trust Funds........................................... (4,829,186) (5,767,512) (4,851,186) (+22,000) (-916,326)
CURES Act................................................. (1,085,000) (407,000) (407,000) (-678,000) ................
Prevention and Public Health Fund......................... (943,000) (1,225,900) (1,225,900) (+282,900) ................
TITLE III--DEPARTMENT OF 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 2025........................... 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 2025........................ 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 1,362,301 1,362,301 1,362,301 ................ ................
this bill........................................
Targeted Grants:
Appropriations from prior year advances............... 4,357,550 4,357,550 4,357,550 ................ ................
Forward funded........................................ 925,000 2,000,000 1,012,500 +87,500 -987,500
-----------------------------------------------------------------------------------------
Subtotal, Targeted Grants available this fiscal 5,282,550 6,357,550 5,370,050 +87,500 -987,500
year.............................................
Advance appropriations FY 2025........................ 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 5,282,550 6,357,550 5,370,050 +87,500 -987,500
bill.............................................
Education Finance Incentive Grants:
Appropriations from prior year advances............... 4,357,550 4,357,550 4,357,550 ................ ................
Forward Funded........................................ 925,000 2,000,000 1,012,500 +87,500 -987,500
Advance appropriations, FY 2025....................... 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, 5,282,550 6,357,550 5,370,050 +87,500 -987,500
appropriated in this bill........................
-----------------------------------------------------------------------------------------
Subtotal, Grants to LEAs, fiscal year program 18,386,802 20,536,802 18,561,802 +175,000 -1,975,000
level............................................
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 52,000 49,239 ................ -2,761
-----------------------------------------------------------------------------------------
Subtotal, State Agency programs....................... 424,865 427,626 424,865 ................ -2,761
Special Programs for Migrant Students......................... 52,123 66,123 52,123 ................ -14,000
-----------------------------------------------------------------------------------------
Total, Education for the disadvantaged.................... 19,087,790 21,254,551 19,262,790 +175,000 -1,991,761
=========================================================================================
Current year appropriations........................... (8,246,613) (10,413,374) (8,421,613) (+175,000) (-1,991,761)
(Forward Funded).................................. (8,159,490) (10,312,251) (8,334,490) (+175,000) (-1,977,761)
Advance appropriations................................ (10,841,177) (10,841,177) (10,841,177) ................ ................
IMPACT AID
Basic Support Payments........................................ 1,468,242 1,468,242 1,477,000 +8,758 +8,758
Payments for Children with Disabilities....................... 48,316 48,316 48,316 ................ ................
Facilities Maintenance (Sec 8008)............................. 4,835 4,835 4,835 ................ ................
Construction (Sec 8007)....................................... 18,406 18,406 19,000 +594 +594
Payments for Federal Property (Sec 8002)...................... 78,313 78,313 79,000 +687 +687
-----------------------------------------------------------------------------------------
Total, Impact aid......................................... 1,618,112 1,618,112 1,628,151 +10,039 +10,039
=========================================================================================
SCHOOL IMPROVEMENT PROGRAMS
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 2025........................... 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.....................
Supplemental Education Grants................................. 24,464 ................ 24,464 ................ +24,464
Nita M Lowey 21st Century Community Learning Centers.......... 1,329,673 1,329,673 1,329,673 ................ ................
State Assessments............................................. 390,000 469,100 380,000 -10,000 -89,100
Education for Homeless Children and Youth..................... 129,000 129,000 129,000 ................ ................
Training and Advisory Services (Civil Rights)................. 6,575 6,575 6,575 ................ ................
Education for Native Hawaiians................................ 45,897 45,897 45,897 ................ ................
Alaska Native Education Equity................................ 44,953 44,953 44,953 ................ ................
Rural Education............................................... 215,000 215,000 220,000 +5,000 +5,000
Comprehensive Centers......................................... 55,000 55,000 50,000 -5,000 -5,000
Student Support and Academic Enrichment grants................ 1,380,000 1,405,000 1,400,000 +20,000 -5,000
-----------------------------------------------------------------------------------------
Total, School Improvement Programs........................ 5,810,642 5,890,278 5,820,642 +10,000 -69,636
=========================================================================================
Current year appropriations........................... (4,129,201) (4,208,837) (4,139,201) (+10,000) (-69,636)
(Forward Funded).................................. (3,952,312) (4,056,412) (3,967,312) (+15,000) (-89,100)
Advance appropriations................................ (1,681,441) (1,681,441) (1,681,441) ................ ................
SCHOOL READINESS
Preschool Incentive Demonstration Program (legislative ................ 500,000 ................ ................ -500,000
proposal)....................................................
INDIAN EDUCATION
Grants to Local Educational Agencies.......................... 110,381 117,381 110,381 ................ -7,000
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................................... 194,746 201,746 194,746 ................ -7,000
=========================================================================================
INNOVATION AND IMPROVEMENT
Education Innovation and Research............................. 284,000 405,000 240,000 -44,000 -165,000
American History and Civics Academies......................... 3,000 ................ 3,000 ................ +3,000
American History and Civics National Activities............... 20,000 73,000 20,000 ................ -53,000
School Leader Recruitment and Support......................... ................ 40,000 ................ ................ -40,000
Charter Schools Grants........................................ 440,000 440,000 440,000 ................ ................
Magnet Schools Assistance..................................... 139,000 149,000 139,000 ................ -10,000
Congressionally Directed Spending/Community Project Funding... 200,443 ................ 87,344 -113,099 +87,344
Teacher and School Leader Incentive Grants.................... 173,000 200,000 120,000 -53,000 -80,000
Ready-to-Learn Television..................................... 31,000 31,000 31,000 ................ ................
Supporting Effective Educator Development (SEED).............. 90,000 93,000 90,000 ................ -3,000
Arts in Education............................................. 36,500 36,500 30,000 -6,500 -6,500
Javits Gifted and Talented Students........................... 16,500 16,500 16,500 ................ ................
Statewide Family Engagement Centers........................... 20,000 20,000 20,000 ................ ................
Fostering Diverse Schools (legislative proposal).............. ................ 100,000 ................ ................ -100,000
-----------------------------------------------------------------------------------------
Total, Innovation and Improvement......................... 1,453,443 1,604,000 1,236,844 -216,599 -367,156
=========================================================================================
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Promise Neighborhoods......................................... 91,000 106,000 91,000 ................ -15,000
School Safety National Activities............................. 216,000 601,000 196,000 -20,000 -405,000
Bipartisan Safer Communities Act (PL 117-159) (prior year (200,000) (200,000) (200,000) ................ ................
emergency advance).......................................
Full-Service Community Schools................................ 150,000 368,000 150,000 ................ -218,000
-----------------------------------------------------------------------------------------
Total, Safe Schools and Citizenship Education............. 457,000 1,075,000 437,000 -20,000 -638,000
=========================================================================================
Total, Safe Schools and Citizenship Education, program 657,000 1,275,000 637,000 -20,000 -638,000
level (with emergencies).................................
=========================================================================================
ENGLISH LANGUAGE ACQUISITION
Current year appropriations................................... 57,850 95,600 58,305 +455 -37,295
Forward funded................................................ 832,150 1,099,400 838,695 +6,545 -260,705
-----------------------------------------------------------------------------------------
Total, English Language Acquisition....................... 890,000 1,195,000 897,000 +7,000 -298,000
=========================================================================================
SPECIAL EDUCATION
State Grants:
Grants to States Part B current year...................... 4,910,321 6,975,810 5,085,321 +175,000 -1,890,489
Part B advance from prior year........................ (9,283,383) (9,283,383) (9,283,383) ................ ................
Grants to States Part B (FY 2024)......................... 9,283,383 9,283,383 9,283,383 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, program level............................... 14,193,704 16,259,193 14,368,704 +175,000 -1,890,489
Preschool Grants.......................................... 420,000 502,620 420,000 ................ -82,620
Grants for Infants and Families........................... 540,000 932,000 560,000 +20,000 -372,000
-----------------------------------------------------------------------------------------
Subtotal, program level............................... 15,153,704 17,693,813 15,348,704 +195,000 -2,345,109
IDEA National Activities (current funded):
State Personnel Development............................... 38,630 53,630 38,630 ................ -15,000
Technical Assistance and Dissemination.................... 45,345 55,345 39,345 -6,000 -16,000
Personnel Preparation..................................... 115,000 250,000 134,500 +19,500 -115,500
Parent Information Centers................................ 33,152 49,152 33,152 ................ -16,000
Educational Technology, Media, and Materials.............. 31,433 41,433 31,433 ................ -10,000
-----------------------------------------------------------------------------------------
Subtotal, IDEA National Activities.................... 263,560 449,560 277,060 +13,500 -172,500
Special Olympics Education Programs........................... 36,000 36,000 36,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special education.................................. 15,453,264 18,179,373 15,661,764 +208,500 -2,517,609
=========================================================================================
Current Year appropriations........................... (6,169,881) (8,895,990) (6,378,381) (+208,500) (-2,517,609)
(Forward Funded).................................. (5,870,321) (8,410,430) (6,065,321) (+195,000) (-2,345,109)
Advance appropriations................................ (9,283,383) (9,283,383) (9,283,383) ................ ................
REHABILITATION SERVICES
Vocational Rehabilitation State Grants........................ 3,949,707 4,253,834 4,253,834 +304,127 ................
Client Assistance State grants................................ 13,000 15,000 13,000 ................ -2,000
Training...................................................... 29,388 29,388 29,388 ................ ................
Demonstration and Training programs........................... 5,796 7,296 5,796 ................ -1,500
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 38,317 33,317 ................ -5,000
Helen Keller National Center for Deaf/Blind Youth and......... ................ ................ ................ ................ ................
Adults.................................................... 19,000 19,000 19,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Rehabilitation Services........................ 4,092,906 4,405,533 4,397,033 +304,127 -8,500
=========================================================================================
(Discretionary)................................... (143,199) (151,699) (143,199) ................ (-8,500)
(Mandatory)....................................... (3,949,707) (4,253,834) (4,253,834) (+304,127) ................
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
American Printing House for the Blind......................... 43,431 43,431 43,431 ................ ................
National Technical Institute for the Deaf [NTID]:
Operations................................................ 92,500 92,500 92,500 ................ ................
Gallaudet University:
Operations................................................ 165,361 165,361 165,361 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Institutions for Persons with 301,292 301,292 301,292 ................ ................
Disabilities.........................................
=========================================================================================
CAREER, TECHNICAL, AND ADULT EDUCATION
Career Education:
Basic State Grants:
State Grants.......................................... 638,848 682,312 678,848 +40,000 -3,464
Appropriations available from prior year advances..... 791,000 791,000 791,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Basic State Grants, fiscal year program 1,429,848 1,473,312 1,469,848 +40,000 -3,464
level............................................
=========================================================================================
Advance appropriations, FY 2025....................... 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 1,429,848 1,473,312 1,469,848 +40,000 -3,464
bill.............................................
National Programs......................................... 32,421 215,421 12,421 -20,000 -203,000
-----------------------------------------------------------------------------------------
Subtotal, Career Education............................ 1,462,269 1,688,733 1,482,269 +20,000 -206,464
Adult Education:
State Grants/Adult Basic and Literacy Education:
State Grants, forward funded.......................... 715,455 715,455 715,455 ................ ................
National Leadership Activities............................ 13,712 43,712 13,712 ................ -30,000
-----------------------------------------------------------------------------------------
Subtotal, Adult education............................. 729,167 759,167 729,167 ................ -30,000
-----------------------------------------------------------------------------------------
Total, Career, Technical, and Adult Education......... 2,191,436 2,447,900 2,211,436 +20,000 -236,464
=========================================================================================
Current Year appropriations....................... (1,400,436) (1,656,900) (1,420,436) (+20,000) (-236,464)
(Forward Funded).............................. (1,400,436) (1,656,900) (1,420,436) (+20,000) (-236,464)
Advance appropriations............................ (791,000) (791,000) (791,000) ................ ................
STUDENT FINANCIAL ASSISTANCE
Pell Grants--maximum grant (NA)............................... (6,335) (6,835) (6,585) (+250) (-250)
Pell Grants................................................... 22,475,352 24,275,352 22,475,352 ................ -1,800,000
Federal Supplemental Educational Opportunity Grants........... 910,000 910,000 900,000 -10,000 -10,000
Federal Work Study............................................ 1,230,000 1,230,000 1,220,000 -10,000 -10,000
-----------------------------------------------------------------------------------------
Total, Student Financial Assistance....................... 24,615,352 26,415,352 24,595,352 -20,000 -1,820,000
=========================================================================================
STUDENT AID ADMINISTRATION
Salaries and Expenses......................................... 1,058,943 1,205,412 996,667 -62,276 -208,745
Servicing Activities.......................................... 975,000 1,448,622 1,187,276 +212,276 -261,346
-----------------------------------------------------------------------------------------
Total, Student Aid Administration......................... 2,033,943 2,654,034 2,183,943 +150,000 -470,091
=========================================================================================
FREE COMMUNITY COLLEGE AND TUITION SUBSIDIES
Accelerated Success: Free Community College................... ................ 500,000 ................ ................ -500,000
HIGHER EDUCATION
Aid for Institutional Development:
Strengthening Institutions................................ 122,070 209,007 112,070 -10,000 -96,937
Hispanic-Serving Institutions............................. 227,751 236,732 231,547 +3,796 -5,185
Promoting Postbaccalaureate Opportunities for Hispanic 27,314 28,845 27,769 +455 -1,076
Americans................................................
Strengthening Historically Black Colleges (HBCUs)......... 395,986 402,619 402,585 +6,599 -34
Strengthening Historically Black Graduate Institutions.... 100,782 102,313 102,462 +1,680 +149
Strengthening Predominantly Black Institutions............ 22,300 23,218 22,672 +372 -546
Strengthening Asian American and Native American Pacific 18,589 20,120 18,899 +310 -1,221
Islander-Serving Institutions............................
Strengthing Alaska Native and Native Hawaiian-Serving 24,433 25,044 24,840 +407 -204
Institutions.............................................
Strengthening Native American-Serving Nontribal 11,405 12,120 11,595 +190 -525
Institutions.............................................
Strengthening Tribal Colleges............................. 51,549 53,080 52,408 +859 -672
Strengthening HBCU Masters programs....................... 19,937 20,956 20,269 +332 -687
-----------------------------------------------------------------------------------------
Subtotal, Aid for Institutional Development........... 1,022,116 1,134,054 1,027,116 +5,000 -106,938
International Education and Foreign Language:
Domestic Programs......................................... 75,353 75,353 75,353 ................ ................
Overseas Programs......................................... 10,311 10,311 10,311 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, International Education and Foreign Language 85,664 85,664 85,664 ................ ................
Transition and Postsecondary Programs for Students with 13,800 15,180 13,800 ................ -1,380
Intellectual Disabilities....................................
Minority Science and Engineering Improvement.................. 16,370 18,370 16,370 ................ -2,000
Tribally Controlled Postsec Voc/Tech Institutions............. 11,953 11,953 11,953 ................ ................
Federal TRIO Programs......................................... 1,191,000 1,297,761 1,191,000 ................ -106,761
GEAR UP....................................................... 388,000 408,000 388,000 ................ -20,000
Graduate Assistance in Areas of National Need................. 23,547 23,547 23,547 ................ ................
Teacher Quality Partnerships.................................. 70,000 132,092 83,000 +13,000 -49,092
Child Care Access Means Parents in School..................... 75,000 95,000 80,000 +5,000 -15,000
Fund for the Improvement of Postsecondary Ed (FIPSE).......... 613,587 725,000 324,979 -288,608 -400,021
Congressionally Directed Spending/Community Project Funding (429,587) ................ (202,979) (-226,608) (+202,979)
(non-add)....................................................
Hawkins Centers of Excellence................................. 15,000 30,000 15,000 ................ -15,000
Graduate Fellowships to Prepare Faculty....................... ................ 10,000 ................ ................ -10,000
-----------------------------------------------------------------------------------------
Total, Higher Education................................... 3,526,037 3,986,621 3,260,429 -265,608 -726,192
=========================================================================================
HOWARD UNIVERSITY
Academic Program.............................................. 223,288 223,288 223,288 ................ ................
Endowment Program............................................. 3,405 3,405 3,405 ................ ................
Howard University Hospital.................................... 127,325 120,325 77,325 -50,000 -43,000
-----------------------------------------------------------------------------------------
Total, Howard University.................................. 354,018 347,018 304,018 -50,000 -43,000
=========================================================================================
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM......... 298 321 298 ................ -23
HISTORICALLY BLACK COLLEGE AND UNIVERSITY [HBCU]
CAPITAL FINANCING PROGRAM ACCOUNT
HBCU Federal Administration................................... 528 600 528 ................ -72
HBCU Loan Subsidies........................................... 20,150 20,150 20,150 ................ ................
-----------------------------------------------------------------------------------------
Total, HBCU Capital Financing Program..................... 20,678 20,750 20,678 ................ -72
=========================================================================================
INSTITUTE OF EDUCATION SCIENCES (IES)
Research, Development and Dissemination....................... 245,000 291,877 245,000 ................ -46,877
Statistics.................................................... 121,500 127,000 121,500 ................ -5,500
Regional Educational Laboratories............................. 58,733 60,733 53,733 -5,000 -7,000
Research in Special Education................................. 64,255 64,255 64,255 ................ ................
Special Education Studies and Evaluations..................... 13,318 13,318 13,318 ................ ................
Statewide Data Systems........................................ 38,500 38,500 28,500 -10,000 -10,000
Assessment:
National Assessment....................................... 185,000 189,000 185,000 ................ -4,000
National Assessment Governing Board....................... 7,799 9,300 8,300 +501 -1,000
-----------------------------------------------------------------------------------------
Subtotal, Assessment.................................. 192,799 198,300 193,300 +501 -5,000
Program Administration........................................ 73,500 76,885 73,500 ................ -3,385
-----------------------------------------------------------------------------------------
Total, Institute of Education Sciences.................... 807,605 870,868 793,106 -14,499 -77,762
=========================================================================================
DEPARTMENTAL MANAGEMENT
Program Administration:
Salaries and Expenses..................................... 419,907 508,359 419,907 ................ -88,452
Building Modernization.................................... 7,000 19,250 ................ -7,000 -19,250
-----------------------------------------------------------------------------------------
Total, Program administration......................... 426,907 527,609 419,907 -7,000 -107,702
=========================================================================================
Office for Civil Rights....................................... 140,000 177,600 140,000 ................ -37,600
Office of Inspector General................................... 67,500 87,497 67,500 ................ -19,997
-----------------------------------------------------------------------------------------
Total, Departmental management............................ 634,407 792,706 627,407 -7,000 -165,299
=========================================================================================
Total, Title III, Department of Education................. 83,542,969 94,260,455 83,833,929 +290,960 -10,426,526
=========================================================================================
Current Year appropriations........................... (60,945,968) (71,663,454) (61,236,928) (+290,960) (-10,426,526)
Advance appropriations................................ (22,597,001) (22,597,001) (22,597,001) ................ ................
TITLE IV--RELATED AGENCIES
COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY 13,124 15,400 13,124 ................ -2,276
DISABLED.....................................................
Office of Inspector General............................... (3,150) (3,600) (3,150) ................ (-450)
CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
Operating Expenses
Domestic Volunteer Service Programs:
Volunteers in Service to America [VISTA].................. 103,285 141,626 103,285 ................ -38,341
National Senior Volunteer Corps:
Foster Grandparents Program........................... 125,363 143,450 125,363 ................ -18,087
Senior Companion Program.............................. 56,449 63,809 56,449 ................ -7,360
Retired Senior Volunteer Program...................... 55,105 55,105 55,105 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Senior Volunteer Corps.................. 236,917 262,364 236,917 ................ -25,447
-----------------------------------------------------------------------------------------
Subtotal, Domestic Volunteer Service.................. 340,202 403,990 340,202 ................ -63,788
National and Community Service Programs:
AmeriCorps State and National Grants...................... 557,094 650,834 557,094 ................ -93,740
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 43,300 37,735 ................ -5,565
State Commission Support Grants........................... 19,538 19,538 19,538 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, National and Community Service.............. 635,323 734,628 635,323 ................ -99,305
-----------------------------------------------------------------------------------------
Total, Operating expenses................................. 975,525 1,138,618 975,525 ................ -163,093
=========================================================================================
National Service Trust........................................ 230,000 213,000 180,000 -50,000 -33,000
Salaries and Expenses......................................... 99,686 118,434 99,686 ................ -18,748
Office of Inspector General................................... 7,595 8,572 7,595 ................ -977
-----------------------------------------------------------------------------------------
Total, Corporation for National and Community Service..... 1,312,806 1,478,624 1,262,806 -50,000 -215,818
=========================================================================================
CORPORATION FOR PUBLIC BROADCASTING:
Appropriation available from FY 2022 advance.................. 475,000 525,000 525,000 +50,000 ................
-----------------------------------------------------------------------------------------
Total, available this fiscal year......................... 475,000 525,000 525,000 +50,000 ................
=========================================================================================
Advance appropriation, FY 2026............................ 535,000 575,000 535,000 ................ -40,000
less appropriations provided from prior year advances (FY -475,000 -525,000 -525,000 -50,000 ................
2022)....................................................
Public television interconnection system.................. 60,000 60,000 60,000 ................ ................
-----------------------------------------------------------------------------------------
Total CPB, appropriated in this bill...................... 595,000 635,000 595,000 ................ -40,000
=========================================================================================
Federal Mediation and Conciliation Service.................... 53,705 55,815 53,705 ................ -2,110
Federal Mine Safety and Health Review Commission.............. 18,012 18,657 18,012 ................ -645
Institute of Museum and Library Services...................... 294,800 294,800 289,800 -5,000 -5,000
Medicaid and CHIP Payment and Access Commission............... 9,405 10,053 9,405 ................ -648
Medicare Payment Advisory Commission.......................... 13,824 13,824 13,824 ................ ................
National Council on Disability................................ 3,850 3,850 3,850 ................ ................
National Labor Relations Board................................ 299,224 376,163 299,224 ................ -76,939
National Mediation Board...................................... 15,113 15,601 15,113 ................ -488
Occupational Safety and Health Review Commission.............. 15,449 16,179 15,449 ................ -730
RAILROAD RETIREMENT BOARD
Dual Benefits Payments Account................................ 9,000 8,000 8,000 -1,000 ................
Less Income Tax Receipts on Dual Benefits................. -1,000 -1,000 -1,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Dual Benefits............................... 8,000 7,000 7,000 -1,000 ................
Federal Payments to the Railroad Retirement Accounts.......... 150 150 150 ................ ................
Limitation on administrative expenses......................... 128,000 138,575 128,000 ................ -10,575
Limitation on the Office of Inspector General................. 14,000 14,600 14,000 ................ -600
-----------------------------------------------------------------------------------------
Total, Railroad Retirement Board.......................... 150,150 160,325 149,150 -1,000 -11,175
=========================================================================================
SOCIAL SECURITY ADMINISTRATION
Payments to Social Security Trust Funds....................... 11,000 10,000 10,000 -1,000 ................
Supplemental Security Income Program
Federal Benefit Payments...................................... 59,225,000 56,328,000 56,328,000 -2,897,000 ................
Beneficiary Services.......................................... 124,000 137,000 137,000 +13,000 ................
Research and Demonstration.................................... 86,000 91,000 91,000 +5,000 ................
Administration................................................ 4,774,338 4,961,853 4,805,145 +30,807 -156,708
-----------------------------------------------------------------------------------------
Subtotal, available this fiscal year...................... 64,209,338 61,517,853 61,361,145 -2,848,193 -156,708
Less appropriations provided from prior year advances......... -15,600,000 -15,800,000 -15,800,000 -200,000 ................
-----------------------------------------------------------------------------------------
Subtotal, current year appropriation...................... 48,609,338 45,717,853 45,561,145 -3,048,193 -156,708
-----------------------------------------------------------------------------------------
Subtotal, Mandatory....................................... 43,835,000 40,756,000 40,756,000 -3,079,000 ................
Advance appropriations, 1st quarter, FY 2025.................. 15,800,000 21,700,000 21,700,000 +5,900,000 ................
-----------------------------------------------------------------------------------------
Total, SSI program appropriated in this bill.............. 64,409,338 67,417,853 67,261,145 +2,851,807 -156,708
=========================================================================================
Limitation on Administrative Expenses
OASI/DI Trust Funds........................................... 5,840,734 6,567,231 5,938,485 +97,751 -628,746
HI/SMI Trust Funds............................................ 3,075,880 3,430,858 3,132,598 +56,718 -298,260
Social Security Advisory Board................................ 2,700 3,020 2,700 ................ -320
SSI........................................................... 3,282,664 3,467,091 3,343,195 +60,531 -123,896
-----------------------------------------------------------------------------------------
Subtotal.................................................. 12,201,978 13,468,200 12,416,978 +215,000 -1,051,222
User Fees:
SSI User Fee activities................................... 140,000 150,000 150,000 +10,000 ................
SSPA User Fee Activities.................................. 1,000 1,000 1,000 ................ ................
CBO adjustment........................................ -1,000 -1,000 -1,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, User fees............................... 140,000 150,000 150,000 +10,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Limitation on administrative expenses....... 12,341,978 13,618,200 12,566,978 +225,000 -1,051,222
Program Integrity:
OASDI Trust Funds......................................... 292,326 375,238 389,050 +96,724 +13,812
SSI....................................................... 1,491,674 1,494,762 1,461,950 -29,724 -32,812
-----------------------------------------------------------------------------------------
Subtotal, Program integrity funding................... 1,784,000 1,870,000 1,851,000 +67,000 -19,000
Base Program Integrity............................ (273,000) (287,000) (273,000) ................ (-14,000)
Program Integrity (cap adjustment)................ (1,511,000) (1,583,000) (1,578,000) (+67,000) (-5,000)
-----------------------------------------------------------------------------------------
Total, Limitation on Administrative Expenses.......... 14,125,978 15,488,200 14,417,978 +292,000 -1,070,222
=========================================================================================
Total, Limitation on Administrative Expenses (less 13,985,978 15,338,200 14,267,978 +282,000 -1,070,222
user fees)...........................................
=========================================================================================
Office of Inspector General
Federal Funds................................................. 32,000 34,000 32,000 ................ -2,000
Trust Funds................................................... 82,665 86,400 82,665 ................ -3,735
-----------------------------------------------------------------------------------------
Total, Office of Inspector General........................ 114,665 120,400 114,665 ................ -5,735
=========================================================================================
Adjustment: Trust fund transfers from general revenues........ -4,774,338 -4,961,853 -4,805,145 -30,807 +156,708
-----------------------------------------------------------------------------------------
Total, Social Security Administration..................... 73,886,643 78,074,600 76,998,643 +3,112,000 -1,075,957
=========================================================================================
Federal funds......................................... (64,592,338) (67,611,853) (67,453,145) (+2,860,807) (-158,708)
Current year...................................... (48,792,338) (45,911,853) (45,753,145) (-3,039,193) (-158,708)
New advances, 1st quarter, FY 2024................ (15,800,000) (21,700,000) (21,700,000) (+5,900,000) ................
Trust funds........................................... (9,294,305) (10,462,747) (9,545,498) (+251,193) (-917,249)
-----------------------------------------------------------------------------------------
Total, Title IV, Related Agencies......................... 76,681,105 81,168,891 79,737,105 +3,056,000 -1,431,786
=========================================================================================
Federal Funds......................................... (67,230,976) (70,539,145) (70,035,783) (+2,804,807) (-503,362)
Current Year...................................... (50,895,976) (48,264,145) (47,800,783) (-3,095,193) (-463,362)
FY 2025 Advance................................... (15,800,000) (21,700,000) (21,700,000) (+5,900,000) ................
FY 2026 Advance................................... (535,000) (575,000) (535,000) ................ (-40,000)
Trust Funds........................................... (9,450,129) (10,629,746) (9,701,322) (+251,193) (-928,424)
DISCRETIONARY ADJUSTMENTS
Traditional Medicare Program.................................. 455,000 ................ 455,000 ................ +455,000
National Labor Relations Board Moving Expenses................ ................ ................ 10,000 +10,000 +10,000
Less advances for subsequent years........................ -24,904,001 -24,944,001 -24,904,001 ................ +40,000
Less advance emergency appropriations..................... ................ ................ ................ ................ ................
Plus advances provided in prior years..................... 24,844,001 24,894,001 24,894,001 +50,000 ................
Plus emergency advances provided in prior years........... 494,500 494,500 494,500 ................ ................
Average Weekly Insured Unemployment (AWIU) Contingent..... 40,000 100,000 20,000 -20,000 -80,000
Medicare Eligible Accruals (permanent,indefinite)......... 37,000 42,000 42,000 +5,000 ................
SSI User Fee Collection................................... -140,000 -150,000 -150,000 -10,000 ................
CBO adjustment........................................ -5,000 6,000 6,000 +11,000 ................
Surplus property (Department of Labor).................... 2,000 2,000 2,000 ................ ................
H-1B (rescission) (DOL)................................... -142,000 ................ -206,000 -64,000 -206,000
Dislocated Worker National Reserve............................ ................ ................ -100,000 -100,000 -100,000
Nonrecurring expenses fund (rescission)................... -650,000 -350,000 -1,000,000 -350,000 -650,000
American Rescue Plan COVID Balances (rescission).............. ................ ................ -850,000 -850,000 -850,000
Child Enrollment Contingency Fund............................. -14,628,000 -19,193,000 -19,193,000 -4,565,000 ................
Pell unobligated balances (rescission).................... -360,000 ................ -200,000 +160,000 -200,000
Pell: Increase maximum award.............................. 75,000 85,000 50,000 -25,000 -35,000
Pell max award (rescission)............................... -75,000 -62,000 -50,000 +25,000 +12,000
CNCS National Service Trust (rescission).................. ................ -210,000 -243,000 -243,000 -33,000
Performance Bonus Payments................................ ................ -10,732,000 -5,031,000 -5,031,000 +5,701,000
CBO adjustment: Extension of Parolee Eligibility Public 1,000 ................ ................ -1,000 ................
Law 117-180 (Sec 149)(emergency).........................
Refugee and Entrant Assistance Contingency Fund........... 360,000 ................ ................ -360,000 ................
Refugee and Entrant Assistance Contingency Fund ................ 4,650,000 380,000 +380,000 -4,270,000
(emergency)..............................................
Proceeds from Job Corps facilities (Sec 114).................. ................ 1,000 ................ ................ -1,000
-----------------------------------------------------------------------------------------
Total, Discretionary adjustments.......................... -15,050,500 -25,366,500 -26,038,500 -10,988,000 -672,000
=========================================================================================
OTHER APPROPRIATIONS
THE INFRASTRUCTURE INVESTMENT AND JOBS ACT, 2022
(Public Law 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 ................ ................
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Total, Low Income Home Energy Assistance.............. 100,000 100,000 100,000 ................ ................
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Total, Infrastructure Investment and Jobs Act............. 100,000 100,000 100,000 ................ ................
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BIPARTISAN SAFER COMMUNITIES SUPPLEMENTAL APPROPRIATIONS ACT,
2022
(Public Law 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) ................ ................
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Total, Health Resources and Services Administration....... 32,000 32,000 32,000 ................ ................
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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)..............................................
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Total, Health Surveillance and Program Support........ 162,500 162,500 162,500 ................ ................
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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)..............................................
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Total, Public Health and Social Services Emergency 32,000 32,000 32,000 ................ ................
Fund.................................................
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Total Department of Health and Human Services............. 194,500 194,500 194,500 ................ ................
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DEPARTMENT OF EDUCATION
Safe Schools and Citizenship Education:
Appropriations available from prior year advances 200,000 200,000 200,000 ................ ................
(emergency)..............................................
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Total, Safe Schools and Citizenship Education......... 200,000 200,000 200,000 ................ ................
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Total, Bipartisan Safer Communities Supplemetal 394,500 394,500 394,500 ................ ................
Appriations Act, 2022................................
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ADDITIONAL UKRAINE SUPPLEMENTAL APPROPRIATIONS ACT, 2023
(Public Law 117-328 DIVISION M)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Refugee and Entrant Assistance (emergency).................... 2,400,000 ................ ................ -2,400,000 ................
General Provisions--This Title
Afghan resettlement (Sec 1501) (emergency).................... 9,000 ................ ................ -9,000 ................
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Total, Additional Ukraine Supplemental Appropriations Act, 2,409,000 ................ ................ -2,409,000 ................
2023.....................................................
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DISASTER RELIEF SUPPLEMENTAL APPROPRIATIONS ACT, 2023
(Public Law 117-328 DIVISION N)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
CDC-Wide Activities and Program Support (emergency)........... 86,000 ................ ................ -86,000 ................
National Institutes of Health
National Institute of Environmental Health Sciences 2,500 ................ ................ -2,500 ................
(emergency)..................................................
Office of the Director (emergency)............................ 25,000 ................ ................ -25,000 ................
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Total, National Institutes of Health...................... 27,500 ................ ................ -27,500 ................
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Administration for Children and Families
Low Income Energy Assistance (emergency)...................... 1,000,000 ................ ................ -1,000,000 ................
Payments to States for the Child Care and Development Block 100,000 ................ ................ -100,000 ................
Grant (emergency)............................................
Children and Families Services Programs (emergency)........... 408,000 ................ ................ -408,000 ................
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Total, Administration for Children and Families........... 1,508,000 ................ ................ -1,508,000 ................
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Office of the Secretary
Public Health and Social Services Emergency Fund (emergency).. 128,792 ................ ................ -128,792 ................
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Total, Disaster Relief Supplemental Appropriations Act, 1,750,292 ................ ................ -1,750,292 ................
2023.....................................................
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Less prior year appropriations (emergency).................... -494,500 -494,500 -494,500 ................ ................
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Total, Other Appropriations............................... 4,159,292 ................ ................ -4,159,292 ................
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Less prior year appropriations (emergency).................... ................ ................ ................ ................ ................
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Grand Total................................................... 1,430,661,909 1,470,554,232 1,445,830,783 +15,168,874 -24,723,449
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Appropriations............................................ (1,185,495,784) (1,177,588,043) (1,151,017,067) (-34,478,717) (-26,570,976)
Emergency appropriations.................................. (9,435,292) (4,650,000) (4,500,000) (-4,935,292) (-150,000)
Trust funds............................................... (18,644,609) (21,409,275) (18,960,802) (+316,193) (-2,448,473)
Advance Appropriations, FY 25............................. (242,259,725) (296,456,415) (296,456,415) (+54,196,690) ................
Advance appropriations, FY 26............................. (535,000) (575,000) (535,000) ................ (-40,000)
21st Century CURES Act funding................................ (1,085,000) (407,000) (407,000) (-678,000) ................
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