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                                                       Calendar No. 189
104th Congress                                                   Report
                                 SENATE

   1st Session                                                  104-145
_______________________________________________________________________


 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION AND 
               RELATED AGENCIES APPROPRIATION BILL, 1996

                                _______


   September 15 (legislative day, September 5), 1995.--Ordered to be 
                                printed

_______________________________________________________________________


   Mr. Specter, from the Committee on Appropriations, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 2127]

    The Committee on Appropriations, to which was referred the 
bill (H.R. 2127) making appropriations for the Departments of 
Labor, Health and Human Services, and Education and related 
agencies for the fiscal year ending September 30, 1996, and for 
other purposes, reports the same to the Senate with amendments 
and recommends that the bill as amended do pass.



Amount of discretionary budget authority \1\

Amount of House bill.................................... $60,974,651,000
Amount of Senate bill over House bill...................  +1,834,349,000
                    --------------------------------------------------------
                    ____________________________________________________
      Total bill as reported to Senate..................  62,809,000,000
Amount of adjusted appropriations, 1995.................  67,154,817,000
Budget estimates, 1996..................................  72,079,948,000
The bill as reported to the Senate:
    Under the adjusted appropriations for 1995..........  -4,345,817,000
    Under the budget estimates for 1996.................  -9,270,948,000

\1\ Excludes mandatory appropriations; total funding summary on page 4.


                            C O N T E N T S

                              ----------                              
                                                                   Page
Budget estimates.................................................     4
Title I--Department of Labor:
    Employment and Training Administration.......................     7
    Office of the American Workplace.............................    17
    Pension and Welfare Benefits Administration..................    18
    Pension Benefit Guaranty Corporation.........................    18
    Employment Standards Administration..........................    19
    Occupational Safety and Health Administration................    22
    Mine Safety and Health Administration........................    23
    Bureau of Labor Statistics...................................    24
    Departmental management......................................    25
    Assistant Secretary for Veterans' Employment and Training....    27
    Office of the Inspector General..............................    27
Title II--Department of Health and Human Services:
    Health Resources and Services Administration.................    29
    Centers for Disease Control and Prevention...................    50
    National Institutes of Health................................    67
    Substance Abuse and Mental Health Services Administration....   116
    Office of the Assistant Secretary for Health.................   122
    Agency for Health Care Policy and Research...................   123
    Health Care Financing Administration.........................   127
    Administration for Children and Families.....................   133
    Administration on Aging......................................   145
    Office of the Secretary......................................   148
Title III--Department of Education:
    Education reform.............................................   157
    Education for the Disadvantaged..............................   158
    Impact aid...................................................   162
    School improvement programs..................................   164
    Bilingual and immigrant education............................   170
    Special education............................................   171
    Rehabilitation services and disability research..............   176
    Special institutions for persons with disabilities:
        American Printing House for the Blind....................   181
        National Technical Institute for the Deaf................   181
        Gallaudet University.....................................   182
    Vocational and adult education...............................   183
    Student financial assistance.................................   187
    Federal family education loan program........................   189
    Federal direct student loan program..........................   190
    Higher education.............................................   190
    Howard University............................................   199
    College housing and academic facilities loans................   200
    Historically black college and university capital financing 
      program....................................................   200
    Education research, statistics, and improvement..............   200
    Libraries....................................................   207
    Departmental management......................................   209
    Office for Civil Rights......................................   210
    Office of the Inspector General..............................   210
Title IV--Related agencies:
    Armed Forces Retirement Home.................................   212
    Corporation for National and Community Service...............   212
    Corporation for Public Broadcasting..........................   214
    Federal Mediation and Conciliation Service...................   214
    Federal Mine Safety and Health Review Commission.............   215
    National Commission on Libraries and Information Science.....   215
    National Council on Disability...............................   215
    National Labor Relations Board...............................   216
    National Mediation Board.....................................   217
    Occupational Safety and Health Review Commission.............   217
    Physician Payment Review Commission..........................   217
    Prospective Payment Assessment Commission....................   218
    Social Security Administration...............................   218
    Railroad Retirement Board....................................   223
    U.S. Institute of Peace......................................   224
Title V--General provisions......................................   225
Budgetary impact of bill.........................................   227
Compliance with standing rules of the Senate.....................   227
Title VI--Political Advocacy.....................................   230
Title VII--Deficit Reduction Lockbox.............................   231
Comparative statement of new budget authority....................   232
       Summary of Budget Estimates and Committee Recommendations

    For fiscal year 1996, the Committee recommends total 
current year budget authority of $263,769,783,000 for the 
Department of Labor, Health and Human Services, and Education, 
and Related Agencies. Of this amount, $62,809,000,000 is 
discretionary and $200,960,783,000 is mandatory funding. The 
discretionary amount represents a 6.4-percent decrease below 
the fiscal year 1995 level, while mandatory funding represents 
an increase of 9.3 percent.

                           allocation ceiling

    Consistent with Congressional Budget Office scorekeeping, 
the recommendations result in full use of discretionary outlays 
pursuant to section 602(b) of the Congressional Budget Act of 
1974, as amended.

                         Highlights of the Bill

    Pell grants.--The Committee bill includes $6,115,000,000 
for the Federal Pell Grant Program. The amount provided will 
allow the increase in the maximum Pell grant to be raised to 
$2,440, an increase of $100 over the 1995 amount.
    Education for individuals with disabilities.--The Committee 
bill provides $3,245,447,000 to ensure that all children have 
access to a free appropriate education and that all infants and 
toddlers with disabilities have access to early intervention 
services.
    Rehabilitation services.--The Committee bill provides 
$2,455,760,000 for rehabilitation programs, an increase of 
$59,268,000 above the amount provided in 1995. These funds are 
essential for individuals with disabilities seeking employment.
    Family planning.--The Committee bill includes $193,349,000 
for the family planning program, the same amount appropriated 
in 1995. These funds support primary health care services at 
over 4,000 clinics nationwide.
    National Institutes of Health.--The Committee bill includes 
$11,597,539,000 for the National Institutes of Health, an 
increase of $300,993,000 above the amount provided in 1995.
    Grants for disadvantaged children.--The Committee bill 
provides $6,517,166,000 for grants to disadvantaged children. 
Included in that amount is $692,341,000, an increase of 
$29,204,000 above the 1995 appropriation, for school districts 
with the highest concentration of poor students.
    Nutrition programs for the elderly.--The Committee bill 
provides $474,874,000 for the elderly nutrition programs. To 
direct funds to the area of greatest need, the bill includes 
$110,339,000 for the home-delivered meals program, an increase 
of $16,274,000 over the 1995 appropriation.
    Women's health.--The Committee bill provides $5,362,000, 
which more than doubles the amount provided in 1995 for 
programs focused on prevention and education and the 
advancement of women's health initiatives, and the coordination 
of the breast cancer action plan.
    Breast cancer screening.--The Committee bill provides 
$125,000,000, an increase of $25,000,000 over the 1995 level.
    AIDS.--The Committee bill provides $1,388,678,000, an 
increase of $52,000,000 over the 1995 level for the Office of 
AIDS Research at the National Institutes of Health. The bill 
also includes $656,465,000 for Ryan White programs, an increase 
of $23,500,000, and $589,962,000 for AIDS prevention programs 
at the Centers for Disease Control and Prevention.
    Family violence.--The bill includes $50,000,000 for family 
violence, an increase of $17,355,000 over the 1995 amount, and 
provides the full amount authorized for this fiscal year.
    Rape prevention.--The bill provides $35,000,000 for a new 
rape prevention programs at the Centers for Disease Control and 
Prevention, the full amount authorized in fiscal year 1996.
    Low-income home energy assistance.--The Committee 
recommendation includes $900,000,000 for heating and cooling 
assistance, together with an estimated $100,000,000 in 
carryover funds, for this coming year. The Committee has also 
recommended $1,000,000,000 for the fiscal year 1997 advance 
appropriation. Also included is bill language permitting up to 
$600,000,000 in additional funding to meet emergencies.
    Community services block grant.--The Committee bill 
maintains the current funding level of $389,600,000 for the 
community services block grant program.
    Child care and development block grant.--The Committee 
recommendation provides $934,642,000 for child care services, 
the same as the 1995 appropriation.
    Infectious disease.--The Committee bill recommends 
$58,402,000 within the Centers for Disease Control and 
Prevention to combat the growing threat of infectious disease. 
The amount recommended is an increase of 7 percent over the 
fiscal year 1995 amount.
    Social Security Administration.--The Committee bill 
recommends $5,845,183,000, an increase of nearly $300,000,000 
over the 1995 level, which expands both the automation and 
disability initiatives at the Social Security Administration.
    Job Corps.--The Committee bill provides $1,093,942,000 for 
the Job Corps, an increase of $4,482,000 over the 1995 level.
    School-to-work.--The bill includes $245,000,000 for school-
to-work programs, the same as the 1995 level; funding is 
equally divided between the Departments of Labor and Education 
for this jointly administered program.

              reprogramming and initiation of new programs

    Reprogramming is the utilization of funds for purposes 
other than those contemplated at the time of appropriation 
enactment. Reprogramming actions do not represent requests for 
additional funds from the Congress, rather, the reapplication 
of resources already available.
    The Committee has a particular interest in approving 
reprogrammings which, although they may not change either the 
total amount available in an account or, any of the purposes 
for which the appropriation is legally available, represent a 
significant departure from budget plans presented to the 
Committee in an agency's budget justifications.
    Consequently, the Committee directs that the Departments 
and Agencies funded through this bill make a written request to 
the chairman of the Committee prior to reprogramming of funds 
in excess of 10 percent, or $250,000, whichever is less, 
between programs, activities, or elements. The Committee 
desires to have the requests for reprogramming actions which 
involve less than the above-mentioned amounts if such actions 
would have the effect of changing an agency's funding 
requirements in future years, if programs or projects 
specifically cited in the Committee's reports are affected or 
if the action can be considered to be the initiation of a new 
program.
    Prior Committee notification is also required for actions 
requiring the use of general transfer authority, or which move 
funds between appropriations accounts, unless otherwise 
provided for in this act. Such transfers specifically include 
taps, or other assessments made between agencies, or between 
offices within agencies. Funds have been appropriated for each 
office funded by this Committee; it is not the intention of 
this Committee to augment those funding levels through the use 
of special assessments. This directive does not apply to 
working capital funds or other fee-for-service activities.
    The Committee directs that it be notified regarding 
reorganization of offices, programs, or activities prior to the 
planned implementation of such reorganizations.
    The Committee further directs that each agency under its 
jurisdiction submit to the Committee statements on the effect 
of this appropriation act within 30 days of final enactment of 
this act.
                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

Appropriations, 1995....................................  $3,956,770,000
Budget estimate, 1996...................................   5,464,484,000
House allowance.........................................   3,180,441,000

Committee recommendation

                                                           3,427,305,000

    The Committee recommends $3,427,305,000 for this account 
which provides funding authorized primarily by the Job Training 
Partnership Act. This is $246,864,000 more than the House 
allowance and $529,465,000 less than the 1995 enacted level.
    The Committee is aware of pending legislation that would 
consolidate many job training programs that are currently 
authorized by the Job Training Partnership Act, the School-to-
Work Opportunities Act and other acts. Therefore, the Committee 
has drafted this bill in anticipation of future consolidation.
    Training and employment services is comprised of programs 
designed to enhance the employment and earnings of economically 
disadvantaged and dislocated workers, operated through a 
decentralized system of skill training and related services. As 
required by the Job Training Partnership Act, this 
appropriation is forwarded-funded on a July to June cycle. 
Funds provided for fiscal year 1996 will support the program 
from July 1, 1996 through June 30, 1997.
    Adult programs.--For adult programs under title II-A, title 
III, and title IV-C of the Job Training Partnership Act and the 
State program portion of title V of the Older Americans Act, 
the Committee recommends $1,714,000,000. This is $736,813,000 
less than the budget request, an increase of $34,000,000 above 
the House allowance, and a decrease of $511,363,000 below the 
1995 comparable level.
    The Committee recommends $830,000,000 for adult training 
programs. Included in this amount is $77,000,000 for the State 
operated portion of the Community Service Employment Program 
authorized by title V of the Older Americans Act and $7,300,000 
for JTPA title IV-C veterans training. This is the $224,813,000 
below the budget request, the same as the House allowance, and 
a decrease of $166,813,000 below the 1995 comparable level.
    The title II-A adult training program is designed to 
prepare adults for participation in the labor force by 
increasing their occupational and educational skills, resulting 
in improved long-term employability, increased employment and 
earnings, and reduced welfare dependency. It is operated at the 
local level through service delivery areas designated by the 
Governor. Each area has a private industry council to provide 
guidance and oversight with respect to activities under that 
area's job training plan, in partnership with the unit or units 
of general local government in the areas. The private industry 
council includes representatives of the private sector, 
educational agencies, organized labor, and other groups in the 
area. All funds are allocated to the States by statutory 
formula.
    The Committee recommends $884,000,000 for dislocated worker 
programs. This is $512,000,000 below the budget request, an 
increase of $34,000,000 above the House allowance, and a 
decrease of $344,550,000 below the 1995 comparable level.
    The title III system provides for early identification of 
dislocated workers, the rapid provision of services to such 
workers, and quality training. Among the program's components 
are universal rapid response capabilities, early intervention 
activities, the availability of needs-related payments to 
assist workers in training, and substate delivery systems. 
Funds are allocated to the States by statutory formula; 20 
percent is retained by the Secretary for discretionary 
purposes.
    The Committee continues to be concerned about the 
readjustment needs confronting workers in the Pacific Northwest 
dislocated as a result of changes in Federal environmental 
policies. Most notably, reductions in Federal timber sales are 
projected to cost an estimated 6,000 to 85,000 jobs in the 
Pacific Northwest. The Committee understands that the Secretary 
will continue to make available sufficient funds to implement 
the administration's economic adjustment initiative for timber 
communities. This initiative sets aside funding annually from 
the Secretary's ``National reserve'' account for emergency 
discretionary grants to affected localities. The Committee 
expects that the Department will give expeditious consideration 
to applications for emergency assistance from States with 
affected communities.
    It is the Committee's intent that funds appropriated under 
title III-B of JTPA be used to the greatest extent possible for 
emergency dislocations as opposed to other activities that 
serve less immediate needs such as demonstration projects and 
technical assistance and training.
    The Committee has included language in the bill which 
continues flexibility in three areas. First, the language 
removes the cost limitations that States utilize not more than 
25 percent of funds on needs-related payments and supportive 
services. It does not remove the 15-percent administrative cost 
limit. Second, the language modifies the State waiver authority 
which permits the Governor to reduce to 30 percent the 
requirement that not less than 50 percent of the funds be used 
for retraining services. This language will enable local areas 
to determine the appropriate share of resources for upfront, 
cost-effective readjustment services that can facilitate rapid 
reemployment. Third, the language allows funds awarded under 
the National Discretionary Grant Program to be used to provide 
needs-related payments to participants who, in lieu of meeting 
the general EDWAA requirement that they be enrolled in training 
by the 13th week after layoff, have enrolled in training by the 
6th week after the grant is awarded. This provision adds 
appropriate flexibility while preserving the principle that 
retraining is most effective if individuals are enrolled in 
training early in the adjustment process. These provisions are 
effective for 1 year only.
    The Dislocated Workers Program is invaluable in assisting 
civilian and military personnel dislocated by post-cold war 
military downsizing. Recent amendments to the JTPA authorize 
the use of title III moneys to continue to provide assistance 
to Americans displaced as a result of the country's changing 
military needs. The Committee notes that an additional 34,000 
civilian workers on military installations are expected to lose 
their jobs during the next 2 years as a result of base closures 
and urges the Department to give serious attention to needs in 
this area.
    In anticipation of pending legislation to consolidate adult 
training programs, the Committee has transferred funds to adult 
training programs for veterans and senior citizens.
    Youth programs.--For youth training programs under title 
II-B, title II-C, and title IV-B of the Job Training 
Partnership Act and the School-to-Work Opportunities Act, the 
Committee recommends $1,727,902,000. This is $947,331,000 below 
the budget request, and an increase of $185,220,000 above the 
House allowance and $204,482,000 above the 1995 comparable 
level.
    The title II-C Youth Training Program is designed for youth 
to improve their long-term employability, enhance their 
educational, occupational, and citizenship skills, encourage 
their school completion, increase their employment and 
earnings, and reduce welfare dependency. Like adult training, 
the program is administered by local service delivery areas, as 
directed by private industry councils.
    The summer youth program offers work experience, supportive 
services, and academic enrichment to economically disadvantaged 
youth, aged 14 to 21. Participants receive the minimum wage. 
Funds are allocated to the States by formula based on relative 
numbers of unemployed and economically disadvantaged 
individuals.
    To promote greater flexibility in local decisionmaking, the 
Committee has included bill language to give service delivery 
areas greater latitude in transferring funds among title II-A 
adult training and title III dislocated worker assistance, as 
well as from the title II-C year-round youth program to the 
title II-B summer program. In addition to the $311,460,000 
included in this bill, an estimated $200,000,000 in unspent 
summer youth carryover funds is estimated to be available to 
carry out these programs in 1996.
    For the Job Corps, the Committee recommends $1,093,942,000 
for program year 1996. This is $133,772,000 below the budget 
request, $27,068,000 below the House allowance, and an increase 
of $4,482,000 above the 1995 comparable level. The amount in 
the bill includes $972,475,000 for operations and $121,467,000 
for facility construction, rehabilitation, and acquisition. 
This program has been highly effective over a period of many 
years in preparing extremely disadvantaged young people for 
productive lives.
    The Committee has deleted without prejudice the language 
included by the House repealing the Job Training Partnership 
Act prohibition on contracting the operation of the Job Corps 
Civilian Conservation Centers. The Committee is aware of 
pending legislation that would substantially revise the Job 
Corps Program. Bill language is included that will allow the 
Secretary to retain the proceeds from the sale of Job Corps 
Center facilities.
    The Committee recommends $122,500,000 for school-to-work. 
This is $77,500,000 below the budget request, an increase of 
$27,500,000 above the House allowance, and the same as the 1995 
comparable level. The school-to-work program provides a 
national framework within which all States can create statewide 
systems to help youth acquire the knowledge, skills, abilities, 
and labor market information they need to make an effective 
transition from school to work, or to further education or 
training. It is jointly administered by the Departments of 
Labor and Education.
    It is the intent of the Committee that funds provided for 
school-to-work activities be utilized to continue projects 
initiated with previously enacted appropriations.
    Native Americans.--For native American programs, the bill 
provides $55,004,000. This $6,867,000 below the budget request, 
an increase of $5,004,000 above the House allowance, and a 
decrease of $4,783,000 below the 1995 comparable level. These 
programs are designed to improve the economic well-being of 
disadvantaged native Americans through vocational training, 
work experience, and other services aimed at getting 
participants into permanent unsubsidized jobs.
    Migrant and seasonal farmworkers.--For migrant and seasonal 
farmworker programs, the bill provides $73,570,000. This is 
$4,733,000 less than the budget request, an increase of 
$8,570,000 above the House allowance, and a decrease of 
$6,397,000 below the 1995 comparable level. This program is 
aimed at alleviating chronic unemployment and underemployment 
being experienced by farmworker families. Training and 
employability development services prepare farmworkers for 
stable, year-round employment, both in and outside the 
agricultural industry. Supportive services such as 
transportation, housing, health care, and day care are also 
provided.
    The Committee believes that the Migrant and Seasonal 
Farmworker Program can benefit from centralized administration 
from the national level and believes that administration of the 
program should continue at the national level and in the same 
manner as the section 401 native American program.
    The Committee is concerned that the Department has yet to 
implement many of the reforms outline in the conference report 
accompanying the Job Training Reform Amendments of 1992. The 
Committee understands that the delay may be due to staffing 
reductions in the Division of Seasonal Farmworker Programs and 
encourages the Department to review the staffing needs of this 
Office.
    The Committee believes that the Association of Farmworker 
Opportunity Programs [AFOP] provides valuable assistance to 
section 402 grantees in the form of technical assistance and 
training, training resource materials for grantee staff, and 
the development of a national farmworker data base to track 
program services of migrants who travel throughout the United 
States. The Committee has provided sufficient funds to maintain 
AFOP's support in fiscal year 1996.
    The Committee directs the Department of Labor to continue 
the Farmworker Housing Program at the rate in effect in fiscal 
year 1995.
    National activities.--For national activities $56,829,000 
is provided. This is $82,770,000 less than the budget request, 
an increase of $21,370,000 above the House allowance, and a 
decrease of $2,524,000 below the 1995 comparable level. The 
bill includes funding for research and evaluation ($6,196,000), 
pilots and demonstrations ($35,258,000), labor market 
information ($5,489,000), the National Occupational Information 
Coordinating Committee ($5,060,000), Glass Ceiling Commission 
phaseout ($142,000), skill standards ($4,000,000), and women in 
apprenticeship ($684,000).
    Under pilots and demonstrations, the Committee has provided 
sufficient funding to continue the continuing partnerships, 
community-based partnerships, and persons with disability 
partnerships. The Committee has also provided $2,250,000 for 
microenterprise grants and $5,000,000 for the American Samoan 
job training program. The Committee directs the Secretary to 
give funding priority to a State agency with a proven track 
record in successful job training programs for American 
Samoans.
    The Committee recommendation also provides, under pilots 
and demonstrations, $1,500,000 to expand a pioneering 
industrial employment program for the disabled to include 
training severely handicapped individuals to operate and 
maintain specially modified computer milling machines. The 
Committee is aware of a proposal by the Cerebral Palsy Research 
Foundation of Wichita, KS, in this area, and encourages full 
and fair consideration of a proposal from this institution.
    With regard to the National Occupational Information 
Coordinating Committee [NOICC], the Committee supports the 
continuation of career development programs to train personnel 
in assisting students to understand themselves in the context 
of their career development, to be aware of the world of work, 
to understand the linkage between academic skills and work-
related skills, and to make effective career decisions. The 
Committee recommends that NOICC expend up to $2,500,000 in 
fiscal year 1996 for the continuation of such programs.
    The Committee notes that the Homeless Veterans 
Reintegration Program is not funded in fiscal year 1996. The 
Committee remains concerned about the problems facing homeless 
veterans, and urges the Secretary of Labor to identify and 
provide pilot program and demonstration project funds 
sufficient to meet the needs of homeless veterans during fiscal 
year 1996.
    The Committee encourages the Secretary to give full and 
fair consideration to a proposal for a disability employment 
and training initiative in connection with the 10th Paralympic 
Games. These games, an international celebration of the 
abilities of people with disabilities, will be hosted by 
Atlanta in the summer of 1996.
    The Committee recognizes the past success and strong 
potential of the Goodwill Industries-Manasota, Inc. and 
Goodwill Industries of Acadiana, Inc. Job Connection Program 
for successfully moving people off of welfare and into real and 
permanent jobs. Its performance-based loan-to-grant concept, in 
conjunction with its self-sustaining operations, makes the 
Goodwill Job Connection a strong candidate for funding. The 
Committee encourages full and fair consideration of a proposal 
from this organization.
    The Committee is aware of a proposal from the Eisenhower 
Foundation to replicate the Argus project at two additional 
sites. Argus combines remedial education, job training, and job 
placement in a strictly violence-free and drug-free 
environment. The Committee encourages full and fair 
consideration of a proposal from this organization.
    The Committee is aware of a proposal for a work force 
literacy training grant for the Great Falls Area Labor 
Management Committee in Great Falls, MT. The program is 
designed to provide literacy assistance which would improve the 
productivity of the workforce through improvement of literacy 
skills needed in the workforce. The Committee encourages full 
and fair consideration of a proposal from this organization.
    The Committee encourages full and fair consideration of a 
proposal from the city of Newark, NJ, to design and implement a 
dropout prevention, education and job training, job placement, 
and health care employment network.
    The Committee is aware that the geographic information 
system data collected by Federal agencies in the Klamath basin 
in Oregon has been questioned as uncoordinated and 
insufficient. The Committee also recognizes that the Oregon 
Institute of Technology, in Klamath Falls, OR, has developed a 
proposal to create a center to compile and coordinate this data 
and to provide education and training on its use. The Committee 
encourages full and fair consideration of a proposal from this 
organization.
    The Committee recognizes the need to address career 
opportunities for high school age individuals in economically 
depressed timber communities. The Committee is aware of the 
need for a demonstration in southwest Washington State 
developing alternative career opportunities for high school age 
individuals in conjunction with local education agencies, and 
encourages full and fair consideration of a proposal in this 
area.
    The Committee recommends continued funding for a special 
native Hawaiian vocational education demonstration initiative 
that provides basic education skills and preemployment tutoring 
for high-risk youth.
    The Committee is aware of a memorandum of understanding 
which has been executed between the State of Oregon and nine 
Federal partners including the Department of Labor. The purpose 
of this partnership is to encourage and facilitate cooperation 
among Federal, State, and local entities to redesign and test 
an outcomes oriented approach to intergovernmental service 
delivery. The Oregon option experiment is focused on three 
areas of human investment: healthy children, stable families, 
and a highly developed and prepared workforce. In working with 
the State of Oregon to reduce Federal barriers to service 
delivery, the Committee urges the Department to streamline and 
expedite regulatory processes where possible in order to help 
the State meet its performance outcomes.
    The Committee has included a provision which would 
authorize the Secretary of Labor to grant a waiver of certain 
statutory requirements under the Job Training Partnership Act 
to assist States in implementing reforms in State work force 
development systems, such as under the Oregon option 
initiative. In exchange for granting greater flexibility, the 
proviso ensures that States will be held accountable for the 
outcomes of the work force development system pursuant to 
memorandums of understanding executed with the Federal 
Government. The provisions of JTPA that would be waivable by 
the Secretary of Labor relate to definitions, planning and 
procurement requirements, cost categories and cost limitations, 
and program design requirements. It is not intended that such 
waivers would extend to eligibility for services, distribution 
of funds, public health or safety, labor standards, civil 
rights, occupational health and safety, or environmental 
protections. This proviso is similar to authority under the 
School-to-Work Opportunities Act that allows the Secretary to 
grant waivers to assist States in implementing school-to-work 
systems.

            community service employment for older americans

Appropriations, 1995....................................    $396,060,000
Budget estimate, 1996...................................     410,500,000
House allowance.........................................     350,000,000
Committee recommendation \1\............................     273,000,000

\1\ Excludes $77,000,000 included in JTPA Grants to States.

    The Committee recommends $273,000,000 for the national 
programs portion of community service employment for older 
Americans. The program, authorized by title V of the Older 
Americans Act, provides part-time employment in community 
service activities for unemployed, low-income persons aged 55 
and over. It is forward-funded from July to June, and the 1996 
appropriation will support the effort from July 1, 1996 through 
June 30, 1997. Another $77,000,000 for the State operated 
portion of this program is included in the recommendation for 
grants to States for adult training under the ``Training and 
employment services'' appropriation, for a total Committee 
recommendation of $350,000,000. The State grant funds are to be 
distributed in the same manner as currently authorized under 
the Older Americans Act, unless this law is subsequently 
altered.
    In allocating the reduced amount among national sponsors, 
the Committee directs the Secretary of Labor to give preference 
to national sponsors which have not exceeded limits on 
administrative costs nor have made improper indirect costs 
administrative charges. Problems in these areas have been 
documented in a recent GAO report and several inspector general 
reports. The Secretary should also give preference to national 
sponsors which use their grants primarily for direct services 
to older Americans. In addition, the Committee directs the 
Secretary to include this program in its normal review process 
for noncompetitive grants.
    The Committee, recognizing that the Older Americans Act has 
not yet been reauthorized for fiscal year 1996, has included 
bill language clarifying that funds appropriated for older 
worker activities are to be utilized in conformance with 
subsequent action by Congress, which may substantially alter 
the existing title V program.

              federal unemployment benefits and allowances

Appropriations, 1995....................................    $274,400,000
Budget estimate, 1996...................................     346,100,000
House allowance.........................................     346,100,000

Committee recommendation

                                                             346,100,000

    The Committee recommends $346,100,000, the same as the 
budget request and House allowance, and an increase of 
$71,700,000 above the 1995 enacted level for Federal 
unemployment benefits and allowances. An estimated $67,100,000 
will be tranferred from the ``Advances to the unemployment 
trust fund'' account into this account in fiscal 1995, 
providing an estimated total of $341,500,000 in fiscal year 
1995. These are entitlement funds.
    The trade adjustment line-item has two activities totaling 
$279,600,000 in fiscal year 1996.
    The first activity, trade adjustment assistance benefits, 
provides for special unemployment benefit payments to workers 
as authorized by the Trade Act of 1974, as amended. For this 
activity the Committee recommends $183,000,000. This is the 
same as the budget request and House allowance, and an increase 
of $4,000,000 above the 1995 comparable level. These funds will 
permit payment of benefits, averaging $198 per week, to 34,000 
workers for 1996. Of these workers, 19,300 will participate in 
training programs, receiving benefits for an average of 32 
weeks. The remaining 14,700 workers receiving benefits will 
receive training waivers and collect benefits for an average of 
21 weeks.
    The second activity, trade adjustment assistance training, 
provides training, job search and job relocation allowances to 
workers adversely affected by imports. The funding for this 
activity is also authorized under the Trade Act of 1974, as 
amended. The Committee recommends $96,600,000 for this 
activity. This is the same as the budget request and House 
allowance, and a decrease of $1,200,000 below the 1995 
comparable level. These funds will provide services for an 
estimated 24,200 workers of whom 23,600 will be enrolled in 
classroom training and 600 will receive on-the-job training. In 
addition a total of 2,400 will receive job search and job 
relocation allowances.
    For NAFTA activities, $66,500,000 is provided, in two 
components.
    The first component, NAFTA transitional adjustment 
assistance benefits, provides for weekly benefit payments to 
workers affected by imports from Mexico and Canada. These 
payments are also authorized by the Trade Act of 1974, as 
amended as a result of the signing of the North American Free 
Trade Agreement [NAFTA]. The Committee recommends $34,000,000 
for this activity. This is the same as the budget request and 
House allowance, and an increase of $1,000,000 above the 1995 
comparable level. These funds will provide 5,400 eligible 
workers an average of 32 weeks of benefits each, at an average 
weekly amount of $198.
    The second component, NAFTA transitional adjustment 
assistance training, provides funds for training, job search 
and job relocation to workers affected by imports from Mexico 
and Canada. The funding for this activity is also authorized by 
the amendment to the Trade Act of 1974 resulting from the 
signing of the NAFTA. The Committee recommends $32,500,000 for 
this activity. This is the same as the budget request and House 
allowance, and an increase of $800,000 above the 1995 
comparable level. These funds will provide training for an 
estimated 7,650 workers, 7,450 in classroom training and 200 in 
on the job training. In addition these funds will provide for 
job search and relocation allowances for 900 workers.

     state unemployment insurance and employment service operations

Appropriations, 1995....................................  $3,329,362,000
Budget estimate, 1996...................................   3,541,983,000
House allowance.........................................   3,232,732,000

Committee recommendation

                                                           3,221,522,000

    The Committee recommends $3,221,522,000 for this account. 
This is $320,461,000 below the budget request, a decrease of 
$11,210,000 below the House allowance, and a decrease of 
$107,840,000 below the 1995 comparable level. Included in the 
total availability is $3,104,194,000 authorized to be drawn 
from the ``Employment Security Administration'' account of the 
unemployment trust fund, and $117,328,000 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 which 
administer Federal and State unemployment compensation laws and 
operate the public employment service.
    For unemployment insurance services, the bill provides 
$2,306,853,000. This total includes a regular contingency 
amount of $216,333,000 which may be drawn from the Employment 
Security Administration account of the unemployment trust fund. 
In addition the bill further provides for a second contingency 
amount should the unemployment workload exceed an average 
weekly insured claims volume of 2,785,000. This second 
contingency amount would fund the administrative costs of 
unemployment insurance workload over the level of 2,785,000 
insured unemployed per week at a rate of $28,600,000 per 
100,000 insured unemployed, with a pro rata amount granted for 
amounts of less than 100,000 insured unemployed.
    The unemployment insurance service recommendation is the 
same as the House allowance, and would support an estimated 
44,600 State staff years. The Committee recommendation provides 
a small increase over the fiscal year 1995 level for funds 
allocated to States.
    For the employment service, the Committee recommends 
$822,669,000 which includes $25,328,000 in general funds 
together with an authorization to spend $797,341,000 from the 
``Employment Security Administration'' account of the 
unemployment trust fund. These amounts are $49,371,000 less 
than the budget request, $3,210,000 less than the House 
allowance, and $92,621,000 less than the 1995 comparable level.
    Included in the recommendation for the employment service 
is $761,735,000 for State grants, available for the program 
year of July 1, 1996 through June 30, 1997. This is $44,177,000 
below the budget request, the same as the House allowance, and 
a decrease of $77,177,000 below the 1995 comparable level. Also 
included is $60,934,000 for national activities. This is 
$5,194,000 below the budget request, $3,210,000 less than the 
House allowance, and a decrease of $15,444,000 below the 1995 
comparable level. Further, the recommendation includes 
$92,000,000 for one-stop career centers, which is $108,000,000 
less than the budget request, and $8,000,000 less than the 
House allowance and the 1995 comparable level. A reduction of 
$10,250,000 reflects expiration of the Targeted Jobs Tax Credit 
Program.

        advances to the unemployment trust fund and other funds

Appropriations, 1995....................................  $1,004,485,000
Budget estimate, 1996...................................     369,000,000
House allowance.........................................     369,000,000

Committee recommendation

                                                             369,000,000

    The Committee recommends $369,000,000, the same as the 
budget request and House allowance, and a decrease of 
$635,485,000 below the 1995 comparable level, 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. The bill anticipates that fiscal year 1996 
advances will be made to the black lung disability trust fund.
    The separate appropriations provided by the Committee for 
all other accounts eligible to borrow from this account in 
fiscal year 1996 are expected to be sufficient. Should the need 
arise, due to unanticipated changes in the economic situation, 
laws, or for other legitimate reasons, advances will be made to 
the needy accounts to the extent funds are available. Funds 
advanced to the black lung disability trust fund are now 
repayable with interest to the general fund of the Treasury.

   advances to the employment security administration account of the 
                        unemployment trust fund

                              (rescission)

    The Committee has included bill language to rescind 
unobligated balances in the advances to the ``Employment 
Security Administration'' account that are no longer needed. 
This rescission results in a budget authority savings of 
$56,300,000. The House did not address this matter, for which 
there was no budget request.
    This account is a revolving account authorized under 
section 901e of the Social Security Act. It provides loans, 
repayable with interest, to the unemployment trust fund's 
``Employment Security Administration'' account [ESAA]. These 
loans are to be made only when taxes which normally fund the 
ESAA account are insufficient.
    This account was created to provide funds to the ESAA 
during periods when Federal Unemployment Tax Act [FUTA] tax 
payments, which normally provide funding for the account, were 
insufficient due to cyclical tax collection. The majority of 
FUTA taxes are now collected at least monthly (due to law 
change) fully covering ESAA needs, and the funds in this 
account have lain dormant since the end of fiscal year 1984.
    In fiscal year 1984, $120,000,000 was appropriated to this 
account. In fiscal year 1988, $63,700,000 was taken from this 
account to assist in reducing the budget request level.
    Rescission of the $56,300,000 remaining in this account 
will result only in a reduction of budget authority as no 
outlays are associated with this loan account.

                           program operations

Appropriations, 1995....................................    $134,572,000
Budget estimate, 1996...................................     147,415,000
House allowance.........................................     124,479,000

Committee recommendation

                                                             123,847,000

    The Committee recommendation includes $83,054,000 in 
general funds for this account, as well as authority to expend 
$40,793,000 from the ``Employment Security Administration'' 
account of the unemployment trust fund, for a total of 
$123,847,000. This is $23,568,000 less than the budget request, 
$632,000 less than the House allowance, and $10,725,000 less 
than the 1995 comparable level.
    General funds in this account provide the Federal staff to 
administer employment and training programs under the Job 
Training Partnership Act, the Older Americans Act, the Trade 
Act of 1974, and the National Apprenticeship Act. Trust funds 
provide for the Federal administration of employment security 
functions under title III of the Social Security Act and the 
Immigration and Nationality Act, as amended. Federal staff 
costs related to the Wagner-Peyser Act in this account are 
split 97 percent to 3 percent between unemployment trust funds 
and general revenue, respectively.
    The recommendation reflects a financing change to provide 
for trust fund financing consistent with section 901 of the 
Social Security Act, and an object class shift from rental 
payments to GSA, to purchases of goods and services from 
Government accounts, reflecting a change in the method of 
financing maintenance costs and capital improvements for the 
Frances Perkins Building.

                    Office of the American Workplace

                         SALARIES AND EXPENSES

Appropriations, 1995....................................      $7,197,000
Budget estimate, 1996...................................      10,770,000
House allowance.........................................................

Committee recommendation

                                             ...........................

    The Committee has provided no funding for this agency for 
1996. The Office of Labor-Management Standards, which has the 
statutory responsibility to enforce the Labor-Management 
Reporting and Disclosure Act, including necessary 
administrative and financial management staff that was formerly 
funded in the Office of the American Workplace as well as the 
Secretary of Labor's responsibilities under the Fedeal Transit 
Act, and related activities, is funded in the ``Employment 
Standards Administration salaries and expenses'' account. The 
Secretary may exercise his discretion in placing this Office in 
whatever Department of Labor organization he feels is most 
appropriate.
    The Committee has eliminated the Office of the American 
Workplace. It was established in 1993 to provide a national 
focal point for encouraging the creation of high performance 
workplace practices and policies and to encourage the 
development of work organizations and promote innovation in the 
workplace. It appears to the Committee that these things should 
be and are being done in the private sector, and it should not 
be necessary to spend scarce Federal funds for these purposes.

              Pension and Welfare Benefits Administration

                         SALARIES AND EXPENSES

Appropriations, 1995....................................     $69,311,000
Budget estimate, 1996...................................      81,182,000
House allowance.........................................      64,113,000

Committee recommendation

                                                              65,740,000

    The Committee recommendation provides $65,740,000 for this 
account, which is $15,442,000 less than the budget request, an 
increase of $1,627,000 above the House allowance, and a 
decrease of $3,571,000 below the 1995 comparable level.
    The Pension and Welfare Benefits Administration [PWBA] is 
responsible for the enforcement of title I of the Employee 
Retirement Income Security Act of 1974 [ERISA] in both civil 
and criminal areas. PWBA is also responsible for enforcement of 
sections 8477 and 8478 of the Federal Employees' Retirement 
Security Act of 1986 [FERSA]. PWBA provides funding for the 
enforcement and compliance; policy, regulation, and public 
services; and program oversight activities.
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from Government accounts, reflecting a 
change in the method of financing maintenance costs and capital 
improvements for the Frances Perkins Building.
    The Committee has deleted without prejudice bill language 
included by the House (sec. 104) to restrict activities 
promoting so-called economically targeted investments [ETI's] 
by private pension funds covered by ERISA. However, the 
Committee recomendation does not include any funding for the 
continuation of a clearinghouse on so-called economically 
targeted investments. Legislation in this area should be 
addressed by the authorizing committees.

                  PENSION BENEFIT GUARANTY CORPORATION

    The Corporation's estimate for fiscal year 1996 includes 
benefit payments of $1,060,970,000, multiemployer financial 
assistance of $4,570,000, administrative expenses limitation of 
$12,043,000, and services related to terminations expenses of 
$128,496,000. In the administrative expenses activity, the 
recommendation concurs with the House allowance of $10,603,000, 
a reduction of $860,000 below the 1995 comparable level. In the 
services related to terminations activity, the Committee 
recommends an increase of $2,238,000, the same as the House 
allowance.
    The Pension Benefit Guaranty Corporation is a wholly owned 
Government corporation established by the Employee Retirement 
Income Security Act of 1974. The law places it within the 
Department of Labor and makes the Secretary of Labor the chair 
of its board of directors. The Corporation receives its income 
primarily from insurance premiums collected from covered 
pension plans, collections of employer liabilities imposed by 
the act, and investment earnings. It is also authorized to 
borrow up to $100,000,000 from the Treasury. The primary 
purpose of the Corporation is to guarantee the payment of 
pension plan benefits to participants if covered plans fail or 
go out of existence.

                  Employment Standards Administration

                         SALARIES AND EXPENSES

Appropriations, 1995....................................    $272,989,000
Budget estimate, 1996...................................     308,145,000
House allowance.........................................     247,945,000

Committee recommendation

                                                             260,168,000

    The Committee recommendation includes $259,190,000 in 
general funds for this account. This is $47,286,000 less than 
the budget request, an increase of $12,742,000 above the House 
allowance, and a decrease of $12,821,000 below the 1995 
comparable level. The bill also contains authority to expend 
$978,000 from the special fund established by the Longshore and 
Harbor Workers' Compensation Act. This is $691,000 less than 
the budget request, the same as the House allowance, and 
$79,000 less than the 1995 comparable amount. In addition, an 
amount of $28,655,000 is available by transfer from the black 
lung disability trust fund. This is the same as the request, an 
increase of $2,610,000 above the House allowance, and an 
increase of $498,000 above the 1995 comparable level.
    The Committee has funded the Office of Labor-Management 
Standards, including the necessary administrative and financial 
management staff that was formerly funded in the Office of the 
American Workplace, in the ``Employment Standards 
Administration salaries and expenses'' account. This includes 
funding to carry out administrative responsibilities under the 
Federal Transit Act, and related activities. The Secretary may 
exercise his discretion in placing this Office in whatever 
Department of Labor organization he feels is most appropriate.
    The Employment Standards Administration is involved in the 
administration of numerous laws, including the Fair Labor 
Standards Act, the Immigration and Nationality Act, the Migrant 
and Seasonal Agricultural Workers' Protection Act, the Davis-
Bacon Act, the Family and Medical Leave Act, the Federal 
Employees' Compensation Act [FECA], the Longshore and Harbor 
Workers' Compensation Act, and the Federal Mine Safety and 
Health Act [black lung].
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from Government accounts, reflecting a 
change in the method of financing maintenance costs and capitol 
improvements for the Frances Perkins Building.
    The Committee has deleted without prejudice bill language 
included by the House (sec. 103) prohibiting the Secretary from 
using funds made available in this act to implement, 
administer, or enforce any Executive order, or other rule or 
order, that prohibits Federal contracts with, or requires the 
debarment of, or imposes other sanction on, a contractor on the 
basis that such contractor or organizational unit thereof has 
permanently replaced lawfully striking workers. This is a 
legislative matter that should be addressed by the authorizing 
committees.
    The Committee strongly urges the Secretary to suspend 
enforcement under hazardous occupation order No. 2 with respect 
to incidental and occasional driving by minors under age 18, 
unless the Secretary finds that the operation of a motor 
vehicle is the primary duty of the minor's employment, until a 
revised order is issued.
    The Committee strongly urges the Secretary to suspend 
enforcement under hazardous occupation order No. 12 with 
respect to the placement or loading of materials by persons 
under 18 years of age into a cardboard baler that is in 
compliance with the American National Standards Institute 
safety standard ANSI Z245.5 1990, and a compactor that is in 
compliance with the American National Standards Institute 
safety standard ANSI Z245.2 1992, until a revised order is 
issued. These stipulations are in lieu of House bill language 
(secs. 107 and 108), which are legislative provisions that 
should be addressed by the authorizing committees.
    The Committee is concerned by reports that the Fair Labor 
Standards Act [FLSA] is not being enforced fairly and uniformly 
as to cable television installation companies in the New York/
New Jersey area. The Secretary is instructed to allocate 
sufficient resources to ensure fair and uniform enforcement of 
the FLSA with respect to the cable television installation 
industry in that region.

                            SPECIAL BENEFITS

Appropriations, 1995....................................    $258,000,000
Budget estimate, 1996...................................     218,000,000
House allowance.........................................     218,000,000

Committee recommendation

                                                             218,000,000

    The bill includes $218,000,000, the same as the budget 
request and House allowance, and a decrease of $40,000,000 
below the 1995 comparable level. This appropriation primarily 
provides benefits under the Federal Employees' Compensation Act 
[FECA]. The payments are prescribed by law.
    The total amount to be available in fiscal year 1996, 
including anticipated reimbursements from Federal agencies of 
$1,895,000,000, is $2,113,000,000, an increase of $39,000,000 
above the 1995 comparable level. The remaining estimated 
unobligated balance of $547,504,000 will carry over into fiscal 
year 1997 and remain available until expended.
    The Committee recommends continuation of appropriation 
language that provides authority to use the FECA fund to 
reimburse a new employer for a portion of the salary of a newly 
reemployed injured Federal worker. The 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 workers' 
first year, 50 percent in the second year, and 25 percent in 
the third year. Costs will be charged to the FECA fund.
    The Committee recommends continuation of appropriation 
language that retains the drawdown date of August 15. The 
drawdown authority enables the agency to meet any immediate 
shortage of funds without requesting supplemental 
appropriations. The August 15 drawdown date allows maximum 
flexibility for continuation of benefit payments without 
interruption.
    The Committee recommends approval of appropriation 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. The Committee recommends appropriation language to 
provide that $19,383,000 of the funds transferred from the fair 
share agencies to pay the costs of administration will be 
available to the Secretary of Labor to finance capital 
improvements relating to upgrading and enhancing the Federal 
employees' compensation computer system's hardware and 
software. This compares to the House allowance of $11,383,000, 
which would let the remaining balance of the administrative 
costs paid by the fair share agencies revert to Treasury as 
miscellaneous receipts. The Senate allowance would speed up 
completion of the 4-year automation project.
    The Committee recommends continuation of appropriation 
language to provide authority to require disclosure of Social 
Security account numbers by individuals filing claims under the 
Federal Employees' Compensation Act or the Longshore and Harbor 
Workers' Compensation Act and its extensions.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 1995....................................    $975,561,000
Budget estimate, 1996...................................     998,836,000
House allowance.........................................     996,203,000

Committee recommendation

                                                             998,836,000

    The bill includes authority to obligate $998,836,000 from 
the black lung disability trust fund in fiscal year 1995. This 
is an increase of $23,275,000 above the 1995 comparable level.
    The total amount available for fiscal year 1996, including 
$17,164,000 from the prior year, will provide $501,494,000 for 
benefit payments, and $48,586,000 and $756,000 for 
administrative expenses for the Departments of Labor and 
Treasury, respectively. Also included is $448,000,000 for 
interest payments on advances. In fiscal year 1995, comparable 
obligations for benefit payments are estimated to be 
$516,005,000, while administrative expenses for the Departments 
of Labor and Treasury respectively are $51,800,000 and 
$756,000.
    The Committee reiterates its directive to prevent the 
closing of and to ensure the staffing of black lung field 
offices.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
can be assigned liability for such benefits, or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs which are incurred in administering the benefits program 
and operating the trust fund.
    It is estimated that 81,500 people will be receiving black 
lung benefits financed from the trust fund by the end of fiscal 
year 1995. This compares with an estimated 86,500 receiving 
benefits in fiscal year 1995.
    The basic financing for the trust fund comes from a coal 
excise tax for underground and surface-mined coal. Additional 
funds come from reimbursement payments from mine operators for 
benefit payments made by the trust fund before the mine 
operator is found liable, and advances, estimated at 
$369,000,000 in fiscal year 1996. The advances to the fund 
assure availability of necessary funds when liabilities may 
exceed other income. The Omnibus Budget Reconciliation Act of 
1987 continues the current tax structure until 2014.

             Occupational Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 1995....................................    $312,500,000
Budget estimate, 1996...................................     346,503,000
House allowance.........................................     263,985,000

Committee recommendation

                                                             296,656,000

    The Committee recommendation includes $296,656,000 for this 
account. This is $49,847,000 less than the budget request, an 
increase of $32,671,000 above the House allowance, and a 
decrease of $15,844,000 below the 1995 comparable level. This 
agency is responsible for enforcing the Occupational Safety and 
Health Act of 1970 in the Nation's workplaces.
    The Committee recommendation reduces all OSHA activities by 
5 percent below the fiscal year 1995 enacted level, except for 
executive direction and administration, which is reduced 8 
percent. This compares to an overall reduction of 15.5 percent 
recommended by the House.
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from government accounts, reflecting a 
change in the method of financing maintenance costs and capital 
improvements for the Frances Perkins Building.
    In addition, the Committee has included language to allow 
OSHA to retain up to $750,000 per fiscal year of training 
institute course tuition fees to be utilized for occupational 
safety and health training and education grants in the private 
sector; the House allowed $500,000 for this activity.
    The Committee encourages OSHA to refocus compliance centers 
and efficiently increase consultation centers.
    The Committee concurs with the House in retaining language 
carried in last year's bill effectively exempting farms 
employing 10 or fewer people from the provisions of the act 
except those farms having a temporary labor camp. The Committee 
also concurs with the House in retaining language exempting 
small firms in industry classifications having a lost workday 
injury rate less than the national average from general 
schedule safety inspections. These provisions have been in the 
bill for many years.
    The Committee has deleted without prejudice House bill 
language (sec. 105) that would prohibit OSHA from promulgating 
or issuing any proposed or final standard or guideline 
regarding ergonomic protection. This is a legislative matter 
that should be addressed by the authorizing committees.
    The Committee has deleted without prejudice House bill 
language (sec. 106) that would temporarily halt implementation 
of the fall protection standard published at subpart M of 29 
CFR part 1926, until 30 days after a new standard has been 
promulgated. The House provision would also require the 
Secretary to develop this standard no later than 180 days after 
enactment of this act, and until the publishing of the revised 
final rule, only funds designated for the enforcement of an 
interim fall protection standard which adjusts all height 
requirements referenced at subpart M of 29 CFR part 1926 from 6 
feet to 16 feet may be expended. This is a legislative matter 
that should be addressed by the authorizing committees.
    The Committee is nevertheless aware of serious concerns 
raised about the heavy compliance burden on employers imposed 
by OSHA enforcement of its new fall protection standard. The 
impact of the new standard on safety has also been questioned. 
Due to these and other concerns, the Committee expects the 
Secretary of Labor to review the impact of the fall protection 
standard, including an assessment of its costs and benefits.
    The Committee further directs the Secretary to conduct a 
review and report back on the Labor Department's findings, 
recommendations for change, and steps taken to implement the 
recommendations on modifying the regulation by January 1, 1996.
    The Committee intends that the Office of Occupational 
Medicine continue to be funded as nearly as possible at its 
present level. The Office of Occupational Medicine has a 
significant role to play in carrying out the agency's mission 
to protect the health and safety of workers. The 
responsibilities of the Office of Occupational Medicine include 
providing compliance assistance to states and employers and 
assisting the agency in the development of sound, 
scientifically based standards and guidelines which balance 
costs and benefits. The Committee expects that these 
responsibilities will be continued. The Committee also intends 
that the Office of Regulatory Analysis continue to be funded as 
nearly as possible at its present level.
    The Committee is encouraged by the accomplishments of the 
Office of Nursing at OSHA. Occupational health nurses are the 
largest group of health care providers at the Nation's 
worksites. As such, they are uniquely qualified to assess the 
practical realities of worksites and related regulatory 
activities. The Committee supports the continuation of the 
Office of Nursing as a distinct Federal entity.
    The Committee urges OSHA to consider exempting recreational 
dive training from commercial restrictions that prohibit use of 
closed-circuit, mixed-gas SCUBA apparatus or diving equipment 
using nitrogen/oxygen breathing mixtures.
    The Committee urges the Secretary to consider suspending 
enforcement of the OSHA standard curtailing work conducted near 
a snag tree, until a revised standard is issued that does not 
contradict Federal and State wildlife snag tree guidelines.

                 Mine Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 1995....................................    $200,646,000
Budget estimate, 1996...................................     212,106,000
House allowance.........................................     185,154,000

Committee recommendation

                                                             200,646,000

    The Committee recommendation includes $200,646,000 for this 
account. This is $11,460,000 less than the budget request, an 
increase of $15,492,000 above the House allowance, and the same 
as the 1995 comparable level. This agency is responsible for 
enforcing the Federal Mine Safety and Health Act in our 
Nation's underground and surface mines.
    While the Committee has been unable to grant the increases 
requested by the administration, it believes the activities of 
this agency are too important to be cut below last year's 
level. This agency insures the safety and health of the 
Nation's miners 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 concurs with the House in retaining bill 
language carried in last year's bill prohibiting the use of 
funds to carry out the training provisions of the act with 
respect to shell dredging or with respect to any sand, gravel, 
surface stone, surface clay, colloidal phosphate or surface 
limestone mine.
    The Committee encourages the Secretary to study whether 
it's necessary to revise the standards of section 30 CFR 
subpart T relating to standards for methane in metal and 
nonmetal mines, and be prepared to address the matter at next 
year's hearings.

                       Bureau of Labor Statistics

                         SALARIES AND EXPENSES

Appropriations, 1995....................................    $351,674,000
Budget estimate, 1996...................................     376,681,000
House allowance.........................................     347,213,000

Committee recommendation

                                                             330,373,000

    The Committee includes $330,373,000 for this account, which 
is $46,308,000 less than the budget request, $16,840,000 less 
than the House allowance, and $21,301,000 less than the 1995 
comparable level. This includes $49,774,000 from the Employment 
Security Administration account of the unemployment trust fund, 
and $280,599,000 in Federal funds. This reduction has been 
necessitated by severe budgetary limitations. The Bureau of 
Labor Statistics is the principal factfinding agency in the 
Federal Government in the broad field of labor economics.
    The Committee directs that the Bureau of Labor Statistics, 
despite reductions from the administration request, continue to 
collect survey data on injury and illness rates that permit the 
analysis of industry performance at the State level.
    The Committee concurs with the budget request and House 
allowance of $11,549,000 for the Consumer Price Index revision, 
but has been unable to provide requested increases for emerging 
labor market issues, and for standard industrial classification 
and standard occupational classification revisions. Revision of 
the Consumer Price Index should remain the highest priority for 
the Bureau. The Committee has deleted House bill language, 
section 515, relating to the CPI index, consistent with the 
approach throughout this bill of deleting new special general 
provisions.

                        Departmental Management

                         SALARIES AND EXPENSES

Appropriations, 1995....................................    $155,028,000
Budget estimate, 1996...................................     173,089,000
House allowance.........................................     134,523,000

Committee recommendation

                                                             143,243,000

    The Committee recommendation includes $142,940,000 in 
general funds for this account, which is $29,807,000 less than 
the budget request, an increase of $8,720,000 above the House 
allowance, and $11,760,000 below the 1995 comparable level. The 
bill also includes authority to transfer $303,000 from the 
Employment Security Administration account of the unemployment 
trust fund. In addition, an amount of $19,621,000 is available 
by transfer from the black lung disability trust fund. This is 
the same as the budget request and House allowance, and a 
decrease of $3,712,000 below the 1995 comparable level.
    The primary goal of the Department of Labor is to protect 
and promote the interests of American workers. The departmental 
management appropriation finances 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 salaries and expenses 
appropriations are not suitable.
    The Committee recommendation generally reflects an 8-
percent across-the-board reduction for departmental management 
administrative activities, due to severe budgetary constraints. 
The Committee concurred with the House in recommending 7.5 
percent reductions for the Women's Bureau, adjudication, civil 
rights, and chief financial officer activities. For promoting 
employment of people with disabilities, the $4,385,000 
recommendation is the same as the fiscal year 1995 enacted 
level.
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from Government accounts, reflecting a 
change in the method of financing maintenance costs and capital 
improvements for the Frances Perkins Building.
    The Committee supports the ongoing efforts of the 
Department of Justice to rid the International Brotherhood of 
Teamsters of organized crime influence and the Department's 
decision to supervise the upcoming elections pursuant to the 
consent decree. The Committee concurs with the House in 
providing that up to $5,600,000 of the amount available to the 
Department of Labor for fiscal year 1996 may be allocated for 
this purpose, subject to the normal reprogramming requirements.
    The Committee has included bill language, carried in last 
year's bill but not considered by the House for fiscal year 
1996, permitting transfers of up to 1 percent between 
appropriations.
    The Committee intends that the Women's Bureau maintain 
support for technical assistance and training on displaced 
homemaker programming through effective programs such as women 
work. This assistance is critical as State and local agencies 
develop and implement employment and training programs under 
legislation that consolidates job training and vocational 
programs.
    Abusive and exploitive child labor has been documented in 
two reports by the Secretary of Labor for this Committee, 
pursuant to directives by the Committee in fiscal year 1994-95. 
The Committee notes the problem of child exploitation has 
gained increased recognition in recent years, although the 
international response remains inadequate to the scope of the 
problems. The Committee notes the positive work being done by 
the International Labor Organization's International Program 
for the Elimination of Child Labor [IPEC], including through 
the funds made available to the Secretary of Labor by this 
Committee.
    The Committee has provided an additional $1,500,000 from 
within funds for the Bureau of International Labor Affairs, to 
continue work on international child labor issues and funding 
of the IPEC program. The Committee notes that a number of U.S. 
companies and nongovernmental agencies have begun efforts aimed 
at eliminating the use of abusive and exploitive child labor in 
the production of goods imported into the United States.
    The Secretary of Labor is asked to complete a report 
examining these efforts and submit it to the Committee by July 
15, 1996. In an effort to get the most specific information 
possible, this report should include an examination of the top 
20 U.S. garments importers, their subsidiaries, contractors, 
and their subcontractors codes of conduct regarding the use of 
abusive and exploitive child labor in the production of goods 
imported to the United States and the adequacy and 
effectiveness of their enforcement of these codes. The report 
should also include conclusions regarding the necessary 
components of an effective code of conduct and its enforcement.
    The Secretary, in consultation with other appropriate 
agencies, is also asked to include in such report a review of 
United States and international laws that might be used to 
encourage the elimination of child labor exploitation, 
including in the product of items imported into the United 
States, and any appropriate changes to such laws. The Secretary 
of Labor is also asked to publish, by July 15, an updated 
registry of items that are likely to be produced with abusive 
and exploitative child labor and imported into the United 
States.
    The Committee also believes it is important to recognize 
those U.S. companies that have effective programs to assure 
that products imported to our country are not made by abusive 
and exploitive child labor and therefore requests the Secretary 
to give formal recognition to outstanding efforts in this area.
    The Committee expects the Department to provide a report no 
later than 60 days after the date of enactment of this 
legislation addressing the relationship between increased 
cruise ship business in our Nation's ports including, but not 
limited to, Philadelphia, Seattle, Portland, San Francisco, San 
Diego, and Miami, and job growth in the private sector in the 
services, travel, and tourism industries and port-related jobs.

        Assistant Secretary for Veterans Employment and Training

Appropriations, 1995....................................    $185,206,000
Budget estimate, 1996...................................     187,114,000
House allowance.........................................     175,883,000

Committee recommendation

                                                             170,390,000

    The Committee recommendation includes $170,390,000 to be 
expended from the Employment Security Administration account of 
the unemployment trust fund. This is $16,724,000 less than the 
budget request $5,493,000 less than the House allowance, and 
$14,816,000 below the 1995 comparable level.
    For State grants the bill provides $76,913,000 for the 
Disabled Veterans Outreach Program and $71,386,000 for the 
Local Veterans Employment Representative Program. These amounts 
represent an 8-percent reduction below the 1995 enacted level, 
due to severe budgetary constraints.
    For Federal administration, the Committee recommends 
$19,419,000, which is $3,598,000 less than the budget request, 
$106,000 below the House allowance, and $1,689,000 below the 
1995 comparable level. Included is funding to continue the 
Transition Assistance Program, which provides reemployment 
assistance to people separating from the military.
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from Government accounts, reflecting a 
change in the method of financing maintenance costs and capital 
improvements for the Frances Perkins Building.
    In addition the Committee recommends $2,672,000 for the 
National Veterans Training Institute [NVTI]. This Institute 
provides training to the Federal and State staff involved in 
the direct delivery of employment and training related services 
to veterans. The amounts for both Federal administration and 
the National Veterans Training Institute represent 92 percent 
of fiscal 1995 enacted funding levels, necessitated by severe 
budgetary constraints.

                          WORKING CAPITAL FUND

    The Committee concurs with the House in recommending 
appropriations language expanding the working capital fund 
authorizing language to establish an investment in reinvention 
fund in the working capital fund, and to allow the Department 
to utilize up to $3,900,000 in unobligated balances in 
departmental salaries and expenses accounts to capitalize this 
fund. This fund will become self-sustaining through the 
repayment of initial investments from savings generated through 
improvements and efficiencies.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1995....................................     $51,936,000
Budget estimate, 1996...................................      53,307,000
House allowance.........................................      48,041,000

Committee recommendation

                                                              48,041,000

    The bill includes $44,426,000 in general funds for this 
account, which is the same as the House allowance, $4,826,000 
below the budget request, and $3,602,000 below the 1995 
comparable level. The bill also includes authority to transfer 
$3,615,000 from the Employment Security Administration account 
of the unemployment trust fund which is the same as the House 
allowance, and $293,000 below the budget request and the 1995 
comparable level. In addition, an amount of $310,000 is 
available by transfer from the black lung disability trust 
fund.
    The Office of the Inspector General [OIG] was created by 
law to protect the integrity of departmental programs as well 
as the welfare of beneficiaries served by those programs. 
Through a comprehensive program of audits, investigations, 
inspections, and program evaluations, the OIG attempts to 
reduce the incidence of fraud, waste, abuse, and mismanagement, 
and to promote economy, efficiency, and effectiveness 
throughout the Department.
    The recommendation reflects a financing change for an 
object class shift from rental payments to GSA, to purchases of 
goods and services from Government accounts, reflecting a 
change in the method of financing maintenance costs and capital 
improvements for the Frances Perkins Building.

                     ADDITIONAL GENERAL PROVISIONS

    General provisions bill language is included to: Prohibit 
funding to implement the President's Executive order concerning 
striker replacements (sec. 103); permit transfers of up to 1 
percent between appropriations (sec. 109); and prohibit the 
payment of more than $125,000 to Job Corps contractor employees 
(sec. 101). Sections 102, 104, 105, 106, 107, and 108 of the 
House bill have been deleted without prejudice.
           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     health resources and services

Appropriations, 1995....................................  $3,028,959,000
Budget estimate, 1996...................................   3,102,395,000
House allowance.........................................   2,927,122,000

Committee recommendation

                                                           2,951,159,000

    The Committee recommends an appropriation of $2,951,159,000 
for health resources and services. This is $151,236,000 below 
the administration request, $24,037,000 over the House amount, 
and $77,800,000 less than the fiscal year 1995 allowance.
    Health Resource Services Administration [HRSA] activities 
support programs to provide health care services for mothers 
and infants; the underserved, elderly, homeless; migrant 
farmworkers; and disadvantaged minorities. This appropriation 
supports cooperative programs in community health, AIDS care, 
health provider training, and health care delivery systems and 
facilities.

                      CONSOLIDATED HEALTH CENTERS

    The Committee has provided funds for community health 
centers, migrant health centers, health care for the homeless, 
and public housing health service grants in a consolidated line 
rather than through separate activities, consistent with the 
reauthorization legislation pending in the Senate. The 
Committee provides $756,518,000 for the consolidated health 
centers cluster, which is the same as the 1995 comparable level 
and the House allowance for a consolidated health centers line 
and $119,000 above the administration request for this grouping 
of programs.
    Health centers were brought under the Federal Tort Claims 
Act [FTCA] in 1993. This coverage expires on December 31, 1995. 
The Committee has included bill language which extends this 
coverage until December 31, 1996, and has included $5,000,000 
in the above amount for the health centers malpractice claims 
fund in fiscal year 1996.
    It is clear that some populations do not have the same type 
of access to primary care than other populations. This is 
particularly true for the Hispanic population in some States. 
Due to social, cultural, and language barriers, it is often 
difficult to effectively provide primary health care to the 
Hispanic population. The Committee encourages HRSA to assist 
communities in the establishment of health centers that will 
primarily serve the Hispanic community.

Community health centers

    The community health centers provide comprehensive, case-
managed primary health care services to medically indigent and 
underserved populations in rural and urban areas. About 44 
percent of the clients served by community health centers are 
children.

Migrant health centers

    The program helps provide culturally sensitive 
comprehensive primary care services to migrant and seasonal 
farmworkers and their families. Over 80 percent of the centers 
also receive funds from the community health centers program.

Health care for the homeless

    The program provides project grants for the delivery of 
primary health care services, substance abuse services, and 
mental health services to homeless adults and children. About 
one-half of the projects are administered by community health 
centers. The other one-half are administered by nonprofit 
coalitions, inner-city hospitals, and local public health 
departments.

Public housing health service grants

    The program awards grants to community-based organizations 
to provide case-managed ambulatory primary health and social 
services in clinics at or in proximity to public housing. More 
than 60 percent of the programs are operated by community 
health centers.

                           HEALTH PROFESSIONS

    For health professions, the bill includes $343,835,000, 
which is $62,264,000 less than the fiscal year 1995 
appropriation, and $62,264,000 less than the House allowance.
    All the existing health profession programs are being 
reauthorized for fiscal year 1996. The President requested 
funding in five clusters of programs. The House appropriated 
all funds in a single line item and requested HRSA to produce 
an operating plan prior to conference.
    The Committee has appropriated funds for health professions 
based on the consolidated reauthorization proposals set forth 
in Senate bill 555, the Health Professions Education 
Consolidation and Reauthorization Act of 1995. The Senate 
allowance consolidates 44 health professions programs into 6 
general and flexible authorities which are designed to train 
health providers most inclined to enter practice in rural and 
other medically underserved areas. To ensure that these 
programs are accountable and effective, each grant applicant 
would be required to have a strong evaluation component.
    However, if sufficient legislative progress is not made 
prior to conference, it is the intention of the Committee to 
then fund these programs under existing legislative authorities 
and to provide separate funding for each program.

           PRIMARY CARE MEDICINE AND RELATED TRAINING CLUSTER

    The Committee recommends $70,298,000 for the primary care 
medicine and related training cluster. The purpose of this 
cluster is to provide for the training of primary care health 
professionals and to improve the quality of health care in 
underserved areas.
    The following current law authorities are consolidated in 
this cluster: Family medicine training, physician assistants, 
general internal medicine and pediatrics training, preventive 
medicine and dental public health, geriatric medicine, and 
dentistry faculty development and general dentistry training.

Family medicine training

    Family medicine activities support grants for graduate 
training in family medicine, grants for predoctoral training in 
family medicine, grants for faculty development in family 
medicine, and grants for the establishment of departments of 
family medicine. The Committee reiterates its support for this 
program and recognizes its importance in increasing the number 
of primary care physicians in underserved areas.

General internal medicine and pediatrics training

    This program provides funds to public and private nonprofit 
hospitals and schools of medicine and osteopathic medicine to 
support residencies in internal medicine and pediatrics. Grants 
may also include support for faculty.

Physician assistants

    This program supports planning, development, and operation 
of physician assistant training programs.

Preventive medicine and dental public health

    This program supports awards to schools of medicine, 
osteopathic medicine, public health, and dentistry for support 
of residency training programs in preventive medicine and 
dental public health; and for financial assistance to trainees 
enrolled in such programs.

Geriatric medicine and dentistry faculty development

    This program provides support, including fellowships, for 
geriatric training projects to train physicians and dentists 
who plan to teach geriatric medicine, geriatric psychiatry, or 
geriatric dentistry. The Secretary would determine which type 
of faculty development projects to fund based on national and 
State work force goals.

General dentistry training

    This program assists dental schools and postgraduate dental 
training institutions to meet the costs of planning, 
developing, and operating residency training and advanced 
education programs in general practice of dentistry and funds 
innovative models for postdoctoral general dentistry.

           MINORITY/DISADVANTAGED HEALTH PROFESSIONS CLUSTER

    The Committee recommends $44,411,000 for the minority/
disadvantaged health professions cluster. The purpose of this 
cluster is to provide for the training of minority and 
disadvantaged health professionals to improve health care 
access in underserved areas and to improve the representation 
of minorities in the health professions.
    The following current law authorities are consolidated into 
this cluster: Centers of excellence in minority health, health 
careers opportunity program, minority faculty fellowships, and 
faculty loan repayment.

Centers of excellence

    This program was established to fund institutions that 
train a significant portion of the Nation's minority health 
professionals. Funds are used for the recruitment and retention 
of students, faculty training, and the development of plans to 
achieve institutional improvements.
    The Committee recognizes the importance of the Centers of 
Excellence Program. The institutions that are designated as 
centers of excellence are private institutions, that receive 
little State funding, whose mission is to train disadvantaged 
minority students for service in underserved areas. Located in 
poor communities, they serve the health care needs of their 
patients often without remuneration.

Health careers opportunity program

    This program provides funds to medical and other health 
professions schools for recruitment of disadvantaged students 
and preprofessional school preparations.

Minority faculty fellowships

    This program allows institutions to provide a fellowship to 
underrepresented minorities who have the potential for 
teaching, administering programs, or conducting research as 
faculty members.

Faculty loan repayment

    This program provides for the repayment of education loans 
for individuals from disadvantaged backgrounds who are health 
professions students or graduates, and who have agreed to serve 
for not less than 2 years as a faculty member of a health 
professions school.

   AREA HEALTH EDUCATION CENTERS AND OTHER EDUCATION CENTERS CLUSTER

    The Committee recommends $28,363,000 for the area health 
education centers and other education centers cluster. The 
purpose of this cluster is to provide support for training 
centers remote from health professions schools to improve and 
maintain the distribution of health providers in rural and 
urban underserved areas and provide support for geriatric and 
public health training centers.
    The Committee recognizes the critical role social workers 
play in providing social and behavioral health services through 
community-based agencies in underserved communities. The 
Department is urged to fund schools of social work to work 
collaboratively with health care agencies, including managed 
care, in underserved communities to prepare social workers for 
case management, health promotion, and the delivery of mental 
health services.
    The following current law authorities are consolidated into 
this cluster: Area health education centers, health education 
and training centers, geriatric education centers, rural health 
interdisciplinary training, and public health special projects.

Area health education centers

    This 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 (State funded) 
programs in which non-Federal contributions in cash shall 
consist of not less than 50 percent of the total operating 
costs of an AHEC program.
    If, at conference, the conferees appropriate funds for the 
health profession programs under existing authorities, the 
Committee intends to include language which deletes the 
limitation for core programs included in Public Law 102-408.
    The Committee has been impressed with the various AHEC 
models operated in a variety of States and directs HRSA to give 
this program the highest priority within this cluster. The 
Committee believes that AHEC's can provide an important network 
not only for the training of health service providers but also 
for the dissemination of health care information, including 
practice guidelines.
    The fiscal year 1995 Committee report directed the 
Department to give highest priority to funding grant proposals 
that were approved but not funded in fiscal year 1994. The 
Committee understands that Vermont's application was approved 
but not funded in fiscal year 1995. The Committee strongly 
supports Vermont's application for an AHEC grant in fiscal year 
1996, and requests that the proposal receive full and fair 
consideration in awarding new starts in fiscal year 1996.

Health education and training centers

    These centers provide training to improve the supply, 
distribution, and quality of personnel providing health 
services in the State of Florida or along the border between 
the United States and Mexico and in other urban and rural areas 
with populations with serious unmet health care needs.

Geriatric education centers

    This program supports grants to health professions schools 
to establish geriatric education centers and to support 
geriatric training projects.

Rural health interdisciplinary training

    This program addresses shortages of health professionals in 
rural areas through interdisciplinary training projects that 
prepare students from various disciplines to practice together, 
and offers clinical training experiences in rural health and 
mental health care settings to expose students to rural 
practice. Under this program in the past 2 fiscal years, the 
Committee has provided funding for a rural chiropractic 
interdisciplinary training program designed to enhance the 
delivery of chiropractic health care in rural areas of the 
country and to increase the recruitment of women and minorities 
as chiropractic health care professionals in such areas. The 
Committee continues to support this initiative and directs that 
no less than fiscal year 1995 levels be provided by the 
Department for this program in fiscal year 1996, and that the 
program be carried out in close cooperation with members of the 
Association of Chiropractic Colleges.

Public health special projects

    This program provides funds to accredited schools of public 
health for planning, developing, demonstrating, operating, and 
evaluating projects that will further the goals in the areas of 
preventive medicine; health promotion and disease prevention; 
improving access to health services in medically underserved 
communities; or reducing the incidence of domestic violence.

               HEALTH PROFESSIONS WORK FORCE DEVELOPMENT

    The Committee recommends $12,774,000 for the health 
professions work force development cluster. The purpose of this 
cluster is to provide support to strengthen capacity for the 
education of individuals in certain health professions which 
the Secretary determines to have a severe shortage of personnel 
and to improve the care of underserved populations and other 
high-risk groups.
    The following current law authorities are consolidated in 
this cluster: Health administration traineeships and special 
projects, geriatric optometry training, allied health advanced 
training and special projects, chiropractic demonstration 
projects, and AIDS dental services. The Committee recommends 
that, within the total amount of funding provided for this 
cluster, the podiatric primary care residency training program 
be funded at no less than the fiscal year 1995 levels. The 
Committee encourages HRSA to give priority to those programs 
within this cluster that fund training programs over research 
and data collection activities.

Allied health advanced training and special projects

    This program provides funds to assist schools or programs 
with projects designed to plan, develop, or expand post 
baccalaureate programs for the advanced training of allied 
health professions; and provide traineeships or fellowships to 
postbaccalaureate students who are participating in the program 
and who commit to teaching in the allied health profession 
involved. This program also provides funds to expand existing 
training programs or develop new ones; recruit individuals into 
allied professions with the most severe shortages or whose 
services are most needed by the elderly; increase faculty 
recruitment and education, and research.
    The Committee continues to encourage HRSA to give priority 
consideration to those projects for schools training allied 
health professions experiencing shortages, such as medical 
technologists and cytotechnologist.
    The Committee is strongly supportive of efforts to assure 
an adequate supply of allied health professionals. These low 
cost professionals provide critical services that often 
ameliorate the need for more expensive care, yet there continue 
to be shortages of allied health professionals in many areas. 
From within this account, the Committee expects that funding 
for allied health training will be maintained at last year's 
level.

Podiatric primary care residency training

    This program supports projects at hospitals and podiatry 
schools for residency training in primary care.

Geriatric optometry training

    This program provides support for projects to plan, 
develop, and operate projects in postgraduate geriatric care 
training for optometrists who will teach geriatric optometry; 
provide residencies, traineeships, and fellowships to 
participants in such projects; and establish new affiliations 
with nursing homes, ambulatory care centers, senior centers, 
and other public or nonprofit private entities.

Health administration traineeships and special projects

    This program provides grants to public or nonprofit private 
educational entities, including schools of social work but not 
schools of public health, to expand and improve graduate 
programs in health administration, hospital administration and 
health policy analysis and planning; and assists educational 
institutions to prepare students for employment with public or 
nonprofit private agencies.

Chiropractic demonstration projects

    This program supports projects in which chiropractors and 
physicians collaborate to identify and provide effective 
treatment for spinal and lower back conditions.
    The Committee notes that the chiropractic demonstration 
grant program, originally authorized under section 782 of 
Public Law 102-408, and funded by the Committee in previous 
years, has been proposed for consolidation this year in Senate 
bill 555. The Committee further notes that the authorizing 
committee has recognized the importance of this grant program 
and set forth certain criteria for future funding of the 
chiropractic-medical school demonstration grant program in the 
report accompanying Senate bill 555.
    The Committee concurs with the focus of the language and 
the criteria to be used by the Department in funding 
continuation of this important program. The Committee 
recommends that, within the total funds made available for the 
consolidated work force development programs, the chiropractic-
medical school demonstration grant program be continued and 
funded at current levels.

AIDS dental services

    This program provides grants to dental schools and 
postdoctoral dental education programs to assist with the cost 
of providing unreimbursed oral health care to patients with HIV 
disease.

Health professions data and analysis

    This program supports the collection and analysis of data 
on the labor supply in various health professions and on future 
work force configurations.

Health professions research

    This program supports research on issues such as the extent 
to which debt has a detrimental effect on students entering 
primary care and the effects that federally funded educational 
programs for minorities have on the number of such individuals 
attending health professions schools.

                 NURSING WORK FORCE DEVELOPMENT CLUSTER

    The Committee recommends $52,776,000 for the nursing work 
force development cluster. The purpose of this cluster is to 
provide for the training of advanced degree nurses and to 
improve access to and quality of health care in underserved 
medical and public health areas.
    The Committee expects that, with the greater flexibility 
afforded in this appropriation, the division of nursing will be 
able to move quickly to allocate resources to meet the rapidly 
evolving changes in the health care system. Priority should be 
given to those projects which would substantially benefit rural 
or underserved populations by producing nurses for these areas, 
including primary care nurses, and would meet other relevant 
national and State nursing work goals.
    The following current law authorities are consolidated in 
this cluster: Nursing special projects, advanced nurse 
education, nurse practitioners/nurse midwife education, nurse 
anesthetist training, nursing education opportunities for 
individuals from disadvantaged backgrounds and professional 
nurse traineeships.

Nursing special projects

    This program supports projects to increase the supply of 
nurses meeting the unique health needs of underserved areas; 
demonstrate methods to improve access to nursing services in 
nontraditional settings; and demonstrate innovate nursing 
practices. Examples of innovation include community nursing 
centers, which offer an excellent model of nurse-managed, 
community-based health care, with an emphasis on health 
promotion and disease prevention. Fifty percent of the centers 
have been developed or expanded with HRSA support, all of which 
operate in federally designated medically underserved areas and 
serve ethnic and racial minorities.
    The Committee notes that there continues to be a dramatic 
shift in the health care delivery systems from inpatient to 
outpatient settings. The Committee recommends that funds be 
directed toward developing retraining programs to better 
prepare health care professionals, especially nurses, who are 
displaced from hospital inpatient settings to new health care 
delivery settings.

Advanced nurse education

    This program funds nursing schools to prepare nurses at the 
master's degree or higher level for teaching, administration, 
or service in other professional nursing specialties.

Nurse practitioner/nurse midwife education

    This program supports programs preparing nurse 
practitioners and nurse midwives to effectively provide primary 
health care in settings such as the home, ambulatory and long-
term care facilities, and other health institutions. These 
professionals are in especially short supply in rural and 
underserved urban areas.

Nurse education opportunities for individuals from disadvantaged 
        backgrounds

    This program provides grants and contracts to qualified 
schools and education programs to recruit individuals from 
minority and disadvantaged backgrounds, and to assist them with 
their nursing education by providing training, counseling, and 
stipends.

Professional nurse traineeships

    Traineeships fund registered nurses in programs of advanced 
nursing education, including preparation for teaching, 
administration, supervision, clinical specialization, research, 
and nurse practitioner and nurse midwife training.

Nurse anesthetist traineeships

    Grants are awarded to eligible institutions to provide 
traineeships for licensed registered nurses to become nurse 
anesthetists.

Nurse anesthetist training

    This program funds grants to eligible institutions for 
traineeships and education projects designed to qualify 
registered nurses to become certified registered nurse 
anesthetists [CRNA]; and enables CRNA faculty members to obtain 
relevant advanced education.

Nurse anesthetist faculty fellowships

    Grants are awarded to eligible institutions which employ 
CRNA faculty to teach registered nurses in a full-time 
accredited nurse anesthetist training program.

              CONSOLIDATED SCHOLARSHIPS AND LOANS CLUSTER

    The Committee recommends $106,148,000 for the National 
Health Services Corps scholarship and loan payback programs and 
$29,065,000 for other scholarship programs for disadvantaged 
students.
    The purpose of this consolidation is to provide 
consolidation of current loan repayment, scholarship, and 
scholarship payback programs into a flexible National Health 
Service Corps Program requiring service payback in underserved 
areas in return for Federal financial assistance and to 
consolidate scholarship programs for the disadvantaged.
    The Committee intends that HRSA uses $3,000,000 of funds 
appropriated for this cluster be used for State offices of 
rural health. The Committee is concerned about possible overlap 
and duplication between primary care offices [PCO's] supported 
in every State through the health centers appropriation and 
State Offices of Rural Health [SORH's] supported in each State 
through the National Health Service Corps appropriation.
    While some required activities are exclusive to one program 
or another, the majority are similar. These include assessment 
of need for health services and available resources, targeting 
areas of unmet need, site and community development, technical 
assistance and training. Of the 50 PCO's and SORH's, 11 are 
located in the same office within the State. The Committee 
recommends that HSRA encourage States to create agreements 
between each State's PCO and SORH delineating joint and 
separate activities and promoting collaboration to the 
satisfaction of program officials.
    The Committee recognizes the importance of training greater 
numbers of mental health professionals including social workers 
and psychologists from disadvantaged and minority backgrounds 
to work in underserved communities as part of interdisciplinary 
teams addressing a range of social, behavioral and mental 
health problems. The Committee directs the Secretary to ensure 
that projects funded under this cluster train a mix of 
providers, including social workers and psychologists.
    The following current law authorities are consolidated in 
this cluster: Scholarships for disadvantaged students, 
exceptional financial need scholarships, financial assistance 
to disadvantaged health professions students, State loan 
repayment program, community based scholarship program, nursing 
loan repayment program, national health service corps and 
public health traineeships.

Scholarships for disadvantaged students [SDS]

    This program provides grants to health professions schools 
for student scholarships to individuals who are from 
disadvantaged backgrounds and are enrolled as full-time 
students in such schools. The Committee intends that all health 
professions disciplines made eligible by statute be able to 
participate in the scholarship program.

Exceptional financial need [EFN]

    This program assists persons with limited resources to 
enter health professions training by providing comprehensive 
scholarship support.

Financial assistance for disadvantaged health professions students 
        [FADHPS] scholarships

    This program provides financial assistance to disadvantaged 
students at medical, osteopathic or dental schools who agree to 
practice primary health care for 5 years after completing 
training.

National Health Service Corps: Field placements

    The funds provided for this program are used to support the 
activities of National Health Service Corps obligers and 
volunteers in the field, including travel and transportation 
costs of assignees, training and education, recruitment of 
volunteers, and retention activities. Salary costs of most new 
assignees are paid by the employing entity.

National Health Service Corps: Scholarships and loan repayment

    This program provides major benefits to students (full-cost 
scholarships or sizeable loan repayment) in exchange for an 
agreement to serve as a primary care provider in a high 
priority federally designated health professional shortage 
area. The Committee intends that funds provided be used to 
support multiyear, rather than single-year, commitments.
    The Committee is aware that the National Health Service 
Corps has conducted a special pilot project over the past year 
to place psychologists and other mental health providers in 
community and migrant health centers. The Committee applauds 
this effort and its rationale based on studies documenting the 
savings that are achieved when mental health services are 
provided along with primary health care. The Committee urges 
the National Health Service Corps to continue and expand this 
effort and to develop more sites for mental health care 
providers particularly in areas already designated as Mental 
Health Manpower Shortage Areas.
    The Committee is concerned that there has been no recent 
dental participation in the NHSC Scholarship Program and few 
dental recipients of NHSC loan repayment awards, despite a 
significant dental health profession shortage areas. The 
Committee strongly urges the NHSC to address this problem 
through increased dental participation in these programs.
    The Committee is also pleased with the progress made 
through the oral health initiative in providing startup grants 
to initiate the provision of dental care at 10 health centers 
with significant oral health needs. The Committee encourages 
HRSA to expand this initiative in fiscal year 1996 so that 
greater progress can be made in addressing oral diseases, which 
have been identified as the most pressing need in migrant 
centers and one of the top five unmet needs throughout the 
health care system.

Grants to communities for scholarships

    This program provides grants to States to provide financing 
for community organizations located in health professions 
shortage areas to make scholarship awards to health professions 
students in exchange for a service obligation in the community. 
Sixty percent of the costs of scholarships are paid by the 
States and sponsoring community organizations. The Committee 
considers this activity to be a vital option for enabling 
communities to meet their health provider needs.

Nurse loan repayment for shortage area service

    This program offers student loan repayment to nurses in 
exchange for an agreement to serve not less than 2 years in an 
Indian health service health center, native Hawaiian health 
center, public hospital, community or migrant health center, or 
rural health clinic.

                          other hrsa programs

Hansen's disease services (Carville)

    The Committee has included $17,500,000 for the Hansen's 
Disease Program, which is $3,326,000 less than the 
administration request and the appropriation for fiscal year 
1995, and the same as the House allowance. The Hansen's Disease 
Program consists of the Gillis W. Long Hansen's Disease Center 
at Carville, LA, and the regional Patient Care Program which 
provides for regionalized care for Hansen's disease patients on 
an outpatient basis.

Maternal and child health block grant

    The Committee recommends $678,866,000 for the maternal and 
child health [MCH] block grant. This is $5,084,000 less than 
the fiscal year 1995 appropriation and the House allowance and 
the same as the administration request.
    The MCH block grant funds are provided to States to support 
health care for mothers and children. According to statute, 15 
percent of funds are used for special projects of regional or 
national significance [SPRANS]; and 12.75 percent of funds over 
$600,000,000 are used for community integrated service systems 
[CISS] programs. After taking the 12.75 percent set-aside, the 
remaining 87.25 percent is distributed on the same percent 
split as the basic block grant formula.
    The Committee supports the continuation of the hemophilia 
treatment centers program and is pleased with the collaborative 
efforts of the Maternal and Child Health Bureau with the 
Centers for Disease Control and Prevention to improve current 
methods of measuring outcomes to better reach the unserved and 
underserved hemophilia population working with the National 
Hemophilia Foundation.
    The Committee continues to support the efforts of the 
university affiliated programs for individuals with 
developmental disabilities. Sufficient funding has been 
provided to maintain all existing grantees. The Committee also 
encourages HRSA to continue its support of training programs in 
schools of public health through SPRANS funding.
    The Committee is concerned about emerging reports that 
indicate significant increases in infant abuse, post partum 
complications, and other problems associated with early 
discharge following delivery. Discharge of the mother and her 
new baby from the hospital must be based upon sound clinical 
judgment determined by the clinician and family in partnership.
    The Committee directs the Bureau to collaborate with 
Federal agencies, including the Department of Defense, as well 
as appropriate professional organizations such as the American 
Nurses Association and the American Academy of Pediatrics and 
representatives from the insurance industry to explore the 
issue further and provide a report on the status of this issue 
with a plan of action within 1 year.
    The Committee understands that the Maternal and Child 
Health Bureau has sought to improve access to appropriate 
services for handicapped children, to improve the coordination 
of these services and to improve resource utilization through 
the elimination of duplication and more appropriate use of 
limited public and private resources.
    Progress toward these objectives has been accomplished 
through the CHOICES project (children's healthcare options 
improved through collaborative efforts and services), a 
demonstration project funded by the Maternal and Child Health 
Bureau and Shiners Hospitals for Crippled Children. This 
project effectively involves the private sector in 
supplementing public support for the care of disadvantaged 
children. For this reason, the Committee continues to strongly 
support the CHOICES program and encourages HRSA to continue its 
support for CHOICES through SPRANS set-aside funding.
    The Committee supports implementation of the recommendation 
made by the nationwide survey of sudden -infant death syndrome 
[SIDS] services, which demonstrate the need for a more active 
MCH presence in supporting SIDS services.

Healthy start initiative

    The Committee recommends $100,000,000 for the healthy start 
infant mortality initiative. This amount is $5,000,000 less 
than the fiscal year 1995 amount, $50,000,000 more than the 
House allowance, and the same as the administration request. 
The fiscal year 1995 appropriation represents the peak year of 
the program.
    Sufficient funding has been included to continue all 
projects funded in fiscal year 1995. This will enable the 
Department to assess the success and impact of the healthy 
start concept while at the same time planning for the 
replication of these efforts in other affected communities 
across the Nation.
    The Committee does not concur with the House language which 
begins the phase down of the Healthy Start Program in fiscal 
year 1996. The healthy start initiative was developed to 
respond to persistently high rates of infant mortality in this 
Nation. Fifteen projects were awarded grants in fiscal year 
1992 with the goal of reducing infant mortality in their 
project area by 50 percent over a 5-year period. Fiscal year 
1996 is the fifth project year for these 15 grantees.

Organ procurement and transplantation

    The bill includes $2,400,000 for organ transplant 
activities. This is $229,000 less than the administration 
request and the fiscal year 1995 appropriation, and the same as 
the House allowance. These funds support a scientific registry 
of organ transplant recipients and kidney dialysis patients, 
and the National Organ Procurement and Transplantation Network 
to match donors and potential recipients of organs. A portion 
of the appropriated funds may be used for education of the 
public and health professionals about organ donations and 
transplants, and to support agency staff providing 
clearinghouse and technical assistance functions. The Committee 
agrees with the House that the contractor should plan over time 
to decrease its dependence on Federal funds, which constitute 
only a small share of its total budget.

Health teaching facilities interest subsidies

    The Committee recommends $411,000 for interest subsidies 
for three health professions teaching facilities. This is the 
same as the administration request, the fiscal year 1995 
appropriation and the House allowance.

National bone marrow donor program

    The Committee has included $15,360,000 for the national 
bone marrow donor program. This the same as the administration 
request, the fiscal year 1995 allowance, and the House 
allowance. These resources include $14,750,000 to support the 
second year of a 3-year contract with the National Marrow Donor 
Program, Inc., and $610,000 for program evaluation and program 
management.

Rural health outreach grants

    The Committee recommends $28,500,000 for health outreach 
grants. This amount is $2,409,000 more than both the fiscal 
year 1995 level and the House allowance. This program supports 
projects that demonstrate new and innovative models of outreach 
in rural areas such as integration and coordination of health 
services and also supports rural telemedicine projects.
    The Committee believes that telemedicine networks offer 
significant potential for improving outreach to underserved 
rural areas. The Committee expects that HRSA will give priority 
to proposals seeking to initiate or expand rural telemedicine 
networks, as well as rural health networks.
    The Committee is aware of a proposal to develop and 
implement a telemedicine/telecommunications network to aid in 
facilitating the delivery of quality health care services to 
rural and underserved populations in central, north-central, 
and northeastern Pennsylvania by the Geisinger health system. 
The Committee encourages full and fair consideration of a 
proposal from this organization.
    The Committee understands that three grantees would have 
received continuation funding in fiscal year 1995 under the 
trauma-care program administered by HRSA if that program had 
not been terminated in the fiscal year 1995 rescission bill. 
While the program has been terminated, HRSA should use every 
effort to fund these previously funded grants for the balance 
of the grant period under the rural health outreach program.
    Ceasing funding for these grantees in the midst of the 
establishment of a trauma-care system would have detrimental 
effects and would negate the efforts that have already been 
made.
    The Committee encourages favorable consideration of a 
proposal from the University of South Dakota [USD] School of 
Medicine's Health Sciences Information Center for a rural 
health information network. The network would provide rural 
health care providers with innovative technologies and 
substantially increase access to printed materials and an ever-
increasing number of online health data bases. The project will 
serve as a model for other rural States in seeking to establish 
health information networks in rural areas by demonstrating to 
small communities how emerging electronic technologies can 
bring critical information to rural health care providers.
    The Committee believes that pediatric hospitals and medical 
centers have a unique role to play in the reengineering of our 
pediatric health care delivery system, and that the 
requirements of a reformed health care delivery system must be 
tailored to the specialized needs of children.
    The Committee urges HRSA to give priority attention to 
initiatives which are geared to providing a regionalized plan 
for a seamless consolidated system of high quality pediatric 
care. The Committee strongly supports an innovative proposal by 
the Children's Hospital of Pittsburgh to establish a regional 
pediatric network to improve access to specialty care through 
partnerships with rural community hospitals.

Trauma care

    The Committee recommends no funding for the trauma care 
program, which is $293,000 below the fiscal year 1995 level and 
the same as the House allowance. Both the House and Senate 
agreed to terminate this program in Public Law 104-19.

Pediatric emergency care

    The Committee has included $11,000,000 for emergency 
medical services for children. This is $1,000,000 more than 
both the fiscal year 1995 level and House allowance. The 
program supports demonstration grants for the delivery of 
emergency medical services to acutely ill and seriously injured 
children.
    The Committee is pleased with the accomplishments of the 
EMSC program over the past decade and wishes to see the program 
proceed with the activities proposed in the document: 
``Emergency Medical Services for Children: Five Year Plan 1995-
2000.'' The Committee recognizes the importance of the 
collaboration among Federal, State, and professional 
organizations in the success of the Emergency Medical Services 
for Children Program, and notes the bombing in Oklahoma in 1995 
demonstrated the magnitude of this collaborative success.
    To ensure the continued collaboration, the Committee 
encourages the Maternal and Child Health Bureau and the 
National Highway Traffic Safety Administration to continue and 
expand the use of contractors from professional organizations 
to partner with Federal staff in the implementation of the EMSC 
Program. Organizations of particular importance include the 
Emergency Nurses Association, the American Psychological 
Association, the American Academy of Pediatrics, the American 
College of Emergency Physicians, and the Association of State 
EMS Directors.

Black lung clinics

    The Committee has included $3,811,000 for black lung 
clinics. This is $331,000 less than the fiscal year 1995 
amount. The House did not provide funding for this activity. 
This program funds clinics which treat respiratory and 
pulmonary diseases of 47,350 active and retired coal miners. 
These clinics reduce the incidence of high-cost inpatient 
treatment for these conditions.

Alzheimer's demonstration grants

    The Committee recommends $4,000,000 for Alzheimer's 
demonstration grants which is $959,000 below the 1995 
appropriation and the same as the House allowance. Thorough 
matching grants, this program has proved to be an effective 
tool in stimulating States to design an implement support 
services to families struggling to care for individuals with 
Alzheimer's disease. Not less than 50 percent of each State's 
matching grant is used to provide respite care for family 
caregivers, disease.

Payment to Hawaii, treatment of Hansen's disease

    The bill includes $2,738,000 for the treatment of persons 
with Hansen's disease in the State of Hawaii. This is $238,000 
less than the 1995 level, and $2,738,000 more than the House 
allowance. The Committee, while not prepared to eliminate 
funding for this activity in fiscal year 1996, does expect that 
a plan be developed which would grant a stipend option to 
residential patients in Hawaii similar to the option being 
considered for patients at the Gillis W. Long National Hansen's 
Disease Center in Carville, LA.

Pacific basin initiative

    The Committee includes $2,000,000 for the Pacific basin. 
This is $500,000 more than the fiscal year 1995 appropriation; 
the House did not provide funding for this initiative. Of the 
funds provided, the Committee intends that $1,500,000 be used 
to continue the Medical Officer Training Program. The Committee 
is pleased with the program's success and is confident that it 
will significantly contribute to the improvement of the health 
status of the Pacific basin region.
    The Committee remains supportive and again funds the 
Institute of Medicine's development of a long-term strategic 
plan for the future of this region, which includes dental care, 
as well as the efforts of the Waianae Coast Comprehensive 
Health Center, which has an outstanding record of being 
responsive to the primary health care needs in the region. The 
Committee accordingly strongly urges HHS to implement these 
recommendations in a timely fashion.

Native Hawaiian Health Care

    The Committee recommends $4,140,000 for the native Hawaiian 
health care services. This is $196,000 less than the fiscal 
year 1995 amount. The House did not provide funding for this 
program. The Committee notes the improvement in the provision 
of acute and preventive health services to native Hawaiians, as 
well as a rise in the numbers of native Hawaiians working in 
health fields as a result of the health scholarship program. 
The Committee expects that in fiscal year 1996, Papa Ola Lokahi 
and the health care systems will continue to collaborate 
efforts with community health centers and other native Hawaiian 
services organizations to further improve the delivery of 
health services to the native Hawaiian community.

                  acquired immune deficiency syndrome

AIDS education and training centers

    The Committee recommends $8,000,000 for the AIDS education 
and training centers [AETC's]. This amount is $8,287,000 less 
than the fiscal year 1995 amount and the President's request 
and $8,000,000 more than the House allowance. This amount 
provided by the Committee reflects a transition from separate 
line-item funding for this activity to support for this 
training activity by State and local Ryan White grantees.
    AIDS education and training centers train health care 
practitioners, faculty, and students who care for AIDS patients 
outside of the traditional health professions education venues, 
and support curriculum development on diagnosis and treatment 
of HIV infection for health professions schools and training 
organizations.
    All Ryan White grantees benefit from and depend on trained 
health professionals. The Committee understands that both Ryan 
White title I planning councils and title II grantees are 
authorized to expend funds for training projects. The Committee 
believes that now that the title I and II grantees are in 
place, decisions regarding allocation of funds toward training 
should be made, in large part, by those grantees. The Committee 
urges these grantees to meet these training needs through the 
existing AETC system.

AIDS dental services

    This program has been consolidated with other health 
profession programs in the health professions work force 
development cluster discussed earlier.

                        Ryan White aids programs

    The Ryan White Program is being reauthorized in fiscal year 
1996; however, since new legislation has not yet been enacted, 
the Committee has provided funding for the Ryan White titles 
under the existing authority. If legislation is enacted between 
now and the conference with the House, the Committee intends to 
appropriate funds for Ryan White under the newly enacted 
legislation.

Emergency assistance--Title I

    The Committee recommends $379,500,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic. This 
amount is $23,000,000 over the fiscal year 1995 amount and the 
same as the House allowance. It is $27,500,000 less than the 
administration request. These funds are provided to 
metropolitan areas with a cumulative total of more than 2,000 
cases of AIDS or a per capita incidence of 0.0025. One-half of 
the funds are awarded by formula and one-half are awarded 
though supplemental competitive grants.
    In fiscal year 1995, 42 metropolitan areas were eligible 
for funding under title I. New cities are expected to become 
eligible in fiscal year 1996. Without an increase in funding 
for title I, a real reduction in services to people living with 
HIV/AIDS will result.
    Bill language has been included which is meant to hold 
harmless, in fiscal year 1996, title I metropolitan areas that 
received funding in fiscal year 1995 to ensure that those 
cities do not receive less funding in fiscal year 1996 than 
they did in fiscal year 1995 under the formula portion of title 
I.

Comprehensive care programs--Title II

    The Committee has provided $198,147,000 for HIV health care 
and support services. This amount is $23,750,000 less than the 
administration request and the same as both the fiscal year 
1995 amount and the House allowance. These 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 drug treatments that have 
been determined to prolong life or prevent serious 
deterioration of health for low-income individuals with HIV 
disease.
    A State must use at least 15 percent of its grant funds to 
provide health and support services to infants, children, 
women, and families with HIV disease. State grant amounts are 
distributed by formula based on the reported cases of AIDS in 
the preceding 2 fiscal years and per capita income. The minimum 
State grant is $100,000. An amount, not to exceed 10 percent of 
the appropriation for title II, is used to support a program of 
special projects of national significance. This program 
provides funds to projects which contribute to the advancement 
of knowledge and skills in the delivery of health and support 
services to persons with HIV infection.

Early intervention program--Title III-B

    The Committee recommends $52,318,000 for early intervention 
grants. This is the same as both the fiscal year 1995 amount 
and the House allowance and $10,250,000 less than the 
administration request. These funds are awarded competitively 
to primary health care providers to enhance health care 
services available to people at risk of HIV and AIDS. Funds are 
used for counseling, testing, diagnostic, and therapeutic 
services.

Pediatric AIDS demonstrations--Title IV

    The Committee recommends $26,500,000 for title IV pediatric 
AIDS demonstrations, which is $5,500,000 less than the 
administration request, and $500,000 above both the fiscal year 
1995 amount and House allowance. This program supports 
demonstration grants to develop innovative models that foster 
collaboration between clinical research institutions and 
primary/community-based medical and social service providers 
for underserved children, youth, pregnant women, and their 
families.
    The Committee fully supports enhancing developmental 
disability services for children with HIV where identified gaps 
exist in comprehensive care systems. Technical assistance 
should be provided to those systems by established experts in 
HIV-related developmental disabilities when requested. 
Attention should be given to native American and native 
Hawaiian children, adolescents, and families with HIV through 
linkage with and expanding HRSA and MCH sponsored comprehensive 
care projects.
    The Committee affirms its commitment to support 
comprehensive, family-centered and youth-centered HIV care 
systems for children, youth, women and families, and the 
provision of voluntary access to clinical research programs in 
section 401.
    The Committee understands that participation of children, 
youth, women and families in HIV clinical research programs has 
been successful when projects are convenient to patients, are 
sensitive to nontraditional services, and when the research is 
conducted within established, comprehensive HIV care systems. 
Programs should be flexible and organize, coordinate and 
support a broad range of HIV services directly or though 
subcontractors that link institutional and community based 
providers. Grantees may make referrals for or provide for 
services to facilitate access to care and research.
    Some 5 percent of the funds appropriated under this section 
may be used to provide peer-based training and technical 
assistance through national organizations that collaborate with 
projects to ensure development of innovative models of family-
centered and youth-centered care; advanced provider training 
for pediatric, adolescent and family HIV providers; health care 
financing, outcome measures and policy analysis; and 
coordination with research programs.
    The Committee notes that the provisions of title IV place 
additional responsibilities on grantees to increase 
participation in research programs. Implementation of ACTG 076 
to reduce perinatal transmission and the recently published PCP 
prophylaxis guidelines for infants are significant new 
initiatives for title IV programs. Implementation of new 
initiatives as well as relationships with research programs 
have increased the administrative demands on HRSA staff and the 
Committee urges HRSA to devote additional program management 
staff to the title IV program, if possible given reduced 
overall availability of funding.

Family planning

    The Committee recommends $193,349,000 for the title X 
family planning program. This is the same as the fiscal year 
1995 amount and the House allowance and $5,633,000 less than 
the administration request. Title X grants support primary 
health care services at over 4,000 clinics nationwide. About 85 
percent of family planning clients are women at or below 150 
percent of poverty level.
    Title X of the Public Health Service Act, which established 
the family planning program, authorizes the use of a broad 
range of acceptable and effective family planning methods and 
services. The Committee believes this includes oral, 
injectable, and other preventive modalities.
    The Committee directs that the family planning program be 
formally administered, as well as funded, in HRSA as a separate 
program in the Office of the Administrator. In the early 1980's 
the program was transferred from HRSA to the Office of the 
Assistant Secretary of Health [OASH]. With the current 
reorganization of OASH, the Committee believes the program 
should again be administered by HRSA. The funds for family 
planning are appropriated to HRSA and the Committee believes 
that program direction activities are better located in the 
operating agencies rather than in the Office of the Secretary.

Rural health research

    The Committee recommends $10,172,000 for the Office of 
Rural Health Policy. This is $746,000 more than the 
administration request, an increase of $746,000 over the fiscal 
year 1995 appropriation, and $10,172,000 more than the House 
allowance. The funds provided support the Office as the focal 
point for the Department's efforts to improve the delivery of 
health services to rural communities and populations. Funds are 
used for rural health research centers, grants to telemedicine 
projects, the National Advisory Committee on Rural Health, and 
a reference and information service. Funding has been provided 
to continue all existing rural telemedicine projects including 
the West Virginia telemedicine project.
    The Committee recognizes that there is a need for objective 
and scientific evaluation of telemedicine programs. It further 
recognizes that the Advanced Telemedicine Research Group at 
Oregon Health Sciences University [OHSU], working in 
cooperation with the multistate Clinical Telemedicine 
Cooperative Group of which it is a member, is performing 
important research into the medical effectiveness and utility 
of telemedicine. This collaborative approach to research will 
make it possible to obtain statistically valid scientific data 
and results in a timely fashion, thus facilitating 
implementation of important telemedicine technologies. The 
Committee encourages full and fair consideration of a proposal 
from the OSHU group.
    The Committee also encourages full and fair consideration 
of a rural health care research proposal from Montana State 
University-Bozeman. Designed by economists, this research would 
focus on the value of changes in access to health care and the 
level of care provided in a particular region.
    The Committee recognizes the work at the Dartmouth 
Hitchcock Medical Center in Lebanon, NH, on the C. Everett Koop 
Education and Conference Center. The center will develop and 
implement training programs for rural practitioners that will 
be designed to especially enhance community-based training of 
primary care medical personnel in subspecialties important to 
providing basic, rural primary care. The center will also 
incorporate technology such as interactive video to educate 
providers in new medical procedures, continuing education, and 
primary care health outcomes programs.

Building and facilities

    The Committee recommends $858,000 for buildings and 
facilities, the same as the administration request and the 
fiscal year 1995 amount. These funds provide for routine 
repairs and improvements at the Gillis W. Long Hansen's Disease 
Center located at Carville, LA.

Health facilities construction

    The Committee has not included funds for health facilities 
construction. This is $10,000,000 below the fiscal year 1995 
amount, the same as the House allowance, and $2,000,000 less 
than the administration request. Given this year's budget 
constraints, the Committee was unable to provide funding for 
this activity.

National practitioner data bank

    The Committee recommends $6,000,000 for the national 
practitioner data bank, which is the same as the House 
allowance, the administration request, and the fiscal year 1995 
level. The $6,000,000 will be provided entirely through the 
collection of user fees and will cover the full cost of 
operating the data bank.

Program management

    The Committee recommends $111,236,000 for program 
management activities for fiscal year 1996. This is $9,310,000 
less than the administration request and $9,673,000 less than 
the fiscal year 1995 amount. The House allowance was 
$120,546,000 with an undistributed administrative reduction of 
$16,000,000 to be applied to the categories of funding that are 
displayed as administrative cost in the HRSA 1996 budget 
justification. The Committee allowance reflects the savings in 
administrative costs attributed to the consolidation of agency 
programs into clusters.
    The Committee understands that HRSA has initiated actions 
to establish the Office of Adolescent Health within its 
Maternal and Child Health Bureau and commends the agency for 
doing so.
    The Committee has directed the Office of Women's Health in 
the Office of the Secretary to develop and implement the 
national women's health clearinghouse and has directed that the 
Public Health Service agencies contribute a total of $1,400,000 
to this effort, each agency contributing their proportionate 
share as determined by the Office of the Secretary. Sufficient 
funding has been included to provide that support to the 
clearinghouse.

               medical facilities guarantee and loan fund

Appropriations, 1995....................................      $9,000,000
Budget estimate, 1996...................................       8,000,000
House allowance.........................................       8,000,000

Committee recommendation

                                                               8,000,000

    The Committee recommends $8,000,000 for the medical 
facilities guarantee and loan fund. This is the same as both 
the administration request and House allowance and $1,000,000 
less than the fiscal year 1995 appropriation. These funds are 
used to comply with the obligation of the Federal Government to 
pay interest subsidies on federally guaranteed loans throughout 
the life of the loans. These loans were used for hospital 
modernization, construction, and conversion.

                   health education assistance loans

Appropriations, 1995....................................     $22,050,000
Budget estimate, 1996...................................      18,044,000
House allowance.........................................      13,500,000

Committee recommendation

                                                              13,500,000

    The Committee recommends guarantee authority of 
$210,000,000 for new HEAL loans in fiscal year 1996, which is 
$70,000,000 below the President's request, the same as the 
House level, and $165,000,000 below the fiscal year 1995 level.
    The Committee recommends $42,000,000 to liquidate 1996 
obligations from loans guaranteed before 1992, which is the 
same as the administration request and the House allowance and 
$24,010,000 above the 1995 appropriation. In addition, the 
Committee provides $13,500,000,000 to pay default claims 
arising from loans guaranteed in 1996, which is $4,544,000 
below the administration request and $8,550,000 below the 1995 
appropriation.
    For administration of the HEAL Program, the Committee 
recommends $2,688,000, which is $234,000 below the 1995 
appropriation, the administration request, and the House 
allowance.
    The HEAL Program insures loans to students in the health 
professions. The Budget Enforcement Act of 1990 changed the 
accounting of the HEAL Program. One account is used to pay 
obligations arising from loans guaranteed prior to 1992. A 
second account was created to pay obligations and collect 
premiums on loans guaranteed in 1992 and after. Administration 
of the HEAL Program is separate from administration of other 
HRSA programs.
    The Committee has provided a loan limitation level 
sufficient only to support the continuation costs of those 
students currently receiving HEAL loans. The Committee 
instructs HRSA to review the HEAL Program to determine whether 
there is still a need for the program given the availability of 
programs in the Department of Education.
    The Committee has also included language in the Department 
of Education section of this report requesting that the 
Secretary of Education consider the needs of graduate health 
professions students, in light of the phaseout of the HEAL 
Program, and use his authority to increase the loan limits for 
the Federal Family Education Loan Program.

                 vaccine injury compensation trust fund

Appropriations, 1995....................................    $167,476,000
Budget estimate, 1996...................................     169,721,000
House allowance.........................................     169,721,000

Committee recommendation

                                                             169,721,000

    The Committee recommends that $59,721,000 be released from 
the vaccine injury compensation trust fund in 1996, of which 
$3,000,000 is for administration costs. This amount is the same 
as both the budget request and House allowance and $2,245,000 
more than the 1995 amount. In addition, $110,000,000 in general 
funds are appropriated for compensation of vaccine-related 
injuries associated with vaccines administered before fiscal 
year 1989. This is the same as administration request, House 
allowance, and the fiscal year 1995 amount.
    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 a death 
benefit.

               Centers for Disease Control and Prevention

                disease control, research, and training

Appropriations, 1995....................................  $2,085,831,000
Budget estimate, 1996...................................   2,183,560,000
House allowance.........................................   2,085,831,000

Committee recommendation

                                                           2,052,783,000

    The Committee views prevention as a sound investment. 
Preventive health in areas such as childhood immunization, 
infectious disease, injury control, breast and cervical cancer, 
and human immunodeficiency virus, can materially affect a 
reduction in health care costs. While Americans today enjoy the 
longest life expectancy of any time in our Nation's history, 
preventable diseases and conditions still cause death, and 
disability, and still compromise the quality of life for 
millions of our citizens. About one-half of the deaths which 
occur in the United States every year are considered 
preventable, as are many of the illnesses.
    The Centers for Disease Control and Prevention is the 
Nation's lead health prevention agency with the mission of 
protecting the health of our people by making prevention a 
practical reality. In order to address this mission, CDC 
focuses on four major priorities: Provide core public health 
functions; respond to urgent health threats; promote women's 
health; and provide leadership in the implementation of 
nationwide prevention strategies to encourage responsible 
behavior and adoption of lifestyles that are conducive to good 
health.
    The Committee expects the CDC to continue the Office of 
Women's Health in the Office of the Director. Understanding and 
preventing disease, disability, and injury among women requires 
a full agency effort, one that crosses program lines. The CDC 
Office of Women's Health ensures that priority is given to 
women's health throughout CDC program areas. The Committee 
encourages the Office to communicate regularly with all 
relevant CDC programs, other HHS agencies, private and 
nonprofit organizations, and other individuals and 
organizations deemed appropriate by the Director.

Preventive health and health services block grant

    The Committee recommends $132,918,000 for the preventive 
health and health services block grant, $21,420,000 less than 
the President's request and $25,000,000 less than the House 
allowance and the fiscal year 1995 appropriation. Funding has 
been reduced below the fiscal year 1995 level due to fiscal 
constraints. The Committee, however, has provided an additional 
$35,000,000 from the violent crime reduction trust fund for 
rape prevention and education activities authorized by the 
Violence Against Women Act to be carried out through the 
preventive health block grant.
    The preventive health block grant provides States with 
funds for services to reduce preventable morbidity and 
mortality and improve the quality of life. The grants give 
States flexibility in deciding how available funding can be 
used to meet State preventive health priorities. Programs 
eligible for funding include screening, laboratory services, 
health education, and outreach programs for such conditions as 
high blood pressure and cholesterol, and breast and uterine 
cancer. The Committee continues to encourage that emphasis be 
placed on chronic diseases under the PHHS block grant. Chronic 
diseases account for 70 percent of all deaths in the United 
States and diminish the quality of life for millions.

Prevention centers

    The Committee recommends $8,224,000 for prevention centers. 
This is $500,000 over the President's request, the House 
allowance, and the fiscal year 1995 appropriation.
    CDC's Prevention Centers Program provides grants to 
academic programs to fund applied research designed to yield 
tangible results in health promotion and disease prevention. 
This network of collaborating prevention centers works to fill 
the knowledge gaps that block achievement of prevention goals. 
The centers work with State and local health departments and 
other organizations to increase the implementation of research 
findings.
    The level of funding will continue activities at 12 
prevention centers as well as initiate one new center. The 
Committee has included $500,000 for a prevention center to 
focus on research, demonstration, evaluation and training, for 
health and other public sector professionals, and community-
based organizations to prevent teen pregnancy. The Committee 
believes that the development and evaluation of successful 
programs which can prevent teen pregnancies is one of the 
Nation's most pressing needs.
    The Committee encourages that CDC sponsor, through the 
national network of collaborating academic prevention centers, 
extramural research targeted at disease prevention and health 
promotion in communities, and continue to build alliances with 
schools of public health, community-based organizations, and 
State and local public health officials.
    The Committee also encourages the continued support of 
center activities aimed at improving knowledge about the 
usefulness and effectiveness of health promotion programs for 
persons with disabilities.

Sexually transmitted diseases

    The Committee recommends $106,242,000 for sexually 
transmitted disease prevention and control, $4,000,000 less 
than the House allowance, and $1,000,000 more than the fiscal 
year 1995 appropriation. Since no action has been taken by the 
authorizing committee, funds have been provided under current 
law and not through an HIV/TB/STD partnership grant as proposed 
in the President's budget.
    Sexually transmitted diseases continue to be one of the 
most formidable health challenges facing the United States 
because of the high rates of STD's in adolescents and young 
adults, and their facilitation of HIV transmission. The 
objective of the program is to survey, prevent, and control the 
transmission of STD's by providing national leadership for: 
prevention and control programs; monitoring disease trends; 
behavioral and clinical research; education and training; 
building partnerships for STD prevention; the STD accelerated 
prevention campaign; and infertility. Grants are awarded to 
State and local health departments and other nonprofit entities 
to support primary prevention activities, surveillance systems, 
screening programs, partner notification and counseling, 
outbreak control, and clinical skills training.
    In light of the new research demonstrating as much as a 40-
percent reduction in new HIV infections due to control of other 
STD's, the Committee provides a $1,000,000 increase in funding 
for CDC's STD prevention efforts. The Committee recognizes that 
chlamydia is the most comon bacterial STD in the United States, 
with approximately 4 million new cases each year. Having 
supported demonstration projects in all regions of the country 
in an attempt to replicate the successful reduction in 
chlamydia achieved in region X, the Committee expects that a 
portion of this increase be utilized to expand demonstration 
efforts across the country.

Immunization

    The Committee recommends $465,497,000 for immunization 
activities in fiscal year 1996, $10,000,000 less than the House 
allowance, and the same as the fiscal year 1995 appropriation. 
The Omnibus Reconciliation Act [OBRA] of 1993 authorized the 
establishment of a new vaccine purchase and distribution system 
that provides, free of charge, all pediatric vaccines 
recommended for routine use by the Advisory Committee on 
Immunization Practices to all Medicaid-eligible children, 
uninsured children, underinsured, and native Americans through 
program-registered providers. Included in the Medicaid estimate 
for fiscal year 1996 is $477,818,000 for the purchase and 
distribution of vaccines for a total immunization 
recommendation of $873,804,000, an increase of $32,307,000 over 
fiscal year 1995.
    CDC provides leadership and support for national efforts to 
prevent and/or control vaccine-preventable diseases, which 
include availability of vaccine services, outreach programs, 
education and training, surveillance and investigation, and 
applied research.
    Within the amounts appropriated, $149,000,000 is provided 
for the purchase of vaccine under the 317 program. Of the 
$149,000,000 made available for vaccine to the States, CDC has 
the discretion to reallocate additional funding for 
infrastructure grants if the entire amount available for 317 
vaccine purchases is not needed by the States. This will ensure 
that States receive up to their maximum estimates for vaccine 
purchase, and, at the same time, provide CDC with flexibility 
to reallocate vaccine purchase dollars if States' needs prove 
lower than the amount provided. The Committee expects to be 
notified prior to the transfer of any funds between vaccine 
purchase and infrastructure, of the amount of transfer, the 
State carryover balances, and the justification for the 
transfer.
    The Committee has provided $33,000,000 for a bonus program 
to improve immunization rates. Using State-specific 
immunization coverage data, CDC will provide payments to States 
for 2-year-olds who have been fully immunized. CDC will provide 
to the States: $50 per child in excess of 65 percent and less 
than 75 percent; $75 per child in excess of 75 percent and less 
than 85 percent; and $100 per child in excess of 85 percent.
    Recent surveys of immunization coverage conducted by the 
Department of Health and Human Services reflect national 
coverage rates at an all-time high and close to the 1996 goal 
of 90 percent coverage for all antigens. In 1994, vaccination 
levels among children age 19 to 35 months were as follows: 93 
percent for three doses of DTP; 83 percent for three doses of 
polio virus; 89 percent for measles-containing vaccine; 86 
percent for haemophilus influenza vaccine. Nevertheless, 
anecdotal evidence and some survey data indicate that coverage 
rates remain unacceptably low in certain inner-city communities 
with high poverty rates and concentrated populations of 
underprivileged children. The Committee directs CDC to develop 
and implement a strategy for identifying and targeting 
resources on these high-risk populations and, in particular, to 
expand the use of practice assessments and WIC linkages in the 
following manner:
    One, over the past several years, CDC has developed a 
technical assessment method based on computer analysis of 
provider records, to diagnose problems within the practice 
sites. This methodology is shown to be highly effective at 
reducing missed opportunities and improving coverage rates. As 
in the previous year, the Committee directs CDC to ensure that 
all States receiving IAP funds continue to conduct annual 
provider site assessments in all public clinics, using CDC-
approved methodology. In the event that States lack sufficient 
resources to conduct such assessments, the Committee directs 
CDC to provide technical assistance for this purpose.
    Two, CDC has also conducted a number of studies to measure 
the effect of linking immunization assessment and referral with 
WIC services. A number of linkage methods, including voucher 
incentives, have been tested and have resulted in dramatic 
improvements in coverage rates for high-risk children at very 
low cost. The Committee, therefore, directs CDC to ensure that 
all grantees receiving IAP funds reserve 10 percent of those 
funds for the purpose of funding immunization assessment and 
referral services in WIC sites in 1996. The grantees must use 
all of the funds for WIC linkage unless the grantee can 
document that assessment and referral are taking place in WIC 
sites without the need for specific funds. CDC should define 
for grantees the criteria for assessment, referral, and annual 
reporting of WIC coverage.
    The Committee has continuing concerns about the inability 
of 317 program grantees to expend funds allocated for 
immunization services, particularly in areas with large 
populations of high-risk children. This failure has resulted in 
a large pool of unspent carryover funds from previous fiscal 
years. The Committee believes that new ways to develop and 
implement immunization initiatives must be created and tested. 
The Committee, therefore, directs CDC to allocate $30,000,000 
for the purpose of conducting and evaluating community-based 
interventions funded directly by the CDC.
    The goal of this demonstration is to measure the 
effectiveness of programs that: (1) target populations of 
underserved children with low coverage rates; and (2) 
incorporate immunization initiatives with primary care 
services. The Committee expects that the $30,000,000 allocated 
will be spent over a 2- to 5-year period and will accommodate 
between four and eight demonstration projects, at least one of 
which should be located in a rural area. All projects should be 
located in a federally designated health professional shortage 
area [HPSA] and funding should be contingent on documentation 
of low coverage rates among the target population.
    CDC should require that selected projects demonstrate an 
expansion of current service capacity and an ability to 
evaluate target sites and measure program impact. Further, CDC 
should ensure that all projects link immunization efforts with 
each child's source of primary care. The Committee expects that 
grantees will be academic medical center based networks of 
pediatric primary care providers with significant experience in 
delivering services to underserved child populations in urban 
and rural sites.
    The Committee directs CDC to: (1) survey current efforts in 
school-based health centers to immunize preschool children, and 
(2) conduct three to four demonstration projects for the 
purpose of expanding such efforts, using the most successful 
methodologies identified by the survey. These demonstrations 
should be conducted using existing funds available for such 
purposes.
    The Committee has provided $20,000,000 for polio vaccine to 
expand CDC's capacity to meet the goal of global eradication of 
polio by the year 2000. This is an increase of $15,884,000 over 
the 1995 level. The Committee recognizes the remarkable success 
that has been made in eradicating polio and the potential for 
eliminating this disease by the year 2000. The Committee 
commends the CDC for its active leadership in the effort. 
Achieving the goal of eradication will mean tremendous savings 
in human and financial costs. In the United States alone, 
savings of $230,000,000 will accrue on an annual basis once the 
disease is eradicated and the need for immunization is 
eliminated. Within the amount provided, the CDC may use up to 
$4,000,000 to expand its technical, laboratory, and program 
support services that support the eradication effort. This 
amount is in addition to $5,727,000 included in the budget 
requested for 1996.
    In order to offset the increased funding for the global 
polio eradication effort, the Committee recommends the CDC 
consider reductions to the following two activities:
    One, eliminating, or significantly curtailing, the random 
digit dialing [RDD] survey. This survey, conducted for the 
first time over the past year, provides comparable data on 
coverage rates for IAP grantees (all States and some cities). 
The Committee is concerned that: (1) the survey's national 
findings duplicate the findings of the National Health 
Information Survey [NHIS] which CDC will continue to fund at a 
cost of around $1,000,000 annually; and (2) the annual cost of 
the survey cannot be justified by its utility. RDD does not 
provide significant information on high-risk communities for 
targeting purposes, and in some respects, it duplicates surveys 
conducted by each State.
    Two, reducing the $9,261,000 in the request for grants for 
immunization tracking systems. This allocation was initially 
made in anticipation of authorizing legislation to establish a 
national tracking. The authorizing legislation has never been 
enacted. Instead, these funds have been used to develop State-
level tracking systems. The Committee supports development of 
State tracking systems; however, given the high carryover 
balances of IAP funds, the Committee believes funding for State 
tracking systems should be financed from individual IAP grants.
    Finally, the Committee recommends a reduction of $1,300,000 
for the national outreach project. This project was funded in 
1995 to publicize the children's immunization initiative and to 
test national outreach approaches for a 1-year period. This 
effort was in addition to the ongoing outreach and education 
efforts conducted by the CDC. The Committee encourages CDC to 
incorporate any successful strategies developed during this 
pilot project in the Agency's ongoing outreach operations.
    The recommendation includes a rescission of $53,000,000 
from funds provided in fiscal years 1995, 1994, and 1993 for 
317 vaccine purchase. The Committee has taken this action due 
to the substantial amount of carryover in both 317 vaccine 
purchase and infrastructure funds. The Committee intends that 
CDC work with the States to ensure better management of these 
funds and that this action not penalize States that do not have 
carryover balances. The recommendation includes $149,000,000 
for 317 vaccine purchase in fiscal year 1996, which is the same 
amount initially provided for fiscal year 1995. The Committee 
has received testimony that a number of the States and 
localities with substantial carryover funds have significant 
pockets of underimmunized children. The Committee directs the 
CDC prepare and submit a report prior to February 15, 1996, on 
the status of carryover balances in the 317 program and on 
steps taken to ensure that funds appropriated for immunization 
activities are utilized in a timely and efficient manner.
    Implementation of the Vaccines for Children Program in 
Alaska should be integrated with the existing Alaska 
Immunization Program which already provides universal coverage 
of Alaskan children. The Committee intends that the CDC 
maintain at least the current level of 317 grant funds to 
Alaska as it administers the vaccines for children. Provided 
that Alaska continues to provide universal coverage of children 
for vaccination, Alaska's participation in vaccines for 
children shall be at the State of Alaska's option.
    The Committee is aware of high incidence of hepatitis A in 
Alaska, particularly among the rural populations. In the Yukon-
Kuskokwim region alone, there were over 2,000 cases of 
hepatitis A during the most recent outbreak. The Committee 
urges the CDC to work with the State of Alaska to ensure that 
hepatitis A vaccine is made available to Alaskans for whom it 
is indicated.
    As was noted in the recent reports by the GAO and the 
Institute on Advanced Studies in Immunology and Aging, the 
Committee is impressed with the important role which adult 
immunizations, particularly influenza and pneumoceal vaccines, 
can have in maintaining the health of aging adults, as well as 
in significantly reducing health care expenditures. As such, 
the Committee encourages the CDC to work with the private 
sector in an effort to increase public information, awareness, 
and use of adult immunizations.

Infectious diseases

    The Committee's recommendation includes $58,402,000 for 
infectious diseases activities, $4,789,000 less than the 
President's request, $8,874,000 less than the House allowance, 
and $4,000,000 over the 1995 appropriation.
    These activities focus on: National surveillance of 
infectious diseases; applied research to develop new or 
improved diagnoses; prevention and control strategies; working 
with State and local departments and private health-care 
providers, to transfer application of infectious diseases 
prevention technologies; and strengthening the capability to 
respond to outbreaks of new or reemerging disease.
    Emerging infectious diseases, including drug-resistant 
infections, pose an increasing threat to the health and well-
being of the public. The Committee is pleased that CDC has 
prepared and released a comprehensive plan, ``Addressing 
Emerging Infectious Disease Threats: A Prevention Strategy for 
the United States,'' in response to a report issued by the 
Institute of Medicine that outlined the threat of infectious 
diseases in the United States. The Committee urges CDC to make 
the implementation of the comprehensive plan a priority.
    The Committee recognizes the need for E. coli research such 
as that conducted by Children's Hospital in Washington State 
and urges CDC to consider committing additional resources to E. 
coli research in Washington State.

Tuberculosis elimination

    The Committee's recommendation provides $119,582,000 for 
CDC's activities to prevent or control tuberculosis. This is 
the same as the House allowance, and the fiscal year 1995 
appropriation. The President's budget proposed consolidation of 
these funds into an HIV/STD/TB partnership grant. Since no 
action has been taken by the authorizing committee, funding for 
TB elimination activities has been provided under current law.
    CDC provides leadership and support for the control and 
elimination of TB. This is accomplished in large part through 
awarding cooperative agreements to State, territorial, and 
large city health departments to strengthen their control and 
elimination programs. This includes supporting State and local 
surveillance systems necessary to clearly identify the 
magnitude of the TB problem and what segments of the community 
is at greatest risk. This allows CDC, the States, and 
communities to target resources to areas with the greatest 
need.
    The Committee continues to recognize outreach activities, 
such as directly observed therapy, supported by the 
tuberculosis grant program as among the most effective methods 
of controlling tuberculosis. The Committee is aware, however, 
that if the global TB crisis continues, there is little hope to 
effectively eliminate TB in the United States. The Committee is 
concerned that expertise developed by CDC to combat TB in the 
United States has not been fully utilized in the global 
eradication effort, and recommends that the CDC work with the 
U.S. Agency for International Development, to develop a joint 
plan for collaboration among both agencies that will outline 
specific initiatives and enhancements to the ongoing global TB 
control activities.
    The Committee is concerned about the rising incidence of 
tuberculosis in many areas of the United States. In Alaska, for 
example, one out of three residents of the rural communities of 
Savoonga and Gambell have been infected with TB in the past 4 
years. The Committee encourages CDC to expand its tuberculosis 
prevention and control programs in communities of greatest 
need, such as those in Alaska.
    The State of Hawaii continues to experience an 
extraordinarily high incidence of tuberculosis, possessing the 
second highest case rate in the Nation at 21.3 per 100,000. One 
particular cause of the high TB rate is immigration. During 
1994, 80 percent of the active TB cases in Hawaii were born 
outside of the United States. The Committee urges the CDC to 
develop specific interventions that target this high incidence 
population.

Chronic and environmental disease prevention

    The Committee's recommendation includes $139,754,000 for 
chronic and environmental disease prevention activities, 
$10,246,000 less than the House allowance, but the same as the 
1995 appropriation.
    In many instances, premature death, avoidable illness, and 
disability are caused by personal behavior, exposure to toxic 
substances, and/or natural disasters. Prevention of the 
occurrence and progression of chronic diseases, therefore, is 
based on reducing or eliminating behavioral risk factors, 
increasing the prevalence of health promoting practices, 
detecting disease early to avoid complications, assessing human 
risks from environmental exposures, and reducing or eliminating 
exposures to environmental hazards.
    The focus of the programs in this activity includes 
diabetes, developmental disabilities, tobacco use, 
comprehensive school health, teen pregnancy, birth defects, 
fetal alcohol syndrome, spina bifida, chronic fatigue syndrome, 
prostate cancer, women's health, cancer registries, dental 
health, skin cancer, arthritis, and epilepsy. The Committee 
concurs with the recommendation of the House that the CDC 
conduct an evaluation of chronic disease programs and 
priorities within the Center with a view toward determining 
those programs which most appropriately need Federal seed 
money, coordination, leadership, and/or technical support. The 
Committee notes that most of the chronic and environmental 
disease prevention activities do not reach all the States, and 
are not likely to do so in the future, due to the overall 
decline in discretionary appropriations. Therefore, it is 
essential that CDC examine the Center's programs and priorities 
in order to maximize the use of Federal resources.
    In fiscal year 1995, the Committee provided funding for 
demonstration grants for the development of community 
partnership coalitions for the prevention of teen pregnancies. 
Sufficient funds have been provided to continue this 
initiative. The Committee is pleased with the first steps taken 
by the CDC in the creation of community coalitions to respond 
to the problem of teen pregnancy. The Committee believes that 
in the second year of funding the CDC should make funds 
available for pilot testing and expanding programs with the 
greatest chance of success in reducing the number of teen 
pregnancies. Sufficient funds have been provided to expand this 
initiative.
    The Committee remains concerned with the alarming rates of 
diabetes, up to 50 percent, among the population in the 
Commonwealth of the Northern Marianas Islands. The Committee 
urges that special consideration be given to this group in 
prevention and outreach efforts by the CDC. The Committee also 
is concerned with the high incidence of diabetes among the 
native Hawaiian population. Accordingly, the Committee 
reiterates its request for CDC to develop specific 
interventions for this population.
    The Committee is pleased that the CDC has been working 
closely with the Hawaii Department of Health and the U.S. 
Geological Survey to determine the environmental, physical, and 
mental effects of volcanic emissions that might result in 
higher levels of cancer, asthma, and other serious illnesses. 
The Committee is particularly interested in the health impact 
on children of volcanic emissions.
    Sufficient funds have been included to continue to support 
certain activities related to autism training and education.
    The Committee has provided funds above the request for the 
CDC to continue the full Hanford thyroid disease study in 
fiscal year 1996. To date, approximately $8,000,000 has been 
provided by the Committee in preparation for the study, 
including completion of a pilot study involving 1,600 persons 
born between 1942 and 1946 which determined that the proposed 
full study is feasible. The full study will involve 
approximately 3,400 participants and is scheduled for 
completion in 1998. The Committee understands that funding for 
the study will be supplemented by $1,700,000 transferred to the 
CDC from the Department of Energy.
    The Committee is aware that an innovative and culturally 
sensitive community partnership program of prenatal care 
developed for rural Hawaii called Malama has been very 
successful in addressing the prenatal care needs of minorities 
in this region. The program has provided a model for 
effectively integrating the values and expertise of academia 
and those of the community, as well as of psychology and 
nursing. The Committee encourages the CDC to consider providing 
support to expand this project to address other minorities in 
Hawaii.
    The Committee has provided funding to complete current 
chronic fatigue and immune dysfunction syndrome [CFIDS] 
surveillance projects at the CDC. The Committee requests that 
the CDC consider commencing a case-control phase of the 
surveillance study recently completed in San Francisco. 
Furthermore, CDC is strongly encouraged to conduct appropriate 
education programs and to begin studies on possible 
transmission routes for CFIDS, especially among health care 
workers, family members, and mothers.
    The Committee has included funding to expand the current 
level of support for State birth defects surveillance grants 
and spina bifida prevention grants. Because the causes of 75 
percent of birth defects remain unknown, the Committee 
encourages the CDC to consider initiating regional centers of 
excellence to study the cause of birth defects through 
epidemiologic research.
    The Committee realizes that the rate of babies born with 
health problems caused by the fetal alcohol syndrome [FAS] has 
increased sixfold in the United States in the past 5 years. The 
Committee has provided funding for the CDC to expand its 
efforts to prevent FAS, especially in high-incidence States, 
such as Alaska.
    The Committee also is aware that Alaska has one of the 
highest rates of sudden infant death syndrome [SIDS] in the 
United States, and encourages the CDC to develop and assess the 
effectiveness of programs to prevent SIDS, especially among 
Alaska Natives.
    The Committee notes that an estimated 1.2 million people in 
the United States are affected by hemochromatosis, a genetic 
blood disorder that leads to tissue damage in multiple organs 
without preventive efforts. The Committee is aware of efforts 
at CDC to develop a national program for the control of this 
disease, and urges the maintenance of this program.
    CDC has built a strong national program in school health 
education. The Committee encourages CDC to include health 
programs aimed at preventing teen pregnancy as part of the 
comprehensive school health program.
    The Committee notes the work of the CDC, the NICHD, and 
HRSA in developing a guideline for death scene protocol for 
sudden infant death syndrome. The Committee encourages 
continued development and publication of the guideline.
    The Committee notes a recent estimate by the CDC that 
arthritis will affect more than 59 million Americans by the 
year 2020, compared to the current estimate of 38 million. 
Arthritis is the leading cause of disability and the second-
leading cause of work disability. Despite its impact, little is 
known about the frequency and impact of the 100 different types 
of this disease, particularly in special populations. In the 
past, the Committee has encouraged CDC to expand its data 
collection on the incidence and prevalence of rheumatic 
diseases in special populations and to develop strategies to 
limit the impact of arthritis on these populations. The 
Committee urges CDC to continue support of this important 
activity.
    The Committee was alarmed by recent reports that the number 
of youth using tobacco is on the rise. The Committee continues 
to be concerned with the targeting of youth by tobacco 
advertising and promotion campaigns and notes the increase in 
youth smoking of brands promoted through cartoon characters. 
Counteradvertising has proven an effective means of combating 
tobacco use by children and adolescents. The Committee expects 
CDC to utilize a portion of the funds to support 
counteradvertising aimed at reducing smoking and other tobacco 
use by children and youth.
    The Committee continues to strongly support the CDC 
disabilities prevention program, which provides support to 
States and academic centers to reduce the incidence and 
severity of disabilities, especially developmental and 
secondary disabilities.
    The Committee is pleased that CDC continues to make 
progress in establishing a prostate cancer awareness and 
outreach program targeted to high-risk populations. Both the 
incidence of, and death rate from, prostate cancer continues to 
rise, with a disproportionate impact on African-American men. 
Early detection and an understanding of the treatment options 
for prostate cancer are important. The Committee encourages the 
CDC to continue its outreach efforts into high-risk 
populations, working with public and private nonprofit 
organizations with experience in cancer outreach and education.
    The Committee continues to be concerned about the 
disproportionately high prevalence of cancer generally among 
disadvantaged and minority populations and encourages continued 
cancer control emphasis in these areas. The Committee has 
provided additional funds to continue the development of the 
Cancer Registries Program and commends the CDC for initiating 
programs for the prevention and early detection of skin cancer.
    The Committee remains supportive of the epilepsy program 
and encourages the CDC to continue funding these important 
activities.
    Cardiovascular disease, including heart attack and stroke, 
continues to be America's No. 1 killer of men and women. Yet, 
many of the deaths each year from cardiovascular diseases are 
preventable. Most States have not yet implemented broad-based 
and integrated cardiovascular disease prevention efforts. The 
Committee understands the CDC has plans to begin a State-based 
cardiovascular disease prevention and control program focusing 
on physical inactivity and poor nutrition with an emphasis on 
underserved populations, and is supportive of their 
implementation.

Lead poisoning

    The Committee's recommendation includes $36,409,000 for 
lead poisoning prevention activities, $18,000 more than the 
President's request and the same as the House allowance and the 
1995 appropriation.
    Since its inception in fiscal year 1990, the CDC program 
has expanded to about 31 project areas that encompass States, 
local areas, and numerous communities.
    The Committee continues to place high priority on efforts 
to combat childhood lead poisoning the No. 1 preventable cause 
of childhood disability. Over the past years, the Committee has 
provided significant increases to allow for an expansion of the 
CDC Childhood Lead Poisoning Prevention Program.
    The Committee encourages support for the continued 
development of more effective and portable hand screening 
tools, and commends CDC for supporting the development of 
screening kits for professionals to use in the field that will 
allow an almost immediate reading, which makes possible 
immediate intervention and treatment.

Breast and cervical cancer mortality prevention

    The Committee's recommendation includes $125,000,000 for 
breast and cervical cancer mortality prevention activities, the 
same as the House allowance, but $25,000,000 more than the 1995 
appropriation. The President's budget had recommended 
consolidation of this program into a chronic disease 
partnership grant. Since no action has been taken by the 
authorizing committee, funds have been provided under current 
law.
    The Committee views the Breast and Cervical Cancer 
Mortality Prevention Program as one of its highest priorities. 
This year, for the first time, a reduction of approximately 5 
percent in deaths from breast cancer was reported. Appropriate 
mammograms do prevent breast cancer. However, many of the women 
who develop these cancers and who are at highest risk for 
premature death from cancers of the breast and cervix are 
minorities and/or the economically disadvantaged. These women 
often do not have access to preventive services such as 
screening mammograms and pap smears.
    In fiscal year 1995, 35 States and 9 American Indian tribal 
organizations will receive resources for comprehensive programs 
and 18 States, territories, and the District of Columbia will 
receive capacity building grants. When fully implemented, this 
program will ensure that all women have access to these 
preventive services, and that State programs: Inform women of 
the value of early detection; educate physicians about 
recommended screening guidelines; ensure the quality of 
screening mammography and pap tests; and monitor program 
effectiveness through appropriate surveillance and evaluation 
activities. Priority for breast cancer screening should be 
given to postmenopausal, low-income, underinsured and uninsured 
women, and those women at high risk of breast cancer, such as 
minority women and women with a familial history of breast 
cancer.
    The Committee directs the CDC to work with a national 
social work organization which supports social and behavioral 
applied services based research for women at risk for breast 
and cervical cancer to provide professional education 
opportunities for social workers related to cancer prevention.

Injury control

    The recommendation by the Committee includes $43,679,000 
for injury control efforts. This is $982,000 less then the 
President's request and the same as the House allowance and the 
fiscal year 1995 appropriation. The Committee, has provided an 
additional $4,100,000 from the violent crime reduction trust 
fund for activities of the Center authorized by the Violence 
Against Women Act. This brings the total amount recommended for 
the Center in fiscal year 1995 to $47,779,000.
    The Center 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: fires and burns; poisoning; drowning; violence; lack 
of bicycle helmets, seatbelts, and baby seats; and other 
injuries. The national injury control program encompasses 
nonoccupational injury and applied research in acute care and 
rehabilitation of the injured. Funds are utilized both for 
intramural and extramural research as well as for assisting 
State and local health agencies in implementing injury 
prevention programs. The Committee recognizes the important 
role that CDC provides as a focal point for all Federal injury 
control activities.
    The Committee supports the extramural program of the Center 
which supports research aimed at preventing and/or mitigating 
the effects of injuries. The program supports eight existing 
and two recently approved regional injury control research 
centers, individual investigator-initiated research projects, 
and the training of new workers in the injury control field. 
The Committee has provided sufficient funds to support the 
existing injury control centers at not less than the 1995 
amount and the new centers at not less then their startup 
levels.
    The Committee remains supportive of acute care training 
demonstrations at existing university-based injury control 
research centers and encourages CDC to make acute care training 
demonstrations a priority. In addition, the Committee is 
pleased with the ICRC's work, especially in regards to acute 
trauma care.
    The recommendation includes sufficient funding to continue 
the initiative on playground injuries being undertaken by the 
University of Northern Iowa.
    The recommendation includes $4,100,000 for domestic 
violence activities authorized by the Violence Against Women 
Act in the crime bill. This is the fully authorized level for 
fiscal year 1996. Within the amount provided, $4,000,000 is to 
support community programs on domestic violence and $100,000 
will be used by the CDC to conduct a study relating to the 
incidence, injuries, and costs resulting from domestic 
violence. These funds will be used to supplement the ongoing 
activities of the Center relating to domestic violence.

Occupational safety and health

    The Committee's recommendation includes $137,084,000 for 
the National Institute for Occupational Safety and Health 
[NIOSH], the same as the President's request, $37,862,000 more 
than the House allowance, and $4,964,000 more than the 1995 
appropriation.
    The National Institute for Occupational Safety and Health 
[NIOSH] in CDC is charged with conducting a national program of 
occupational safety and health research and information 
dissemination to ensure safe and healthful working conditions 
for the 124 million American working men and women.
    Occupational injuries occur at twice the rate of injuries 
in the home or in public places. Severe occupational trauma is 
second only to motor vehicle incidents as a cause of 
unintentional death in the United States. The majority of all 
of these deaths and injuries are preventable.
    To prevent work-related hazards, NIOSH conducts applied 
research with a corps of occupational safety and health 
professionals operating in multidisciplinary teams comprised of 
engineers, epidemiologists, industrial hygienists, physicians, 
and toxicologists. Intramural efforts are complemented by 
grants, contracts, and cooperative agreements to form a 
comprehensive and integrated program consisting of four 
components: Identification of hazards, research on causes and 
prevention of occupational injuries and illnesses, 
dissemination of research findings and recommendations, and 
training of those involved in preventing disease and injury at 
work.
    The Committee recommendation includes $124,186,000 for 
NIOSH research activities. This is the same as the President's 
request, $24,964,000 more than the House allowance, and 
$4,964,000 above the 1995 appropriation. Funds above the 1995 
level have been provided for NIOSH to fully support intramural 
research on work-related diseases at the laboratory in 
Morgantown and sufficient FTE's are available within the 
Department to fully staff their research program. Outmoded 
facilities had left NIOSH incapable of supporting state-of-the-
art laboratory research in major areas of occupational safety 
and health. Since 1991, approximately $75,000,000 has been 
invested in building, equipping, and preparing programs for the 
new laboratory to bring NIOSH into the 21st century. The new 
laboratory is scheduled to be ready to be occupied early in 
1996.
    The Committee has included funding to continue the farm 
health and safety initiative at the fiscal year 1995 level. 
This important initiative, begun in fiscal year 1990, has a 
primary focus of reducing the incidence of fatal and nonfatal 
injuries and occupational diseases among the 3,500,000 
agricultural workers in the United States. The Committee is 
particularly pleased with the research being undertaken by the 
agricultural research centers and expects that this program 
will continue at no less than the level of funding provided in 
fiscal year 1995.
    After more than 20 years of increasing rates of injuries in 
the building and construction trades industry, the Committee 
was very pleased to note from BLS statistics that the rate of 
injuries decreased by 28 percent in 1993. The Committee is 
impressed with the progress that has been made on construction 
safety and health during the last 5 years, and has included 
funds to continue the CDC initiative in this area at current 
levels.
    The Committee is supportive of the activities of the 
National Environmental Education and Training Center, [NEETC] 
Inc. The center is a not-for-profit partnership of academia, 
employers, labor, and government whose purpose is to train, 
educate, and conduct research on the occupational and 
environmental health and safety of worker and community 
exposure to hazardous and toxic wastes. The Committee 
recommends continued funding for NEETC's program 
implementation.
    The Committee recommends $12,898,000 for training grants in 
fiscal year 1996. This is $12,898,000 above the House allowance 
and the same as both the President's request and the 1995 
level.
    The Committee commends the work of the 14 university-based 
educational resource centers which are supported by NIOSH. 
These centers are multidisciplinary university-based 
occupational health training and research centers. NIOSH also 
supports smaller, single-discipline training project grants for 
the purposes of undergraduate and graduate training in various 
occupational health specialties. In the last 5 years, these 
institutions have graduated some 2,700 safety and health 
professionals and more had than 150,000 attendees in their 
continuing education courses. Still, there is an ongoing 
shortage of qualified occupational health and safety 
professionals. The Committee, therefore, has provided 
sufficient funds for continuation of training grants in fiscal 
year 1996.
    The Committee is concerned about occupational or workplace 
stress and notes that worker compensation claims for job stress 
have doubled in the last decade. The Committee urges CDC to 
give consideration to devote additional resources to the CDC 
Workplace Stress Program, including the program component that 
provides postdoctoral training in occupational health 
psychology.
    The Committee is pleased with the partnership between NIOSH 
and the State of Alaska to reduce workplace injury and 
fatality, especially in the fishing and timber industries. The 
work has served as a model for assessing the effectiveness of 
prevention strategies in workplace injury, and has offered 
resources where there were none in the past. The partnership is 
one which should be maintained in Alaska for a period 
sufficient to give the State of Alaska the capacity to continue 
the work on its own.

Epidemic services

    The Committee's recommendation includes $73,325,000 for 
epidemic services, $7,000 more than the President's request and 
the same as the House allowance and the 1995 appropriation.
    The objectives of the epidemic services activity are to: 
provide for the investigation, prevention, or control of 
epidemics, develop, operate, and maintain surveillance systems, 
analyze data, and respond to public health problems when 
indicated; train public health epidemiologist [EIS]; carry out 
quarantine regulations; reduce the importation of disease from 
developing countries; publish the morbidity and mortality 
weekly report; develop, coordinate, and provide efficacious, 
effective, and economic prevention strategies; and assist in 
the improvement of State infrastructure.

Health statistics

    Included in the recommendation of the Committee is 
$40,063,000 in Federal funds for health statistics. Also 
included is $40,063,000 to be provided from PHS 1 percent 
evaluation funds. This brings the total available to the CDC 
for health statistics to $80,126,000. This is $1,300,000 less 
than the President's request, $1,311,000 less than the House 
allowance, and the same as the fiscal year 1995 level.
    CDC's National Center for Health Statistics [NCHS] is the 
Nation's principal health statistics agency, whose mission is 
to provide statistical information that will guide actions and 
policies to improve the health of the American people.
    NCHS conducts a broad-based program of ongoing and special 
studies to meet the Nation's needs for high-quality health 
information, supported by programs to analyze, interpret, and 
disseminate data, and to advance statistical and survey 
methods. The recommendation provides for continued operation of 
major surveys and data systems.

Human immunodeficiency virus

    The Committee recommendation includes $589,962,000 for HIV/
AIDS activities, the same as the House allowance and the fiscal 
year 1995 appropriation. Since no action has been taken by the 
authorizing committee, funds have been provided under current 
law, instead of through an HIV/TB/STD performance partnership 
grant as proposed in the budget request.
    The Committee continues to support CDC's strategy to 
develop community planning to direct resources to where the 
most critical needs are. It is the Committee's belief that 
community planning will have a greater impact on the prevention 
and transmission of HIV/AIDS.
    The Committee is very supportive of the hemophilia 
consumer-based patient involvement programs that have been 
successful in HIV/AIDS risk reduction and in the prevention of 
the complications of hemophilia. The Committee has included 
funds to maintain and strengthen hemophilia and other 
hematologic program activities focused on preventing and 
reducing the crippling, debilitating complications, and death 
caused by such bleeding disorders. The Committee also requests 
that the CDC be prepared to report on steps taken to coordinate 
these efforts with the National Hemophilia Foundation during 
the fiscal year 1997 budget hearings.
    The Committee is aware that high rates of syphilis and 
other STD's in some regions of the country are dramatically 
exacerbating the spread of HIV/AIDS. The risk of HIV 
transmission is increased sixfold in men, and fourfold in women 
who are infected with syphilis. Public health experts have 
stated that sexually transmitted disease, such as syphilis, is 
one of the most easily modified risk factors for the spread of 
HIV within a community. Regions that have failed to control the 
spread of syphilis in recent years, are confronted today with a 
significant increase in HIV infection, particularly among women 
and their newborn infants. Accordingly, the Committee urges the 
HIV and STD programs to jointly support an initiative to reduce 
syphilis and other STD rates in the Southeastern region of the 
United States.

Building and facilities

    The Committee recommendation includes $4,575,000 for repair 
and renovation of CDC facilities, $1,000,000 over the 
President's request, $222,000 above the House allowance, and 
$1,000,000 more than the fiscal year 1995 appropriation.
    Funds are provided for the most needed repair and 
improvement projects as facilities age and programs change.

Program management

    For program management, the Committee recommends 
$3,067,000, the same as the President's request, the House 
allowance, and the fiscal year 1995 appropriation. The 
recommended level will support the direction and management of 
CDC through the Office of the CDC Director.
    The ``Program management'' account primarily supports the 
activities of the Office of the Director of the CDC. The vast 
majority of administrative costs are captured throughout the 
program accounts within the CDC. Accordingly, the Committee 
recommendation includes an undistributed administrative 
reduction of $31,000,000. This is consistent with the billwide 
policy of reducing Federal administrative accounts.
    The Committee has provided discretion to the Director to 
apply this reduction to all elements of each budget activity 
line item having components within the administration cost 
exhibit in the CDC congressional budget justification for 
fiscal year 1996. The Committee would expect that these 
reductions be applied to ensure fiscal efficiencies while 
continuing priority program efforts.
    The Committee concurs with concerns expressed by the House 
regarding reports over needed improvements in the management of 
both employee wage grade classification, the allocation of 
administrative and scientific staff, and the cost and staff 
attendance of CDC supported conferences. The Committee 
recognizes that there are legitimate purposes for CDC-sponsored 
scientific and programmatic conferences and that management 
issues, such as these, are best left to the Director to 
address. The Committee expects that the Director will take 
action to better manage conference and staffing costs and be 
prepared to report during the fiscal year 1997 budget hearings 
on steps taken on these matters.
    The recommendation includes bill language providing the 
Director with authority to transfer funds available from the 
sale of surplus vaccine from the vaccine stockpile to other 
activities within the jurisdiction of the Centers for Disease 
Control and Prevention. In the event the Director exercises 
this transfer authority, the Committee is to be notified 
immediately.
    The Committee continues to be pleased with CDC's program 
activity and commitment to improving the health status of 
minority and disadvantaged individuals, and urges continued 
expansion of these efforts.
    The Committee has directed the Office of Women's Health in 
the Office of the Secretary to develop and implement the 
national women's health clearinghouse and has directed that the 
Public Health Service agencies contribute a total of $1,400,000 
to this effort, each agency contributing their proportionate 
share as determined by the Office of the Secretary. Sufficient 
funding has been included to provide that support to the 
clearinghouse.

Violent crime reduction trust fund

    The Committee recommendation includes $39,100,000 from the 
violent crime reduction trust fund for activities authorized by 
the Violence Against Women Act in the crime bill. These 
programs are being funded for the first time in fiscal year 
1996 at the fully authorized level. Included is $35,000,000 to 
augment rape prevention services supported by the States 
through the preventive health services block grant, $4,000,000 
for grants to public and private nonprofit organizations to 
support community programs to prevent domestic violence, and 
$100,000 for a study on the incidence of domestic violence.

                     National Institutes of Health

    The Committee regards the Federal investment in biomedical 
research at the National Institutes of Health as one of its 
highest priorities. The United States has built an impressive 
biomedical research enterprise since the seeds of NIH were 
planted over 100 years ago. Today, the NIH has the world's 
largest research hospital, supports medical research in nearly 
1,700 institutions throughout the country, and has supported 
the work of more than one-half of the 100 scientists that have 
been awarded the Nobel Prize of Medicine and Physiology since 
World War II. The biomedical sciences stand at the threshold of 
tremendous opportunity for unlocking the mysteries, and 
developing treatments, for a host of diseases. The Committee 
has struggled to recommend funding for the NIH which reflects 
its strong commitment to NIH-supported research while also 
maintaining support for other essential primary and preventive 
health programs.
    The Committee concurs in the view of the House that 
improvements and greater efficiencies need to be made to the 
administrative structure and management of its research 
enterprise. In an era of declining discretionary resources it 
is essential that the NIH further streamline its administrative 
structure in order to maximize the use of limited Federal 
research funds. Particular consideration should be given to the 
consolidation of functions across Institutes, such as 
personnel, legislation, planning and evaluation, contracting 
and grant administration and public affairs.
    Consistent with a billwide policy, the Committee has 
reduced funds for administrative expenses at the NIH. A general 
provision has been included directing the NIH to reduce by 
$41,665,000.
    The Committee recommendation, therefore, totals 
$11,597,539,000 in fiscal year 1996 for the 24 Institutes, 
Centers, and Divisions that compromise the National Institutes 
of Health. This is $300,993,000 above the 1995 level, 
$166,527,000 below the administration's request and 
$341,462,000 below the House allowance.

                       NATIONAL CANCER INSTITUTE

Appropriations, 1995....................................  $2,136,408,000
Budget estimate, 1996...................................   2,219,797,000
House allowance.........................................   2,251,084,000

Committee recommendation

                                                           2,195,476,000

    The Committee recommends an appropriation of $2,195,476,000 
for the National Cancer Institute [NCI]. This is $24,321,000 
less than the administration's request, $59,068,000 more than 
the fiscal year 1995 appropriation, and $55,608,000 less than 
the House allowance. The comparable numbers for the 1995 
appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NCI conducts and supports basic and applied 
cancer research in prevention, early detection, diagnosis, 
treatment, and rehabilitation. NCI provides training support 
for research scientists, clinicians and educators, and 
maintains a national network of cancer centers, clinical 
cooperative groups, community clinical oncology programs, 
cancer prevention and control initiatives and outreach programs 
to rapidly translate basic research findings into clinical 
practice.
    Cancer program.--The Committee continues to support a 
balanced research program that includes basic, clinical, 
translational, prevention, control, and survivorship research. 
Within this balanced approach, the Committee recommends the 
maximum flexibility be given to the NCI in its support of 
research priorities identified by scientific opportunities and 
research needs. As we approach the 25th anniversary of the 
signing of the National Cancer Act, the Committee recognizes 
the high priority which must continue to be given to cancer 
research so as to address this growing epidemic.
    Breast cancer.--Breast cancer will strike 183,000 Americans 
this year. Recent encouraging statistics show a 5-percent 
decrease in deaths between 1989-92, however, which appears to 
result from adjuvant therapy, breast cancer awareness, and 
screening. The Committee recognizes that breast cancer 
continues to require a significant devotion of NCI resources in 
order to decipher the complex mysteries of this disease. The 
Committee concurs with the decision of the NCI to place breast 
cancer research as a high priority, as reflected in its 1996 
bypass budget, and urges the Institute to continue to 
strengthen its budgetary commitment to breast cancer research.
    Sufficient funds have been included to expand support for 
the implementation of the national action plan on breast 
cancer. Leadership for the implementation of this multiagency 
initiative has been carried out by the Office of Women's Health 
in coordination with the participating agencies.
    Cancer prevention.--Because as many as 70 percent of all 
cancers are related to such factors as diet or smoking, the 
Committee encourages the NCI to aggressively pursue cancer 
prevention and control research which focuses on affecting 
these lifestyle choices. The Committee commends the NCI for its 
support of the 5 A Day for Better Health Program which 
encourages the consumption of more fruits and vegetables, and 
of smoking prevention and cessation programs, such as ASSIST 
(American stop smoking intervention study).
    Clinical research.--Clinical research is the vital link in 
translating progress in basic research to lifesaving treatments 
and approaches to cancer prevention. Clinical research in 
cancer is critically important in advancing our capacity to 
identify new agents for cancer treatment, define complex 
treatment strategies, effectively pursue the tremendous 
opportunities that exist in molecular medicine, and address 
public health challenges posed by cancer. The Committee 
believes that the clinical trial initiatives, supported by the 
Division of Cancer Treatment, Diagnosis, and Centers, remains a 
key component of our national capacity to develop effective 
treatment strategies for cancer and looks forward to learning 
about the progress in this area at next year's hearings.
    Information dissemination/translation of research 
results.--The Committee remains strongly supportive of NCI's 
program of information dissemination which focuses on making 
information about cancer and cancer treatment easily available 
to the general public, to cancer patients, and to health care 
providers. Currently, research results and treatment advances 
are communicated through professional meetings and workshops, 
and through the cancer information service (1-800-4-CANCER), 
PDQ, CancerFAX, and the journal of the National Cancer 
Institute. The tremendous scientific and medical advances of 
the last 50 years would not have been possible without the 
NIH's leadership in fundamental, basic research. Progress in 
the fight against cancer starts with an understanding of how 
normal cells become cancerous. However, this research is only 
useful to the extent that we move it from the bench to the 
bedside. Translational research moves basic research into 
applications that can be used in the clinic. As the National 
Cancer Advisory Board reported in a 1994 report entitled 
``Cancer at a Crossroads: A Report to Congress for the 
Nation,'' ``* * * an unparalleled opportunity now exists to 
apply rapidly to clinical practice the knowledge gained from 
basic research.'' The report noted, however, barriers to 
translational research, including difficulty in competing for 
grant support; training requirements for the translational 
scientist; and reductions in clinical care resources, including 
that from industry and providers. The Committee urges the 
Institute to provide increased emphasis on the translation of 
basic biomedical research to the clinical level, which will 
help establish new treatments for cancer patients and new 
methods of prevention.
    National Cancer Institute intramural review.--The Committee 
is very pleased that the NCI Advisory Board ad hoc working 
group on the Intramural Research Program has conducted an in-
depth, thoughtful review of the Intramural Research Program of 
the NCI. As the largest intramural program within the largest 
Institute at NIH, it is critical that this research set an 
example for scientific quality, training of young scientists, 
intellectual excellence, and effective scientific planning. The 
Committee looks forward to a report from the new NCI Director 
at next year's hearing regarding the implementation of the ad 
hoc groups' recommendation and their impact on NCI's intramural 
efforts.
    Neurofibromatosis.--Research on neurofibromatosis [NF] 
already has produced major breakthroughs in the areas of 
genetics and the links between NF, various cancers, and other 
diseases. The Committee remains committed to an aggressive 
program of research on neurofibromatosis throughout the NIH and 
expects that funding levels are commensurate with this 
commitment. The Committee encourages the NCI and other relevant 
NIH institutes to develop, in consultation with the extramural 
community, a comprehensive plan for a coordinated research and 
therapy agenda on NF. Finally, the NCI is urged to give 
consideration to issuing a joint request for applications in 
cooperation with the other NIH institutes involved in NF 
research.
    Bionutrition.--The Committee recognizes the exceptional 
effort of the Institute over the past few years in supporting 
nutrition research. Diet ranks second only to smoking with 
regard to its association with cancer. The Committee encourages 
the NCI to continue its work in the field of nutrition, 
including support of the clinical nutrition research units, and 
to continue placing priority on research involved with women's 
health.
    Nursing.--The Committee urges the NCI to continue to work 
collaboratively with the National Institute of Nursing Research 
to address research issues involving nursing practice in the 
field of cancer, particularly prevention and symptom 
management.
    Cancer in minorities.--The Committee continues to be 
concerned about the disproportionately high prevalence of 
cancer among disadvantaged and minority populations. Despite an 
overall drop in breast cancer rates, breast cancer rates for 
minority groups increased last year. Also, African-American 
males experience the highest rate of prostate cancer of any 
population group. The Committee encourages continued research 
emphasis in these and other high-priority areas.
    Cancer coordination.--The 1994 report of the National 
Cancer Advisory Board entitled ``Cancer at a Crossroads'' 
outlined that the national cancer program suffered from an 
absence of a national coordination of cancer fighting efforts 
in the public, private, and voluntary sectors. The Committee 
concurs with this view and recommends that the NCI take the 
lead and work in coordination with the CDC and other Federal 
agencies to reestablish coordination of the national cancer 
program. The Committee expects that other agencies will work 
with the NCI to facilitate this recommendation. Before hearings 
on the fiscal year 1997 budget, the Committee would like a 
brief report outlining the progress made to accomplish this 
recommendation.
    Ataxia telangiectasia [A-T].--The Committee is extremely 
pleased to learn that scientists have isolated the gene and 
identified mutations which cause this rare hereditary childhood 
disorder. The Committee expresses high praise for the 
cooperative effort of the NCHGR, NCI, NINDS, and private 
entities in this important scientific breakthrough. The 
Committee believes it is extremely important to continue to 
pursue research which will benefit current and future A-T 
patients. Furthermore, the Committee strongly encourages 
continued research to determine the cancer risk of A-T 
carriers.
    Prostate cancer.--The Committee is pleased by the increased 
funding which has been devoted to many areas of prostate cancer 
research. However, the incidence of prostate cancer continues 
to rise, and the Committee urges that further effort be placed 
on research related to early detection, diagnosis, and 
treatment. The Committee directs NCI to collaborate with the 
Interagency Coordinating Committee for Urological Diseases' 
initiative to develop a long-range plan for focusing research 
on prostate disease among minority Americans.
    Brain tumor research.--Brain tumors are a much more common 
cancer than is generally realized. Malignant primary tumors in 
adults occur at the rate of about 15,000 per year and usually 
are lethal within 12 months. The Committee is concerned about 
the pace of progress in determining the cause for the change of 
normal cells to malignant cells and in improving diagnosis and 
treatment of brain tumors. The Committee believes that 
utilization of the centers mechanism could accelerate the pace 
of progress and encourages the NCI, in cooperation with the 
NINDS, to support up to five centers of excellence in brain 
tumor research. These centers could better target limited 
resources to support basic, translational, and clinical 
research to determine the cause, mechanisms of development, and 
better methods of treatment and prevention of primary and 
secondary brain tumors.
    DES.--The Committee continues to strongly support increased 
efforts to study and educate the public about the impact of 
exposure to the synthetic hormone diethylstilbestrol [DES]. NCI 
and other Institutes, along with the Office of Women's Health 
have developed a plan for expanded activities in this area. The 
Committee is pleased with the Institute's efforts in this area 
and expects NCI to continue its strong support for carrying out 
the recommendations of this plan.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 1995....................................  $1,297,032,000
Budget estimate, 1996...................................   1,337,021,000
House allowance.........................................   1,335,866,000

Committee recommendation

                                                           1,323,602,000

    The Committee recommends an appropriation of $1,323,602,000 
for the National Heart, Lung, and Blood Institute [NHLBI]. This 
is $13,419,000 less than the administration's request, 
$26,570,000 more than the fiscal year 1995 appropriation, and 
$32,264,000 less than the House allowance.
    Mission.--The National Heart, Lung, and Blood Institute 
provides leadership for a national research program in diseases 
of the heart, blood vessels, lungs, and blood, in transfusion 
medicine, and in sleep disorders through support of innovative 
basic, clinical, population-based, and health education 
research.
    Cardiovascular diseases.--Despite impressive progress over 
the past several decades, coronary heart disease [CHD] remains 
the leading cause of death in both men and women in the United 
States. About 1 in 4 Americans suffers from cardiovascular 
disease which costs this country an estimated $138,000,000,000 
in medical expenses and lost productivity annually. The 
Committee believes that additional cardiovascular research is 
critical and intends that within the funds provided, research 
in this area be given the highest priority.
    Heart disease in women and minorities.--Heart attack, 
stroke, and other cardiovascular diseases remain the No. 1 
killer of American women. Yet, reports indicate that women 
often receive less aggressive care than men. This problem 
appears to be related to difficulties in diagnosing chest pain 
in women. The Committee encourages the Institute to expedite 
planned research to develop reliable, safe, efficient, and 
cost-effective diagnostic approaches for evaluating women with 
suspected ischemic heart disease in order to decrease heart 
disease and death in women.
    African-Americans have disproportionately higher death 
rates from heart disease than whites. Although death rates for 
heart disease have dropped significantly over the past 20 
years, the drop has been much greater for whites than for 
African-Americans. The Committee urges the Institute to expand 
research to advance understanding of heart disease in African-
Americans, using molecular biology, cellular, and organ 
physiology, and clinical medicine.
    The Committee further recommends that the NHLBI continue 
the Honolulu heart study.
    Pediatric cardiovascular disease.--Sufficient funding is 
provided to continue support for the three specialized centers 
of research in pediatric cardiovascular diseases.
    High blood pressure.--About 50 million Americans age 6 and 
older suffer from high blood pressure. High blood pressure is 
the most critical stroke risk factor and a leading cause of 
heart attack, congestive heart failure, and kidney failure. The 
Committee is supportive of the Institute's planned research to 
identify and map genes responsible for high blood pressure and 
clarify the role of defective genes in the development and 
maintenance of high blood pressure.
    Asthma management.--The Committee commends the Institute on 
its multifaceted basic and applied asthma research programs and 
for its efforts in asthma education. Asthma prevalence, 
mortality, and hospitalization rates have increased in recent 
years, and minority populations are disproportionately 
affected. Although the reasons for the racial disparity are not 
fully known, access to health care services undoubtedly plays a 
role. The school setting, therefore, offers an opportunity to 
assist children who are not reached through the health care 
system. The Committee supports development and evaluation of 
innovative model school programs to increase identification and 
appropriate referral of children with uncontrolled asthma, 
reduce exposure to known allergens and irritants, increase 
participation of students with asthma in all school activities, 
improve support to students for following their asthma 
management plans, and enhance communication between school and 
home.
    Sarcoidosis.--Sarcoidosis is an inflammatory disease that 
can lead to fibrosis, or scarring, of the lung. It occurs in 
about 40,000 of 100,000 African-Americans compared with about 5 
in 100,000 whites, and African-American women are especially 
vulnerable. Although the disease has been recognized for over 
100 years, information on its incidence, prevalence, risk 
factors, and natural history remains limited. Geographic and 
racial variations in the occurrence of sarcoidosis suggest that 
it may be caused by environmental factors of a combination of 
environmental factors and a susceptible host. The Committee, 
therefore, encourages the Institute to explore environmental 
and genetic causes of sarcoidosis as an essential step toward 
identifying risk factors and improving treatment and prevention 
of the disease.
    Sickle cell disease.--The Committee understands a recent 
clinical trial found that the drug hydroxyurea significantly 
reduced the frequency of painful crises and associated 
hospitalizations in adult sickle cell disease patients. New 
studies will determine whether hydroxyurea can safely and 
effectively be used in children with sickle cell disease.
    Fanconi anemia.--The identification and cloning of a gene 
responsible for Fanconi anemia represents a major advance that 
may improve understanding of the underlying biochemical defect 
and constitute an important first step in developing gene 
replacement therapy. The Committee supports the NHLBI in 
encouraging basic research on the genetic, molecular, and 
cellular pathophysiology of this disease, as well as clinical 
research aimed at prevention and treatment of its hematological 
consequences.
    National Center on Sleep Disorders Research.--The Committee 
notes the continued development of the National Center on Sleep 
Disorders Research and the expansion of the Center's research 
portfolio and commends the Institute for its work in fiscal 
year 1995. The Committee strongly supports the development and 
implementation of a vigorous national sleep disorders public 
education campaign. The Committee requests that the Institute 
work in cooperation with the National Highway Traffic Safety 
Administration on the development and implementation of such a 
public awareness campaign. The Committee recommends continued 
development of a plan for scientific collaboration among the 
National Center, and other NIH Institutes. The Committee also 
notes the initiation of a sleep academic award program and 
encourages support for this effort.
    Bionutrition.--The Committee urges the National Heart, 
Lung, and Blood Institute to continue its bionutrition research 
initiative. The Committee also encourages the Institute to 
include nutrition research in its critical care medicine 
initiative.
    Hemophilia.--The Committee supports expansion of NHLBI's 
very promising hemophilia gene therapy program. Further, the 
Committee remains deeply concerned about taking every necessary 
step to ensure the safety of the Nation's blood supply and is 
concerned over the recent withdrawal of blood products 
contaminated with Creutzdfeldt-Jakob disease [CJD]. Therefore, 
the Committee requests NHLBI to work in collaboration with CDC 
and FDA to investigate the potential impact of CJD on the 
safety of the U.S. blood supply and specifically on people with 
bleeding disorders and transfusion recipients. The Committee 
requests that the Director be prepared to report to the 
Committee during the fiscal year 1997 budget hearings on steps 
taken to address this issue.
    Cooley's anemia.--The Committee continues to strongly 
support the work of the Institute in the area of Cooley's 
anemia research. The Committee is encouraged by the initiatives 
in gene therapy, stem cell biology, transplantation, and fetal 
hemoglobin switching and commends the Institute for its 
development of a plan for a clinical network for treatment of 
patients and encourages the Institute to move forward in this 
area.
    Transfusion medicine.--By holding a consensus conferences 
on infectious disease testing for blood transfusion and by 
establishing specialized centers of research for transfusion 
medicine and for hematopoietic stem cells research, the NHLBI 
has demonstrated its commitment to assuring a safer and more 
efficacious blood supply and has recognized the potential of 
gene therapy to cure both genetic and acquired diseases. The 
Committee encourages NHLBI to provide investigator-initiated 
grants and other funding mechanisms to support initiatives 
relating to viral inactivation of cellular blood components, 
improved platelet collection and storage techniques, and 
transfusion associated immunomodulation. To facilitate research 
initiatives in the stem cell area, the Committee is pleased to 
see that the NHLBI plans to create a network of umbilical cord 
blood and stem cell collection centers. Recognizing that blood 
is increasingly in short supply and that an adequate eligible 
donor base is needed to avoid shortages, the Committee also 
encourages NHLBI to study strategies for increasing the 
Nation's blood supply.
    Nursing.--The Committee strongly urges the NHLBI to 
collaborate with the National Institute of Nursing Research 
[NINR] to address research issues involving nursing practice 
such as prevention and symptom management of cardiovascular 
diseases.

                 NATIONAL INSTITUTE OF DENTAL RESEARCH

Appropriations, 1995....................................    $175,213,000
Budget estimate, 1996...................................     180,650,000
House allowance.........................................     183,196,000

Committee recommendation

                                                             178,689,000

    The Committee recommends an appropriation of $178,689,000 
for the National Institute of Dental Research [NIDR]. This is 
$1,961,000 less than the administration's request, $3,476,000 
more than the fiscal year 1995 appropriation, and $4,507,000 
less than the House allowance. The comparable numbers for the 
1995 appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NIDR supports research and research training 
to improve the oral health of the American people. The 
Institute emphasizes ways to prevent disease in high-risk 
groups, including the elderly, minority populations, and people 
with medical conditions and medications that compromise oral 
health. The research agenda includes studies of craniofacial 
genes and birth defects; bone and joint diseases; AIDS, other 
infections, and immunity; oral cancer; chronic pain; 
epidemiology; biomaterials; and diagnostic systems.
    Saliva and HIV.--The Committee understands oral health 
scientists are making pivotal discoveries about the body's 
immune system, especially the system of secretory immunity 
involving the cells that form the mucosal linings of the mouth 
and other organs. The recent discovery of a protein in saliva 
that prevents cells from being infected with the AIDS virus may 
explain why AIDS is rarely transmitted by mouth. Researchers 
are now studying how the protein works in order to develop it 
for clinical use.
    Research on pain.--The Committee commends the Institute for 
its leadership in the field of pain research. NIDR scientists 
are investigating a number of commonplace drugs--including a 
widely used cough suppressant--for the drugs ability to block a 
nervous system molecule involved in some of the most 
intractable pains known to mankind. Combinations of drugs, 
working by different means, may be the answer pain patients so 
badly need.
    Bone clinic.--The Committee is supportive of the 
establishment of a new bone clinic in the NIH Clinical Center, 
with the aim of moving basic research into the clinical arena.
    Industry.--The Committee is aware of the Institute's work 
in building relationships with industry in order to expand the 
investment in dental science. In this public/private sector 
partnership NIDR has produced extensive knowledge of basic 
science and developing technologies which the private sector 
has built upon to produce new products, new industries, new 
jobs, and improved oral health. Due to the Institute's 
commitment to working with industry, the United States has 
remained No. 1 in the field of dental science and technology 
and its dental industries have developed strong national and 
international markets.
    Women's health.--In addition, the Committee is particularly 
impressed with the current research efforts of the Institute in 
the field of women's oral health, and the oral disorders of 
postmenopausal women. The NIH and the NIDR are encouraged to 
continue work in this area, as well as to continue its research 
efforts in dental caries, periodontal diseases, diseases and 
disorders of special populations, material science, and pain.
    Temporomandibular joint disorders [TMJ].--The Committee 
remains strongly interested in research on temporomandibular 
joint disorders. The Institute convened an international 
workshop to develop a research agenda for TMJ. The Committee 
urges the Institute to continue to aggressively pursue this 
agenda in collaboration with the NIAMS, NIAID, and other 
appropriate Institutes. The Committee is particularly concerned 
about the need for greater consensus regarding the number of 
people impacted by TMJ and on the most appropriate treatment 
modalities for TMJ.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 1995....................................    $737,026,000
Budget estimate, 1996...................................     760,533,000
House allowance.........................................     771,252,000

Committee recommendation

                                                             752,393,000

    The Committee recommends an appropriation of $752,393,000 
for the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK]. This is $8,140,000 less than the 
administration's request, $15,367,000 more than the fiscal year 
1995 appropriation, and $18,859,000 less than the House 
allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--The NIDDK provides leadership for a national 
program in three major disease categories: diabetes, 
endocrinology, and metabolic diseases; digestive diseases and 
nutrition; and kidney, urologic, and hematologic diseases. The 
NIDDK plans, conducts, fosters, and supports a coordinated 
program of fundamental and clinical research and demonstration 
projects relating to the causes, prevention, diagnosis, and 
treatment of diseases within these categories. The Institute 
also supports efforts to transfer the knowledge gained from its 
research program to health professionals, patients, and the 
general public.
    Breast cancer.--The Committee is pleased to learn that the 
NIDDK has begun a major initiative to determine the endocrine 
basis of breast disease. These studies, which will increase 
understanding of how the actions of hormones and growth factors 
regulate gene expression and cellular processes in breast 
tissue, should lead to potential endocrine-based approaches to 
prevent or reverse tumor development and metastasis.
    Diabetes.--Diabetes remains the fourth leading cause of 
death by disease in America, taking the lives of more than 
162,000 persons annually, at a cost of over $100,000,000,000 a 
year. Diabetes disproportionately affects minority populations, 
especially African-Americans, Hispanics, and native Americans, 
who are at greater risk for developing this disease and its 
complications.
    Unique research possibilities were presented earlier this 
year by the National Diabetes Research Coalition [NDRC], who 
released an document entitled ``Diabetes Research: A National 
Opportunity.'' This document presents a bold new investment 
strategy in diabetes research which substantiates that we are 
on the threshold of research breakthroughs and new treatments 
for diabetes and its complications.
    The Committee views the problem of diabetes as an 
especially high priority and urges NIDDK to redouble its 
efforts in this time of extraordinary research possibilities. 
In particular, the Committee urges consideration of expanding 
support for genetic research, prevention of diabetes, islet 
cell transplantation, and investigations to prevent 
complications of diabetes.
    The Committee continues to be concerned about the extremely 
high incidence of diabetes among native Americans, native 
Hawaiians, and Pacific islanders, particularly residents of the 
Commonwealth of the Northern Marianas Islands where as many as 
50 percent are afflicted with diabetes. The Committee urges the 
Director to develop specific interventions targeted to high-
risk populations such as these.
    Cooley's anemia.--The Committee is aware that NIDDK has 
long supported research in the area of Cooley's anemia and 
continues to strongly support its efforts in this area. The 
Committee notes the promising research in the areas of fetal 
hemoglobin switching, gene therapy, and oral iron chelation.
    Liver disease.--The Committee received testimony on the 
impact of hepatitis and other liver and gallbladder diseases, 
which affect 25 million Americans. Over 5 million people suffer 
from hepatitis B and C, and many will suffer long-term liver 
diseases, cirrhosis or liver cancer. Liver transplants are 
effective therapy, but they are expensive ($280,000 per 
patient) and the need far outstrips the supply of donors.
    The Committee believes that greater emphasis needs to be 
placed on liver disease research and encourages the NIDDK to 
convene a conference of leading scientists to develop a 
national research agenda with specific recommendations for the 
Committee to consider next year. In the meantime, the Committee 
expects that current levels of liver disease research will be 
maintained. The Committee understands that the incidence of 
hepatitis C is more widespread than previously believed and 
urges that it be made a research priority.
    Bionutrition.--The Committee urges the National Institute 
of Diabetes and Digestive and Kidney Diseases to continue its 
bionutrition initiative and particularly its focus on obesity 
and on clinical research in nutrition. Obesity research has had 
significant impact recently as a gene associated with obesity 
has been identified and clinical research has established the 
relationship between weight gain and loss and metabolic 
adjustment. The Committee is supportive of the clinical 
nutrition research unit and obesity and nutrition research 
centers programs and urges that they be maintained.
    Urological diseases.--The Committee is pleased with the 
continued growth of research on urological diseases. Diseases 
of the prostate are a significant health burden. Funds have 
been provided to increase new research grants in the basic 
science of prostate growth, utilizing the tissue resources 
available from the ongoing clinical trial. The Committee 
continues to acknowledge the importance of establishing a 
prostate disease data base. Insufficient attention is being 
directed to women's urological health. The Committee urges that 
the Institute, working with the Office of Research on Women's 
Health, to expand its research program on women's urological 
diseases by placing special emphasis on grants related to 
interstitial cystitis, urinary incontinence and urinary tract 
infections. The Committee is concerned about the high 
prevalence of prostate disease in minority populations. The 
Committee directs the Interagency Coordinating Committee for 
Urological Diseases to develop a joint plan to expand research 
in this area and include this plan in its annual report.
    Interstitial cystitis.--The Committee strongly supports 
research into interstitial cystitis [IC], a painful and 
debilitating bladder disease mostly affecting women. It is 
pleased that in fiscal year 1995 the NIDDK solicited new 
research on interstitial cystitis. The Committee supports the 
continuation of this research initiative, as well as the 
national IC data base. The Committee also requests that the NIH 
continue to address and resolve the problem of the lack of 
urological expertise on the NIH study sections which review 
urology grants including IC.
    Digestive disease.--Disease of the digestive system 
continues to affect more than one-half of all Americans at some 
time in their lives. Serious disorders such as colon cancer, 
inflammatory bowel disease, cirrhosis of the liver, irritable 
bowel syndrome, and celiac disease contribute to a significant 
toll in human suffering, chronic illness, and mortality. The 
Committee is encouraged about the scientific treatment progress 
made to treat peptic ulcers through the use of antimicrobial 
agents and antisecretory agents to combat the helicobacter 
pylori bacterium. Further progress is being made to enlist 
liver directed gene therapy to treat liver metabolic disease, 
and identify the genes responsible for Wilson's disease and 
hemochromatosis. The Committee encourages the NIDDK to continue 
its efforts to develop the appropriate balance between 
conducting basic studies on digestive disease and bringing this 
critical knowledge gained, to the bedside to improve patient 
care.
    Inflammatory bowel disease.--The Committee recommends that 
the Institute consider targeting three areas for inflammatory 
bowel disease [IBD] research: (1) the continuation of the RFA 
mechanism to supplement existing programs in IBD and to 
stimulate new research, particularly on the establishment of 
animal models and on the investigation of the 
immuneopathogenesis of Crohn's disease; (2) mapping the genes 
of IBD-affected human families and relevant mouse strains, 
which have genetic structures comparable to humans, in order to 
eventually identify all the genes involved in IBD; and (3) 
developing new investigators in order to be poised to take 
advantage of the progress that basic scientists are making in 
the laboratory by testing the hypotheses of the latter in a 
clinical setting.
    Polycystic kidney disease.--The Committee encourages NIDDK 
to expand its research agenda to understand the mechanism 
underlying polycystic kidney disease progression and to develop 
new treatments to prevent progression of polycystic kidney 
disease to end-stage renal disease. The Committee recognizes 
that new scientific opportunities may be available because of 
important research breakthroughs in the past year of cloning 
and sequencing the gene responsible for 90 percent of 
polycystic kidney disease.
    For a decade the Colorado polycystic kidney disease project 
has compiled the world's largest, most exact and only 
longitudinal collection of data on well-studied adults and 
children with polycystic kidney disease. The Committee urges 
continuing support for this invaluable resource that will 
facilitate new insights based on gene studies leading to 
improved diagnosis and treatment of patients with polycystic 
kidney disease.
    Irritable bowel syndrome.--Irritable bowel syndrome [IBS] 
is a chronic complex of disorders that malign the digestive 
system, affecting 35 million people annually. These common 
dysfunctions strike people from all walks of life and result in 
a significant toll of human suffering and disability. The 
Committee is concerned about the increasing frequency of IBS 
and the adverse impact these disorders have on the quality of 
life and health care expenditures of those afflicted. The 
Committee recommends that NIDDK provide adequate funding for 
irritable bowel syndrome/functional bowel disorders research 
and be prepared to report on the feasibility of developing 
comprehensive IBS education initiatives during the fiscal year 
1997 budget hearings.
    Prostatitis.--The Committee has received information 
concerning the problem of prostatitis, which leaves men in 
their twenties and thirties with a lifelong disability. The 
Committee understands that little research is being supported 
on understanding and treating prostatitis and encourages the 
NIDDK to take steps to develop a plan to stimulate and support 
research on this problem. The Committee expects the Director 
will be prepared to report on the Institutes plans for 
prostatitis during the regular budget hearings for fiscal year 
1997.
    Cystic fibrosis.--The Committee notes the tremendous 
advances in cystic fibrosis [CF] research, which has extended 
the life expectancy of cystic fibrosis patients from 5 years of 
age 30 years ago to over 30 years of age for children diagnosed 
today. This success has been a direct result of the public/
foundation support for CF centers and research grants. Among 
the most promising research on cystic fibrosis is that of gene 
therapy, which is occurring at nine research centers, supported 
in part by the NIH. To date, more than 70 patients have been 
treated with this pioneering therapy. To continue this 
important progress, the Committee strongly supports the NIDDK 
and NHLBI's plans to implement the 1995 request for 
applications program for cystic fibrosis research. This is yet 
another example of the success of the public/private 
partnership in seeking a cure for cystic fibrosis.
    Hemolytic uremic syndrome [HUS].--This syndrome is caused 
by a bacterium that may be present in undercooked meat products 
which can result in sudden and sever digestive and kidney 
complications. The Committee encourages NIDDK to support 
research on HUS in order to develop effective treatments for 
the disorder.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 1995....................................    $652,204,000
Budget estimate, 1996...................................     672,062,000
House allowance.........................................     681,534,000

Committee recommendation

                                                             664,830,000

    The Committee recommends an appropriation of $664,830,000 
for the National Institute of Neurological Disorders and Stroke 
[NINDS]. This is $7,232,000 less than the administration's 
request, $12,626,000 more than the fiscal year 1995 
appropriation, and $16,704,000 less than the House allowance. 
The comparable numbers for the 1995 appropriation, the budget 
estimate, and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The House 
allowance did not include an appropriation for the Office of 
AIDS Research.
    Mission.--The NINDS conducts and supports a broad range of 
research and research training on the normal function of the 
brain, spinal cord, and peripheral nerves, and on neurological 
and neuromuscular disorders. Neurological research includes 
epidemiology studies to identify risk factors for disease; 
laboratory studies to examine the structure and function of 
nerve cells; and brain imaging studies to understand how the 
brain is affected by disease and how it operates to carry out 
tasks such as learning and memory. New approaches for the 
diagnosis, treatment, and prevention of brain disorders are 
evaluated in studies with patients and people at risk for brain 
disorders.
    Brain and brain disorders.--Until very recently, little 
could be done to intervene and prevent or delay the onset of 
many brain disorders, or to treat patients so that they could 
hope for a full recovery. Consequently, brain disorders 
typically have resulted in high health care costs, disability, 
and death. However, increasing evidence points to the 
possibility of a new era in which prevention and effective 
treatment of brain disorders will become the rule, rather than 
the exception. The Committee encourages the NIH to expand its 
research on the prevention and treatment of neurological 
disorders, including Alzheimer's disease. The Committee urges 
the NIH to further explore the possibility that 
antiinflammatory drugs and estrogen may offer means of slowing 
the progression of Alzheimer's disease.
    Parkinson's disease.--Approximately 500,000 Americans, or 
about 1 percent of the population over 50, have Parkinson's 
disease [PD]. There is considerable need for breakthroughs in 
prevention and treatment of Parkinson's disease, given the 
substantial, and growing, health care and disability-related 
costs associated. The Committee is pleased by reports from the 
August 1995 Parkinson's research planning conference that 
indicate strong potential to produce therapeutic and preventive 
breakthroughs in the near term with effective use of our 
research investment. The Committee urges the Director to take 
steps to expand support for research initiatives in the areas 
of promise identified at the planning conference, including 
considering issuance of request for applications to focus 
research in these areas.
    Neurofibromatosis.--Research on neurofibromatosis [NF] 
already has produced major breakthroughs in the areas of 
genetics and the links between NF, various cancers, and other 
diseases. The Committee remains committed to an aggressive 
program of research on neurofibromatosis [NF] throughout the 
NIH and expects that funding levels are commensurate with this 
commitment. The Committee encourages the NINDS and other 
relevant NIH institutes to develop, in consultation with the 
extramural community, a comprehensive NINDS plan for a 
coordinated research and therapy agenda on NF. The Committee 
recommends that the NIH provide opportunities for informed 
representatives of voluntary organizations involved in NF 
research and patient advocacy to participate in the NF research 
planning and coordination process. Finally, the NINDS is urged 
to give careful consideration to issuing a joint request for 
applications in cooperation with the other NIH institutes 
involved in NF research.
    Stroke.--Stroke remains America's third most common cause 
of death, the leading cause of serious disability, and a major 
contributor to late-life dementia. The Committee is concerned 
that recent estimates by the National Center for Health 
Statistics show that the number of deaths from stroke is on the 
rise. The Committee believes that additional stroke research is 
important and urges the Director to expand the stroke education 
program and to continue and initiate innovative approaches to 
the diagnosis, treatment, rehabilitation, and prevention of 
stroke, including collaboration with the NINR and the NIMH.
    Epilepsy.--Epilepsy is one of the most common neurological 
conditions afflicting approximately 3 million Americans and has 
become one of the critical public health problems of our time. 
Intractable epilepsy is an especially difficult problem, 
because it usually develops in childhood. Some hope has been 
given to patients with epilepsy through specialized surgery and 
through anticonvulsant medications, but for many with epilepsy 
these treatments have limited or no success at all. The 
Committee encourages the Director to maintain a vigorous 
research program on epilepsy, including the consideration of 
the establishment of an intractable epilepsy center.
    Lou Gehrig's disease.--Amyotrophic lateral sclerosis [ALS], 
commonly referred to as Lou Gehrig's disease, is a progressive, 
fatal neuromuscular disease for which no known cure or 
treatment currently exists. The first real finding of a cause 
of the disease recently occurred with the identification of a 
gene defect linked to some cases of familial ALS. The 
increasing number of recent clinical tests have provided some 
encouragement that a treatment may be found. But much more 
needs to be done to capitalize on these recent developments in 
order to successfully treat and cure this disease. These recent 
ALS research discoveries can lead to other important 
breakthroughs in the treatment of ALS and other neurological 
disorders. The Committee encourages NINDS to increase spending 
on brain research relevant to ALS.
    Batten disease.--The Committee continues to be concerned 
with the pace of research in Batten disease. The Committee 
believes that the Institute should actively solicit and 
encourage quality grant applications for Batten disease and 
that it should continue to take the steps necessary to assure 
that a vigorous research program is sustained and expanded.
    Dystonia.--The Committee has been pleased with NINDS 
efforts to encourage extramural research initiatives in 
dystonia-specific research, including a recent NINDS-sponsored 
workshop on dystonia research opportunities. The Committee 
encourages NINDS to work closely with other organizations 
having an interest in dystonia research to collaborate on joint 
research programs encouraging investigators to study dystonia.
    Neurodegenerative disorders.--The Committee encourages the 
Institute to continue research to determine the role of 
neurotransmitters in neurodegenerative disorders.
    Alzheimer's disease.--The Committee encourages the 
Institute to expand its research on the prevention and 
treatment of neurological disorders, including Alzheimer's 
disease [AD]. The Committee urges the NINDS to further explore 
the possibility that antiinflammatory drugs and estrogen may 
offer means of slowing the progression of AD.
    Rett syndrome.--The Committee remains interested in 
research supported by the Institute on Rett Syndrome and 
encourages the NINDS to continue to pursue research in this 
area.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 1995....................................  $1,096,457,000
Budget estimate, 1996...................................   1,153,372,000
House allowance.........................................   1,169,628,000

Committee recommendation

                                                           1,139,326,000

    The Committee recommends an appropriation of $1,139,326,000 
for the National Institute of Allergy and Infectious Diseases 
[NIAID]. This is $14,046,000 less than the administration's 
request, $42,869,000 more than the fiscal year 1995 
appropriation, and $30,302,000 less than the House allowance. 
The comparable numbers for the 1995 appropriation, the budget 
estimate, and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The House 
allowance did not include an appropriation for the Office of 
AIDS Research.
    Mission.--The NIAID supports and conducts basic and 
clinical research and research training programs in infectious 
diseases, including AIDS, and diseases caused by, or associated 
with, disorders of the immune system. The NIAID is the lead NIH 
Institute charged with developing new and improved vaccines and 
supporting research on acquired immunodeficiency syndrome, 
tuberculosis, sexually transmitted diseases, and tropical 
diseases. The NIAID's research goal is to improve the health 
and quality of life of people by improving diagnosis, 
treatment, and prevention of diseases.
    Tuberculosis.--The Committee commends the NIAID's support 
for developing improved diagnostic tests, treatments, and 
prevention strategies in response to the reemergence of 
tuberculosis in the United States. The Committee encourages the 
NIAID to continue studies aimed at designing new drugs and 
developing new animal models to assess those drugs, conduct 
clinical trials to evaluate the safety and efficacy of those 
new drugs, and support research to develop and evaluate new TB 
vaccines.
    Topical microbicides.--The NIAID is the lead Institute at 
the NIH for the conduct of biomedical research on HIV, STD's, 
and infectious diseases. In this regard, the NIAID has 
developed a comprehensive, coordinated, focused research plan 
for the development of topical microbicides. Topical 
microbicides are safe, effective products for intravaginal use, 
for use by women, to prevent sexually transmitted infections 
including HIV and STD's. The successful development of these 
products will empower women to take control of their own 
reproductive health and significantly reduce the incidence of 
STD's and HIV. The Committee encourages the NIAID to continue 
research aimed at developing topical microbicides.
    Asthma.--Research on asthma and many types of allergies has 
led to a greater understanding about their underlying 
mechanisms and has contributed to the development of effective 
ways to help affected individuals. NIAID has established a 
network of asthma and allergic disease centers to transfer 
rapidly the results from fundamental studies in immunology and 
clinical studies to clinical practice. The Committee encourages 
the NIAID to support demonstration and education projects to 
assess the effectiveness of specific interventions, and to 
apply culturally appropriate approaches to reduce the burden of 
asthma in inner-city populations. The Committee has been very 
pleased with-the continued activities of the national 
cooperative inner city asthma study. The number of asthma cases 
and the number of asthma-related deaths have increased 
dramatically in the past decade, particularly among minority 
populations. The inner-city asthma study is a comprehensive 
effort in eight cities to design and evaluate intervention 
programs to counter risk factors for inner-city asthmatic 
children.
    Lyme disease.--The Committee notes with concern that the 
reported incidence of Lyme disease rose more than 50 percent in 
1994, to the highest level since surveillance was initiated in 
the early 1980's. An increase in the number of Lyme disease 
cases can be expected to produce a corresponding rise in the 
number of patients with chronic symptoms.
    The Committee acknowledges NIAID's efforts in the areas of 
diagnostic test development, prevention strategies, and the 
early treatment of disease. The Committee is particularly 
heartened by NIAID's efforts of the last year to lay the 
groundwork for intensive study of the phenomenon of chronic 
Lyme disease and strongly encourages the NIAID to expand its 
efforts in this direction. The Committee requests that NIAID be 
prepared to report on its progress during the 1997 budget 
hearings.
    Emerging infectious diseases.--To successfully confront the 
challenge posed by future emerging diseases, a critical 
knowledge of the fundamental biology of infectious agents and 
the clinical disease processes they induce is required. Since 
it is clear that the issue of emerging diseases is global in 
scope and cannot be addressed by our country in isolation, the 
Committee supports the NIAID's efforts to maintain strong 
international ties through many of its programs. The Committee 
encourages the NIAID to continue to support a broad and 
comprehensive program of fundamental research, applied 
research, and research training on emerging diseases.
    Hemophilia.--The Committee fully supports NIAID's 
continuing commitment to provide access to HIV/AIDS clinical 
trials for hemophilia patients, utilizing the existing network 
of hemophilia treatment centers, through the ACTU without walls 
clinical trials program.
    Chronic fatigue and immune dysfunction syndrome.--The 
Committee recommends that additional funding within the NIH be 
directed toward CFIDS [CFS] research, most of which should be 
directed to extramural grants focused on promising areas of 
biomedical research. The Committee urges consideration be given 
to supporting investigations which seek to identify the 
etiological agent(s) and markers for and the pathophysiology of 
CFIDS [CFS]. Sufficient funds have already been provided for 
the appointment of a coordinator of CFIDS [CFS] research within 
the National Institute of Allergy and Infectious Diseases 
[NIAID], and to support the CFIDS [CFS] cooperative research 
centers. Additionally, consideration should be given to 
establishing a coordinator with Institute-wide authority to 
provide leadership on CFIDS. The Committee looks forward to the 
results of the NIAID Advisory Council meeting scheduled for the 
fall of 1995 that focuses on CFIDS.
    Tropical diseases.--The Committee notes that the NIAID, as 
the primary supporter of extramural research on tropical 
infectious diseases, supports critical basic research mandates 
of not only NIAID, but also those of the Centers for Disease 
Control and Prevention, the Department of Defense, and the 
Agency for International Development. Further, a 1992 report by 
the Institute of Medicine on emerging infections recommended 
the expansion of NIH-supported research on factors that lead to 
emergence of infectious diseases. The Committee is concerned 
about the needs identified in the IOM report and encourages the 
Institute to provide additional support.
    The Committee is also concerned about the drop in the 
number of investigator-initiated RO1 grants for many bacterial 
and viral diseases, including tropical infectious diseases, 
funded by NIAID. Low success rates for non-HIV grants demand 
that other funding mechanisms, which target specific needs, 
take on an even greater importance. The Committee believes that 
special programs for tropical infectious diseases such as the 
international collaborations for infectious disease research 
[ICIDR]; the tropical disease research units [TDRU]; and the 
tropical medicine research centers [TMRC] are of critical 
importance in our efforts to combat these diseases and urges 
the Institute to provide continued support to these mechanisms.

             National Institute of General Medical Sciences

Appropriations, 1995....................................    $904,925,000
Budget estimate, 1996...................................     933,809,000
House allowance.........................................     946,971,000

Committee recommendation

                                                             923,781,000

    The Committee recommends an appropriation of $923,781,000 
for the National Institute of General Medical Sciences [NIGMS]. 
This is $10,028,000 less than the administration's request, 
$18,856,000 more than the fiscal year 1995 appropriation, and 
$23,190,000 less than the House allowance. The comparable 
numbers for the 1995 appropriation, the budget estimate, and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The House allowance did not 
include an appropriation for the Office of AIDS Research.
    Mission.--NIGMS supports research and research training in 
the basic biomedical sciences. Institute grantees, working in 
such fields as cell biology, biophysics, genetics, 
developmental biology, pharmacology, physiology, and biological 
chemistry, study normal biological processes to better 
understand what goes wrong when disease occurs. In this way, 
NIGMS supplies the new knowledge, theories, and technologies 
that can then be applied to the disease-targeted studies 
supported by other NIH components. NIGMS-supported basic 
research advances also regularly find applications in the 
biotechnology and pharmaceutical industries. The Institute's 
training programs help provide the scientists needed by 
industry and academia to maintain U.S. leadership in biomedical 
science.
    Training.--The Committee commends the Institutes for its 
leadership in increasing the number and capabilities of 
underrepresented minority individuals engaged in biomedical 
research. Through the minority access to research careers 
[MARC] and the minority biomedical research support [MBRS], the 
Institute encourages more minority students to pursue training 
for scientific careers and the enhancement of the science 
curricula at institutions with substantial minority 
enrollments.

    NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT [NICHD]

Appropriations, 1995....................................    $568,823,000
Budget estimate, 1996...................................     586,890,000
House allowance.........................................     595,162,000

Committee recommendation

                                                             580,457,000

    The Committee recommends an appropriation of $580,457,000 
for the National Institute of Child Health and Human 
Development [NICHD]. This is $6,433,000 less than the 
administration's request, $11,634,000 more than the fiscal year 
1995 appropriation and $14,705,000 less than the House 
allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--NICHD is that component of the National 
Institutes of Health which is responsible for conducting and 
supporting research on maternal and child health, the 
population sciences and medical rehabilitation. Research 
encompassed by these areas targets infant mortality; genetic 
diseases, including birth defects; mental retardation; 
contraceptive development and evaluation; pediatric, maternal 
and adolescent AIDS; developmental biology; vaccine 
development; demographic and behavioral research; and 
restoration or enhancement of function in individuals 
experiencing physical disability due to injury, disease, or 
birth defect.
    Infertility and contraceptive research.--The Committee 
continues to place high priority on research to combat 
infertility and speed the development of improved 
contraceptives. It urges NICHD to continue aggressive 
activities in this area, including individual research grants 
and those of the infertility and contraceptive research 
centers.
    The Committee encourages the NICHD to expand its ongoing 
research program to develop and test female controlled barrier 
contraceptives, as well as spermicides that would also be 
microbicidal. The NICHD has been working on this project for 
several years. Such products would protect against both 
pregnancy and sexually transmitted diseases, including HIV 
infection. Expansion of this initiative, which is being 
conducted in concert with the National Institute of Allergy and 
Infectious Diseases, will allow NICHD to expand basic research 
and to develop new improved products and test them as quickly 
as possible through NICHD's contraceptive testing network.
    Oral contraceptives [OC].--The Committee also is supportive 
of NICHD's additional research to determine if oral 
contraceptive use is associated with the development of breast 
cancer. The project, the NICHD women's contraceptive and 
reproductive experience [CARE] study, will recruit 
approximately 10,000 women from five geographic regions: 
Atlanta, Detroit, Los Angeles, Philadelphia, and Seattle. The 
project will permit study of the women who first used OC's 
during the 1960's and are presently entering the ages of 
highest risk for breast cancer.
    Sudden infant death syndrome.--Sudden infant death syndrome 
accounts for approximately 7,000 unexplained infant deaths per 
year. The Committee is very pleased that the NICHD has 
vigorously pursued answers to SIDS through their 5 year 
research plans, and through their successful back to sleep 
campaign. The Committee has provided funding for continued 
activity in this important effort.
    National Center for Medical Rehabilitation Research 
[NCMRR].--NCMRR is taking advantage of remarkable advances in 
bioengineering and applying them to the development of new, 
improved orthotic and prosthetic devices. These and other 
assistive devices enhance the mobility, independence, and 
quality of life of persons with physical disabilities.
    The Committee recognizes the importance of assistive 
technology research and development in the lives of people with 
physical disabilities and urges the Director of NIH to consider 
increasing the share of the NIH-wide small business innovation 
research [SBIR] grants dedicated to such research and 
development. Funding should be coordinated by the National 
Center for Medical Rehabilitation Research [NCMRR] within the 
National Institute of Child Health and Human Development 
[NICHD].
    Bionutrition.--The Committee is very supportive of the 
bionutrition research at the National Institute on Child Health 
and Human Development. Of particular significance is the 
research regarding folic acid and vitamin B-12 use during 
pregnancy, and the reduction in the incidence of neural tube 
defects among infants. Further research should be supported 
regarding the role of nutrition in the support of very low 
birthweight children including the development of nutrition 
services during hospitalization.
    Behavioral and social science.--The Committee commends the 
NICHD for its excellence over the years and is pleased to note 
that research on behavioral development has been given a high 
priority for funding. The Committee takes particular note of 
three areas of promising research: biobehavioral research that 
focuses on the interactions between biological and behavioral 
factors in development; risk taking behaviors in middle 
childhood and adolescence; and learning disabilities. The 
Committee encourages NICHD to continue to place a high priority 
on research in these areas, and particularly on learning 
disabilities.
    Nursing.--The Committee strongly urges the NICHD to work 
collaboratively with the NINR to address research issues 
involving nursing practice and children's health and 
development. The Committee further recommends that the NICHD 
collaborate with the Department of Defense nursing researchers 
on the identification of high risk families and the prevention 
of child abuse and neglect.
    Demographic research.--Recent findings on the social, 
economic, health, and personal benefits of marriage have 
received national attention. Those findings and other critical 
research are supported by the demographic research program at 
NICHD. The Committee recognizes the importance of demographic 
research, especially its ability to provide the basis of 
understanding for those policies and programs which best serve 
the needs of the country. The Committee urges NICHD to continue 
giving demographic research high priority.
    Autism and other communicative disorders.--The Committee 
urges NICHD to continue its collaborations with the National 
Centers for Disease Control, NIMH, and NIDCD. As a part of 
these collaborations, the Committee encourages the NICHD to 
support research and service activities related to the 
development of culturally and linguistically sensitive 
normative and diagnostic data, assessment instruments and 
procedures for Hispanic infants and youth suffering from autism 
and other communicative disorders.
    Fragile X syndrome.--The Committee commends NICHD for its 
work on fragile X syndrome and encourages the Institute to 
accelerate and expand its research in this important area.

                         NATIONAL EYE INSTITUTE

Appropriations, 1995....................................    $300,590,000
Budget estimate, 1996...................................     309,818,000
House allowance.........................................     314,185,000

Committee recommendation

                                                             306,490,000

    The Committee recommends an appropriation of $306,490,000 
for the National Eye Institute [NEI]. This is $3,328,000 less 
than the administration's request, $5,900,000 more than the 
fiscal year 1995 appropriation, and $7,695,000 less than the 
House allowance. The comparable numbers for the 1995 
appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NEI is the Nation's Federal resource for the 
conduct and support of basic and clinical research, research 
training, and other programs with respect to blinding eye 
diseases, visual disorders, mechanisms of visual function, 
preservation of sight, and the special health problems and 
needs of individuals who are visually impaired or blind. In 
addition, the NEI is responsible for the dissemination of 
information, specifically public and professional education 
programs aimed at the prevention of blindness.
    Cost savings.--The Committee is aware that a number of 
clinical trials supported by the NEI have yielded significant 
savings over the last several years. New treatments for 
diabetic retinopathy, for example, are highly effective in 
preventing blindness. Several other studies have indicated that 
certain costly procedures and treatments are of no benefit to 
the patient and may actually be harmful. The Committee 
encourages NEI to continue the support of meritorious projects 
of this type to evaluate the safety, efficacy, and cost 
effectiveness of new treatments, and the effect which these 
treatments have on the quality of life of those affected.
    Education program.--The NEI has developed a comprehensive 
eye health education program in diabetic retinopathy and 
glaucoma which is being adapted to the disproportionate needs 
of the Hispanic/Latino community in accordance with Committee 
recommendations. The NEI is urged to evaluate the potential of 
additional eye health education initiatives to address the 
visual problems of the growing population of older Americans. 
Also, NEI is urged to develop a data base to document the 
magnitude of current blindness and vision problems and to allow 
the assessment of research advances and changes in eye care 
services.
    Aging research.--The aging of the U.S. population is of 
particular importance to the Committee because of the increased 
incidence of blindness and severe visual disability among the 
elderly. The Committee, therefore, commends the NEI's support 
of research to determine the potential value of eye health 
education programs targeted to the elderly and the magnitude of 
vision impairment among this group.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 1995....................................    $272,733,000
Budget estimate, 1996...................................     284,883,000
House allowance.........................................     288,898,000

Committee recommendation

                                                             281,830,000

    The Committee recommends an appropriation of $281,830,000 
for the National Institute of Environmental Health Sciences 
[NIEHS]. This is $3,053,000 less than the administration's 
request, $9,097,000 more than the fiscal year 1995 
appropriation, and $7,068,000 less than the House allowance. 
The comparable numbers for the 1995 appropriation, the budget 
estimate, and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The House 
allowance did not include an appropriation for the Office of 
AIDS Research.
    Mission.--The mission of the NIEHS is to define how 
environmental exposures affect our health, how individuals 
differ in their susceptibility to these effects, and how these 
susceptibilities change with time. This knowledge, coupled with 
prevention and communication programs, can lead to a reduction 
in environmentally associated diseases and dysfunctions.
    Breast cancer.--The Committee was pleased to learn that 
NIEHS scientists, working with researchers in Utah, 
successfully isolated the breast cancer susceptibility gene, 
BRCA1. BRCA1 is thought to account for 5 percent of breast 
cancer cases overall and for 25 percent of early onset (women 
under age 30) breast cancer cases. The discovery of this gene 
is an important step toward understanding the origins of the 
development of this devastating disease. NIEHS scientists plan 
to study the ability of different environmental agents to 
mutate this gene, a process which is critical to the 
development of many cases of breast cancer.
    Parkinson's disease.--The Committee commends the Institute 
for sponsoring a workshop on the link between toxic exposures 
and Parkinson's disease and other neurological disorders, and 
encourages the NIEHS to build upon this initiative by 
supporting further research in the area.
    Research centers.--The Committee continues to strongly 
support the NIEHS-supported environmental health science 
research centers and requests the Institute give careful 
consideration to fully funding current centers before 
additional expansion is contemplated. The Committee commends 
the Institute for its support of the international 
environmental health initiative of the Fogarty International 
Center.
    Volcanic emissions.--The Committee continues to be 
concerned about the public health aspects of volcanic emissions 
[VOG] in the State of Hawaii. The Committee appreciates the 
initial efforts of NIEHS to work with the University of Hawaii 
on this problem.
    Marine toxins.--The Committee recommends support for 
research to study and evaluate natural marine toxins and their 
effects upon human health. The Committee strongly encourages 
the Institute to give priority to this research and carefully 
consider proposals from centers which have demonstrated a high 
degree of expertise in this field.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 1995....................................    $434,580,000
Budget estimate, 1996...................................     447,608,000
House allowance.........................................     453,917,000

Committee recommendation

                                                             442,833,000

    The Committee recommends an appropriation of $442,833,000 
for the National Institute on Aging [NIA]. This is $4,775,000 
less than the administration's request, $8,253,000 more than 
the fiscal year 1995 appropriation, and $11,084,000 less than 
the House allowance. The comparable numbers for the 1995 
appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NIA conducts biomedical, behavioral, and 
social research related to the aging process to prevent disease 
and other problems of the aged, and to maintain the health and 
independence of older Americans. Research in aging over the 
last two decades demonstrates that aging should not be equated 
with inevitable decline and disease. Several diseases and 
conditions stand out as particularly burdensome for older 
Americans, including Alzheimer's disease, physical frailty, et 
cetera.
    Alzheimer's disease.--For the past several years the 
Committee has called attention to the growing threat 
Alzheimer's disease presents to society. The most expensive 
uninsured illness confronting most Americans as they near 
retirement, Alzheimer's disease will overwhelm our health care 
system and consume more of the Nation's resources than any 
other illness except cancer and heart disease. Unless science 
can find a way to cure or effectively treat the disease, the 
number of persons affected will explode, growing from 4 million 
today to over 14 million within a few decades. And, if the 
incidence of the disease continues at its current rate, society 
will spend more than $1,075,000,000,000 just to care for its 
victims.
    Funding increases recommended by this Committee in the past 
have helped advance understanding of Alzheimer's disease. In 
quick succession, scientists have identified the gene 
combinations that determine who is at risk, created a model in 
transgenic mice to speed drug development, and devised better 
diagnostics. If these and other advances should lead to a way 
to delay onset of Alzheimer's disease by 5 years, half of the 
potential victims can live out their lives without serious 
impairment, and the Nation will save $50,000,000,000 a year.
    Under the circumstances, the Committee believes it would 
penny-wise and pound-foolish to hold back resources attacking a 
problem that wastes precious human resources, causes enormous 
hardship for families, and creates a tremendous drain on public 
funds and institutions. The Committee, therefore, recommends 
that the highest priority be given to support research on 
Alzheimer's disease.
    The Committee is concerned that it has been nearly 2 years 
since the NIA was asked to develop and submit a long-range plan 
for attacking Alzheimer's disease. The broad objectives of this 
initiative was to develop a plan to slow the rate of 
deterioration from Alzheimer's disease by 5 years during the 
next 5 years, and by 10 years over the next decade. The 
Committee understands that the initial planning workshops have 
been completed and, therefore, directs the Institute to 
complete action on the plan and submit the report to the 
Committee no later than January 1, 1996.
    Osteoporosis/women's health.--Osteoporosis, loss of bone 
mass, is a major contributor to physical frailty and the loss 
of independence and affects more than 20,000,000 Americans. 
Older women in particular experience pain, broken bones and 
impaired function as a result of this disease. Clinical studies 
recently funded will determine the contributions of age and 
ovarian hormone status to changes in bone mass as women 
approach and traverse menopause. The Committee urges NIA to 
pursue research into the pathophysiology of osteoporosis to 
expand the knowledge base for prevention and treatment and to 
maintain support for NIA's women's health and aging study.
    Behavioral and demographic research.--The Committee 
continues to support demographic research currently underway at 
NIA, of particular interest is the health and retirement and 
the AHEAD studies. The Committee urges NIA to vigorously 
maintain its own support of these important research programs.
    Cardiovascular aging research.--Heart attack, congestive 
heart failure, stroke, and other cardiovascular diseases remain 
America's No. 1 killer of older men and women and a main cause 
of disability. The Committee believes that additional research 
on cardiovascular aging is important and supports expansion of 
its extramural and intramural cardiovascular research programs.
    Nursing.--The Committee urges the NIA to continue to 
collaborate with the NINR to address research issues involving 
nursing practice in the process of the aging population.
    Research on self-care.--The Committee recognizes that 
prevention of disease, as well as management of chronic health 
conditions, is influenced greatly by the manner in which people 
care for themselves. The Committee is pleased to note that NIA 
is conducting research on how self-care behaviors vary with the 
severity of illness or disabling condition, social and 
behavioral strategies for encouraging health-promoting behavior 
and techniques for eliminating health-impairing habits and 
lifestyles in older adults, and the ways in which self-care 
behaviors change as adults age. Of particular concern is how 
self-care relates to the need for use of both informal and 
formal health care services. The Committee encourages NIA to 
continue to emphasize research on self-care behaviors.
    Task force on aging research.--The Committee is grateful 
for the comprehensive assessment of progress in the scientific 
understanding of aging, a report requested by the Committee in 
November 1990. The Committee commends the diligence and 
commitment of the task force in producing an excellent report. 
The Committee is particularly pleased to understand what areas 
of research are of immediate priority and is interested in how 
the NIA will implement the identified research priorities, 
including research in basic cognition and neuropsychology; 
cognitive function through training and environmental support; 
health behaviors and behavior change over the life course; 
older drivers; elder-friendly environments; and working into 
late adulthood. The Committee requests that the Director be 
prepared to report on NIA's progress in implementing the above 
priorities during the fiscal year 1997 budget hearings.
    Immune system research.--The Committee recognizes that 
changes in immune function of persons as they age impact many 
priority health disorders of adults, including cancer, 
osteoporosis, diabetes, AIDS, Alzheimer's disease, allergies, 
as well as the performance of vaccines and therapies. Given 
recent advances in basic research, the Committee encourages the 
NIA, in collaboration with other NIH Institutes and the CDC, to 
pursue intramural and extramural research designed to define 
the underlying mechanisms of immune system functioning with 
aging, and to promote application of this knowledge to new or 
improved preventive and clinical strategies.
    Claude Pepper older Americans independence centers.--The 
Committee continues to support expanded efforts by the NIA to 
develop and evaluate innovative approaches to maintaining and 
increasing independence among older Americans. As the 
population ages, and particularly as the population of those 
over the oldest old (those age 85 and older) increases, it is 
critical that we develop approaches that will both enhance the 
quality of life for older Americans and reduce health and long-
term care costs. The Committee anticipates receiving a report 
on the progress being made by these important centers by the 
end of this calendar year.
    Nutrition and the elderly.--Malnutrition among the elderly 
is a serious public health problem and has been identified as a 
clinical research priority by the Institute of Medicine. The 
Committee is disappointed in the progress made on its fiscal 
year 1993 recommendation for research on the efficacy and 
outcomes of nutrition screening to identify the levels of 
malnutrition and other nutrition-related problems among the 
elderly. The Institute is urged to redouble its efforts in this 
important area.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 1995....................................    $231,399,000
Budget estimate, 1996...................................     238,467,000
House allowance.........................................     241,828,000

Committee recommendation

                                                             235,917,000

    The Committee recommends an appropriation of $235,917,000 
for the National Institute of Arthritis and Musculoskeletal and 
Skin Diseases [NIAMS]. This is $2,550,000 less than the 
administration's request, $4,518,000 more than the fiscal year 
1995 appropriation, and $5,911,000 less than the House 
allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--The NIAMS conducts and supports basic and 
clinical research and research training, and the dissemination 
of health information on the more than 100 forms of arthritis; 
osteoporosis and other bone diseases; muscle biology and muscle 
diseases; orthopedic disorders, such as back pain and sports 
injuries; and numerous skin diseases. The research agenda of 
the NIAMS includes many devastating and debilitating diseases 
that afflict millions of Americans. These diseases of the 
joints, muscles, bones, connective tissues, and skin, in the 
aggregate, will affect nearly every American at some point in 
their lives, causing tremendous human suffering and costing the 
Nation billions of dollars in both health care and lost 
productivity. The research activities of this Institute serve 
the concerns of many different special populations; these 
include women, minorities, children, and the elderly.
    Osteoarthritis.--Osteoarthritis is a degenerative joint 
disease for which there is no known cure. It continues to be 
the most widespread of all the chronically disabling arthritic 
diseases, costing society, particularly the Medicare Program, 
in excess of $8,000,000,000 annually. NIAMS-supported research 
has contributed significantly to the understanding of this 
disease and the Committee encourages NIAMS to continue to move 
forward with its commitment to osteoarthritis research.
    The Committee is aware that in the absence of a cure for 
osteoarthritis, total joint replacement has been successful in 
relieving pain, enhancing mobility and independent living for 
many people who would otherwise be substantially disabled and 
dependent on family or government programs. During its 
hearings, the Committee learned that wear related failure of 
the replacements has become a prevalent problem. Although NIAMS 
has made great advances in this area, the Committee urges NIAMS 
to expand its investigations of new materials, the interaction 
of implant devices and tissue, and to create a better 
understanding of wear processes that can prolong the life of 
the implant.
    Lupus.--The Committee encourages the NIH to continue to 
support research aimed at furthering the understanding of risk 
factors for lupus and to support appropriate clinical trials 
for promising treatments for lupus.
    Osteoporosis.--As a result of a recent initiative, the 
NIAMS is funding new research on promising basic cellular, 
molecular, physiological, and genetic approaches to 
osteoporosis. In addition, a consensus development conference 
on optimal calcium intake recently reviewed the latest 
information and provided recommendations on the optimal calcium 
intake for children, young adults, postmenopausal women, and 
the elderly. As a next step in understanding the importance of 
calcium in building bone, NIAMS will support a clinical trial 
of calcium supplements in young women.
    The Committee commends the Institute for its leadership and 
urges the Director to continue to give osteoporosis research 
high priority.
    The NIH Revitalization Act of 1993 authorized the creation 
of an Osteoporosis and Related Bone Diseases National Resource 
Center. Last year, the NIAMS awarded a 4-year grant for the 
establishment of the Resource Center. The Center has a twofold 
objective: (1) to provide comprehensive services to reach the 
American population with medically sound information and 
programs on the prevention, early detection, and treatment of 
bone disease; and (2) to conduct behavioral research of key 
subsets of population, such as adolescent girls and the 
population most prone to suffer osteoporotic fractures due to 
falls--the frail elderly. The Committee is pleased with the 
progress that has been made in getting the Center underway and 
encourages the Institute to consider providing additional 
support to the Center in fiscal year 1996.
    Lupus and women's health.--The Committee encourages the 
Institute to continue support of a portfolio of research on 
understanding why this disease is more prevalent in women and 
black women in particular, as well as to pursue new and 
innovative treatments for this disease.
    Fibromyalgia.--Over the past several years, the Committee 
has expressed interest in an increased research effort in 
fibromyalgia and commends the NIAMS for steps to encourage new 
investigators to enter the field. Current NIAMS research 
projects focus on basic research, and investigators are 
studying the causes, diagnosis, and treatment of fibromyalgia. 
The Committee urges the NIAMS to continue to support an 
aggressive research program on fibromyalgia.
    Epidermolysis bullosa [EB].--Several years ago it was 
discovered that in one of the severe forms of EB, a normal 
structure called an anchoring fibril was missing. In the last 
few years it has become clear that anchoring fibrils are 
composed of a type of protein that is abnormal in essentially 
all forms of dystrophic EB, both recessive and dominant. In 
addition, the defective genes and abnormal proteins in the most 
frequently fatal form of EB have been found. This work now 
provides the basis for early (including prenatal) diagnosis 
and, once technology is far enough advanced, potential gene 
therapy for this devastating disease. The Committee supports an 
accelerated research program on EB.
    Psoriasis (acquired skin diseases).--Psoriasis is a chronic 
skin disease characterized by thickened, red areas of skin with 
silvery scales. Of the 4 million to 5 million Americans who 
suffer from psoriasis, about 1 million have the severe form.
    NIAMS supported researchers using tissue samples from the 
National Psoriasis Foundation Tissue Bank have demonstrated 
that the gene for familial psoriasis is located on chromosome 
17 of the human genome. This collaboration between private and 
public sector-supported research initiatives has enabled 
genetic research on this disease to move ahead at an 
accelerated rate. Through this genetic research, investigators 
have learned that, of the known genes in this area of 
chromosome 17, several have to do with activation of immune 
cells, leading to new theories of how psoriasis develops. The 
Committee strongly encourages NIAMS to support additional 
genetic research to determine which gene is the specific 
gene(s) for psoriasis as well as to pursue research on the 
mechanisms that lead to the onset of this disease.
    Low back pain.--Low back pain continues to be a leading 
cause of limitation in adults and has become a major public 
health problem. Some 80 percent of Americans will experience an 
episode of low back pain during their lifetime; and in any 1 
year, 50 percent of all working adults have low back pain.
    The Committee commends NIAMS on its upcoming workshop on 
low back pain that will address future research needs to 
improve the understanding of this condition and the care of the 
patient. As a result of this workshop, the Committee encourages 
the Institute to develop and disseminate workshop findings to 
the public and the scientific community. The Committee also 
encourages the NIAMS to consider utilizing the area health 
education centers supported by the Health Resources and 
Services Administration, as one mechanism for dissemination of 
workshop findings.
    Repetitive motion syndrome.--The occurrence of repetitive 
motion syndrome in the work force is growing and is recognized 
as a major source of disability in middle-aged and older 
workers. These disorders of the musculoskeletal system may be 
caused or aggravated by repetitive motions of the upper or 
lower extremities over extended periods. The Committee is 
pleased that the NIAMS recognized the magnitude of the problem 
and held a workshop on repetitive motion disorders in June 
1994. The Committee urges the Institute to continue its 
investigations into this area and to conduct studies toward the 
understanding, prevention, and treatment of these extremely 
painful disorders. NIAMS is also encouraged to address the 
impact of repetitive motion disorders on children, given 
society's dependency on computers and the increased use by our 
children at the elementary school level.
    Scleroderma research.--An estimated 500,000 Americans are 
affected by scleroderma, a chronic, degenerative autoimmune 
disorder that leads to the overproduction of collagen hardens 
the connective tissue and damages the organs involved.
    The Committee is aware that the Scleroderma Research 
Foundation's [SRF] has launched an innovative $3,000,000 
investment strategy in scleroderma research, and encourages the 
NIAMS to maximize each Federal dollar invested in research by 
working closely with the foundation. The Committee further 
encourages NIH to consider the development of a national 
scleroderma patient registry. The Committee understands that a 
regional registry is already in operation at the Scleroderma 
Research Foundation's San Francisco Bay Area Scleroderma 
Research Center and encourages NIH to use it as a testing 
ground for the registry.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 1995....................................    $168,933,000
Budget estimate, 1996...................................     174,049,000
House allowance.........................................     176,502,000

Committee recommendation

                                                             172,190,000

    The Committee recommends an appropriation of $172,190,000 
for the National Institute on Deafness and Other Communication 
Disorders [NIDCD]. This is $1,859,000 less than the 
administration's request, $3,257,000 more than the fiscal year 
1995 appropriation, and $4,312,000 less than the House 
Allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--The NIDCD funds and conducts research and 
research training in the normal and disordered processes of 
human communication, specifically in the areas of hearing, 
balance, smell, taste, voice, speech, and language. The 
Institute addresses the special biomedical and behavioral 
problems of people who have communication impairments or 
disorders, is actively involved in health promotion and disease 
prevention, and supports efforts to create devices that 
substitute for lost and impaired sensory and communication 
functions.
    Spasmodic dysphonia.--Spasmodic dysphonia is a voice 
disorder that affects women predominantly, and usually renders 
a person difficult to understand because of uncontrolled voice 
and pitch breaks. NIDCD intramural scientists pioneered the 
development of a new treatment for spasmodic dysphonia using 
botulinum toxin A injections into the laryngeal musculature. 
The Committee recommends continued NIDCD intramural and 
extramural study into spasmodic dysphonia.
    Partnership program.--The Committee continues to support 
the Comprehensive Minority Partnership Program between NIDCD, 
the University of Puerto Rico, Morehouse School of Medicine, 
and the University of Alaska system. The Committee encourages 
NIDCD to provide the resources needed to develop culturally and 
linguistically sensitive diagnostic and assessment tools for 
each of the populations served by these institutions and 
encourages the NIDCD to provide these institutions an 
opportunity to compete for funding in this area.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 1995....................................     $52,757,000
Budget estimate, 1996...................................      55,055,000
House allowance.........................................      55,831,000

Committee recommendation

                                                              54,453,000

    The Committee recommends an appropriation of $54,453,000 
for the National Institute of Nursing Research [NINR]. This is 
$602,000 less than the administration's request, $1,696,000 
more than the fiscal year 1995 appropriation, and $1,378,000 
less than the House allowance. The comparable numbers for the 
1995 appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NINR supports biomedical and behavioral 
research and research training programs to reduce the burden of 
illness and disability of individuals and their families, 
improve health-related quality of life, establish better means 
to promote health and prevent disease, and reduce the costs and 
demands for care. Research programs address symptoms and side 
effects of disease and treatment, health behaviors and habits, 
and strategies to improve patient care.
    Managing pain.--The Committee recognizes that problems 
associated with pain extend far beyond its discomfort. 
Untreated or undertreated pain is known to prolong recovery 
from illness and, in extreme cases, result in death. Pain is 
the most common reason for some 40 million visits to physicians 
a year, at an estimated annual cost, in health care and lost 
productivity terms, amounting to more than $100,000,000,000. 
While the Committee is encouraged with the progress in 
understanding the extremely complex phenomenon of pain, 
particularly certain biological aspects, much more needs to be 
known about the pain experience and how to ease it.
    The Committee further commends NINR's research progress in 
better understanding pain in young children and adolescents, 
and encourages research aimed at discovering ways to quantify 
pain intensity in infants. The Committee also supports studies 
that address intervention to activate the body's innate pain 
control mechanisms. The Committee strongly supports NINR's 
taking the lead in a major NIH-wide research initiative that 
addresses both biological and behavioral aspects of pain. This 
effort promises to contribute valuable insights into the 
comparative effectiveness of various pain treatments for 
subgroups of patients, such as the elderly, infants, and those 
with physical disabilities or cognitive impairments.
    Managing symptoms associated with dementia.--Since more 
people are living to an old age, the number who have dementia 
will continue to increase. At this time, dementing disorders, 
such as Alzheimer's disease, cannot be prevented, nor can their 
clinical course be altered significantly. It is estimated that 
costs of care for one person with Alzheimer's disease is 
$47,000 per year for an illness that can last from 8 to 20 
years before death occurs. The Committee believes it imperative 
to reduce these staggering human and financial costs so that 
dementia's life-altering impact on patients, their families, 
the health care system, and the economy can be mitigated.
    Genetic testing and gene therapy.--Compelling advances in 
molecular genetics are outpacing knowledge of the clinical 
implications. The Committee is concerned about this imbalance 
and expresses its support for NINR's increased collaboration 
with the National Center for Human Genome Research. Joint 
efforts are essential to develop and evaluate teaching and 
counseling methods that help patients and their families make 
informed decisions about whether to undergo genetic screening.
    Prevention of risk factors for illness.--The Committee is 
well aware that through healthy behaviors, people may save or 
prolong their lives, yet successful methods to encourage 
adoption and maintenance of these practices throughout the 
lifespan remain to be developed and tested. The Committee 
applauds NINR's research efforts thus far regarding prevention 
of adolescent risk factors linked to unhealthy habits. These 
risk factors can result in tremendous costs to the Nation's 
health care system.
    Improving the health of vulnerable populations.--The 
Committee is aware that geography and cultural identity and 
beliefs may create barriers to health care, particularly for 
people in rural areas and high risk minority groups. These 
vulnerable populations also infrequently participate in 
prevention programs, putting them at risk for life-threatening 
illnesses such as cancer, tuberculosis, and AIDS. The Committee 
is pleased that the NINR is supporting research to develop and 
test model prevention programs at the community level targeted 
at rural residents who need specially tailored interventions to 
maintain good health.
    Cooperation with the National Cancer Institute.--The 
Committee continues to recommend that the NINR work closely 
with the NCI to develop research studies that address breast 
cancer--including symptom management, quality of life issues, 
and preventive screening.
    Minority health.--The Committee is aware that an innovative 
and culturally sensitive community partnership program of 
prenatal care developed for rural Hawaii called Malama has been 
very successful in addressing the prenatal care needs of 
minorities in this region. This program has provided a model 
for effectively integrating the values and expertise of 
academia and those of the community, as well as of psychology 
and nursing. The Committee encourages the NINR to expand this 
program to further address other minorities in Hawaii.

           National Institute on Alcohol Abuse and Alcoholism

Appropriations, 1995....................................    $190,067,000
Budget estimate, 1996...................................     195,847,000
House allowance.........................................     198,607,000

Committee recommendation

                                                             193,730,000

    The Committee recommends an appropriation of $193,730,000 
for the National Institute on Alcohol Abuse and Alcoholism. 
This is $2,117,000 less than the administration's request, 
$3,663,000 more than the fiscal year 1995 appropriation, and 
$4,877,000 less than the House allowance. The comparable 
numbers for the 1995 appropriation, the budget estimate, and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The House allowance did not 
include an appropriation for the Office of AIDS Research.
    Mission.--The NIAAA conducts biomedical and behavioral 
research for improving prevention and treatment and reducing or 
eliminating the associated health, economic, and social 
consequences. NIAAA provides leadership in the country's effort 
to combat these problems by developing new knowledge that will 
decease the incidence and prevalence of alcohol abuse and 
alcoholism and associated morbidity and mortality. NIAAA 
addresses these questions through an integrated program of 
biomedical, behavioral, and epidemiologic research on 
alcoholism, alcohol abuse, and related problems. This broad-
based program includes various areas of special emphasis such 
as medications development, fetal alcohol syndrome [FAS], 
genetics, and moderate drinking.
    Fetal alcohol syndrome.--The Committee understands that 
fetal alcohol syndrome [FAS] is one of the four leading known 
causes of mental impairment in this country, with an estimated 
incidence of 1 to 3 cases per 1,000 births. FAS is fully 
preventable, because maternal alcohol consumption is its only 
known cause. The Committee strongly encourages the Institute to 
develop a major behavioral research initiative to achieve a 
significant reduction in FAS and requests the Director to 
inform the Committee of its plans in this area during the 
fiscal year 1997 budget hearings.
    Effects of moderate drinking.--An emerging area of interest 
is the investigation of the consequences of moderate alcohol 
consumption. The Committee is supportive of efforts of the 
NIAAA to increase research support to learn more about both the 
beneficial and harmful effects of moderate alcohol consumption. 
Research issues include defining ``moderate'' drinking, 
exploring the impact of alcohol on coronary artery disease, 
illuminating the exact cellular and molecular mechanisms of the 
effects, and identifying the risks and benefits associated with 
moderate alcohol consumption.
    Behavioral research.--The Committee notes with great 
interest the strides that have been made in the area of 
behavioral research on alcohol abuse and alcoholism, including 
effective scientifically based strategies for delaying the 
initiation of drinking by young people, and the potential 
effectiveness of combining behavioral therapy with naltrexone 
to substantially reduce the current 50-percent relapse rate 
among those treated for alcohol abuse and alcoholism. The 
Committee encourages NIAAA to continue testing the 
effectiveness of these approaches.
    Medications development.--The Committee is pleased that 
research supported by NIAAA has led to the first new medication 
approved by FDA for alcoholism treatment in over 40 years. 
Naltrexone, an opiate blocker, in combination with skilled 
counseling, has resulted in alcohol-dependent patients staying 
sober twice as long as placebo-treated patients. Further 
research is needed to determine the effects of naltrexone's 
longer-term use, side effects, and most importantly, how it 
reduces alcohol craving. The Committee supports continued 
research on these promising research opportunities.
    Rural research.--Sufficient funding is provided to continue 
research on alcohol use in rural areas and to continue funding 
for a family focused research program on rural alcohol use.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 1995....................................    $437,443,000
Budget estimate, 1996...................................     452,069,000
House allowance.........................................     458,441,000

Committee recommendation

                                                             446,800,000

    The Committee recommends an appropriation of $446,800,000 
for the National Institute on Drug Abuse [NIDA]. This is 
$5,269,000 less than the administration's request, $9,357,000 
more than the fiscal year 1995 appropriation, and $11,641,000 
less than the House allowance. The comparable numbers for the 
1995 appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--Created in 1974, NIDA supports about 85 percent 
of the world's biomedical research in the area of drug abuse 
and addiction. The Committee commends NIDA for demonstrating 
through research that drug use is a preventable behavior and 
addiction is a treatable disease of the brain. NIDA's basic 
research plays a fundamental role in furthering knowledge about 
the ways in which drugs act on the brain to produce drug 
dependence and contributes to understanding how the brain 
works. In addition, NIDA research identifies the most effective 
pharmacological and behavioral drug abuse treatments. NIDA 
conducts research on the nature and extent of drug abuse in the 
United States and monitors drug abuse trends nationwide to 
provide information for planning both prevention and treatment 
services. An important component of NIDA's mission is also to 
study the outcomes, effectiveness, and cost benefits of drug 
abuse services delivered in a variety of settings.
    Neuroscience.--Because NIDA researchers have cloned the 
genes for the receptors for every major drug of abuse, the 
stage is now set for detailed molecular and cellular studies 
exploring the mechanisms underlying complex and clinically 
important behavior relevant to drug abuse. The Committee 
applauds NIDA's efforts to use imaging technology to actually 
visualize the effects of drugs on the brain as they are 
occurring. Such advances have brought scientists to the brink 
of long-awaited discoveries. The Committee considers 
neuroscience research to be a top priority for the Institute 
and encourage NIDA to continue its involvement in ``Decade of 
the Brain'' activities.
    Treatments for pregnant women.--Another pressing priority 
is the development of effective behavioral and pharmacological 
treatments for pregnant women who use drugs. The Committee 
commends NIDA for its research efforts in this area, 
particularly NIDA's recognition of the importance of developing 
antiaddiction medications that do not cross the placental 
barrier. NIDA is encouraged to continue its research on 
behavioral and pharmacological therapies appropriate for 
pregnant women.
    Treatment medications.--The single most important need for 
conquering the urgent public health problem of drug abuse and 
addiction is an effective anticocaine medication or cocaine 
blocker. NIDA research has led to tremendous breakthroughs in 
molecular-biological and neuroscience research over the last 5 
years. There is now the promise of developing effective 
treatments for addictions, especially a cocaine blocker. The 
development of these medications will not only be a major 
breakthrough in themselves, but when combined with behavioral 
techniques, could dramatically improve treatment outcome. The 
Committee encourages NIDA to continue this critical research, 
particularly the development of small molecule cocaine 
antagonists which will have clinical utility in the treatment 
of cocaine addiction and overdose.
    Comprehensive research centers.--The Committee understands 
that NIDA has conducted a comprehensive review of its center 
grant program which will result in the publication of NIDA-wide 
center grant guidelines. The Committee continues to strongly 
encourage NIDA to support up to five multidisciplinary, 
comprehensive drug abuse research centers to demonstrate the 
effectiveness of a variety of coordinated approaches focussed 
on women, children, minorities, or other undeserved 
populations. Centers should provide a stable environment for 
investigators from biomedical, behavioral, and/or social 
sciences to conduct coordinated and integrated basic and 
clinical research and research training related to drug abuse. 
The Committee requests that NIDA be prepared to report on its 
center grant program during the 1997 appropriations hearings.
    Behavioral research.--The Committee understands that the 
NIDA is in the process of expanding its support of behavioral 
science research, as signaled in part by the establishment of a 
separate behavioral sciences research branch, and believes that 
this area should continue to be one of the Institute's highest 
priorities. The Committee urges NIDA to support investigations 
of the underlying behavioral and biological mechanisms of 
craving, and the role that factors such as peer pressure, 
family, society, and development play in substance abuse. The 
Committee is pleased with the Institute's efforts to work with 
various national professional associations, such as the 
National Association of Social Workers and the American 
Psychological Association.
    Social work services.--The Committee applauds the NIDA for 
its initial effort to support expanding the number of social 
work researchers conducting drug abuse research and encourages 
NIDA to continue these efforts in fiscal year 1996.
    Drug abuse research program.--The economic costs of illegal 
drug use and addiction, including costs related to crime, 
health, AIDS infection, law enforcement, decreased job 
productivity, unemployment, and homelessness, are staggering. 
The Committee commends NIDA and the NIH for its drug abuse and 
addiction research, especially that directed toward children 
and adolescents. Despite marked progress in drug abuse 
treatment and prevention, drug addiction continues to cost 
society an estimated $76,000,000,000 annually. Today, there are 
still 11 million Americans who are illicit drug users and an 
estimated 3 million Americans over the age of 15 who are 
dependent on illicit drugs. As we pass the halfway mark in this 
``Decade of the Brain'' which Congress first authorized in 
1990, the Committee urges NIDA to continue its outstanding work 
in understanding the sites in the brain where addictive drugs 
like cocaine act and to capitalize on these findings in 
furthering NIDA's effort to develop medications for drug abuse 
treatments.
    Although there are important differences among individuals 
in their susceptibility to drug abuse disorders, little is 
known about the sources of this vulnerability. The Committee 
urges NIDA to continue its research in this area to understand 
the basic causes of addictive disorders and individual 
differences in drug effects on behavior. Other important areas 
of drug abuse research include studies of drug effects on the 
immune system and its role in HIV/AIDS, the consequences of 
drug abuse by pregnant women, and behavioral treatments for 
drug addictions.
    Substance abuse services research.--Part of the mission of 
the Institute is to support research to study the outcomes, 
effectiveness, and cost benefits of drug abuse services. In 
this context, the Committee encourages NIDA to consider joining 
with the NIAAA in supporting research to compare the case 
management model of treatment with the residential substance 
abuse model of treatment to be carried out in conjunction with 
nationally recognized organizations with substantial experience 
with both the models of treating substance abuse.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 1995....................................    $631,275,000
Budget estimate, 1996...................................     652,136,000
House allowance.........................................     661,328,000

Committee recommendation

                                                             645,411,000

    The Committee recommends an appropriation of $645,411,000 
for the National Institute of Mental Health [NIMH]. This is 
$6,725,000 less than the administration's request, $14,136,000 
more than fiscal year 1995 appropriation, and $15,917,000 less 
than the House allowance. The comparable numbers for the 1995 
appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The research programs of NIMH lead the Federal 
effort to identify the causes of--and the most effective 
treatments for--mental illnesses, which afflict more than one 
in five Americans. Mental illnesses cost the Nation over 
$150,000,000,000 each year in direct and indirect costs. Severe 
mental illnesses affect 2.8 percent of the U.S. adult 
population annually, approximately 5 million people. These 
individuals suffer from disorders such as schizophrenia, manic-
depressive illness, major depression, panic disorder, and 
obsessive-compulsive disorder. The full range of mental 
disorders produces an as yet unmeasured level of disability in 
our adult population. One result of NIMH research has been a 
new awareness that undiagnosed and untreated mental illness, in 
all its forms and with all of its consequences, is as damaging 
as physical illness is to the Nation's well-being.
    The human brain project.--The Committee was pleased to 
receive the report from the NIMH on the human brain project 
which it has requested last year. The Committee is pleased to 
see that this research initiative is being implemented as a 
multiagency effort, and that the number of Federal 
organizations participating has grown from 11 to 16, including 
12 Institutes and Centers of the National Institutes of Health. 
The coordination of the planning and funding of the human brain 
project across agencies, institutes, and centers is an 
excellent example of how the Federal Government can respond 
effectively to emerging needs of society and to opportunities 
for advancing science and technology.
    The research now funded under the human brain project is 
forgoing a new scientific area of inquiry called 
neuroinformatics. The Committee is pleased that the human brain 
project has allowed the United States to attain the preeminent 
position in this area of science and technology. The Committee 
would like to be kept apprised of the progress of this effort 
and directs the NIMH to submit an update on the human brain 
project prior to next year's hearings.
    Psychopharmacology research in children and adolescents.--
Growing evidence suggests that psychotherapeutic medications 
are increasingly prescribed for use in children and adolescents 
with emotional, behavioral, and mental disorders. Yet knowledge 
of the safety and efficacy of such agents has not kept pace 
with clinical practices, with the result that many of the drugs 
currently prescribed for children and adolescents are used in 
the absence of detailed information on their possible effects. 
The Committee is supportive of NIMH efforts to address this 
situation, by funding a multisite study of mental health 
service use, need, outcomes, and costs in child and adolescent 
populations [UNO-CAP]. UNO-CAP aims to learn more about the 
types of services, efficacy, and cost effectiveness of mental 
health treatment for children and adolescents age 4 to 17.
    Social work services.--The Committee applauds the NIMH for 
funding its third social work research development center and 
recommends that NIMH continue its efforts to develop social 
work research, including considering funding an additional 
social work research development center during 1996. The 
Committee is supportive of the recommendations of the 1991 NIMH 
task force report on ``Social Work Research'' and requests the 
Institute be prepared to report on the status of implementation 
by the fiscal year 1997 budget hearings.
    Emergency medical services for children [EMS-C].--The 
Committee remains supportive of EMS-C projects that address the 
mental health component of emergency health services in 
conjunction with the physical care aspects of EMS-C, and 
encourages NIMH to collaborate with various professional 
organizations, such as the American Academy of Pediatrics, to 
develop comprehensive EMS-C care standards that support the 
family.
    Basic behavioral sciences.--The Committee is pleased to 
have received from the National Advisory Mental Health Council 
its report: ``Basic Behavioral Science Research for Mental 
Health: A National Investment,'' which identifies promising 
research directions for the basic behavioral sciences at NIMH. 
Because behavioral and psychosocial factors play such a 
critical role in both physical and mental health and illness, 
the Committee believes that basic behavioral research on these 
factors is particularly important for the development of 
solutions to these costly and debilitating problems. The 
Committee urges NIMH to begin implementation of the 
recommendations contained in the report.
    Prevention.--In keeping with the Committee's interest in 
NIMH support for prevention research, the Committee commends 
the NIMH for developing an implementation plan to address the 
recommendations of the 1994 Institute of Medicine report: 
``Reducing Risks for Mental Disorders: Frontiers for Preventive 
Intervention Research,'' and urges timely implementation by 
NIMH of two areas of prime importance. First, to meet the need 
to train mental disorder prevention researchers, the Committee 
supports NIMH in expanding funding for the B-START program, 
both for those at the beginning stages of their career and for 
career transitions to behavioral science research. Second, the 
Committee urges NIMH to take the lead in coordinating efforts 
to prevent mental disorders, including support for an Institute 
of Medicine round table created for this purpose.
    Rural mental health.--The Committee is very pleased with 
the work of the rural mental health research centers. 
Sufficient funding is provided to continue the initiative in 
rural mental health.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 1995....................................    $349,367,000
Budget estimate, 1996...................................     375,914,000
House allowance.........................................     390,339,000

Committee recommendation

                                                             371,707,000

    The Committee recommends an appropriation of $371,707,000 
for the National Center for Research Resources [NCRR]. This is 
$4,207,000 less than the administration's request, $22,340,000 
more than the fiscal year 1995 appropriation, and $18,632,000 
less than the House allowance. The comparable numbers for the 
1995 appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NCRR develops and supports critical research 
technologies and shared resources that underpin research to 
maintain and improve the health of our Nation's people. The 
NCRR programs develop a variety of research resources; provide 
biomaterial and resources for complex biotechnologies, clinical 
research, and specialized primate research; develop research 
capacity in minority institutions; and enhance the science 
education of precollege students and the general public.
    Shared resources.--The Committee encourages the NCRR to 
expand its support for shared resources, particularly its 
resource centers in clinical research, biotechnology, and 
primate research. These resources provide a cost-effective 
means for NIH-supported researchers to conduct a variety of 
research programs, without the need for direct grant support by 
the Institute or Center.
    Gene therapy.--The Committee notes with interest that, 
along with several of the categorical institutes of NIH, NCRR 
has established national gene vector laboratories centers. 
These centers will offer state-of-the-art resources for 
researchers to use on a shared and cost-saving basis and will 
provide scientists across the Nation with access to the vectors 
for gene therapy and enable the advancement of this exciting 
area of research.
    Minority programs.--The Committee continues to be committed 
to programs for enhancement of minority participation in 
research. The research centers in minority institutions [RCMI] 
are greatly increasing the capacity of minority institutions 
that grant doctoral degrees in health-related sciences to 
participate in research. In fiscal year 1996, the Committee 
understands the NCRR will continue to develop clinical research 
infrastructure at RCMI institutions affiliated with medical 
schools, which will increase the numbers of minority 
researchers, boost minority representation in research 
projects, and expand research on health problems of 
underrepresented populations. In addition, the Minority High 
School Research Apprentice Program will continue to encourage 
minority students from kindergarten through 12th grade to 
consider careers in science and research.
    The National Center for Research Resources [NCRR] is to be 
commended for its continued efforts to improve the research 
infrastructure of minority institutions capable of improving 
the disparity in the health status of the minority populations 
they serve. The Committee is pleased that the NCRR, together 
with the National Institute of Diabetes and Digestive and 
Kidney Diseases [NIDDK] and the Office of Research on Minority 
Health [ORMH], are supporting efforts in both intervention and 
prevention of diseases that disproportionately affect native 
Hawaiians, African-Americans, and Hispanic Americans. The 
Committee encourages NCRR to continue its leadership role in 
developing the research infrastructure to address the impact of 
diabetes, infant mortality, heart disease, AIDS, and various 
cancers on the population served by the research centers on 
minority health [RCMH].
    Extramural facilities.--The Committee has included 
$11,000,000 for extramural biomedical facility renovation and 
construction, $9,000,000 less than recommended by the House and 
the same as requested by the administration. These funds are to 
be awarded on a competitive basis consistent with section 481A 
and 481B of the Public Health Service Act. The Committee 
recommendation includes $2,500,000 for grants under section 
481B, within the total for extramural construction.
    The Committee understands that several extramural 
construction grants were approved but not funded in fiscal year 
1995 and recommends the NCRR give consideration in fiscal year 
1996 to these proposals which already have been competively 
reviewed without having to resubmit their proposals. The 
Committee has learned of additional facilities construction and 
renovation needs from several research institutions.
     The Committee is very interested in the proposal of the 
Coriell Institute for Medical Research which encompasses the 
establishment of a National Human Cell Repository Center 
[NHCRC]. The Committee is aware of comments from the NIH 
Biomedical Research Facilities Review Board, including one 
which stipulated, ``a centralized facility such as the NHCRC 
will be a valuable asset to the scientific community.'' 
Accordingly, the Committee urges the Center give full and fair 
consideration to a proposal from the Corriell Institute.
    The Committee also is aware of a proposal from the Medical 
College of Virginia/Virginia Commonwealth University to 
construct a center for the study of intractable epilepsy and 
from the Florida A&M; University for construction of a pharmacy 
and biomedical research building and recommends the Director 
give full and fair consideration of proposals from these 
institutions.
    Finally, the Committee is aware of a proposal from the 
University of Pennsylvania Dental School and urges the NCRR to 
ensure the proposals for expansion oral health research 
facilities are given full and fair consideration.
    Biological models and materials.--The Committee strongly 
supports the NCRR's biological models and materials research 
program activity of exploring and developing alternatives to 
the use of animals in biomedical research, and therefore 
directs the NCRR to fund such alternatives as part of a 
comprehensive Federal strategy to maintain our position as the 
world's biomedical research leader. The Committee is aware of 
one such alternative, the National Disease Research Interchange 
[NDRI], whose mission is to ensure regular access to human 
tissues and organs for biomedical researchers throughout the 
country. Breakthroughs in the treatment and cure of many 
diseases can be expected through the use of human tissues and 
organs for research. Accordingly, the Committee directs the 
NCRR to provide not less than the Council-recommended level for 
this resource to allow it to continue to provide its unique 
services to researchers in over 100 disease categories.
    IDeA grants.--The Committee has provided $2,100,000 for the 
Institutional Development Award [IDeA] Program authorized by 
section 402(g) of the Public Health Service Act. This is 
$1,000,000 over both fiscal year 1995 and the budget request. 
The program is intended to broaden the geographic distribution 
of NIH funding of biomedical research through enhancing the 
competitiveness of institutions that conduct biomedical and 
behavioral research which historically have had low rates of 
success in obtaining funding.

               NATIONAL CENTER FOR HUMAN GENOME RESEARCH

Appropriations, 1995....................................    $152,866,000
Budget estimate, 1996...................................     167,678,000
House allowance.........................................     170,041,000

Committee recommendation

                                                             165,888,000

    The Committee recommends an appropriation of $165,888,000 
for the National Center for Human Genome Research [NCHGR]. This 
is $1,790,000 less than the administration's request, 
$13,022,000 more than the fiscal year 1995 appropriation, and 
$4,153,000 less than the House allowance. The comparable 
numbers for the 1995 appropriation, the budget estimate, and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The House allowance did not 
include an appropriation for the Office of AIDS Research.
    Mission.--The NCHGR coordinates extramural research and 
research training for the NIH component of the human genome 
project, an international effort to determine the location and 
sequence of the estimated 100,000 genes which constitute the 
human genome. The Division of Extramural Research supports 
research in genetic and physical mapping, DNA sequencing and 
technology development, data base management and analysis, and 
studies of the ethical, legal, and social implications of human 
genome research. The Division of Intramural Research [DIR] 
focuses on applying the tools and technologies of the human 
genome project to understanding the genetic basis of disease 
and developing DNA-based diagnostics and gene therapies. Since 
its establishment in 1993, the DIR has developed a strong 
research program and forged collaborative ties with several of 
the NIH research institutes to unravel the complexities of 
genetic diseases such as diabetes, breast and colon cancer, and 
melanoma.
    Genetic testing.--The Committee understands that in fiscal 
year 1996, results will be forthcoming from pilot studies 
examining the issues surrounding genetic testing and counseling 
for predisposition to breast, ovarian, and colon cancer. In 
addition, the NIH-DOE joint working group on the ethical, 
legal, and social implications of human genome research has 
established a task force on genetic testing to examine current 
practices and policies surrounding the safety and efficacy of 
new genetic tests. In the intramural program, the Medical 
Genetics Branch has established a new graduate program for 
genetic counselors in collaboration with the Johns Hopkins 
University. This program will train graduates to become 
effective genetic counselors and to conduct research in the 
field of genetic counseling. The Committee commends the Center 
for its activities in this area and urges that it continue to 
be given high priority.

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

Appropriations, 1995....................................     $23,775,000
Budget estimate, 1996...................................      24,961,000
House allowance.........................................      25,313,000

Committee recommendation

                                                              24,666,000

    The Committee recommends an appropriation of $24,666,000 
for the Fogarty International Center [FIC]. This is $295,000 
less than the administration's request, $891,000 more than the 
fiscal year 1995 appropriation, and $647,000 less than the 
House allowance. The comparable numbers for the 1995 
appropriation, the budget estimate, and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The primary function of the FIC is to improve the 
health of the people of the United States and other nations 
through international cooperation in the biomedical sciences. 
In support of this mission, the FIC pursues the following four 
goals: mobilize international research efforts against global 
health threats; advance science through international 
cooperation; develop human resources to meet global research 
challenges; and provide leadership in international science 
policy and research strategies.
    New and emerging infectious diseases.--The recent Ebola 
virus epidemic in Zaire is illustrative of the challenges of 
dealing with new and reoccurring health threats. Other such 
outbreaks in the United States and abroad include Hantavirus, 
Crytosporidium, hemorrhagic and dengue fevers, and Hepatitis C. 
The Committee is supportive of plans to provide leadership in 
the development of research and training programs to mobilize 
global scientific efforts to meet these challenges through 
international studies on microbes, hosts, vectors, and 
environmental and social factors that lead to the emergence of 
infectious diseases.
    International tuberculosis effort.--Elimination of 
tuberculosis in the United States can only be achieved by 
controlling the disease in developing countries where more than 
90 percent of all the world's cases are presently located. 
Preliminary figures for the United States in 1994 showed that 
fully one-third of all persons with newly diagnosed 
tuberculosis were of foreign origin.
    The Committee encourages the Fogarty International Center 
to expand its current efforts to combat tuberculosis in 
developing countries. In this regard, the Committee notes the 
longstanding work of the International Union Against 
Tuberculosis and Lung Disease in international tuberculosis 
control, as well as the resources presently available at the 
U.S.-based tuberculosis model centers. Given the relationship 
between HIV infection and the increased incidence of 
tuberculosis, this program would seem to be an excellent 
complement to the already existing and highly successful 
international AIDS program carried out by the Fogarty 
International Center.
    Infectious diseases.--The Committee commends the FIC for 
the work it has done in the area of infectious diseases of 
international origin. The Committee encourages the Center to 
continue its efforts in this area, as well as consider other 
translational factors that contribute to the world's disease 
burden.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 1995....................................    $128,694,000
Budget estimate, 1996...................................     139,473,000
House allowance.........................................     141,439,000

Committee recommendation

                                                             137,977,000

    The Committee recommends an appropriation of $137,977,000 
for the National Library of Medicine [NLM]. This is $1,496,000 
less than the administration's request, $9,283,000 more than 
the 1995 appropriation, and $3,462,000 less than the House 
allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--The National Library of Medicine collects, 
organizes, disseminates, and preserves biomedical literature, 
in all forms and wherever published. The collection, and the 
information services NLM has created, are available onsite at 
the library in Bethesda, MD. They are also available to U.S. 
health professionals through interlibrary loan and via online 
data bases. In addition to maintaining its collection, the 
library has statutory responsibility to conduct research into 
biomedical communications and biotechnology. It also has an 
extramural grant program to support health science libraries 
and the services they provide to their clientele. Finally, the 
library creates specialized information services in such 
crucial areas as health services research, environmental 
health, hazardous substances, and toxicology.
    Outreach.--NLM's legislation specifically requires it to 
publicize the availability of its services; this has led to the 
creation of a vigorous program of outreach to the health 
professions. Although the library's information services are 
widely available, there are still many health professionals--
especially in rural areas--who could benefit from being 
connected to them. More than 200 projects have been undertaken 
over the last several years that seek to bring NLM's 
information services to, for example: rural and inner-city 
health workers, schools with large minority enrollments, 
community organizations serving those with HIV/AIDS, the 
Mississippi Delta area, the Texas-Mexico border area, and 
Indian Health Service health workers. Extensive outreach 
programs would not be possible without the cooperation of the 
regional medical libraries and other members of the National 
Network of Libraries of Medicine.
    The Committee encourages NLM to continue its special 
outreach efforts to bring the benefits of its information 
systems to all American health professionals. Providing 
information access to health professionals in remote rural and 
inner-city areas is a high priority.
    The Committee supports the NLM's efforts toward improving 
health care information sharing among clinicians, researchers, 
educators, and other health professionals through the 
implementation of the national information superhighway, and 
programs such as internet. In order to maximize the 
productivity of these activities, the Committee urges that they 
be effectively coordinated through the use of medical 
librarians and other health information specialists. The 
Committee requests that the NLM be prepared to report on 
outreach funding and activities planned for fiscal year 1997 
during the budget hearings next year.
    Telemedicine.--The Committee has provided sufficient funds 
to enable the National Library of Medicine to build on previous 
investments in telemedicine test-bed networks to evaluate the 
impact of telemedicine on cost, quality, and access to care. In 
addition, in a study funded by the NLM, the Health Care 
Financing Administration, and the Department of Veterans 
Affairs, the Institute of Medicine is currently identifying key 
criteria for evaluation of the impact of operational 
telemedicine projects. The Committee understands NLM will work 
with its existing test-bed sites to apply these criteria to a 
variety of telemedicine projects.
    Bioethics.--The Committee encourages the National Library 
of Medicine to provide continued support for the program for 
bioethics bibliographic research within available funds.

                         OFFICE OF THE DIRECTOR

Appropriations, 1995....................................    $239,859,000
Budget estimate, 1996...................................     257,854,000
House allowance.........................................     261,488,000

Committee recommendation

                                                             260,374,000

    The Committee recommends an appropriation of $260,374,000 
for the Office of the Director [OD]. This is $2,520,000 more 
than administration's request, $20,515,000 more than the fiscal 
year 1995 appropriation, and $1,114,000 less than the House 
allowance. The comparable numbers for the 1995 appropriation, 
the budget estimate, and the Committee recommendation include 
funds to be transferred from the Office of AIDS Research. The 
House allowance did not include an appropriation for the Office 
of AIDS Research.
    Mission.--The Office of the Director provides leadership 
and direction to the NIH research community, and coordinates 
and directs initiatives which crosscut the NIH. The OD is 
responsible for the development and management of intramural 
and extramural research and research training policy, the 
review of program quality and effectiveness, the coordination 
of selected NIH-wide program activities, and the administration 
of centralized support activities essential to operation of the 
NIH.
    The Office of Research on Women's Health.--The Office of 
Research on Women's Health [ORWH] works to coordinate, refine, 
and expand the programs and activities, of the NIH to address 
the inclusion of women in clinical research and to promote 
biomedical careers for women. In addition, the ORWH is charged 
with developing new collaborative initiatives to address 
continuing gaps in knowledge about women's health which affect 
both mortality and morbidity.
    The Committee has directed the Office of Women's Health in 
the Office of the Secretary to develop and implement the 
national women's health clearinghouse and has directed that the 
Public Health Service agencies contribute a total of $1,400,000 
to this effort, each agency contributing their proportionate 
share as determined by the Office of the Secretary. Sufficient 
funding has been included to provide that support to the 
clearinghouse.
    Women's health initiative.--This initiative is a large 
cross-Institute study regarding the prevention of conditions 
afflicting a large number of women, such as, breast cancer, 
heart disease, and osteoporosis. There are three components of 
the study: a clinical trial; an observational study; and a 
community prevention study. In fiscal year 1996, funds will be 
used to support continued activities in the coordinating center 
and the 40 clinical centers. Funds also will be used to plan 
the community prevention component.
    Office of Research on Minority Health.--The Office of 
Research on Minority Health [ORMH] is the coordinating office 
for minority health research and research training efforts at 
the NIH. ORMH programs strive to improve the health status of 
all minorities across the lifespan and to increase the numbers 
of minorities pursuing careers in the biomedical sciences. 
Additional activities of the ORMH include providing 
supplemental support to ICD projects, developing programs to 
increase minority participation in clinical trials, initiating 
and supporting infrastructure development projects at minority 
institutions, and developing programs to increase the 
competitiveness of grant applications submitted by minority 
researchers.
    The recent discovery of the connection between the 
bacterium Helicobacter Pylori and peptic ulcer disease as well 
as gastric cancer offers an exciting opportunity to work toward 
the eradication of these diseases. Several studies have shown a 
higher rate of H. pylori infection in minorities, possibly 
accounting for the higher gastric cancer rates in these 
populations. The Committee encourages the ORMH to collaborate 
with the NIDDK, the NCI, and the NIAID on the development and 
implementation of a cooperative research plan on H. pylori 
infection in minorities.
    The Committee continues to be supportive of the 
collaborative activities of the ORMH with the NIDDK regarding 
minority health, particularly in the area of the genetics of 
diabetes and the treatment and prevention of diabetes in 
minority populations. The Committee understands that diabetes 
disproportionately affects minority populations and encourages 
the ORMH to continue this important collaboration.
    The Committee has provided adequate funding for the 
continuation and growth of a variety of competitive programs at 
NIH that emphasize improving the health status of disadvantaged 
populations, including racial and ethnic minorities. The 
Committee has placed special emphasis on the MARC, MBRS, RCMI, 
and ORMH programs, and expects these programs to continue to be 
thoroughly supported.
    The Committee urges the Director to ensure that research 
projects involving native Hawaiians, Asian, and Pacific 
islanders, be given full and fair consideration by the NIH and 
that they be appropriately incorporated into projects supported 
by the minority health initiative.
    Minority health initiative.--The minority health initiative 
[MHI] is tailored to improve the overall health of minorities 
through expanded research and to provide training to more 
minority biomedical researchers. The goals of the MHI include 
continuing initiatives in collaboration with several 
institutes, addressing newly emerging areas of research such 
as: health and behavioral effects of lead exposure in childhood 
in inner-city neighborhoods; and the health of minority women. 
In addition, MHI funds will support all minority research 
training efforts.
    Neurodegenerative disorders initiative.--The Committee 
commends the NIH for the development of high priority research 
areas and areas of special emphasis in the budget request. 
These special emphasis areas, selected by the President and 
NIH, have been chosen because of the promise to yield a greater 
return on the Federal investment in biomedical research. NIH 
Institutes, Centers, and Divisions supporting research in these 
areas participate in an ongoing analysis of the research 
portfolio to ensure that NIH is committing its resources to 
reflect these priorities. Research areas of special emphasis 
include: tuberculosis, women's and minority health, breast 
cancer, AIDS, brain disorders, disorders of developmental and 
reproductive biology, bone, muscle, and connective tissue 
diseases, mutations and environmental cancer, DNA sequencing 
technology, prevention, gene therapy, and structural biology 
and drug design.
    The Committee has received compelling testimony this year 
on the promise of intensified research on neurodegenerative 
disorders. Research into neurodegenerative disorders offers the 
benefit of significant improvement in the quality of life and 
savings in long-term care and health care costs for millions of 
Americans. For example, simply delaying the onset of 
Alzheimer's disease for 5 years, which today afflicts over 4 
million individuals and is projected to afflict over 14 million 
by the next decade, could yield savings in excess of 
$50,000,000,000 annually. Another example, by slowing the 
progression of Parkinson's disease by just 10 percent is 
estimated to save up to $327,000,000 a year. Other 
neurodegenerative disorders offer similar promise to develop 
new therapies to restore function and productivity, and to 
deliver a positive return on the Federal investment.
    The Committee is supportive of the Director's placing 
priority on brain disorders research. The Committee believes 
that in addition to brain disorders, research on 
neurodegenerative disorders, in particular, should receive 
special emphasis in fiscal year 1996. For this reason, the 
Committee recommendation includes $8,000,000 within the Office 
of the Director for an initiative to expand the basic and 
clinical research effort on neurodegenerative diseases, such as 
those identified. The Committee has decided not to render a 
judgment on the allocation of these additional funds among the 
neuroscience Institutes, but to leave the allocation decisions 
up to the Director to ensure the highest priority research 
among those Institutes is supported. The Committee requests 
that the Director prepare and submit a report on implementation 
of this initiative and the allocation of funds by February 15, 
1996.
    Office of Behavioral and Social Sciences Research.--The 
Committee is pleased to learn that the Office of Behavioral and 
Social Sciences Research will soon be fully implemented. The 
Committee anticipates that the OBSSR will provide the necessary 
structure to promote, facilitate, and increase behavioral and 
social science research at the NIH. The Committee urges the 
OBSSR to work in partnership with other NIH institutes and 
outside organizations to develop research on testing 
psychosocial and behavioral interventions and strategies aimed 
at improving patient disease management, adherence to 
treatment, appropriate utilization of medical care, and 
promoting expanded quality of life.
    The Committee notes with great interest the National 
Research Council report, ``Meeting the Nation's Needs for 
Biomedical and Behavioral Scientists.'' This report recommends 
placing high priority on NRSA awards to behavioral scientists 
in order to address a shortage of behavioral science 
researchers. The Committee expects the Director to provide an 
update during the fiscal year 1997 hearings on NIH's progress 
in implementing this recommendation and support for behavioral 
science researchers.
    Office of Rare Disease Research.--The Committee is pleased 
with the planning of the rare disease clinical research data 
base and monitoring system and anticipates the availability of 
information from this data base to match potential research 
participants with current clinical research projects. Increased 
participation in clinical research studies and easier access to 
research advances should lead to improved treatment for 
millions of patients with rare diseases or conditions. The 
Committee also recognizes the collaborative efforts of the 
Office, the National Cancer Institute's International Cancer 
Information Center, the Division of Research Grants, the 
General Clinical Research Centers Program, and the National 
Library of Medicine that have been required to reach the 
implementation phase in the development of this data base. 
Continued cooperation will be required in the future to 
maintain the high quality of information provided in this data 
base.
    The Committee recognizes the advances made in identifying 
the location of genes for rare and genetic diseases. The 
scientific research leading to the discovery of these genes is 
the result of many years of dedicated basic research. These 
discoveries have caused some confusion leading to the belief 
that treatment is or will soon be readily available through 
gene therapy. The Committee requests that the Office of Rare 
Disease Research working jointly with the National Center for 
Human Genome Research develop plans for establishing an 
information center to respond to inquiries about rare and 
genetic disorders.
    The Committee recognizes that NIH makes considerable 
resources available to support research on the rare diseases 
and conditions. The Committee requests that the Office of Rare 
Disease Research working jointly with the research institutes 
and centers of the NIH, and other Federal agencies with 
recommendations from voluntary health organizations, and the 
pharmaceutical and biotechnology industries prepare and submit 
to the Committee prior to the hearings for fiscal year 1997 a 
report on steps to coordinate rare disease research programs 
within existing research funds and resources.
    The recommendation includes $1,275,000 for the Office of 
Rare Disease Research to complete the implementation of the 
clinical research data base, to continue support for scientific 
workshops and symposia to stimulate rare disease research, to 
support the development of plans to coordinate rare disease 
research activities, and the operational activities of the 
Office.
    Indirect costs.--The Committee understands that the 
administration has issued a comprehensive list of proposed 
changes to the Federal policies and regulations that govern the 
reimbursement of indirect costs. The Committee supports these 
proposed changes which, among other things, will provide 
greater assurances regarding Federal reimbursement for 
facilities costs, and require the use of terminology that 
reflects the actual costs that are to be reimbursed (that is, 
administrative costs and facilities costs). Last year, the 
Committee called for the administration to review the practice 
of charging to research grants the cost of tuition for family 
members of faculty and staff. The Committee is pleased to see 
that the administration has included the elimination of this 
practice in its list of proposed changes and urges the 
implementation of these changes as soon as possible.
    The Committee believes that added to the changes made in 
1991 and 1993, the new 1995 proposals reflect significant 
changes to the Federal system of reimbursement for these 
infrastructure costs. However, questions about this system 
persist, and careful consideration should be given to ensuring 
a system that is simple, predictable, sustainable, and cost 
effective. The Committee is aware of and supports efforts 
underway by the university community to explore new and 
innovative ways to reimburse institutions for the legitimate 
costs of supporting university-based research and would like to 
be kept informed of these efforts. The Committee also urges the 
community to work closely with the Federal research agencies, 
the Office of Science and Technology Policy, and the Office of 
Management and Budget as proposals for reform move forward. 
Finally, once a new method for reimbursement has been agreed 
upon, the Committee believes that thoughtful planning and ample 
time should be given to the transition process.
    Clinical research.--The Committee is concerned at the slow 
pace NIH is proceeding with the implementation of the 
recommendations of the Institute of Medicine Committee on 
Clinical Research, which published its report 1 year ago. The 
Committee commends the Director for the recently appointed 
Director's Advisory Panel on Clinical Research, and recommends 
as expeditious timeline as possible for addressing an issue 
that requires immediate solutions. The Committee urges the NIH 
Director to build upon steps undertaken to strengthen and 
expand clinical research training opportunities; to expand the 
General Clinical Research Centers Program and GCRC training 
opportunities; and to develop a loan forgiveness program 
available to both intramural and extramural scientists who 
pursue careers in clinical research. The Committee views this 
matter with such importance that it would consider a proposal 
from the Director to utilize the 1-percent transfer authority 
to implement the changes in fiscal year 1996.
    Improving clinical research peer review.--The Committee is 
concerned that vital clinical (or patient-oriented) research is 
not receiving adequate peer review at NIH. To help redress the 
balance between basic and clinical research, the Committee 
directs the Division of Research Grants to modify existing 
review panels to include adequate representation of 
translational scientists; and broaden the criteria for study 
section participation to include those who have received grants 
reviewed by the institutes (where most clinical research is 
evaluated) in addition to those receiving grants reviewed by 
DRG.
    Pediatric research.--The Committee recognizes the 
substantial benefits that biomedical research offers to the 
health and well-being of our Nation's children. Savings from 
productive innovations in health care, derived from scientific 
investigations of the highest quality, can be significant in 
terms of dollars and quality of life for children. The 
opportunities for advancements in the prevention and treatment 
of diseases which affect children or begin in childhood have 
never been greater. The Committee intends to work with the 
Office of the Director as it explores ways to take advantage of 
such opportunities and strengthen the NIH's capacity to support 
and encourage extramural pediatric research. Of particular 
interest is the establishment of guidelines to include children 
in clinical research trials conducted and supported by the NIH.
    Diagnostic radiology.--At the Committee's direction, NIH 
recently completed a conference which found that the results of 
radiological science have become keystones in patient 
diagnosis, management, and therapy. Furthermore, as scientists 
push back the frontiers of understanding disease, the conferees 
concluded, radiological research may soon become essential for 
transferring many of the fundamental discoveries of molecular 
medicine to routine clinical practice. Given the potential 
radiological research holds for saving lives and lowering 
health care costs, the Committee directs that the NIH prepare 
and submit a report prior to next year's hearings describing 
what actions it plans to take in response to the findings of 
its conference on radiological research. The Committee further 
is supportive of the NIH maintaining the central focus afforded 
by the Laboratory for Diagnostic Radiology Research in the 
Office of the Director.
    Bionutrition.--The Committee fully supports the trans-NIH 
nutrition initiative and urges its continuation in fiscal year 
1996, including the use of requests for applications where 
necessary. Enhancing through research our understanding of the 
impact of nutrition on disease and improving its clinical 
application will assist in preventing disease and its 
complications and provide savings for the health care system. 
Nutrition research is particularly important in the prevention 
of diseases associated with women's health including breast 
cancer, and osteoporosis, and in the area of critical care 
including infant care.
    Osteoporosis and related bone diseases.--In the fiscal 
years 1994 and 1995 reports, the Committee urged NIH to 
increase its research efforts in osteoporosis and related bone 
diseases such as Paget's disease. Specifically, the Committee 
directed the four institutes primarily involved in bone disease 
research, NIAMS, NIA, NIDDK, and NIDR to expand and intensify 
their bone disease research programs. Last year, the Committee 
provided additional funding to three of these institutes for 
such purpose. The Committee is concerned that little, if any, 
additional research in the area of bone disease has been 
initiated by these institutions as a result of the Committee's 
direction. The Committee, therefore, requests the NIH to be 
prepared to report to the Committee by January 15, 1996, on the 
specific steps it has taken to implement new research 
initiatives in bone disease since October 1994.
    Chronic fatigue and immune dysfunction syndrome.--The 
Committee recommends that additional funding within NIH be 
directed toward CFIDS [CFS] research, most of which should be 
directed to extramural grants focused on promising areas of 
biomedical research. NIH is encouraged to direct spending 
priorities toward investigations which seek to identify the 
etiological agent(s) and markers for the pathophysiology of 
CFIDS [CFS]. Sufficient funds have already been provided for 
the coordination of CFIDS [CFS] research within the National 
Institute of Allergy and Infectious Diseases [NIAID], the lead 
institute for CFIDS [CFS] research and to expand the CFIDS 
[CFS] cooperative research centers [CRC's] to capitalize on 
accomplishments made by existing CRC's. The Committee believes 
that NIH can maximize its research efforts by investing in a 
CFIDS [CFS] Coordinator with institutewide authority to provide 
leadership on CFIDS [CFS] and by continuing to secure attention 
to CFIDS [CFS] research through the small grants program. The 
Committee looks forward to the results of the NIAID Advisory 
Council meeting scheduled for the fall of 1995 that focuses on 
CFIDS.
    Small Business Innovation Research Program.--The Committee 
notes that a recent General Accounting Office Study (GAO/RCED-
95-59, ``Small Business Innovation Research Program'') has 
raised questions about the merit of small business innovation 
research projects funded by the National Institutes of Health 
[NIH]. The Committee directs the NIH to be prepared to provide 
an accounting of SBIR proposals submitted, their priority 
scores and funding status for fiscal years 1994 and 1995, 
during the fiscal year 1997 budget hearings.
    Prevention research.--The Committee encourages NIH to 
recognize the important contributions of population-based 
approaches to health promotion and disease prevention and 
includes public health sciences, as well as behavioral 
sciences, in the NIH definition of basic biomedical research.
    Office of Dietary Supplements.--There is mounting evidence 
on the important role dietary supplements can have in 
maintaining and improving health. More and more Americans are 
seeking to improve their dietary intake and improve their 
health through the use of dietary supplements. Expanded and 
improved research into dietary supplements is needed and would 
prove very beneficial to consumers. In recognition of this, the 
Dietary Supplement Health and Education Act passed last year 
mandated the establishment of an Office of Dietary Supplements 
within NIH. In compliance with this mandate, an Office has been 
established and has already begun its mandated functions from 
within Office of the Director funds. The Committee strongly 
supports this important new Office and has included funding for 
its operation and expansion. The Committee urges the Office to 
provide an analysis of current NIH research on dietary 
supplements. Funding is provided for this Office to carry out 
its mandated duties as prescribed by the Dietary Supplement 
Health and Education Act.
    Office of Alternative Medicine.--The Committee continues to 
strongly support the work of the Office of Alternative 
Medicine. The Committee is pleased that a new Director of the 
Office is now in place and looks forward to receiving both a 
short- and long-term operational plan for the OAM. Among its 
other activities, the Office is encouraged to expand its work 
to develop greater consensus on the most appropriate ways to 
evaluate alternative therapies, particularly those underpinning 
which are fundamentally different theories of body function and 
disease. Alternative therapies should be held to rigorous 
review to determine their usefulness to consumers. The 
Committee continues to believe that the essential role of the 
OAM is to provide consumers greater information about 
alternative therapies so as to assure them improved access to 
such therapies that can help them and to protect them from 
false and misleading claims about those that will not.

                        BUILDINGS AND FACILITIES

Appropriations, 1995....................................    $114,120,000
Budget estimate, 1996...................................     144,120,000
House allowance.........................................     146,151,000

Committee recommendation

                                                             140,384,000

    The Committee recommends an appropriation of $140,384,000 
for buildings and facilities [B&F;]. This is $3,736,000 less 
than the administration's request, $26,264,000 more than the 
fiscal year 1995 appropriation, and $5,767,000 less than the 
House allowance.
    Mission.--The buildings and facilities appropriation 
provides for the NIH construction programs including design, 
construction, and repair and improvement of the clinical and 
laboratory buildings and supporting facilities necessary to the 
mission of the NIH. This program maintains physical plants at 
Bethesda, Poolesville, Baltimore, and Frederick, MD; Research 
Triangle Park, NC; Hamilton, MT; Perrine, FL; New Iberia, LA; 
and Sabana Seca, PR. The NIH is developing updated campus plans 
scheduled for completion in December 1995, for both the 
Bethesda campus and the NIH Animal Center in Poolesville.
    Construction programs.--The funds provided reflect the 
continuing high priority placed on essential safety and health 
improvements to maintain safety of the NIH Clinical Center; for 
the continuation of the campus infrastructure modernization 
program as well as programs for powerplant safety, asbestos 
abatement, fire protection and life safety, the elimination of 
barriers to persons with disabilities, safety and reliability 
upgrades at the Rocky Mountain Laboratory, indoor air quality 
improvement, and the construction of a new fire station. Also 
provided are funds to begin the renewal of the Clinical Center 
Complex, for the construction of the Consolidated Laboratory 
Building, replacement facilities at the NIEHS, and the final 
annual payment related to the Turner Construction Co., claim 
settlement.
    The Committee notes that the NIH is still reviewing several 
options to finance and construct a new clinical center on the 
NIH campus. The Committee concurs with the House directive that 
it be notified of NIH's plans regarding design and 
construction, before any commitments are made to begin the 
project.

                        OFFICE OF AIDS RESEARCH

Appropriations, 1995....................................  $1,335,726,000
Budget estimate, 1996...................................   1,407,824,000
House allowance.........................................................

Committee recommendation

                                                           1,388,678,000

    The Committee recommends an appropriation of $1,388,678,000 
for Office of AIDS Research [OAR]. This is $19,146,000 less 
than the administration's request and $52,952,000 more than the 
fiscal year 1995 appropriation. The House did not provide 
separate funding to the Office of AIDS Research.
    The NIH Office of AIDS Research [OAR] coordinates the 
scientific, budgetary, legislative, and policy elements of the 
NIH AIDS research program. Congress provided new authorities to 
the OAR to fulfill these responsibilities in the NIH 
Revitalization Act Amendments of 1993. The law mandates the OAR 
to develop an annual comprehensive plan and budget for all NIH 
AIDS research and to prepare a Presidential bypass budget.
    OAR established a unique and inclusive process involving 
scientific experts from Government, academia, industry, and 
foundations as well as community representatives to develop the 
plan, which sets forth scientific opportunities and priorities 
and serves as the framework for the budget. OAR supports six 
trans-NIH coordinating committees to assist in these efforts in 
the following areas: Natural history and epidemiology; etiology 
and pathogenesis; therapeutics; vaccines; behavioral research; 
and information dissemination.
    The law authorizes OAR to evaluate the AIDS research 
activities of the NIH. Utilizing expertise of nongovernment 
scientists and AIDS community representatives, OAR has 
undertaken a major evaluation initiative to review and assess 
each of the components of the NIH AIDS research endeavor to 
determine whether those components are appropriately designed 
and coordinated to answer the critical scientific questions to 
lead to better treatments, prevention, and a cure for AIDS. OAR 
established the NIH AIDS research program evaluation working 
group to carry out the evaluation, and, in addition, six area 
review panels were established to make recommendations to the 
working group. The evaluation, which the OAR intends to 
complete by early 1996, will serve a critical role in shaping 
future planning and budgeting of NIH AIDS research.
    The Committee is not including the House-proposed transfer 
of the Department of Defense [DOD] extramural AIDS research 
program to the NIH. While the House report language does not 
specify an exact amount, it has been estimated that the cost is 
approximately $25,000,000 to $35,000,000. Absorbing 
responsibility for this program by the NIH will require 
reductions in funding for high-priority NIH research and also 
require additional staff administration. Government downsizing, 
mandatory reductions in FTE's, and cuts in research, 
management, and support add to the difficulty such a shift in 
program management would impose on the NIH.

       Substance Abuse and Mental Health Services Administration

Appropriation, 1995.....................................  $2,181,330,000
Budget estimate, 1996...................................   2,247,392,000
House allowance.........................................   1,788,946,000
Committee recommendation...............................\1\ 1,869,928,000

\1\ Includes transfer of $200,000,000 from the Department of Education.

    The Committee recommends $1,869,928,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 1996. The amount recommended is $377,464,000 less 
than the administration request, $311,402,000 less than the 
fiscal year 1995 amount, and $80,982,000 more than the House 
allowance. The Committee has transferred $200,000,000 from the 
Department of Education to SAMHSA for a preventive services 
program in collaboration with the Education Department. SAMHSA 
is responsible for supporting mental health, alcohol abuse, and 
other drug abuse prevention and treatment services throughout 
the country, primarily through categorical grants and block 
grants to States.
    The President had proposed consolidating SAMHSA's separate 
categorical programs into two broader program authorities. The 
House consolidated these categorical programs into one 
demonstration authority. The Committee believes that the 
consolidation of demonstration lines must be limited to one for 
each center and has provided funding for three consolidated 
demonstration programs under general authority to support 
mental health, substance abuse treatment, and substance abuse 
prevention.
    Separate funding is also provided for the Children's Mental 
Health Program, for the Protection and Advocacy Formula Grant 
Program, and for the two block grant programs and the PATH 
formula grant. The Committee expects that SAMHSA will use the 
demonstration funds primarily to fund continuation projects 
which received separate line-item funding in fiscal year 1995, 
to the extent funding is available.

                   CENTER FOR MENTAL HEALTH SERVICES

Mental health block grant

    The Committee recommends $226,281,000 for the mental health 
block grant, $49,139,000 less than the fiscal year 1995 amount 
and the House allowance and $78,336,000 less than the 
President's request. States use these funds to support the 
development and implementation of innovative community-based 
services and maintain continuity of community programs. Funds 
are allocated to States by formula.
    The Committee has reduced funding for the block due to 
limited Federal resources. Note, however, that the mental 
health block grant accounts for only 1.8 percent of all State 
mental health funding; the substance abuse block grant, 30 
percent.

Projects for assistance in transition from homelessness [PATH]

    The Committee recommends $27,105,000 for the PATH Program, 
$2,357,000 less than the fiscal year 1995 amount. The House did 
not provide funding for this program. PATH funds, allotted to 
States by formula, provide services to individuals who suffer 
from a mental illness and are homeless or at risk of becoming 
homeless. These services include outreach, rehabilitation 
services, community mental health services, alcohol or drug 
treatment, case management, referral for primary health care, 
job training, and education.

Children's Mental Health

    The Committee recommends $58,326,000 for the Children's 
Mental Health Program, $1,674,000 less than the President's 
request, the 1995 level, and the House allowance. This program 
provides grants and technical assistance to support community-
based services for children and adolescents with serious 
emotional, behavioral or mental disorders. States must provide 
matching funds, and services must involve the educational, 
juvenile justice, and health systems. The Committee has 
provided sufficient funding to continue all 22 demonstration 
projects in fiscal year 1996.

Protection and advocacy

    The Committee recommends $20,200,000, $1,757,000 less than 
the fiscal year 1995 amount and $700,000 more than the House 
allowance. This program helps ensure that the rights of 
mentally ill individuals are protected while they are patients 
in treatment facilities and for 90 days following their 
discharge. Funds are allocated to States according to a formula 
based on population and relative per capita income.

Consolidated mental health training and demonstration programs

    The Committee recommends $38,100,000 for mental health 
training and demonstration programs, $14,192,000 less than the 
comparable fiscal year 1995 amount. The House provided one 
amount for all demonstration programs in SAMHSA. The following 
programs are included in this consolidation: Community Support 
Program [CSP]; homeless and AIDS demonstrations; and training 
and AIDS training programs. The Committee expects that SAMHSA 
will use the demonstration moneys primarily to fund 
continuation projects that received separate line-item funding 
in fiscal year 1995, in particular, grants and contracts for 
the training of mental health personnel, including social 
workers.
    The Committee is pleased that the Center for Mental Health 
funds state-of-the-art, peer-run programs that help people with 
mental illnesses live successfully in the community. These low-
cost services have an impressive record of assisting people 
with mental disorders decrease their dependence on expensive 
social services and avoid psychiatric hospitalization. Having 
proved effective, they have been replicated in numerous 
communities with State and local funding. The Center has also 
funded two national technical assistance centers that provide 
training and information to help these groups grow. The 
Committee has included sufficient funds to continue to support 
these two clearinghouses.
    The Committee encourages the Center for Mental Health 
Services to assist centers that specialize in treating persons 
who have been tortured by foreign governments. It recognizes 
that victims of torture, suffer from anxiety, depression, 
nightmares, flashbacks, and other mental disorders. With mental 
health service, they can become contributing members of their 
community.

Community Support Program

    The Community Support Program demonstrations seek to 
determine appropriate community-based alternatives for 
chronically mentally ill patients; increase the effectiveness 
of services and statewide service systems of care; and promote 
system improvements for seriously emotionally disturbed 
children and youth.

Clinical and AIDS training

    The Clinical Training Program trains mental health 
personnel to deliver services to designated underserved 
populations in exchange for a repayment through service to 
underserved or priority populations, including severely 
mentally ill adults, children and adolescents with serious 
emotional disorders, and the elderly. The AIDS Training Program 
provides training for mental health providers to address the 
neuropsychiatric aspects of HIV spectrum infection.
    The Committee recognizes the important role SAMHSA plays in 
supporting clinical training and HIV/AIDS professional 
training. The Committee is aware of the need for more trained 
mental health professionals, including social workers and 
psychologists, in rural and other underserved communities. The 
Committee urges the Secretary to fund training projects that 
foster cultural competencies, a diverse work force and 
collaboration among disciplines and that promote the use of 
exemplary interdisciplinary service delivery models. With the 
escalating HIV/AIDS epidemic, special attention must be given 
to increasing the number of trained mental health providers who 
can work with people suffering from this disease. Priority 
should be given to completing existing projects approved by 
SAMHSA under the current AIDS Training Program.

Homeless services demonstrations

    This program funds ACCESS demonstration grants which test 
effective approaches to services integration for homeless 
mentally ill and dually diagnosed adults. These grants support 
comprehensive community mental health services and demonstrate 
effective local interventions for serving homeless persons.

AIDS demonstrations

    This program provides grants to organizations to assist 
individuals who are experiencing severe psychological distress 
as a result of being informed that they are HIV positive.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Substance abuse block grant

    The Committee recommends $1,125,807,000 for the substance 
abuse block grant, $108,300,000 less the fiscal year 1995 level 
and the House allowance and $168,300,000 less than the 
President's request. The substance abuse block grant provides 
funds to States to support alcohol and drug abuse prevention, 
treatment, and rehabilitation services. Funds are allocated to 
the States according to formula. State plans must be submitted 
and approved annually.

Consolidated substance abuse, treatment, training, and demonstrations

    The Committee recommends $108,300,000 for the consolidated 
substance abuse, treatment, training, and demonstration 
programs. This amount is $93,404,000 less than the comparable 
fiscal year 1995 amount. The House provided one amount for all 
the demonstration and training programs in SAMHSA. The 
consolidated activities include target cities, women and 
children, criminal justice, critical populations, comprehensive 
community treatment programs [CCTP], and AIDS demonstrations 
and training. The Committee expects that SAMHSA will primarily 
use the demonstration moneys to fund continuation projects that 
received separate line-item funding in fiscal year 1995.
    The Committee recognizes that both substance abuse 
treatment and prevention programs are both effective and cost 
effective. Numerous studies have confirmed this, and a recent 
report by the Center of Substance Abuse Treatment, ``Producing 
Results: A Report to the Nation, 1995,'' documents the 
effectiveness of the treatment demonstration programs.
    In particular, the Committee recognizes that outreach to 
substance abusers not in treatment has been shown to be an 
effective approach to containment of HIV/AIDS among injecting 
drug users. These projects are demonstrating that substance 
abusers can be encouraged to enter treatment, thereby reducing 
behaviors which promote risk for HIV/AIDS. The Committee 
encourages SAMHSA to continue outreach demonstrations so that 
the field will continue to gain important knowledge to combat 
the spread of HIV/AIDS.

Treatment grants to crisis areas

    The target cities initiative is a series of 
intergovernmental cooperative agreements designed to improve 
treatment systems in metropolitan areas to link and integrate 
alcohol and other drug services with disease prevention, 
primary health, mental health, labor, education, and the 
justice system.
    The Committee is impressed with this demonstration program 
and encourages SAMHSA to give it priority in funding 
continuations.

Pregnant and post partum women and children

    This program supports residential treatment programs for 
pregnant and post partum women in residential settings that 
permits infants and children to live with their mothers. In 
addition, grants may support a comprehensive array of health, 
education, and other social services for mothers and their 
children.
    The Committee reiterates its strong support for this 
program, especially in light of welfare reform.

Criminal Justice Program

    The criminal justice initiative supports and evaluates 
projects which provide substance abuse treatment to 
incarcerated and nonincarcerated populations. Projects may 
support diversion-to-treatment and alternative sentencing 
programs, treatment for prisoners, and treatment for high-risk 
probation/parole clients.

Designated populations

    The Critical Populations Program funds outpatient treatment 
services for a variety of populations, including women and 
their children, such as those in or at risk of being in the 
child welfare system, adolescents, racial and ethnic 
minorities, and persons in rural areas. Projects are designed 
to initiate contacts with designated population groups and to 
encourage individuals to enter treatment.

Comprehensive community treatment programs

    The comprehensive community treatment programs offer a wide 
array of substance abuse treatment initiatives designed to 
improve the effectiveness and comprehensiveness of treatment 
services.

AIDS demonstrations and training

    The AIDS Outreach Program awards grants to organizations to 
engage particularly difficult to reach populations, including 
injecting drug users, their sexual partners and other high-risk 
substance abusers, in drug treatment and health services. The 
AIDS Linkage Program is a collaborative effort with HRSA to 
coordinate a broad array of substance abuse treatment, health, 
and other social agencies for injecting drug users, their 
sexual partners and other high-risk individuals. The AIDS 
Training Program, through a series of courses and workshops, 
supports the education of substance abuse treatment staff in 
providing HIV-related services.

Capacity expansion program

    The bill does not provide funding for the Capacity 
Expansion Program consistent with the President's request.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Consolidated youth substance abuse, prevention, and demonstrations 
        (drug free schools)

    The Committee has transferred $200,000,000 from the 
Department of Education's Safe and Drug Free School Program to 
the Center for Substance Abuse Prevention to fund demonstration 
projects aimed at preventing substance abuse among youth. The 
Committee intends that the Center for Substance Abuse 
Prevention [CSAP] develop a prevention services program that 
would make grants awards to communities that develop a 
cooperative plan for integration of prevention services in 
collaboration with the schools, parents, and other members of 
the community. The Committee expects that the Center for 
Substance Abuse would include an evaluation component for each 
of the grants.

Consolidated substance abuse, prevention, training, and demonstrations

    The Committee has provided $9,571,000 for the consolidated 
substance abuse, prevention, training, and demonstration 
programs. The House provided one amount for all the 
demonstration and program meetings in SAMHSA. The consolidated 
activities include high risk youth, pregnant women and infants, 
community partnership grants, public education, and 
dissemination and training.
    The Committee echoes the House's concern that CSAP may have 
adopted an informal policy of funding only grantees which have 
not received funding from sources within the alcohol or tobacco 
industries, and concurs with the House directive that SAMHSA 
discontinue any such policy whether formal or informal.

High-risk youth

    The Committee has not provided specific funding for the 
High-Risk Youth Program. This program is the principal 
knowledge development resource for the Nation in determining 
effective, pragmatical approaches in the development of drug 
abuse prevention services. The Committee believes that some of 
the projects funded by this program in fiscal year 1995 could 
be continued with the moneys transferred from the Department of 
Education's Safe and Drug Free Schools Program for activities 
consistent with the new community-based program.

Pregnant women and infants

    The Committee has not provided funding for this program. 
This program targets the substance abuse problems of pregnant 
post partum women and their infants. The ADAMHA Reorganization 
Act of 1992, Public Law 102-321, does not provide authority for 
funding new grants in this program, however, it would allow for 
phaseout of existing grants and contracts.

Community partnership grants

    The Community Partnership Program is designed to assist 
communities in developing comprehensive, coordinated prevention 
initiatives that include the formation of public/private sector 
partnerships and are responsive to local, State, and multistate 
needs. The Committee believes that some of the projects funded 
by this program in fiscal year 1995 could be continued with the 
moneys transferred from the Department of Education for 
activities consistent with the new community-based program.

Public education and dissemination

    These activities can be funded through the 5-percent 
Federal administrative set-aside in the substance abuse block 
grant and, to the extent appropriate, from the moneys 
transferred from the Department of Education.

Training

    This program supports three types of training: community 
prevention, health systems and professionals, and medical 
education.

                           PROGRAM MANAGEMENT

    The Committee recommends $56,238,000 for program management 
activities of the agency, $1,804,000 less than the 
administration request and a decrease of $4,890,000 from the 
1995 level. The program management activity includes resources 
for coordinating, directing, and managing the agency's 
programs. Program management funds support salaries, benefits, 
space, supplies, equipment, travel, and departmental overhead 
required to plan, supervise, and administer the programs of the 
Center for Mental Health Services, the Center for Substance 
Abuse Prevention, the Center for Substance Abuse Treatment, and 
the Office of the Administrator.
    The Committee believes that the strength of SAMHSA rests in 
the identity of its three centers and that Center Directors 
should establish the programmatic priorities for each 
demonstration authority. The Committee is concerned that the 
FTE level of the Office of the Administrator exceeds that of 
any of the program centers. This imbalance is inconsistent with 
current departmental streamlining initiatives. The Committee 
requests that SAMHSA report to the Appropriations Committees on 
the status of its streamlining activities no later than March 
31, 1996.
    The Committee has directed the Office of Women's Health in 
the Office of the Secretary to develop and implement the 
national women's health clearinghouse and has directed that the 
Public Health Service agencies contribute a total of $1,400,000 
to this effort, each agency contributing their proportionate 
share as determined by the Office of the Secretary. Sufficient 
funding has been included to provide that support to the 
clearinghouse.

                     Assistant Secretary for Health

              OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH

Appropriations, 1995....................................     $67,359,000
Budget estimate, 1996...................................      66,204,000
House allowance.........................................     166,925,000

Committee recommendation

                                             ...........................

    The Committee has not included separate funding for the 
Office of the Assistant Secretary for Health [OASH], but has 
provided funding in the Office of the Secretary for activities 
previously funded in OASH. The Committee notes that, as part of 
the President's ``Reinvention in Government II'' initiative, 
the Assistant Secretary's office is to merge with the Office of 
the Secretary. The Committee endorses this merger and believes 
that it should occur with proper planning as expeditiously as 
possible after October 1, 1995. The Committee believes that 
significant economies should result from this merger and 
expects a report on savings as part of the fiscal year 1997 
budget.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 1995....................................    $159,321,000
Budget estimate, 1996...................................     166,925,000
House allowance.........................................     166,925,000

Committee recommendation

                                                             166,925,000

    The Committee provides $166,925,000 for the ``Retirement 
pay and medical benefits for commissioned officers'' account. 
This is the same as the administration request and is 
$7,604,000 over the fiscal year 1995 appropriation.
    This account provides for: retirement payments to Public 
Health Service officers who are retired for age, disability, or 
length of service; payments to survivors of deceased officers; 
medical care to active duty and retired members and dependents 
and beneficiaries; and for payments to the Social Security 
Administration for military service credits.

               Agency for Health Care Policy and Research

Appropriations, 1995....................................    $159,505,000
Budget estimate, 1996...................................     193,504,000
House allowance.........................................      66,503,000

Committee recommendation

                                                             127,310,000

    The Committee recommends $62,230,000 in Federal funds for 
the Agency for Health Care Policy and Research [AHCPR]. In 
addition, transfers of $5,796,000 from Medicare trust fund and 
$59,284,000 from funds available under section 241 of the 
Public Health Service Act are provided. Total funding provided 
for the Agency is $127,310,000, which is $32,195,000 less than 
fiscal year 1995, $61,807,000 more than the House allowance, 
and $66,194,000 less than the President's request.
    The Agency for Health Care Policy and Research was 
established in 1990 to promote improvements in clinical 
practice and patient outcomes, promote improvements in the 
financing, organization, and delivery of health care services, 
and increase access to quality care. AHCPR is the only Federal 
agency charged to produce and disseminate scientific and 
policy-relevant information about the cost, quality, access, 
and medical effectiveness of health care.
    AHCPR provides policymakers, health care professionals, and 
the public with the information necessary to improve the cost 
effectiveness and appropriateness of health care and reduce the 
costs of health care.
    Because of concerns regarding AHCPR's development of 
practice guidelines, the Committee believes that AHCPR must 
move to develop more effective partnerships with the private 
sector to leverage its Federal resources. For example, there is 
great activity in the private sector and medical societies in 
the development of medical guidelines. Many of these guidelines 
may be limited in scope or not readily available to the public 
due to proprietary interests; however, the Committee believes 
there are significant opportunities for public guideline 
development through these private efforts, thereby enabling 
AHCPR to allocate guildline resources to other research 
activities. The Committee also encourages AHCPR to direct 
resources toward identifying, supporting, and publicizing 
credible privately sponsored health outcomes measurement 
research.

  Health Service Research and the National Medical Expenditure Survey

    The Committee provides $35,000,000 in Federal funds for 
health services research. In addition, $34,284,000 is made 
available from the section 241 evaluation funds for total 
funding of $69,284,000. This amount is $6,361,000 below the 
fiscal year 1995 amount, $33,433,000 below the President's 
request, and $22,319,000 more than the House allowance.
    These funds support the Extramural Research Grant and 
Contract Program, the Intramural Research Program, and 
dissemination activities (including the User Liaison Program). 
Also included in this amount are funds for the third national 
medical expenditure survey [NMES-3]. The purpose of the survey 
is to provide the basic information for estimating the effects 
of various approaches to reform of the American system of 
health care. For estimating the cost, financing options, and 
distributional impact of reform options, no alternative source 
of information exists. The third in the series of surveys will 
begin data collection in January 1996.

Rural health care

    The Committee is pleased with the collaborative work AHCPR 
has done in the area of rural health care. AHCPR continues to 
fund five specialized centers for rural health managed care 
services demonstrations. Many recent health care innovations 
such as managed care are available in metropolitan areas but 
are frequently unavailable to rural populations. The centers 
will conduct demonstrations of innovations in the delivery of 
health care services in rural areas. The Committee notes that 
sufficient funding has been provided to continue the rural 
managed care pilot projects.

Hispanic serving institutions

    The Committee recognizes that many academic health centers 
are working to develop more unified systems of education, 
delivery of services, and research. The Committee also 
recognizes that in addressing the special needs of a rapidly 
growing, and oftentimes indigent population, Hispanic serving 
institutions face unique obstacles in implementing systemic and 
integrative policies and practices. Of the funds provided, the 
Committee encourages AHCPR to fund at least one planning grant 
supporting the development of a model Hispanic health services 
academic center. The Committee also encourages AHCPR to assist 
Hispanic serving institutions in developing telecommunications 
models that may be used to enhance health care services 
provided to Hispanic and Latino communities.

Preventing clinical and systems errors

    Clinical and systems errors, for example in prescribing and 
administering drugs, can lead to complications and adverse 
outcomes. As the changes in health care delivery accelerate 
across the country, the Committee is concerned that these 
safety issues might become more pronounced. Further clinical 
and organizational research is needed to identify optimal 
techniques to be used in preventing such errors. The impact of 
this research will result in increased patient safety, 
decreased medical negligence, and a reduction in defensive 
medicine costs. To promote this process, the Committee believes 
this research must be a priority.

Home health care

    Given the extent to which managed health care delivery 
arrangements have expanded in the public and private sectors, 
as well as the shift from hospital-based, nurse-intensive 
delivery settings to outpatient settings, the Committee urges 
the Agency to collaborate with HCFA and the American Nurses 
Association to address issues related to the nursing care needs 
of patients upon hospital discharge and the transition of 
nurses into new delivery systems, such as home health care.

Advanced directives

    Last year, the Committee directed AHCPR to conduct a pilot 
project to evaluate the effectiveness of a community focused, 
home-based approach to encouraging people to complete advance 
directives. The Committee continues to believe this research is 
important and has included funding to complete the second year 
of the project.
    Although the Patient Self-Determination Act [PSDA] was 
enacted in 1990 with the goal of encouraging patients to 
complete advance directives, only about 10 percent of the 
general public has done so. The Committee believes that advance 
directives are important tools in protecting personal rights by 
allowing patients to be decisionmakers when incapacitated or 
are at the end stage of a disease.

Community health center network

    The Committee is aware that community health centers need 
to determine the most cost-effective way to provide services 
and maintain the quality of care in urban settings given rising 
health care costs. The Committee understands that the Swope 
Parkway Community Health Center in Missouri is pursuing the 
establishment of health maintenance organization. The Committee 
encourages AHCPR to give fair consideration to this health 
center's proposal to demonstrate the best approaches for a 
community health center to provide services through a health 
care network.

            Medical Treatment Effectiveness Program [MedTEP]

    For the Medical Treatment Effectiveness Program, the 
Committee includes $55,796,000, which is $25,640,000 less than 
the fiscal year 1995 appropriation, $32,568,000 below the 
President's request, and $37,681,000 less than the House 
allowance. These funds include a transfer of $5,796,000 from 
Medicare trust funds as well as $25,000,000 from section 241 
evaluation funds.
    The purpose of this program is to increase the cost 
effectiveness and appropriateness of clinical practice in a 
reformed health care system. Under MedTEP, grants and contracts 
are awarded to: conduct effectiveness research and develop 
research data for later analysis; develop clinical practice 
guidelines; and disseminate research findings and clinical 
practice guidelines.
    The Committee understands that AHCPR has received proposals 
to evaluate the effectiveness of currently used medical 
strategies for the treatment of pelvic inflammatory disease. 
This is a crucial issue for the 1 million American women who 
each year are stricken with this disease. Such studies could 
look at the effectiveness and cost effectiveness of competing 
treatments in preventing infertility. The Committee encourages 
AHCPR to give full and fair consideration to these proposals.
    Social workers represent a significant proportion of health 
and mental health service providers across the spectrum of 
services within the health care system. Social workers are 
positioned to provide cost-effective prevention, primary care, 
and recovery and rehabilitation services. The Committee 
recognizes the lack of data on the types, effectiveness, and 
costs of social work services among different populations and 
encourages the agency to develop training initiatives for 
social work researchers.

Minority populations

    The Committee is pleased with the work that AHCPR has done 
to establish MedTEP research centers on minority populations. 
These are investigating which clinical strategies are best for 
clinical conditions whose prevalence or impact is greatest 
among African-Americans, Latinos, Asian and Pacific islanders, 
American Indians, and/or Alaska Natives. In addition, the 
centers are training minority researchers in effectiveness 
research, providing technical assistance to practitioners in 
their communities, and disseminating information to patients 
and providers. Examples of the conditions being studied are: 
high blood pressure, kidney disease, tuberculosis, low 
birthweight, substance abuse, and certain cancers. The 
Committee is supportive of the agency working with the State of 
Hawaii, its unique health insurance plan, and its culturally 
diverse population.

Practice guidelines

    The Committee has noted the attempts of AHCPR to include a 
broad range of health care professionals, including nurses, in 
the development of clinical practice guidelines. The Committee 
encourages AHCPR to continue to utilize this multidisciplinary 
approach in all agency activities, including the development of 
clinical practice guidelines. The Committee encourages AHCPR to 
emphasize outcomes research that reflects to a greater extent 
more diverse health care providers, particularly nurses. The 
Committee urges AHCPR to continue to work collaboratively with 
nursing to develop national prescription training modules.

Program support

    The Committee recommendation includes $2,230,000 for 
program support. This activity supports the overall management 
of the Agency for Health Care Policy and Research. This is 
$194,000 less than the fiscal year 1995 amount.
    The Committee has directed the Office of Women's Health in 
the Office of the Secretary to develop and implement the 
national women's health clearinghouse and has directed that the 
Public Health Service agencies contribute a total of $1,400,000 
to this effort, each agency contributing their proportionate 
share as determined by the Office of the Secretary. Sufficient 
funding has been included to provide that support to the 
clearinghouse.

                  Health Care Financing Administration

                     GRANTS TO STATES FOR MEDICAID

Appropriations, 1995.................................... $89,240,775,000
Budget Request, 1996....................................  82,142,072,000
House allowance.........................................  82,142,072,000

Committee recommendation

                                                          82,142,072,000

    The Committee recommends $82,142,072,000 for grants to 
States for Medicaid. This amount is $7,098,703,000 less than 
the fiscal year 1995 appropriation and the same as both the 
administration request and the House allowance. This amount 
includes $27,047,717,000 in fiscal year 1996 advance 
appropriations. In addition, $26,155,350,000 is provided for 
the first quarter of fiscal year 1997, as requested by the 
administration and the House.
    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, Puerto Rico, and 
the territories. Federal funds for medical assistance are made 
available to the States according to a formula which determines 
the appropriate Federal matching rate for State program costs. 
This matching rate, which may range from 50 to 83 percent, is 
based upon the State's average per capita income relative to 
the national average.

                  PAYMENTS TO HEALTH CARE TRUST FUNDS

Appropriations, 1995.................................... $37,546,758,000
Budget estimate, 1996...................................  63,313,000,000
House allowance.........................................  63,313,000,000

Committee recommendation

                                                          63,313,000,000

    The Committee recommends $63,313,000,000 for Federal 
payments to the Medicare trust funds. This amount is the same 
as both the administration request and the House allowance and 
is an increase of $25,766,242,000 from the fiscal year 1995 
appropriation.
    This entitlement account includes the general fund subsidy 
to the supplementary medical insurance trust fund (Medicare 
part B), plus other reimbursements to the hospital insurance 
trust fund (Medicare part A), for benefits and related 
administrative costs which have not been financed by payroll 
taxes or premium contributions. The fiscal year 1996 amount 
includes the adjustment made once every 5 years for military 
service credits.
    The Committee has provided $62,122,000,000 for the Federal 
payment to the supplementary medical insurance trust fund. This 
payment provides matching funds for premiums paid by Medicare 
part B enrollees. This amount is the same as both the 
administration request and the House allowance, and is 
$25,167,000,000 more than the fiscal year 1995 amount. The 
large increase is primarily due to a shortfall in fiscal 1995 
funding, which is being made up with fiscal 1996 
appropriations.
    The recommendation also includes $358,000,000 for hospital 
insurance for the uninsured. This amount is the same as both 
the administration request and the House allowance, and is 
$48,000,000 less than the 1995 amount.
    The Committee also recommends $63,000,000 for the Federal 
uninsured benefit payment. This payment reimburses the hospital 
insurance trust fund for the cost of benefits provided to 
Federal annuitants who are eligible for Medicare. This amount 
is the same as both the administration request and the House 
allowance and is $7,000,000 more than the fiscal year 1995 
appropriation.
    The Committee recommendation includes $145,000,000 to be 
transferred to the hospital insurance trust fund as the general 
fund share of HCFA's program management administrative 
expenses. This amount is the same as both the administration 
request and the House allowance and is $15,242,000 more than 
the fiscal year 1995 level.
    Finally, the Committee recommendation includes $625,000,000 
for the quinquennial adjustment for military service credits. 
The last quinquennial adjustment was made in fiscal year 1991.

                           PROGRAM MANAGEMENT

Appropriations, 1995....................................  $2,207,135,000
Budget estimate, 1996...................................   2,253,794,000
House allowance.........................................   2,134,533,000

Committee recommendation

                                                           2,105,869,000

    The Committee recommends $2,105,869,000 for HCFA program 
management. This is $28,664,000 less than the House allowance, 
$147,925,000 less than the budget request, and $73,175,000 less 
than the fiscal year 1995 enacted level.

Research, demonstrations, and evaluation

    The Committee recommends $60,677,000 for research, 
demonstration, and evaluation activities. This amount is 
$10,677,000 more than the House allowance, but $8,626,000 less 
than the amount provided in fiscal year 1995.
    HCFA research and demonstration activities facilitate 
informed, rational Medicare and Medicaid policy choices and 
decisionmaking. These studies and evaluations include projects 
to measure the impact of Medicare and Medicaid policy analysis 
and decisionmaking, to measure the impact of Medicare and 
Medicaid on health care costs, to measure patient outcomes in a 
variety of treatment settings, and to develop alternative 
strategies for reimbursement, coverage, and program management.
    The recommended funding level of $40,000,000 for the 
regular research and demonstration program is the same as the 
House allowance. This amount will provide for continuation of 
current activities including telemedicine demonstration 
projects, which should remain a high priority. It will also 
fund new initiatives. Priority areas for HCFA research include 
access to high-quality health care, health service delivery 
systems, and provider payment systems.
    The Committee expects the Health Care Financing 
Administration to provide a status report at next year's 
appropriations hearings concerning its plans for Medicare 
reimbursement for health care services provided using 
telemedicine. Specifically, the Administrator should be 
prepared to address reimbursement rates for telemedicine 
services, including a timetable for implementation.
    Health care represents one of the largest areas of 
expenditure for the Federal Government. Most of that money is 
spent in hospitals, long-term care facilities, skilled-nursing 
facilities, and clinics. Because of its interest in containing 
health care expenditures, the Committee encourages HCFA to 
review the training of administrators of health care facilities 
and report to the Committee what, if any, steps should be taken 
to improve that training.
    The Committee urges HCFA to collaborate with the American 
Nurses Association and various nurse practitioner organizations 
to explore the extent to which these advanced practice nurses 
can provide primary care to rural and other medically 
underserved populations. The Committee requests that HCFA 
provide a report on the study findings within 1 year.
    The Committee is aware of a proposal from Northwestern 
Memorial Hospital in Chicago for a 3-year project to develop a 
comprehensive health care information management system that 
will link patient care data across the full range of health 
care. The Committee encourages full and fair consideration of a 
proposal from this institution.
    The Committee encourages HCFA to give full and fair 
consideration for a demonstration grant to establish a 
children's ambulatory care center at the University of Miami/
Jackson Memorial Hospital. The university proposes a state-of-
the-art program for comprehensive outpatient care for children 
with a variety of diseases such as cancer, AIDS, sickle cell 
disease, brain injury, genetic disease, and others.
    The Committee believes that significant savings can be 
achieved by incorporating case management into the current fee-
for-service Medicare program. In addition, the Committee 
believes that certain rural and underserved areas of the 
country do not have the market penetration of managed care 
health plans to provide Medicare beneficiaries a choice of 
plans. The Committee, therefore, encourages HCFA to conduct a 
demonstration project to determine the cost effectiveness of 
providing for case management and a continuum of care for 
individual entitled to Medicare benefits who have specific high 
cost chronic conditions.
    The Committee is interested in the impact the growing 
enrollment of Medicaid recipients in managed care plans will 
have on children, as one-half of all Medicaid recipients are 
children. The success of Medicaid managed care for children 
will depend in part on how accurately States calculate the 
annual capitation rate for children. In this calculation, 
States must be able to adjust accurately for the risk 
associated with meeting the health care needs of individual 
children, especially children with disabilities and other 
chronic or congenital conditions. This risk adjustment is 
critical because 1 percent of all children account for 37 
percent of all health care expenditures for children. Until 
this year, HCFA has sponsored research on risk adjustment 
methodologies only for the over age 65 population. The 
Committee supports HCFA's issuance for the first time of 
requests for proposals to begin to fund research on risk 
adjustment for the under 65 age population.
    The Committee directs HCFA to prepare a multiyear plan for 
investing in and achieving the development of methodologies for 
risk adjustment, reinsurance, and carve-outs based on a 
pediatric population. This research agenda should include 
consultation with managed care plans, State Medicaid programs, 
and providers, including children's hospitals, experienced 
specifically in serving children with the most challenging 
health care needs. The research agenda also should plan for and 
disseminate the results of regular surveys of States' current 
methodologies for adjusting for pediatric care populations 
under Medicaid managed care.

Medicare contractors

    The Committee recommends $1,584,767,000 for Medicare 
contractors. This amount is $46,333,000 less than the 
administration request, $20,000,000 less than the House 
allowance, and $24,904,000 less than comparable fiscal year 
1995 appropriation. This takes into account the 
administration's contracting reform proposals, but continues 
the funding of payment safeguards at $396,300,000 until the 
appropriate legislative actions are complete on the 
administration's proposal to remove this activity from the 
``Program management'' account. It also assumes enactment of 
authorizing legislation that would save $20,000,000 by 
assessing a $1 penalty for each duplicate billing or claim 
submitted by a provider. Duplicate claims clog Medicare's 
claims processing system providing extra work and possible 
overpayments to be tracked down during the postpayment review 
process. Current law sets payment floors for the earliest time 
that Medicare can pay claims and provides interest payments to 
providers when payments on clean claims are not made with 
within 30 days. Providers also have the option of calling 
fiscal intermediaries and carriers to learn of the disposition 
of particular claims. This proposal also has implications for 
entitlement savings since it will reduce overpayments due to 
mistaken payments and fraud and abuse and it will also prevent 
gaming by providers.
    Medicare contractors, who are usually insurance companies, 
are responsible for reimbursing Medicare beneficiaries and 
providers in a timely fashion and a fiscally responsible 
manner. These contractors also provide information, guidance, 
and technical support to both providers and beneficiaries.
    Within the resources provided, the Committee expects that 
to the maximum extent possible HCFA should take funding 
reductions from the productivity investments activities. 
However, no reduction should be taken in the Committee's 
initiative regarding the purchase of commercial software to 
detect abusive billings to Medicare.
    The Committee is concerned that the Department is not using 
commercially available technology used in the private sector to 
reduce wasteful abusive billings to Medicare. The GAO has 
testified that the Department's present methods are costing the 
Medicare trust fund $2,000,000 per day and, in addition, 
Medicare beneficiaries are paying additional costs as well. To 
assure that achievable savings are realized the Committee 
directs that HCFA have its carriers purchase and utilize 
existing commercial automatic data processing equipment [ADPE], 
largely software by March 30, 1996, which the GAO has indicated 
is a reasonable period. The Committee urges HCFA to act more 
quickly.
    The automatic data processing equipment [ADPE] should meet 
the following minimum requirements: (1) be a commercial item; 
and (2) surpass carrier's current software in ability to detect 
code manipulations, unbundling, global service violations, 
double billings, duplicate and mutually exclusive procedures 
performed on a single day or over an extended period, and 
unnecessary use of assistants at surgery, and satisfy pertinent 
statutory requirements of the Medicare Program. It is also 
expected that HCFA shall, not later than November 1, order a 
review of existing payment policies and billing code abuse to 
determine if revisions of or addition to those regulations, 
guidelines or guidance is necessary to maximize the benefits to 
Medicare and Medicare beneficiaries of the use of ADPE acquired 
under these provisions. The cost of purchasing and implementing 
the use of the ADPE is modest compared to the savings involved 
and the Committee expects that the funds shall be made 
available within the funds appropriated to HCFA.
    The Committee is also concerned that HCFA's review of 
carriers does not place adequate emphasis on the carrier's 
success in detecting and stopping abusive billings and fraud. 
While the Committee does not believe it is appropriate at this 
time to provide carriers with direct financial incentives to 
detect fraud and abuse, it strongly urges HCFA to carefully 
review and weigh much more heavily the contractors' performance 
in this area in determining if contracts should be let or 
renewed. The Committee requests a report from HCFA on actions 
taken in this regard no later than April 1, 1996.

State survey and certification

    The Committee recommends $134,500,000 for Medicare State 
survey and certification activities. This is $17,500,000 less 
than the House allowance, $27,600,000 less than the request, 
and $11,300,000 below the 1995 enacted level. This includes a 
reduction of $8,800,000 to survey home health agencies on the 
assumption legislative action will be taken on the 
administration's proposal for flexibility in the frequency of 
these surveys. It also assumes enactment of legislation to 
charge facilities who enter the Medicare Program a one-time fee 
for their initial survey to cover costs, for an administrative 
savings of $8,700,000.
    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety, and program 
standards. Onsite surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys.

Federal administration

    The Committee recommends a total of $325,925,000 for 
Federal administrative costs. This is $1,841,000 less than the 
House allowance, $70,169,000 less than the administration 
request, and $28,345,000 less than the fiscal year 1995 
appropriation. This amount represents 92 percent of the 1995 
enacted level, necessitated by severe budgetary constraints.
    The Committee concurs with the House in not providing the 
$150,000,000 requested for a new State grant program for the 
medical costs of undocumented aliens; this program is not yet 
authorized.
    The Committee remains extremely concerned with the amount 
of money lost every year to fraud, waste, and abuse in the 
Medicare Program. The Committee has held many hearings over a 
7-year period to expose and reduce these losses. The Committee 
is pleased that after several years, HCFA, using its inherent 
reasonableness authority, did significantly lower Medicare 
payments for home blood glucose monitors and is now in the 
process of lowering exorbitant payments for oxygen equipment 
and supplies. This process should be streamlined to the 
greatest extent possible and unreasonably high payments reduced 
promptly. HCFA must be much more aggressive generally in 
combating waste and abuse and identifying and correcting 
overpriced items and services.
    A recent report by the General Accounting Office found that 
Medicare is not taking advantage of the latest computer 
technology (such as systems that employ artificial 
intelligence) designed to detect fraud. The Committee urges 
HCFA to move promptly to complete its review of this technology 
and incorporate it no later than January 1, 1996.
    The Committee is very disturbed to learn that even after 
being informed to the contrary by HCFA, that payments for 
surgical dressings continue without appropriate screens to 
protect the program against significant overpayments. HCFA 
expansion of the scope of the surgical dressings benefit 
without proper screens has led to even greater losses. The 
Committee urges HCFA to promptly correct this administrative 
shortcoming.
    The Committee has for 5 years raised its concern with the 
excessive paperwork burden placed by the Medicare Program on 
beneficiaries and providers and has previously directed HCFA to 
reduce paperwork by no less than 20 percent. HCFA has been slow 
to address this problem, but the Committee is pleased that 
important first steps were taken earlier this year to reduce 
Medicare paperwork. The Committee expects HCFA to take further 
significant steps to reduce paperwork and meet our previous 
directive to lower it by 20 percent.
    The Committee expects HCFA to take action to assure that 
State Medicaid agencies continue to establish and maintain 
reasonable Medicaid pharmacy reimbursement levels, both for 
drug product costs and dispensing fees. The Committee expects 
HCFA to develop and apply uniform criteria for consideration of 
State plan amendments which reduce pharmacy reimbursement 
levels, or require that pharmacy providers bill Medicaid their 
lowest third-party charge for a prescription.
    The Committee is concerned about the classification of 
certain colocated long-term hospitals. The Committee strongly 
encourages the Secretary to reexamine current regulations on 
the classification of colocated long-term hospitals to 
determine if more efficient requirements could be adopted.

                    HMO LOAN AND LOAN GUARANTEE FUND

Appropriations, 1995....................................     $15,000,000
Budget estimate, 1996...................................................
House allowance.........................................................

Committee recommendation

                                             ...........................

    The Committee has included no funds for the health 
maintenance organization [HMO] loan and loan guarantee fund. 
This is the same as both the administration request and the 
House allowance and $15,000,000 less than the fiscal year 1995 
amount.
    This fund was established in 1975 to provide working 
capital to HMO's in their initial operation periods (when 
financial deficits were expected) and to guarantee loans made 
to HMO's by private lenders. The fund operated as a revolving 
fund: Direct loans made by the fund to HMO's were sold, with 
guarantees, to the Federal Financing Bank [FFB]; proceeds from 
these sales were then used as capital for additional direct 
loans.
    This fund is now dormant; the last loan commitments were 
made in fiscal year 1983. HCFA now collects principal and 
interest payments from HMO borrowers and in turn, pays the FFB. 
The funds are required to pay prepayment penalties, interest 
and defaults.

                Administration for Children and Families

                   FAMILY SUPPORT PAYMENTS TO STATES

Appropriations, 1995.................................... $13,160,697,000
Budget estimate, 1996...................................  13,614,307,000
House allowance.........................................  13,614,307,000

Committee recommendation

                                                          13,614,307,000

    The Committee recommends an appropriation of 
$13,614,307,000 for family support payments to States, which is 
in addition to $4,400,000,000 appropriated in fiscal year 1995 
as an advance for the first quarter of 1996. This appropriation 
is the same as the administration's request and the House 
allowance, and $453,610,000 more than the fiscal year 1995 
comparable appropriation of $13,160,697,000.
    Under this program, funding supports grants to States for 
the Federal share of public assistance for the needy and for 
child support enforcement and child care activities. Aid to 
families with dependent children [AFDC] is the largest of the 
assistance programs in this account. These dollars support 
children in need who have been deprived of parental support by 
the death, disability, or continued absence of a parent from 
the home, or the unemployment of the principal wage earner.
    Funds are also provided to cover the costs of child care 
for welfare recipients who need this service to participate in 
State job opportunities and basic skills [JOBS] training 
programs, to provide transitional child care for welfare 
recipients who leave the rolls because of increased earnings, 
and for low-income families who need such care to work, or 
would otherwise be at risk of becoming eligible for AFDC. 
Unless child care is provided as necessary to JOBS 
participants, States cannot require their participation.
    This appropriation also funds several other types of 
assistance, including emergency assistance, assistance to 
destitute or ill Americans who have been repatriated, and 
assistance to adults in Puerto Rico and the territories.
    In addition to assistance payments, the appropriation funds 
the Child Support Enforcement Program, which assists families 
by locating absent parents, establishing paternity, and 
enforcing support obligations to ensure that children are 
financially supported by both parents. Grants made under this 
account also include funds for the Federal share of the costs 
States incur in administering these programs.
    The Committee's recommendation is the same as the 
President's estimates of the amounts needed for these 
entitlement programs. The Committee recommendation includes net 
funding of $12,999,000,000 for benefit payments under the Aid 
to Families with Dependent Children Program and $19,428,000 for 
payments to the territories. For emergency assistance, the 
Committee has provided the amount recommended by the President, 
$974,000,000. The Committee recommendation also includes 
$1,000,000 for repatriation and $1,770,000,000 for State and 
local welfare administrative costs. Finally, the Committee 
recommendation includes $734,000,000 for the costs of AFDC/JOBS 
child care, $220,000,000 for transitional child care, and 
$300,000,000 for the At-risk Child Care Program.
    For child support enforcement, $1,943,000,000 is included 
for State and local administration. These costs are offset by 
the Federal share of collections, estimated at $1,314,000,000. 
In addition, Federal incentive payments of $439,000,000, an 
increase of $37,000,000 over fiscal year 1995, are provided.
    The Committee has also included $4,800,000,000 as a first 
quarter advance for fiscal year 1997, the same as the budget 
request.

                      PAYMENTS TO STATES FOR JOBS

Appropriations, 1995....................................    $970,000,000
Budget estimate, 1996...................................   1,000,000,000
House allowance.........................................   1,000,000,000

Committee recommendation

                                                           1,000,000,000

    The Committee recommends $1,000,000,000 for payments to 
States for AFDC work programs, the same amount as is in the 
House allowance and the President's budget request.
    This appropriation will support job opportunities and basic 
skills [JOBS] training programs in all States. JOBS programs 
were created as part of the Family Support Act of 1988 and are 
intended to assure that needy families with children obtain the 
education, training, and employment they need to avoid long-
term welfare dependence.

               low-income home energy assistance program

Appropriations, 1995....................................  $1,000,000,000
Budget estimate,1996....................................   1,319,204,000
House allowance.........................................................

Committee recommendation

                                                             900,000,000

    The Committee recommends that $900,000,000 be made 
available in fiscal year 1996 for the Low-Income Home Energy 
Assistance Program [LIHEAP], $100,000,000 less than the amount 
previously agreed to as an advance for fiscal year 1996 on the 
recently enacted fiscal year 1995 rescission legislation.
    An amount of $1,000,000,000 has been appropriated for 
LIHEAP for the period October 1, 1995, to September 30, 1996. 
The House has recommended rescinding this entire amount. The 
Committee, however, recommends a rescission of $100,000,000. 
The Committee recommends a fiscal year 1997 advance 
appropriation, as authorized by law, for the period October 1, 
1996, to September 30, 1997, of $1,000,000,000 for LIHEAP, for 
which the House recommended no funding.
    LIHEAP grants are awarded to the States, territories, and 
Indian tribes to assist low-income households in meeting the 
costs of home energy. States receive great flexibility in how 
they provide assistance, including direct payments to 
individuals and vendors and direct provision of fuel. LIHEAP 
grants are distributed by a formula defined by statute, based 
in part on each State's share of home energy expenditures by 
low-income households nationwide.
    The Committee recommendation includes an emergency 
allocation of up to $600,000,000 to be made available, only 
upon submission of a formal request designating the need for 
the funds as an emergency as defined by the Budget Enforcement 
Act. These funds are intended to be made available for such 
situations as the extreme heat this summer, which resulted in 
the President releasing $100,000,000 from previous emergency 
funds; additional funds could be released by the President this 
winter, if circumstances warrant.
    The Committee intends that up to $22,500,000 of the amounts 
appropriated for LIHEAP for fiscal year 1996 be used for the 
leveraging incentive fund, which will provide a percentage 
match to States for private or non-Federal public resources 
allocated to low-income energy benefits. Of the fiscal year 
1997 advance appropriation, up to $25,000,000 is also for the 
leveraging fund.

                 child care and development block grant

Appropriations, 1995....................................    $934,642,000
Budget estimate, 1996...................................   1,048,825,000
House allowance.........................................     934,642,000

Committee recommendation

                                                             934,642,000

    The Committee recommends $934,642,000 for the child care 
and development block grant, the same as the House allowance 
and the fiscal year 1995 appropriation.
    These funds provide grants to States to provide low-income 
families with financial assistance for child care; for 
improving the quality and availability of child care; and for 
establishing or expanding child development programs. The 
additional funds provided in fiscal year 1995 will both expand 
the services provided to individuals who need child care in 
order to work or attend job training or education and allow 
States to continue funding the activities previously provided 
under the consolidated programs.

                     refugee and entrant assistance

Appropriations, 1995....................................    $405,772,001
Budget estimate, 1996...................................     414,199,000
House allowance.........................................     411,781,000

Committee recommendation

                                                             397,172,000

    The Committee recommends $397,172,000 for refugee and 
entrant assistance, a decrease of $2,600,000 below the level 
appropriated for fiscal year 1995, and $17,027,000 less than 
the budget request.
    Based on an estimated refugee admission ceiling of 110,000, 
this appropriation, together with bill language allowing prior-
year funds of an estimated $10,590,000 to be available for 1996 
costs, will enable States to continue to provide at least 8 
months of cash and medical assistance to needy refugees.
    The Refugee Assistance Program is designed to assist States 
in their efforts to assimilate refugees into American society 
as quickly and effectively as possible. The program funds 
State-administered cash and medical assistance, the voluntary 
agency matching grant program, employment services, targeted 
assistance, and preventive health.
    In order to carry out the program, the Committee recommends 
$258,273,000 for transitional and medical assistance, including 
State administration and the voluntary agency program; 
$80,802,000 for social services; $5,300,000 for preventive 
health; and $52,797,000 for targeted assistance.
    The Committee agrees that $19,000,000 is available for 
targeted assistance to serve communities affected by the Cuban 
and Haitian entrants and refugees whose arrivals in recent 
years have increased.
    The Committee notes with interest service providers 
offering treatment for persons who have suffered mental and 
physical torture by foreign governments. The Committee 
recommends that special consideration be given to supporting 
such efforts.
    The Committee is concerned that refugees entering the 
United States may have medical conditions that require 
treatment. Over 30 percent of the reported TB cases in this 
country are diagnosed in foreign-born individuals, including 
refugees. Since 1980, the CDC has carried out the public health 
functions as mandated by the Refugee Health Act of 1980. The 
Committee disagrees with the proposed transfer of these 
functions to the Office of Refugee Resettlement [ORR] and 
further expects ORR to continue funding $2,600,000 for refugee 
health screening activities that take place predominately 
overseas. The Committee is convinced that it is essential that 
the CDC continues to monitor and assess the quality of refugee 
medical screening and other health services prior to the 
resettlement in this country. Furthermore, the Committee 
expects ORR to continue funding $2,700,000 in refugee health 
assessment grants through the CDC to the appropriate State and 
local health departments. CDC is the agency responsible for 
infectious disease surveillance and prevention and is best 
suited to ensure that the funds are efficiently and effectively 
utilize.

                     community services block grant

Appropriations, 1995....................................    $457,633,000
Budget estimate, 1996...................................     417,252,000
House allowance.........................................     428,604,000

Committee recommendation

                                                             431,483,000

    The Committee recommends an appropriation of $431,483,000 
for the community services programs, an decrease of $26,150,000 
below the 1995 appropriation, $14,231,000 over the 1996 budget 
request, and $2,879,000 over the House allowance.
    The community services block grant [CSBG] makes formula 
grants to States and Indian tribes to provide a wide range of 
services and activities to alleviate causes of poverty in 
communities and to assist low-income individuals in becoming 
self-sufficient. The majority of CSBG funds go to community 
action agencies who administer these activities. A funding 
level of $389,600,000 is recommended for the community services 
block grant, the same as the House allowance and the 1995 
enacted level.
    Several discretionary programs are funded from this 
account. Funding for these discretionary programs is 
recommended at the following levels for fiscal year 1996: 
community economic development, $21,834,000; rural community 
facilities, $3,009,000; national youth sports, $11,040,000; and 
community food and nutrition, $6,000,000. No funding is 
included for rural housing, farmworker assistance, and 
demonstration partnership activities. The Committee did not 
recommend line-item funding for technical assistance since new 
authorizing legislation permits such funding at the discretion 
of the administration.
    The Committee has not recommended separate line-item 
funding for the Community Services Homeless Program, these 
activities can be funded from the block grant.
    For the National Youth Sports Program, the Committee 
recommends $11,040,000. The Committee expects national youth 
sports funds to be awarded competitively.

                      social services block grant

Appropriations, 1995....................................  $2,800,000,000
Budget estimate, 1996...................................   2,800,000,000
House allowance.........................................   2,800,000,000

Committee recommendation

                                                           2,520,000,000

    The Committee recommends an appropriation of $2,520,000,000 
for the social services block grant. The recommendation is 
$280,000,000 below the House allowance, the budget request, and 
fiscal year 1995 enacted level. Bill language has been included 
to reduce the amount of this capped entitlement program. Many 
of the social services discretionary programs are facing 
reductions in this year's appropriations legislation, due to 
severe budgetary constraints, and the title XX Social Services 
Block Grant Program should not be exempt from such reductions, 
as it has in past years. Without this reduction, it would be 
necessary to further curtail spending for such programs as low-
income home energy assistance, or cut the existing level of 
Head Start and child care activities.
    Social services block grant funds are used by States to 
funds a wide variety of social services for the purpose of 
preventing or reducing dependency, and assisting individuals to 
achieve self-sufficiency. Activities include child and adult 
day care, child and adult abuse and neglect prevention, home-
based services, and independent living services. States are 
entitled to their full share of the appropriated funds, and may 
use these funds to best suit the needs of the individuals 
residing within the State.

                    family support and preservation

Appropriations, 1995....................................    $150,000,000
Budget estimate, 1996...................................     225,000,000
House allowance.........................................     225,000,000

Committee recommendation

                                                             225,000,000

    The Committee recommends $225,000,000 for fiscal year 1996, 
the same amount requested by the administration and allowed by 
the House for this mandatory account. These funds will support 
(1) community-based family support services to assist families 
before a crisis arises and (2) innovative child welfare 
services such as family preservation, family reunification, and 
other services for families in crisis.
    These funds include resources to help with the operation of 
shelters for abused and neglected children, giving them a safe 
haven, and providing a centralized location for counseling.

       payments to states for foster care and adoption assistance

Appropriations, 1995....................................  $3,597,371,000
Budget estimate, 1996...................................   4,307,842,000
House allowance.........................................   4,307,842,000

Committee recommendation

                                                           4,322,238,000

    The Committee recommends $4,322,238,000 for this account, 
which is $14,396,000 more than the budget request and the House 
allowance and $724,867,000 more than the 1995 comparable level.
    The Foster Care Program provides Federal reimbursement to 
States for: maintenance payments to families and institutions 
caring for eligible foster chidren, matched at the Federal 
medical assistance percentage [FMAP] rate for each State; and 
administration and training costs to pay for the efficient 
administration of the Foster Care Program, and for training of 
foster care workers and parents.
    The Adoption Assistance Program provides funds to States 
for maintenance costs, and the nonrecurring costs of adoption, 
for children with special needs. The goal of this program is to 
facilitate the placement of hard-to-place children in permanent 
adoptive homes, and thus prevent long, inappropriate stays in 
foster care. As in the Foster Care Program, State 
administrative and training costs are reimbursed under this 
program.
    The Committee has updated the administration's budget 
estimates to refect midsession review reestimates of the needs 
for these entitlement programs.

                children and families services programs

Appropriations, 1995....................................  $4,433,038,000
Budget estimate, 1996...................................   4,831,965,000
House allowance.........................................   4,116,039,000

Committee recommendation

                                                           4,129,169,000

    The Committee recommends an appropriation of $4,129,169,000 
for the ``Children and families services programs'' account, 
which is $702,796,000 less than the administration request and 
$303,869,000 less than the fiscal year 1995 appropriation.
    The ACF service programs appropriation consists of programs 
for children, youth, and families, the developmentally 
disabled, and native Americans, as well as Federal 
administrative costs.

Head Start

    Head Start provides comprehensive development services for 
low-income children and families, emphasizing cognitive and 
language development, socioemotional development, physical and 
mental health, and parent involvement to enable each child to 
develop and function at his or her highest potential. At least 
10 percent of enrollment opportunities in each State are made 
available to children with disabilities.
    The Committee recommends $3,401,675,000 for the Head Start 
Program, an increase of $4,246,000 above the House. Although 
this reduction is necessitated by severe budgetary constraints, 
funding for Head Start had increased significantly in recent 
years, and the amount recommended is still more than double the 
1990 level.
    The Committee has included $250,000 to continue a 
demonstration program to train Head Start teachers in the basic 
concepts and scientific principles. With proper teacher 
training, a lifelong interest in math and science can be 
created for preschool students.
    The Committee recognizes that homeless families represent 
the fastest growing portion of the homeless population. The 
Committee also recognizes that most early childhood programs do 
not have the specialized training and outreach necessary to 
serve homeless preschoolers and their families. The Head Start 
Program has supported a number of innovative and high-quality 
demonstration programs to serve homeless preschoolers and their 
families. The Head Start Program has supported a number of 
innovative and high-quality demonstration programs to serve 
rural and urban homeless children, and substantial startup 
costs. The Committee recognizes that this demonstration program 
will expire at the end of 1995, and believes that allowing 
these slots to expire would squander the Federal investment 
made in these programs. Therefore, the Committee urges the 
Department to convert the positions currently be used for the 
homeless preschool demonstration program to permanent Head 
Start positions to serve homeless children.
    The Committee applauds the recent efforts of the 
administration to implement Indian preference at the American 
Indian programs branch of the Head Start Bureau. The Committee 
further notes the administration's commitment to ensuring 
tribal consultation in the development of regulations to 
implement the 1994 amendments to the Head Start Act and to 
ensuring that these regulations accurately reflect the intent 
of the Congress.
    The fiscal year 1995 report included $1,000,000 for a 
training program based on the emerging learning concept that 
preparing preschool children for reading ensures school 
readiness. The children's library initiative in Philadelphia 
would be especially well suited to conduct such a national 
training program. In addition, the Committee included 
$3,000,000 to establish a preschool education program at Head 
Start sites utilizing the ``Sesame Street'' program as a means 
to encourage and initiate reading skills, train providers in 
the educational use of visual arts and media, and to assist 
parents in becoming actively involved in their children's 
preschool education. To implement this program, the Committee 
urged the Secretary to contract with an independent nonprofit 
entity that had demonstrated effectiveness in developing and 
administering such a program. The Committee urges the Secretary 
to comply with the 1995 Committee report and establish these 
programs on an expedited basis.

Runaway and homeless youth

    The Committee recommendation is $46,767,000 for this 
program, an increase of $6,309,000 over the House allowance and 
the fiscal year 1995 level. This increase partially offsets the 
elimination of the separate line item for runaway youth 
activities-drugs. The Committee did not approve the budget 
request to consolidate this program and transitional living 
into a single line item. The Committee has also provided an 
additional $7,000,000 from the crime prevention trust fund for 
runaway youth activities.
    This program addresses the crisis needs of runaway and 
homeless youth and their families through support to local and 
State governments and private agencies. The Runaway and 
Homeless Youth Act requires that 90 percent of the funds be 
allocated to States for the purpose of establishing and 
operating community-based runaway and homeless youth centers, 
on the basis of the State youth population under 18 years of 
age in proportion to the national total. The remaining 10 
percent funds networking and research and demonstration 
activities including the National Toll-Free Communications 
Center.

Transitional living for homeless youth

    The Committee recommends an appropriation of $12,557,000 
for transitional living, which is $2,392,000 less than the 
House allowance, and $1,092,000 below the 1995 level.
    This program awards grants to public and private nonprofit 
entities to address the shelter and service needs of homeless 
youth. Grants are used to develop or strengthen community-based 
programs which assist homeless youth in making a smooth 
transition to productive adulthood and social self-sufficiency; 
and to provide technical assistance to transitional living 
programs for the acquisition and maintenance of resources and 
services.

Youth gang substance abuse

    The Committee concurs with the House in not recommending 
line-item funding for youth gang substance abuse, for which 
$10,520,000 was requested. Funds for substance abuse prevention 
and treatment activities are included under the Substance Abuse 
and Mental Health Services Administration.

Child abuse prevention programs

    The Committee has included $35,445,000 for child abuse and 
neglect prevention and treatment activities, including 
$21,026,000 for State grants, $14,154,000 for discretionary 
activities, and $265,000 for the Advisory Board on Child Abuse 
and Neglect.
    These programs improve and increase activities at all 
levels of government which identify, prevent, and treat child 
abuse and neglect through State grants, technical assistance, 
research, demonstration, and service improvement.

Temporary child care and crisis nurseries

    The Committee recommends $9,835,000 for temporary child 
care and crisis nurseries, the same as the House allowance, and 
$2,000,000 less than the budget request and the fiscal year 
1995 level. Grants are made to States which apply to support 
demonstration projects by local governments and private 
nonprofit agencies. This program is intended to demonstrate the 
effectiveness of assisting States to provide temporary, 
nonmedical care for children with special needs, and children 
that are abused and neglected or at risk of abuse and neglect.

Family violence prevention programs

    For programs authorized by the Family Violence Prevention 
and Treatment Act, the Committee recommends $50,000,000, which 
is $17,355,000 more than the House allowance and the fiscal 
year 1995 appropriation. This program makes formula grants to 
States and Indian tribes to assist in supporting programs and 
projects to prevent incidents of family violence and to provide 
immediate shelter and related assistance for victims of family 
violence and their dependents. The amount recommended includes 
$18,100,000 for crime prevention trust funds activities, for 
which the administration requested $15,000,000. The House 
provides no funds from the crime prevention trust fund. The 
amount recommended is the full amount authorized in 1996.

Abandoned infants assistance

    The Committee concurs with the House in recommending an 
appropriation of $12,406,000 for abandoned infants assistance, 
$2,000,000 less than the fiscal year 1995 appropriation and the 
administration request.
    This program provides financial support to public and 
private entities to develop, implement, and operate 
demonstration projects that will prevent the abandonment of 
infants and young children. Grants provide additional services 
such as identifying and addressing the needs of abandoned 
infants, especially those who are drug-exposed or HIV-positive; 
providing respite care for families and caregivers; and 
assisting abandoned infants and children to reside with their 
natural families or in foster care.

Child welfare

    The Committee recommends an appropriation of $268,629,000 
for child welfare services, $23,360,000 less than the fiscal 
year 1995 appropriation and the administration request and 
$23,360,000 less than the House allowance.
    This program helps State public welfare agencies improve 
their child welfare services with the goal of keeping families 
together. State services include: preventive intervention, so 
that, if possible, children will not have to be removed from 
their homes; reunification so that children can return home if 
at all possible; and development of alternative placements like 
foster care or adoption if children cannot remain at home.
    For child welfare training, to ensure the availability of 
adequate numbers of professionally trained social workers to 
provide child protection, family preservation, family support, 
foster care, and adoption services, the Committee has provided 
$2,000,000, the same amount recommended by the House. The 
Committee directs the Secretary to continue to make child 
welfare training funds available to schools of social work, 
with priority given to minority students, and public human 
service agencies to train students for careers in child 
welfare.
    The Committee recognizes that child abuse and neglect is a 
serious and escalating problem in our country. In 1994, over 3 
million children in the United States were reported physically, 
emotionally, or sexually abused or neglected. The need for 
trained, skilled, and qualified child welfare protection 
personnel is essential. Yet, according to the National 
Commission on Children, only 24 percent of child welfare case 
workers have social work training, and 50 percent have no 
previous experience working with children and families. To 
ensure that there is available an adequate supply of 
professionally trained social workers to provide child 
protection, family preservation, family support, foster care, 
and adoption services, the Committee directs the Secretary to 
continue to make child welfare training funds available to 
schools of social work, with priority given to minority 
students, to train students for careers in child welfare.
    Under section 426, title IV-B discretionary grants are 
awarded to public and private nonprofit institutions of higher 
learning to develop and improve education/training programs and 
resources for child welfare service providers. These grants 
upgrade the skills and qualifications of child welfare workers. 
To ensure that there is available an adequate supply of 
professionally trained social workers to provide child 
protection, family preservation, family support, foster care, 
and adoption services, the Committee directs the Secretary to 
continue to make child welfare training funds available, to 
schools of social work, with priority given to minority 
students, to train students for careers in child welfare.
    The Committee concurs with the House in providing no funds 
for child welfare research, for which $6,395,000 was requested.
    The Committee reiterates its interest in the work of the 
University of Hawaii Center on the Family and supports 
continued use of Hawaii's ethnically diverse population to 
devise policies and implement programs to strengthen the 
family, particularly since the results are transferable to 
other U.S. populations. The Committee further endorses work 
directed to policy analysis and outreach programs relating to 
family caregiving and other long-term intergenerational issues. 
The Committee is especially interested in the development of 
programs that are self-help in nature and that contribute to 
containment of social program costs.
    The Committee has previously recommended that the 
Department utilize CAPTA resources for community-based child 
abuse prevention through Parents Anonymous, Inc. This year, the 
Senate authorizing committee has included in the 
reauthorization of the Child Abuse Prevention and Treatment Act 
both bill language and report language urging the Secretary to 
award a grant to a nonprofit organization such as Parents 
Anonymous to assist in the maintenance of a national network of 
mutual support and self-help programs to strengthen families 
and their communities in the fight against child abuse. The 
Committee strongly urges the Department to implement this 
recommendation.

Adoption opportunities

    The Committee recommends $11,000,000 for adoption 
opportunities, the same as the fiscal year 1995 level, 
$2,000,000 less than the administration request, and the same 
as the House allowance.
    This program eliminates barriers to adoption and helps find 
permanent homes for children who would benefit by adoption, 
particularly children with special needs. Since the Committee 
recommendation exceeds $5,000,000, grants for placement of 
minority children and postlegal adoption services, as well as 
grants for improving State efforts to increase placement of 
foster children legally free for adoption, should be made, as 
required by law. This program also funds the national adoption 
clearinghouse, a national adoption information exchange system.
    The Committee concurs with the House in providing no 
funding for social services research, family support centers, 
and community-based resource centers.

Developmental disabilities

    The Committee recommends $112,103,080 for developmental 
disabilities programs, which is $34,947,000 more than the House 
allowance, and $9,747,000 less than the request and fiscal year 
1995 appropriation.
    The Administration on Developmental Disabilities supports 
community-based delivery of services which promote the rights 
of persons of all ages with developmental disabilities. 
Developmental disability is defined as severe, chronic 
disability attributed to mental or physical impairments 
manifested before age 22, which causes substantial limitations 
in major life activities.
    Included in the amount provided is $1,500,000 to fund the 
fifth year of a 5-year demonstration project known as 
transition and natural supports in the workplace. This project 
operates in six different States. It seeks to identify the 
kinds of school preparation persons with moderate and severe 
disabilities need to succeed in the work force, and the types 
of consultative support business require to hire those with 
moderate and severe disabilities. The initiative focuses on 
developing cost-effective methods to address the 85 percent 
unemployment rate of persons with disabilities and the growing 
awareness within the business community of the 
antidiscrimination mandates of the Americans With Disabilities 
Act.

Basic State grants

    For State grants the Committee recommends $64,803,000, 
compared to the $40,438,000 House allowance and $70,438,000 
request and fiscal year 1995 level. In 1987, the Developmental 
Disabilities Act changed the focus of State councils from 
services provision and demonstration to planning and services 
coordination directed to effecting systems change. Since that 
time, the States have been shifting away from their original 
role of services provision to their current mission to effect 
system change on behalf of persons with developmental 
disabilities. The decrease in funding for State grants reflects 
the adjustment of the councils from services provision to their 
current mission.

Protection and advocacy grants

    For protection and advocacy grants, the Committee 
recommends $24,581,000, which is $2,137,000 below the request 
and fiscal year 1995 appropriation. This formula grant program 
provides funds to States to establish protection and advocacy 
systems to protect the legal and human rights of person with 
developmental disabilities who are receiving treatment, 
services, or rehabilitation within the State.

Projects of national significance

    The Committee recommends $5,258,000, which is $457,000 
below the request and fiscal year 1995 appropriation. This 
program funds grants and contracts providing nationwide impact 
by developing new technologies and applying and demonstrating 
innovative methods to support the independence, productivity, 
and integration into the community of persons with 
developmental disabilities.

University-affiliated programs

    For university-affiliated programs, the Committee 
recommends $17,461,000, which is $1,518,000 below the request 
and the fiscal year 1995. This program provides operational and 
administrative support for a national network if university-
affiliated programs and satellite centers. Grants are made 
annually to university affiliated programs and satellite 
centers for interdisciplinary training, exemplary services, 
technical assistance, and information dissemination activities.

Native American programs

    The Committee concurs with the House in recommending 
$35,000,000 for native American programs, for which $38,461,000 
was available in fiscal year 1995.
    The Committee commends the administration for providing 
funds to Indian tribes and native American organizations to 
plan and implement long-term strategies for social and economic 
development and supports funding for the native Hawaiian 
revolving loan fund, the Native American Languages Grant 
Program, and the grants for tribal environmental quality. The 
Committee further notes that the National Indian Policy Center 
at George Washington University has expanded its policy 
information services and that important benefits are accruing 
to tribal governments. Accordingly, the Committee supports 
continued maximum funding of such services.

Program administration

    The Committee recommends $150,117,000 for program 
administration, a decrease of $13,054,000 below the fiscal year 
1995 appropriation. No funds are included for the electronic 
benefit transfer task force, for which the House allowed the 
$2,000,000 budget request.
    This ``Program administration'' account funds Federal 
administration costs for the Administration for Children and 
Families. The Committee is mindful of the many changes taking 
place among the programs administered by the Administration for 
Children and Families [ACF]. The Committee has included what it 
believes are sufficient funds to permit ACF to carry out its 
important mission of improving the lives of America's children 
and families. The Committee recognizes that ACF will have to 
reallocate administrative resources within its budget to 
accommodate its changing workload and program mix. In 
particular, the Committee encourages ACF to utilize resources 
no longer needed to administer programs which the Congress has 
reduced, eliminated, or reformed to carry out its increased 
responsibilities in other important programmatic areas, such as 
child support enforcement, and in expanded activities to ensure 
program accountability, promote effective practices, and 
measure the effectiveness of new approaches to assisting 
families in need.

Crime reduction programs

    The Committee recommends $25,900,000 for violent crime 
reduction programs, consisting of: $7,000,000 for runaway youth 
prevention; $400,000 for the domestic violence hotline; 
$18,100,000 for battered women's shelters; and $400,000 for 
youth education demonstration activities. The House allowance 
consisted of $400,000 for the domestic violence hotline, and 
$400,000 for youth education demonstrations, for a total of 
$800,000.

                        Administration on Aging

Appropriations, 1995....................................    $876,095,000
Budget estimate, 1996...................................     897,148,000
House allowance.........................................     778,246,000

Committee recommendation

                                                             836,027,000

    The Committee recommends an appropriation of $836,027,000 
for aging programs, $57,781,000 more than recommended by the 
House, $40,068,000 less than the 1995 appropriation, and 
$61,121,000 below the amount requested by the administration.
    The Committee urges the AOA to continue to fund national 
aging organizations with a proven track record in providing 
representation and services to low-income-aged minorities. This 
is crucial to implementing the provisions of the Older 
Americans Act, as amended, to promote participation by older 
individuals with the greatest economic or social needs, and 
with particular attention to low-income-aged minorities.

Supportive services and senior centers

    The Committee recommends an appropriation of $291,375,000 
for supportive services and senior centers, a decrease of 
$15,336,000 below the 1995 appropriation and the budget 
request. This State formula grant program funds a wide range of 
social services for the elderly, including multipurpose senior 
centers and ombudsman activities. State agencies on aging make 
awards to area agencies on aging on the basis of State-approved 
area plans and intrastate funding formulas.

Ombudsman/elder abuse

    The Committee recommends an appropriation of $4,449,000 for 
the ombudsman program, that same level as the fiscal year 1995 
enacted level and the President's budget request; and 
$4,732,000 for the prevention of elder abuse, the same amount 
appropriated in 1995 and $1,500,000 below the amount requested 
by the President. The House did not recommend funding for 
either 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 board and care facilities, while 
elder abuse prevention targets its message to the elderly 
community at large.

Pension counseling

    The Committee agrees with the House and provides no funding 
for the public benefit and insurance counseling program. The 
1995 appropriation and the administration request was 
$1,976,000. These funds are distributed to States according to 
formula. The Committee feels that it is more cost effective to 
provide this counseling for the elderly under the Health Care 
Financing Administration and has provided $4,500,000 for that 
purpose.

Preventive health services

    The Committee recommends $15,623,000 for preventive health 
services, a decrease of $1,359,000 below the 1995 level and the 
budget request. The House provided no funds for this purpose. 
Funds appropriated for this activity are part of the 
comprehensive and coordinated service systems targeted to those 
elderly most in need.

Congregate and home-delivered nutrition services

    The Committee recommends an appropriation of $474,874,000, 
the same amount appropriated in 1995 and requested by the 
administration, and an increase of $28,493,000 over the amount 
recommended by the House and $5,000,000 below the 
administration's request and the 1995 level. Of this total, 
$364,535,000 is for congregate meals, and $110,339,000 is for 
home-delivered meals. This program funds nutrition services 
projects for the elderly. Projects funded must make home-
delivered and congregate meals available at least once a day, 5 
days a week, and each meal must meet one-third of the minimum 
daily dietary requirements. While States receive separate 
allotments of funds for congregate and home-delivered nutrition 
services and support services they are permitted to transfer up 
to 30 percent of funds between these programs. The Committee is 
concerned with recent reports stating that approximately 41 
percent of home-delivered programs maintain waiting lists of 
over 2.5 months. To focus resources in areas of the greatest 
need, the Committee has included an increase of $16,274,000 
above the 1995 appropriation for the home-delivered meals 
program.

In-home services for frail elderly

    The Committee recommends $9,263,000 for in-home services 
for the frail elderly, the same level as the fiscal year 1995 
enacted level, the budget request, and the amount recommended 
by the House. In-home services include homemaker and home 
health aides, visiting and telephone reassurance, chore 
maintenance, in-home respite care for families, and minor home 
modifications.

Aging grants to Indian tribes and native Hawaiian organizations

    The Committee recommends $15,550,000 for grants to Indian 
tribes, a decrease of $1,352,000 below the 1995 appropriation, 
$2,852,000 below the 1996 budget request, and $507,000 below 
the amount appropriated by the House. Under this program awards 
are made to tribal and Alaskan Native organizations and to 
public or nonprofit private organizations serving native 
Hawaiians which represent at least 50 Indians or Alaskan 
Natives 60 years of age or older to provide a broad range of 
services and assure that nutrition services and information and 
assistance services are available.

Aging research and training

    The Committee recommends $4,991,000 for aging research, 
training, and discretionary programs, $20,639,000 less than the 
fiscal year 1995 enacted level and $40,143,000 below the budget 
request. The House bill provided no funding for this purpose. 
These funds support activities designed to expand public 
understanding of aging and the aging process, test innovative 
ideas and programs to serve older individuals, and provide 
technical assistance to agencies who administer the Older 
Americans Act. Current activities include elder abuse, long-
term care ombudsman programs, and minority aging. Of the funds 
provided, the Committee directs the Department to use 
$1,500,000 to fund the legal services hotlines and $600,000 to 
continue the Family Friends Program. The Committee directs the 
Secretary to provide level funding for the elder care locator 
program.

Federal Council on Aging

    The Committee agrees with the House and has provided no 
funding for the Federal Council on Aging. The administration 
requested $226,000 for this program. In 1995, $176,000 was 
appropriated.

White House Conference on Aging

    The Committee agrees with the House and provides no funding 
for the White House Conference on Aging, which was authorized 
under the 1992 amendments to the Older Americans Act. This will 
enable for the writing, reviewing, commenting, and filing of 
the final report. The administration had requested $500,000.

Program administration

    The Committee recommends $15,170,000 to support Federal 
staff that administer the programs in the Administration on 
Aging, the same amount recommended by the House, $1,230,000 
below the 1995 appropriation, and $2,229,000 below the budget 
request.

                        Office of the Secretary

                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 1995....................................    $107,343,000
Budget estimate, 1996...................................      93,366,000
House allowance.........................................     123,639,000

Committee recommendation

                                                             140,350,000

    The Committee recommends an appropriation of $133,722,000 
for general departmental management. This is $47,560,000 more 
than the administration request, $16,896,000 more than the 
House allowance, and $45,356,000 more than the fiscal year 1995 
level.
    The Committee also recommends the transfer of $6,628,000 
from the Medicare trust funds, which is $576,000 less than the 
administration request, $185,000 less than the House allowance, 
and $12,349,000 less than the fiscal year 1995 level. The 
numbers reflect the budget amendment submitted by the President 
which reflects the transfer of FTE to the newly independent 
Social Security Agency on April 1, 1995.
    This appropriation supports those activities that are 
associated with the Secretary's role as policy officer and 
general manager of the Department. It also supports several 
offices formally located in the Office of the Assistant 
Secretary of Health.

Departmental management

    The Committee recommends an appropriation of $92,439,000 
for general departmental management. This is $6,277,000 more 
than the administration request, $10,000,000 more than the 
House allowance, and $4,073,000 more than the fiscal year 1995 
level.
    The Committee also recommends the transfer of $6,628,000 
from the Medicare trust funds, which is $576,000 less than the 
administration request, $185,000 less than the House allowance, 
and $738,000 less than the fiscal year 1995 level. The numbers 
reflect the budget amendment submitted by the President which 
reflects the transfer of FTE to the newly independent Social 
Security Agency.
    The Committee has eliminated funding for the Office of the 
Assistant Secretary for Health [OASH]. The Committee 
understands that the Secretary has decided to replace the OASH 
with a smaller office which would serve as the senior advisor 
for health and science policy. This account includes sufficient 
funding for the establishment of this office in the Office of 
the Secretary, as well as funds for the orderly phaseout of the 
OASH.
    The Committee recognizes that this account is the successor 
account to OASH and, as such, may inherit liabilities for some 
related transition costs. The Committee also understands that 
the Secretary may transfer certain current OASH functions to 
agencies within the Department, and is given discretion to also 
transfer the associated funding provided in this account for 
those functions.
    The appropriation supports activities associated with the 
Secretary's role as policy officer and departmental manager. 
GDM funds support the Department's centralized services carried 
out by 8 of the 10 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. It will also support certain 
health activities that were performed in the Office of the 
Assistant Secretary of Health, including the Office of the 
Surgeon General.
    The Office of the Surgeon General, in addition to its other 
responsibilities, provides leadership and management oversight 
for the PHS Commissioned Corps, including the involvement of 
the Corps in departmental emergency preparedness and response 
activities.
    The Committee is aware of a memorandum of understanding 
which has been executed between the State of Oregon and nine 
Federal partners including the Department of Health and Human 
Services. The purpose of this partnership is to encourage and 
facilitate cooperation among Federal, State, and local entities 
to redesign and test an outcomes-oriented approach to 
intergovernmental service delivery. The Oregon Option 
experiment is focused on three areas of human investment: 
healthy children, stable families, and a highly developed and 
prepared work force. In working with the State of Oregon to 
reduce Federal barriers to service delivery, the Committee 
urges the Department to streamline and expedite regulatory 
processes where possible in order to help the State meet its 
performance outcomes.
    The State of New Hampshire is also reengineering their 
Department of Health and Human Services to integrate all health 
and social services at the local level. We urge the Federal 
Government to remove any regulatory barriers which could 
prevent the development of a comprehensive managed approach to 
health care and health-related support services.
    New Hampshire's efforts will be targeted to children and 
families along with the elderly and disabled; these efforts 
will include individuals who are duly eligible for Medicare and 
Medicaid. This Committee additionally encourages the relevant 
Federal agencies to assist the State of New Hampshire in their 
efforts to replace AFDC with a comprehensive performance-based 
employment program.
    The Committee has provided $500,000 from this account for 
continuation of the existing elements of the human services 
transportation technical assistance program. In many cases, 
particularly in rural areas, human services transportation 
providers are the only source of public transportation. The 
technical assistance program provides assistance to these 
organizations on coordination and management, and on meeting 
requirements of the Americans with Disabilities Act.
    The Committee notes that the administration is moving 
closer to establishing a National Bioethics Advisory Commission 
to debate and make recommendations on issues concerning the 
ethical implications of research on human biology and behavior, 
and the applications of that research. With the increasing 
developments in biomedicine and the moral and ethical questions 
that arise as a result, the Nation is in need of a standing 
commission of ethics experts. The Committee urges the prompt 
consideration of nominations for membership and establishment 
of this Commission with the designation by the Secretary of 
dedicated staff by January 1, 1996.
    The Committee requests that the Department of Health and 
Human Services Chronic Fatigue Syndrome Interagency 
Coordinating Committee [DHHS CFSICC] be formally chartered. 
Formal representation on the CFSICC must continue to include 
NIH, CDC, SSA, and FDA, as well as patient advocates an private 
sector researchers. In addition, the Committee strongly 
recommends the addition of a representative from HRSA.

Adolescent family life

    The Committee has provided $6,144,000 for the Adolescent 
Family Life Program [AFL]. This is the same as the 
administration request, and $554,000 less than the fiscal year 
1995 appropriation and the House allowance.
    AFL is the only Federal program focused directly on the 
issue of adolescent sexuality, pregnancy, and parenting. 
Through demonstration grants and contracts, AFL focuses on a 
comprehensive range of health, educational, and social services 
needed to improve the health of adolescents, including the 
complex issues of early adolescent sexuality, pregnancy, and 
parenting.

Disease prevention and health promotion

    The Committee recommends $4,236,000 to support the Office 
of Disease Prevention and Health Promotion [ODPHP], statutorily 
established under title XVII of the Public Health Service Act. 
This is $368,000 less than the fiscal year 1995 amount, 
$365,000 less than the President's request, and $4,236,000 less 
than the House allowance.
    The Office of Disease Prevention and Health Promotion 
manages Healthy People 2000, a national effort to improving the 
health status of all Americans. Other ODPHP efforts include 
operation of the National Health Information Center, directing 
the Put Prevention into Practice national education program, 
working with the U.S. Department of Agriculture in implementing 
the 1995 dietary guidelines for Americans, initiating the 
development of the third Surgeon General's ``Report on 
Nutrition and Health,'' and strengthening interdepartmental 
coordination of school health education and services.

Physical fitness and sports

    The Committee recommends $1,000,000 for the Federal staff 
which supports the President's Council on Physical Fitness and 
Sports. This is $406,000 less than the administration request, 
the same as the House allowance, and $407,000 less than the 
fiscal year 1995 appropriation.
    The President's Council on Physical Fitness and Sports 
serves a catalyst, promoting increased physical activity/
fitness and sports participation for Americans of all ages and 
abilities, in accordance with Executive Order 12345, as 
amended. The programs sponsored by PCPFS are supported largely 
through private sector partnerships.

Minority health

    The Committee recommends $18,981,000 for the Office of 
Minority Health. This is $1,650,000 below the fiscal year 1995 
appropriation and the House allowance, $1,611,000 less than the 
administration request, and $1,650,000 less than the House 
allowance.
    The Office of Minority Health [OMH] focuses on strategies 
designed to decrease the 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 improving health outcomes for disadvantaged 
and minority individuals. OMH supports several demonstration 
projects, including the Minority Community Health Coalition, 
the Bilingual/Bicultural Service, the Center for Linguistic and 
Cultural Competency in Health Care, and the Family and 
Community Violence Prevention Program.
    The Committee notes the importance of primary care health 
centers associated with minority health profession 
institutions. In particular, the Committee is aware of a 
proposal from the Morehouse School of Medicine for support for 
its national center for primary health care. The Committee 
believes this is a meritorious project and encourages the 
Office of Minority Health to give this proposal serious 
consideration.
    The Committee has provided adequate funding for the 
continuation and growth of a variety of competitive programs 
throughout the Public Health Service that emphasize improving 
the health status of disadvantaged populations, including 
racial and ethnic minorities. The need for strong support and 
continued emphasis on these programs is embodied in the mission 
of the Department of Health and Human Services.

National Vaccine Program

    The Committee did not provide funding for the National 
Vaccine Program Office. The Committee understands that the 
National Vaccine Program Office has been transferred to the 
Centers for Disease Control and Prevention.

Office of Research Integrity

    The Committee recommends $3,554,000 for the Office of 
Research Integrity [ORI]. This is $309,000 less than the fiscal 
year 1995 appropriation, $304,000 less than the House allowance 
and the administration request.
    The National Institutes of Health Revitalization Act of 
1993 established ORI as an independent entity in the 
Department. ORI oversees and directs all PHS research integrity 
efforts with the exception of the regulatory research 
activities of the Food and Drug Administration. ORI is 
responsible for assuring that institutions receiving PHS funds 
have appropriate mechanisms in place to deal with allegations 
of misconduct and to protect whistleblowers. It also 
investigates such allegations in the PHS intramural program.

Office on Women's Health

    The Committee recommends $5,362,000 for the Office on 
Women's Health. This is $2,810,000 more than the administration 
request, $2,800,000 more than the fiscal year 1995 amount, and 
$3,162,000 more than the House allowance.
    The PHS Office on Women's Health [OWH] develops, 
stimulates, and coordinates women's health research, health 
care services, and public and health professional education and 
training across HHS agencies, with other Government agencies, 
and with private industry, health care organizations, and 
consumer groups. It advances important crosscutting initiatives 
and develops public-private partnerships, providing leadership 
and policy direction, and initiating and synthesizing program 
activities to redress the disparities in women's health.
    The Committee directs that the Office of Women's Health 
should continue to direct the implementation of the National 
Action Plan on Breast Cancer. This plan, which unites the 
efforts of all HHS and other Federal agencies, is a critical 
element in the fight against breast cancer which will affect 
one out of eight women over a lifetime. The Committee supports 
the President's request to expand this action plan to 
$14,475,000 and directs the National Cancer Institute to 
designate such funds for this important project.
    HHS has undertaken a study of the current curricula used by 
medical schools to train medical students in women's health and 
to begin to develop a model women's health curricula to aid 
medical schools in improving their educational programs 
regarding the conditions, disease, and health needs of women. 
The Committee commends the National Institutes of Health, the 
Health Resources and Services Administration, and the Office of 
Women's Health for their addressing this important aspect of 
medical training, which has been overlooked for too long. The 
Committee encourages these three entities to work together to 
continue this program and expand it to other appropriate health 
professions.
    The Committee commends the Office of Women's Health for its 
commitment to the women's health education and the training of 
women health professionals. Therefore, the Committee has also 
included funding to support leadership training for women and 
curriculum development to include the unique health needs of 
women. The Committee encourages the Office of Women's Health to 
give strong consideration to developing a public/private 
partnership with the Institute for Women's Health at the 
Medical College of Pennsylvania for the development of 
curricula that recognizes the unique health needs of women and 
that provides a model leadership training program to women 
health professionals.
    The Committee is aware the Office of Women's Health is 
developing plans to establish a national women's clearinghouse. 
This clearinghouse, which would operate through a well-
publicized 800 toll-free number, would provide a single point 
of entry by the public and health care professionals to the 
broad range of women's health-related information that has been 
developed across the HHS agencies.
    Currently, women facing health problems, their families, 
women's health organizations, and health care providers must 
walk through a maze of HHS agencies to find appropriate 
information on women's health. While a great deal of 
information is available through the Department, in many 
instances it remains quite difficult to find or access. The 
clearinghouse, which can rely on new computer technology to 
place orders for publications directly with each agency, will 
dramatically increase the access of the public and health care 
providers to critical information on the latest research, drugs 
and devices, public education messages, treatment options, and 
health service programs for women. In addition, women across 
the country will be able to speak to women's health information 
specialists about their health concerns and be directed to 
resources available in their communities. Finally, by compiling 
this information into a single data base, the identification of 
the gaps in information will be facilitated, allowing the 
Office of Women's Health to develop any new materials when 
needed.
    The Committee directs that the Public Health Service 
agencies contribute a total of $1,400,000 with a proportionate 
share from each agency to the Office of Women's Health to carry 
out the development and implementation of the national women's 
health clearinghouse.
    The Committee has provided funding for the Office of 
Women's Health over the fiscal year 1995 amount to enable the 
Office to support innovative demonstrations for the 
comprehensive and coordinated delivery of health care to women. 
The Committee understands that McGee-Women's Hospital in 
Pittsburgh has developed a comprehensive health care model that 
would meet the educational, research, and clinical needs of 
women of all ages. Special attention would be paid to the needs 
of low-income and older women. The Committee believes it is 
important for women to be able to receive comprehensive care 
throughout their life cycle and encourages this Office to give 
strong consideration to supporting this demonstration program 
and other model programs.

Office of Emergency Preparedness

    The Committee provides $2,006,000 for the Office of 
Emergency Preparedness [OEP]. This is $368,000 less than the 
administration request, $2,006,000 more than the House 
allowance, and $174,000 less than the fiscal year 1995 
appropriation. This Office is the sole Office for meeting the 
responsibility of the Secretary in continuity of Government, 
continuity of operations and coordinating the response to major 
emergencies and catastrophic disasters, including domestic 
terrorism.
    OEP coordinates the readiness, response, and recovery 
efforts for all health, medical, and health-related social 
services for the Federal Government under the Federal response 
plan. Additionally, OEP directs the national disaster medical 
system [NDMS] of which the medical component is composed of 
approximately 5,000 private sector health professionals in 60 
disaster medical assistance teams that provide medical 
assistance when State and local resources are exhausted. OEP 
maintains a hospital bed emergency availability list and 
through partnership with the Department of Defense [DOD] and 
the Department of Veterans Affairs, coordinates the evacuation 
of patients and in hospital care within the NDMS.

National AIDS Policy Office [NAPO]

    The Committee has not provided funding for NAPO; however, 
the Committee encourages the Secretary to ensure that the 
coordination of departmental cross-cutting issues, such as HIV/
AIDS, is addressed in the plan to consolidate the Office of the 
Assistant Secretary of Health and the Office of the Secretary 
and that the office responsible for such coordination should 
report directly to the Secretary.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 1995....................................     $89,608,000
Budget estimate, 1996...................................      79,937,000
House allowance.........................................      73,956,000

Committee recommendation

                                                              75,941,000

    The Committee recommends an appropriation of $55,945,00 for 
the Office of Inspector General. This is $2,944,000 less than 
the administration request, $388,000 less than the House 
allowance, and $4,955,000 less than the fiscal year 1995 level.
    The Committee also recommends the transfer of $19,996,000 
from the Medicare trust funds, which is $1,052,000 less than 
the administration request, $2,373,000 more than the House 
allowance, and $850,000 less than the fiscal year 1995 level.
    The Office of Inspector General conducts audits, 
investigations, inspections, and evaluations of the operating 
divisions within the Department of Health and Human Services. 
The OIG functions with the goal of reducing the incidence of 
waste, abuse, and fraud. It also pursues examples of 
mismanagement toward the goal of promoting economy and 
efficiency throughout the Department.
    Pursuant to Public Law 103-296, 259 FTE's and $10,446,000 
were transferred from OIG to the independent Social Security 
Administration on March 31, 1995; this included $8,038,000 from 
Social Security trust fund transfers and $2,408,000 from 
appropriated funds.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 1995....................................     $22,011,000
Budget estimate, 1996...................................      21,160,000
House allowance.........................................      13,500,000

Committee recommendation

                                                              19,467,000

    The Committee recommends an appropriation of $16,153,000 
for the Office for Civil Rights. This is $1,405,000 less than 
the administration request, $5,904,000 more than the House 
allowance, and $2,078,000 less than the fiscal year 1995 level.
    The Committee also recommends the transfer of $3,314,000 
from the Medicare trust funds, which is $288,000 less than the 
administration request, $63,000 less than the House allowance, 
and $466,000 less than the fiscal year 1995 level.
    The Office for Civil Rights is responsible for enforcing 
civil rights-related statutes in health care 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.
    Pursuant to Public Law 103-296, two FTE's and $85,000 were 
transferred from OIG to the independent Social Security 
Administration on March 31, 1995; this included $49,000 from 
Social Security trust fund transfers and $36,000 from 
appropriated funds.

                            POLICY RESEARCH

Appropriations, 1995....................................      $9,417,000
Budget estimate, 1996...................................      12,278,000
House allowance.........................................       9,000,000

Committee recommendation

                                                              14,500,000

    The Committee recommends an appropriation of $14,500,000 
for policy research. This is $3,278,000 less than the 
administration request, the same as the House allowance, and 
$417,000 less than the fiscal year 1995 amount.
    Funds appropriated under this title provide resources for 
research programs that examine broad issues which cut across 
agency and subject lines, as well as new policy approaches 
outside the context of existing programs. This research can be 
categorized into three major areas: health policy, human 
services policy, and disability, aging and long-term care 
policy.
    Pursuant to Public Law 103-296, one FTE and $122,000 were 
transferred from policy research to the independent Social 
Security Administration on March 31, 1995.
    Because welfare reform must emphasize moving people into 
private sector jobs, the Committee has included $5,500,000 from 
within this account for the job creation demonstration 
authorized under section 505 of the Family Support Act of 1988. 
Under this program, welfare recipients and those at risk for 
welfare are given training and financial assistance by 
nonprofit community development organizations to help them 
start their own small businesses or gain private sector 
employment. This program has been very successful in moving 
people off welfare and into work. As in past years, the 
Committee directs that this program be administered by the 
Office of Community Services and that a priority be given to 
community development corporations.

                           General Provisions

    The Committee concurs with the House in recommending a 
$37,000 ceiling on official representation expenses (sec. 201), 
the same as existing law.
    The Committee concurs with the House in retaining language 
from last year's bill limiting assignment of certain public 
health service personnel (sec. 202).
    The Committee has modified House language limiting use of 
health funds for certain activities (sec. 203).
    The Committee concurs with the House in retaining 
provisions carried in last year's bill to ensure that States 
continue to receive child abuse prevention and training grants 
(sec. 204); limit use of grant funds to pay individuals no more 
than an annual rate of $125,000 (sec. 205); and provide for 
transfer of funds to the inspector general's office for 
provision of security protection for the Secretary of Health 
and Human Services (sec. 207).
    The Committee has deleted House provisions prohibiting use 
of funds for the Federal Council on Aging and Advisory Board on 
Child Abuse (sec. 208) and the position of Surgeon General of 
the Public Health Services (sec. 209).
    The Committee has included a new provision (sec. 208) that 
reduces administrative expenses of the National Institutes of 
Health by $41,665,000.
    The Committee has modified House language limiting the use 
of taps (sec. 206) which addresses, in part, evaluation funds. 
Section 241 of the Public Health Service Act authorizes the 
Secretary to redirect up to 1 percent of the appropriations 
provided for programs authorized under the act for program 
evaluation activities.
    The Committee has specifically provided for use of a 
portion of these funds by the Agency for Health Care Policy and 
by the National Center for Health Statistics. The Committee has 
included a provision restricting the use of the balance of 
these funds by the Secretary prior to submitting a report on 
the proposed use of the funds to the Appropriations Committees.
                   TITLE III--DEPARTMENT OF EDUCATION

                            education reform

Appropriations, 1995....................................    $494,370,000
Budget estimate, 1996...................................     950,000,000
House allowance.........................................      95,000,000

Committee recommendation

                                                             432,500,000

    The Committee has provided $432,500,000 in this account for 
two administration reform initiatives: $310,000,000 for 
education reform activities authorized by the recently enacted 
Goals 2000: Educate America Act (Public Law 103-227), and 
$122,500,000 to continue implementation of school-to-work 
transition systems authorized by the School-to-Work 
Opportunities Act (Public Law 103-239).

Goals 2000 State grants

    The Committee bill includes $300,000,000 for State and 
local systemic education improvement grants authorized by title 
III of the Goals 2000: Educate America Act. This amount is 
$61,870,000 below the 1995 appropriation, $393,500,000 below 
the administration request, and $300,000,000 more than the 
House allowance.
    Goals 2000 funds provide incentives for States to devise 
their own strategies for comprehensive reform of elementary and 
secondary education. Grants are distributed to States through a 
formula based on relative shares each State received in the 
previous year under titles I and VI of the Elementary and 
Secondary Education Act. Of the total, 1 percent is reserved 
for the outlying areas, schools supported by the Bureau of 
Indian Affairs, and the Alaska Federation of Natives. 
Participating States must develop comprehensive, statewide 
education reform strategies involving high standards for all 
students, assessments tied to the high standards, and teacher 
training activities. Beginning in the second year a State must 
pass through at least 90 percent of its Goals 2000 funds to 
local educational agencies for the development and 
implementation of local reform plans and the improvement of 
both preservice and inservice professional development.
    The Committee has added a proviso permitting the Secretary 
to authorize up to six additional State education agencies 
authority to waive Federal statutory or regulatory requirements 
for fiscal year 1996 and succeeding fiscal years.

Parental assistance

    The Committee emphasizes the importance of the eighth 
national education goal relating to parental involvement and 
participation in promoting the social, emotional, and academic 
growth of children, and urges the Department to encourage 
parental involvement in every level of education. Assisting 
States in developing policies to aid schools in strengthening 
partnerships with parents and families is an important 
objective which will ensure that the remaining seven national 
education goals are met.
    To further the goal of increased parental involvement, the 
Committee bill includes $10,000,000 for title IV of the Goals 
2000: Educate America Act, which authorizes a variety of 
activities designed to improve parenting skills and strengthen 
the partnership between parents and professionals in meeting 
the education needs of their school-age children, including 
those aged birth through 5. The recommendation is the same as 
the administration request. The House bill provided no funds 
for this purpose. These funds will support the expansion of 
voluntary parent education activities such as the Parents as 
Teachers Program and the Home Instruction for Parents of 
Preschool Youngsters Program.

Goals 2000 national programs

    The Committee has not approved the $46,500,000 requested by 
the administration for Goals 2000: national programs. The House 
also provided no funds for this purpose. Funds appropriated in 
1995 for this activity were rescinded in Public Law 104-19. The 
purpose of this program is to provide support and guidance to 
States and local school districts in their reform efforts.

School-to-work opportunities

    The Committee supports funds for the School-to-Work 
Opportunities Act, and has recommended $122,500,000 for the 
Department of Education share of program funding. The amount 
recommended is the same as the 1995 appropriation, $77,500,000 
less than the administration request, and $27,500,000 more than 
House allowance. Together with $122,500,000 recommended for the 
Labor Department, $245,000,000 in direct funding is provided to 
help States implement their plans for creating systems to 
improve the transition from school to work.
    Within the $122,500,000 provided, the Committee recommends 
$6,875,000 for national programs. The amount recommended is the 
same as the 1995 appropriation, $8,125,000 below the budget 
request, and $6,875,000 more than the amount recommended by the 
House.
    Local school-to-work programs will include a combination of 
work-based learning involving job training and school-based 
learning tied to both occupational skill standards and the 
academic standards States establish under Goals 2000. Students 
who complete a school-to-work program will receive a high 
school diploma, a certificate recognizing 1 or 2 years of 
postsecondary education if appropriate, and a portable, 
industry-recognized skill certificate.
    By 1996, a total of 28 States will have started full 
implementation of comprehensive statewide systems.

                    Education for the Disadvantaged

Appropriations, 1995....................................  $7,228,116,000
Budget estimate, 1996...................................   7,441,292,000
House allowance.........................................   6,014,499,000

Committee recommendation

                                                           6,517,166,000

    The Committee recommends an appropriation of $6,517,166,000 
for education for the disadvantaged. This is $710,950,000 less 
than the fiscal year 1995 comparable level, $710,950,000 less 
than the administration request, and $502,667,000 more than 
House allowance.
    Programs financed under this account are authorized under 
title I (formerly chapter 1) of the Elementary and Secondary 
Education Act [ESEA] and section 418A of the Higher Education 
Act. ESEA title I programs provide financial assistance to 
State and local educational agencies [LEA's] to meet the 
special educational needs of educationally disadvantaged 
children, migrant children, neglected and delinquent children 
in State institutions, and juveniles in adult correctional 
institutions. In addition, the Even Start Program supports 
projects that integrate early childhood education with 
parenting and adult literacy training. Funds for each of these 
programs, except for Even Start, are allocated according to 
formulas that include the number of eligible children and each 
State's average per-pupil expenditure. Even Start funds are 
allocated according to each State's proportion of title I 
grants to LEA's.
    The High School Equivalency Program [HEP] and College 
Assistance Migrant Program [CAMP], authorized by section 418A 
of the Higher Education Act, provide grants to institutions of 
higher education to assist migrant and seasonal farmworkers 
past the age of compulsory school attendance to complete the 
courses necessary to receive a high school diploma or its 
equivalent, and to assist migrant students enrolled in their 
first undergraduate year at a college or university.
    The HEP and CAMP programs and title I evaluation activities 
are current-funded programs with fiscal year 1996 funds 
available for obligation from October 1, 1995, to September 30, 
1996. All other programs in this account are forward funded, 
with funds appropriated for fiscal year 1996 becoming available 
for obligation on July 1, 1996, and remaining available through 
September 30, 1997. These forward-funded programs will 
generally support projects in the 1996-97 school year.

Grants to local educational agencies

    Title I grants to local educational agencies provide 
supplemental education funding to LEA's and schools, especially 
in high-poverty areas, to help low-income, low-achieving 
students learn to the same high standards as other children. 
The formula for basic grants is based on the number of children 
from low-income families in each county, weighted by per-pupil 
expenditures for education in the State. States in turn make 
suballocations from the county to the LEA level using the best 
data available on the number of poor children. States are also 
required to reserve funds generated by counts of children in 
correctional institutions to make awards to LEA's for dropout 
prevention programs involving youth from correctional 
facilities and other at-risk children.
    For title I basic grants, the Committee recommends an 
appropriation of $5,266,863,000. This is $701,372,000 less than 
the 1995 appropriation, the same as the budget request, and 
$317,358,000 more than recommended by the House.
    The Committee recommends $692,341,000 for concentration 
grants, an increase of $29,204,000 above the 1995 appropriation 
and the budget request, and $142,396,000 more than the amount 
provided by the House. The funds are distributed according to 
the basic grants formula, except that they only go to counties 
and LEA's where the number of poor children equals at least 
6,500 or 15 percent of the total school-aged population. 
Approximately 66 percent of counties nationally receive funds. 
The statute requires that, each year, concentration grants 
receive an amount equal the 1995 appropriation for this 
program.
    The Committee recommends $60,194,000 for the Bureau of 
Indian Affairs and the outlying areas. This amount is 
$6,790,000 below the 1995 level, $9,806,000 below the budget 
request, and $4,644,000 above the amount recommended by the 
House. From the amount for the outlying areas, $5,000,000 is 
reserved for a program of discretionary grants to LEA's in 
Palau, the Federated States of Micronesia, and the Marshall 
Islands; this program is administered by the Pacific Regional 
Educational Laboratory.

Capital expenses for private school students

    The Committee recommends $38,119,000 for the Capital 
Expenses Program, a decrease of $3,315,000 below the 1995 
appropriation, $18,119,000 above the budget request and the 
amount recommended by the House.
    The ESEA requires districts to provide equitable title I 
instruction to private school students, but the Supreme Court's 
1985 Aguilar v. Felton decision prohibits districts from 
sending public school teachers or other employees to private 
sectarian schools for the purpose of providing title I 
services. The Capital Expenses Program helps districts comply 
with Felton by paying a portion of the additional capital costs 
associated with serving religious school students outside 
school premises. Funds may be used by districts for 
noninstructional goods and services such as renting classroom 
space in neutral sites, renting or purchasing mobile vans for 
title I instruction, or transporting private schoolchildren to 
the place of title I instruction.
    Funds are allocated to States according to the proportion 
of nonpublic school students served under title I LEA Grants 
Program in the most recent year for which satisfactory data are 
available.

Even Start

    For the Even Start Program, the Committee agrees with the 
House and recommends $102,024,000, the same amount appropriated 
in the 1995 appropriation. The administration requested no 
funds for this purpose because Even Start activities were to be 
carried out through a broader adult education activity.
    The Even Start Program provides grants to school districts 
and nonprofit organizations to operate educational programs 
that serve disadvantaged families with children under 8 years 
of age and adults eligible for services under the Adult 
Education Act. Programs combine early childhood education, 
adult literacy, and parenting education.
    States receive funds on the basis of their proportion of 
title I LEA grant allocations and make competitive 4-year 
grants to local educational agencies and community-based 
organizations. Grant funds must be equitably distributed among 
urban and rural areas and the local share of program costs 
increases from 10 percent in the first year to 40 percent in 
the fourth year.

Migrant

    For the State Agency Migrant Program, the Committee agrees 
with the House and provides $305,475,000. The amount 
recommended is the same amount appropriated in 1995 and 
$4,525,000 below the administration's request.
    The title I migrant program authorizes grants to State 
educational agencies for programs to meet the special 
educational needs of the children of migrant agricultural 
workers and fishermen. Funds are allocated to the States 
through a statutory formula based on each State's average per-
pupil expenditure for education and counts of migratory 
children aged 3 through 21 residing with the States. Under the 
reauthorization, only migratory children who have moved within 
the last 3 years are generally eligible to be counted and 
served by the program. Currently, this program serves 
approximately 541,000 migrant students.
    This appropriation also supports activities to improve 
interstate and intrastate coordination of migrant education 
programs.

Neglected and delinquent

    The Committee recommends $39,311,000 for the title I 
Neglected and Delinquent Program, the same amount appropriated 
in 1995, $689,000 below the administration request, and 
$7,311,000 more than the amount recommended by the House.
    This program provides financial assistance to State 
educational agencies for education services to neglected and 
delinquent children and youth in State-run institutions and for 
juveniles and in adult correctional institutions.
    Funds are allocated to individual States through a formula 
based on the number of children in State-operated institutions 
and per-pupil education expenditures for the State.
    States are authorized to set aside up to 10 percent of 
their neglected and delinquent funds to help students in State-
operated institutions to make the transition into locally 
operated programs. Transition activities are designed to 
address the high failure and dropout rate of institutionalized 
students and may include alternative classes, counseling and 
supervisory services, or educational activities in State-
supported group homes.

State school improvement grants

    The Committee agrees with the House and provides no funds 
for State school improvement grants. The recommendation is 
$35,146,000 below the administration request and $27,560,000 
below the amount appropriated in 1995. This program helps 
States stimulate school-base change and hold local education 
agencies accountable for making significant progress in the 
education of disadvantaged children. Funds for this purpose can 
be sustained through administrative set-asides in the title I 
program and other State and local funding sources.

Demonstrations of innovative practices

    The Committee agrees with the House and provides no funding 
for demonstration and innovative practices. The administration 
had requested $25,146,000 for this purpose. This program 
provides discretionary grants to selected sites to design and 
implement innovative strategies and practices that show the 
most promise of helping title I children achieve to high 
standards. This activity could be funded under the Office of 
Education, Research and Improvement.

Evaluation

    The Committee bill includes $3,370,000 for title I 
evaluation activities, $7,630,000 below the administration 
request. The House recommended no funding for this purpose.
    The Committee has provided funds in order for the 
Department to fund a national assessment of the effectiveness 
of title I programs, and a longitudinal survey of the 
educational progress of educationally disadvantaged children.

High School Equivalency Program

    The Committee bill includes $7,441,000 for the High School 
Equivalency Program [HEP], $647,000 less than the 1995 level. 
Neither the House nor the administration recommended funding 
for this program.
    This program provides 5-year grants to institutions of 
higher education and other nonprofit organizations to recruit 
migrant students aged 16 and over and provide the academic and 
support services needed to help them obtain a high school 
equivalency certificate and subsequently gain employment, win 
admission to a postsecondary institution or a job-training 
program, or join the military. Projects provide counseling, 
health services, stipends, and placement assistance. HEP will 
serve about 3,050 migrants in 1995.

College Assistance Migrant Program

    For the College Assistance Migrant Program [CAMP], the 
Committee bill includes $2,028,000, which is $176,000 below the 
1995 appropriation. Neither the House nor the administration 
recommended funding for this program.
    This program provides 5-year grants to institutions of 
higher education and nonprofit organizations for projects that 
provide tutoring, counseling, and financial assistance to 
migrant students during their first year of postsecondary 
education. Projects also may use up to 10 percent of their 
grants for followup services after students have completed 
their first year of college, including assistance in obtaining 
student financial aid. CAMP will serve about 360 students in 
1995.

                               impact aid

Appropriations, 1995....................................    $728,000,000
Budget estimate, 1996...................................     619,000,000
House allowance.........................................     645,000,000

Committee recommendation

                                                             677,959,000

    The Committee recommends an appropriation of $677,959,000 
for impact aid for the Department of Education. This amount is 
$50,041,000 below the 1995 amount, $58,959,000 above the 
administration request, and $32,959,000 above the amount 
recommended by the House.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities. 
Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education. In 
school year 1995-96 approximately 2,700 school districts will 
receive payments of behalf of 1.8 million eligible children.
    The Committee believes the reforms to the impact aid 
program as provided for in the Improving America's Schools Act 
of 1994, greatly improved the impact aid program. The Committee 
wishes to reaffirm Congress's commitment as contained in the 
impact aid reforms of 1994 in meeting the needs of all school 
districts impacted by a Federal presence. This includes those 
school districts with high concentrations of children residing 
off of Federal property, including the students of our military 
personnel residing off base. The Committee is aware that due to 
base consolidation, some districts are seeing increased 
enrollments of military dependent students residing offbase due 
to inadequate onbase housing facilities. The impact aid program 
should continue to recognize the needs of these school 
districts, and the funds provided herein will continue to 
address the needs of these school districts.
    Basic support payments.--The Committee recommends 
$581,170,000 for basic support payments, a decrease of 
$50,537,000 below the 1995 level, and $31,170,000 more than 
budget request and the House allowance. Under statutory 
formula, payments are made on behalf of all categories of 
federally connected children.
    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. The Committee bill includes 
$40,000,000 for this purpose, the same amount as the 1995 
level, the budget request, and the House.
    Payments for heavily impacted districts.--These payments 
provide additional assistance to certain local education 
agencies that enroll large numbers or proportions of federally 
connected children. The Committee recommends $36,800,000, a 
decrease of $3,200,000 from the 1995 level, $16,800,000 more 
than requested by the administration, and $13,200,000 less than 
recommended by the House.
    Facilities maintenance.--This activity provides funding for 
maintaining certain school facilities owned by the Department 
of Education. The Committee agrees with the House and 
recommends no funding for this program. The administration had 
requested $2,000,000 for this purpose in fiscal year 1996. No 
appropriation was provided in 1995.
    Payments for increases in military dependents.--Funds are 
used to provide immediate financial assistance to local 
educational agencies faced with a sudden increase in 
enrollments due to the consolidation of military bases. The 
Committee agrees with the House and provides no funds for this 
newly authorized activity. The administration had requested 
$2,000,000 for this program in fiscal year 1996. The Committee 
has provided sufficient funds within basic support payments to 
provide relief to school districts experiencing expanded 
enrollments due to military base consolidations.
    Construction.--Payments are made to eligible LEA's to be 
used for construction and renovation of school facilities, or 
for debt service related to the construction of school 
facilities. The Committee recommends $5,000,000 for this 
program, the same amount requested by the administration and 
recommended by the House. No funds were provided for this 
purpose in 1995.
    The Committee is concerned about an impending situation 
affecting children of military personnel at Bangor Submarine 
Base. The school district which serves these dependents, the 
Central Kitsap School District, and the State of Washington, 
have consistently supported the needs of children of military 
families. However, because of the influx of hundreds of 
military dependent students due to base realignment actions, 
the school district is unable to provide appropriate facilities 
for the education of these children.
    The problem is particularly acute for special education 
dependents. Bangor has been designated as a preferred 
assignment for military personnel with special needs children, 
including children with severe handicapping conditions. The 
school district must transport these children to facilities 
some distance from the base, as there are no facilities on-base 
to meet these educational demands caused by these additional 
students.
    The Committee urges the Department, in conjunction with the 
Department of Navy, to initiate discussions with the Central 
Kitsap School District concerning the feasibility, construction 
and design of a facility to accommodate educational 
requirements of military special needs children and other 
elementary aged military dependents. This effort should be 
coordinated with the Central Kitsap School District and the 
State of Washington and the results should be reported to this 
Committee in a timely fashion.
    Payments for Federal property.--These payments compensate 
local educational agencies in part for revenue lost due to the 
removal of Federal property from local tax rolls. Payments are 
made to LEA's that have a loss of tax base of at least 10 
percent of assessed value due to the acquisition since 1938 of 
real property by the U.S. Government. The Committee recommends 
$14,989,000 for this activity in 1996, a decrease of $1,304,000 
from the amount appropriated in 1995. No funds were requested 
by the administration nor provided by the House.

                      school improvement programs

Appropriations, 1995....................................  $1,328,037,000
Budget estimate, 1996...................................   1,554,331,000
House allowance.........................................     892,000,000

Committee recommendation

                                                           1,157,623,000

    The Committee recommends an appropriation of $1,157,623,000 
for school improvement programs. This amount is $170,384,000 
less than the 1995 appropriation, $396,708,000 less than the 
administration's request, and $265,623,000 more than the House 
allowance.

Professional development and program innovation

    The Committee recommends a total of $550,000,000 for the 
Eisenhower professional development State grants ($275,000,000) 
and innovative education program strategies State grants 
($275,000,000). The administration requested $735,000,000 for 
Eisenhower professional development State grants, and proposed 
to eliminate all funding for the Innovative Education 
Strategies Program. The House, in anticipation of the passage 
of an education reform block grant which is currently under 
consideration by the House Economic and Educational 
Opportunities Committee, recommended $550,000,000 and 
consolidated funding for the professional development and 
innovative grants program.
    The Committee reiterates its support for the Eisenhower 
professional development State grant program and recognizes 
that this activity is the major program within the Department 
of Education supporting improvement in math and science 
education. This program is of vital interest to the Committee 
as it works to ensure that the tools are in place to reach 
national educational goal No. 5--that by the year 2000, U.S. 
students will be the first in the world in science and 
mathematics achievement.
    Eisenhower professional development State grants.--The 
Committee recommends $275,000,000 for Eisenhower professional 
development State grants, an incease of $23,702,000 over the 
1995 appropriation. This program provides formula grants to 
States to support sustained and intensive high-quality 
professional development activities in the core academic 
subjects at the State and local levels. Professional 
development in the areas of mathematics and science receives a 
priority in funding, with the first $250,000,000 of the total 
appropriation for this program designated for those subjects.
    Innovative education program strategies State grants.--The 
Committee recommends $275,000,000 for innovative education 
program strategies State grants, a decrease of $72,250,000 
below the 1995 appropriation. The purpose of this program is to 
make grants to State and local educational agencies for 
activities intended to help meet the national education goals 
and assist in their reform of elementary and secondary 
education. Funds are awarded to States by a formula based on 
school-aged population and then to local districts under a 
State-determined formula. State and local funds may be used for 
acquisition of instructional materials such as library books, 
curricular materials, and computer software and hardware; 
improving educational services to disadvantaged children and 
dropout prevention; combating illiteracy among children and 
adults; programs for gifted and talented children; reform 
activities consistent with Goals 2000; and teacher training and 
other related activities in support of any of these purposes 
also is authorized.

Safe and drug-free schools and communities

    State grant program.--The Committee bill provides 
$400,000,000 for the safe and drug free schools and communities 
programs State grant program. The amount recommended is 
$65,981,000 below the 1995 level, $100,000,000 less than the 
budget request, and $200,000,000 more than the House allowance.
    The Committee has included bill language which would 
transfer $200,000,000 of the amount appropriated to the 
Substance Abuse and Mental Health Services Administration of 
the Department of Health and Human Services to fund substance 
abuse prevention demonstration programs for youth. The 
Committee has taken this action to better target resources to 
those programs with a proven track record in educating youth in 
the prevention of substance abuse.
    National programs.--The Committee agrees with the House and 
recommends no funding for the national programs portion of the 
safe and drug free schools program. The administration had 
requested $35,000,000 for 1996.

Education infrastructure

    The Committee agrees with the House and recommends no 
funding for the education infrastructure program, a decrease of 
$35,000,000 below the administration request. No funding was 
provided for this program in 1995. The purpose of this program 
is to assist local educational agencies in the repair and 
renovation or rebuilding of school facilities. The 
administration has proposed legislation to expand the authority 
of the College Construction Loan Insurance Association to make 
loans available to local educational agencies for construction 
and renovation.

Inexpensive book distribution

    For the inexpensive book distribution program, the 
Committee provides $10,300,000 the same as the 1995 
appropriation and the administration request, and $1,300,000 
more than the House allowance. This program is operated by 
Reading Is Fundamental [RIF], a private nonprofit organization 
associated with the Smithsonian Institution. RIF works with 
more than 4,500 local volunteer groups to distribute books to 
children from low-income families to help motivate them to 
read. In 1996, an estimated 7.2 million books will be 
distributed to 2.2 million children. This program has been 
successful in motivating children to read, increasing the use 
of libraries, increasing parental involvement in schools, and 
contributing to improved reading achievement.

Arts in education

    The Committee bill includes $9,000,000 for the arts in 
education program, $1,500,000 less than the 1995 appropriation, 
$1,000,000 less than the administration request, and the same 
as the House allowance. The amount recommended will support two 
awards: $5,000,000 for a grant to Very Special Arts [VSA], 
which supports the development of programs to integrate the 
arts into the lives of children and adults with disabilities; 
and $4,000,000 for a grant to the John F. Kennedy Center for 
the Performing Arts, which supports a variety of activities 
through its education department that promote the arts 
throughout the Nation.

Instruction in civics, government, and the law

    The Committee recommends no funding for instruction in 
civics, government, and the law. Neither the administration nor 
the House recommended funding for this program. In 1995, after 
the rescission was enacted, $4,500,000 remained in the program. 
The purpose of this program is to equip students with knowledge 
and skills pertaining to the law, the legal process and the 
legal system and the fundamental principles and values of U.S. 
citizenship. This program has received support for over 15 
years and should now be able to continue without further 
Federal assistance.

Christa McAuliffe fellowships

    The Committee recommends no funding for the Christa 
McAuliffe fellowship program, which is $1,946,000 less than the 
1995 level. Neither the administration nor the House 
recommended funding for this program. Funds are provided for 
fellowships to teachers for projects to improve education 
through sabbaticals for study, research, or academic 
improvement. The Committee has provided funding under the 
Eisenhower professional development State grant program for 
States to use for professional development.

Magnet schools assistance

    For the magnet schools assistance program, the Committee 
bill provides $95,000,000, which is the same amount recommended 
by the House, and $16,519,000 below the administration's 
request and the 1995 appropriation.
    This program supports grants to local educational agencies 
to establish and operate magnet schools that are part of an 
approved desegregation plan and are designed to attract 
substantial numbers of students of different social, economic, 
ethnic, and racial backgrounds. Grantees may use funds for 
teacher salaries, purchase of computers, and other educational 
materials and equipment.
    The Committee directs the Department to use up to 5 
percent, but no less than $3,000,000 of the magnet school 
appropriation for innovative programs as described in section 
5111 of title V of the Elementary and Secondary Education Act.

Education for homeless children and youth

    For carrying out education activities authorized by the 
Stewart B. McKinney Homeless Assistance Act, the Committee 
recommends $23,000,000, the same as the House recommendation, 
$7,000,000 less than the budget request, and $5,811,000 below 
the 1995 level.
    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 
homeless children, and to carry out other activities to ensure 
that all homeless children and youth in the State have access 
to the same free, appropriate public education including a 
public preschool education as provided to other children and 
youth. Grants are made to States based on the total that each 
States receives under the title I program.

Women's educational equity

    The Committee agrees with the House and recommends no 
funding for the women's educational equity program. The 
recommendation is $3,967,000 below the 1995 appropriation and 
$4,000,000 less than the budget request.

Training and advisory services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $14,000,000, 
the same as the budget request, and $7,412,000 below the 1995 
appropriation. The House eliminated all funding for this 
program.
    The funds provided will fund 10 regional desegregation 
assistance centers. These centers provide technical assistance, 
training, and advisory services to assist school districts in 
addressing problems associated with desegregation on the basis 
of race, color, sex, or national origin. No funds are included 
for civil rights units in State education agencies.

Dropout assistance

    The Committee agrees with the House and the administration 
and recommends no funding for the dropout prevention program. 
This activity was funded at $12,000,000 in 1995. This activity 
provides grants to local educational agencies, community-based 
organizations, and educational partnerships to support 
demonstration projects to reduce the number of students who do 
not complete elementary and secondary education.

Ellender fellowships

    For Ellender fellowships, the Committee bill includes 
$2,760,000, a decrease of $240,000 below the 1995 level. 
Neither the administration nor the House recommended funds for 
this activity.
    The Ellender fellowship program makes an award to the Close 
Up Foundation of Washington, DC, to provide fellowships to 
students from low-income families and their teachers to enable 
them to participate with other students and teachers for a week 
of seminars on Government and meetings with representatives of 
the three branches of the Federal Government.

Education for native Hawaiians

    For programs for the education of native Hawaiians, the 
Committee bill includes $12,000,000, which is $3,000,000 above 
the 1995 appropriation and the budget request. The House bill 
eliminated funding for this purpose.
    The Committee has included this increase because of the 
lack of educational opportunities for native Hawaiians who 
continue to have an extraordinarily high dropout rate which 
leads to unemployment and contributes to the incidence of 
incarceration, teen pregnancy, alcoholism, and suicide.
    Of the funds appropriated within this activity, the 
Committee recommends the following funding levels for native 
Hawaiian programs: $1,500,000 for the curricula development, 
teacher training, and recruitment program; $800,000 for the 
community-based education learning centers; $1,400,000 for the 
Hawaiian higher education program; $1,200,000 for the gifted 
and talented program; $1,200,000 for special education 
programs; $300,000 for the native Hawaiian Education Council 
and island councils; and $5,600,000 for family-based education 
centers.

Foreign language assistance

    The Committee has included $10,039,000 for the Foreign 
Language Assistance Program, $873,000 below the 1995 
appropriation and the budget request. The House eliminated all 
funding for this activity.
    The Foreign Language Assistance Program provides 3-year 
discretionary grants to State and local educational agencies to 
cover one-half the cost of operating innovative model programs 
of foreign language study in elementary and secondary schools.
    Due to budget constraints the Committee was unable to 
provide sufficient funds to make incentive payments on the 
basis of the number of students enrolled in elementary school 
foreign language programs and has, therefore, included 
language, requested by the administration, which will clarify 
that all funds will be used for discretionary grants to LEA's.
    The Committee directs the Department to give priority in 
awarding funds to projects that begin teaching foreign 
languages in the elementary grades, with the primary focus on 
the less commonly taught languages of Japanese, Chinese, 
Russian, Arabic, and Korean.

Training in early childhood education and violence counseling

    The Committee agrees with the House and recommends no 
funding for training in early childhood education and violence 
counseling. The administration had requested $9,600,000 for 
this program in 1996. This demonstration program has enabled 
institutions of higher education to establish innovative 
programs to recruit and train students for careers in early 
childhood development and care and counseling of young children 
from birth to 6 years of age who have been affected by 
violence.

Charter schools

    The Committee recommends $10,000,000 for support of charter 
schools, which is $4,000,000 more than the 1995 level and the 
House allowance, and $10,000,000 below the budget request.
    Under this program, authorized under title X, part C of the 
Elementary and Secondary Act of 1965, as amended, the Secretary 
makes awards to State educational agencies, which, in turn, 
make subgrants to partnerships of developers and local 
education agencies or other public entities that can authorize 
or approve a charter school. Grants are limited to 3 years in 
duration, of which not more than 18 months my be used for 
planning and program design, and not more than 2 years for the 
initial implementation of a charter school.
    Unlike traditional public schools, charter schools operate 
under charters or contracts with school districts, State 
education agencies, or other public institutions. They are 
designed by groups of parents, teachers, school administrators, 
other members of the community, and private corporations and 
are held accountable for student performance under the terms of 
their contracts. Also, charter schools can operate with 
considerable autonomy from external controls such as district, 
State, and union requirements.
    The Committee believes that charter schools offer great 
promise in reforming public education because they link the 
important factors of school-site autonomy, parental choice, 
regulatory flexibility, private sector initiative, 
accountability, and community participation.

Technical assistance for improving ESEA programs

    The Committee recommends $21,524,000 for the comprehensive 
regional technical assistance centers. This recommendation is 
$8,117,000 below the 1995 appropriation and $33,476,000 below 
the administration request. The House recommended no funding 
for this purpose. This program supports 15 regional centers 
that provide support, training, and assistance to Department of 
Education grantees.

Violent Crime Reduction Program

    Due to budget constraints the Committee recommends no 
funding for the family and community endeavor schools program 
authorized by section D, title III of the Violent Crime Control 
and Law Enforcement Act of 1994. The administration requested 
$31,000,000 for this program in 1996. No funds were provided 
for this purpose by the House or appropriated for this purpose 
in 1995. Funds support competitive grants to community-based 
organizations and local educational agencies to improve 
educational and social development for at-risk youth living in 
high-poverty and high-crime areas.

                   bilingual and immigrant education

Appropriations, 1995....................................    $206,700,000
Budget estimate, 1996...................................     300,000,000
House allowance.........................................     103,000,000

Committee recommendation

                                                             172,959,000

    The Committee recommends an appropriation of $172,959,000 
for bilingual and immigrant education. This is $33,741,000 less 
than the 1995 appropriation, $127,041,000 below the 
administration request, and $69,959,000 above the House 
allowance.
    The bilingual programs authorized by title VII of ESEA are 
designed to increase the capacity of States and school 
districts to provide special instruction to limited English-
proficient students.

Instructional services

    The Committee bill includes $107,815,000 for bilingual 
instructional programs, a decrease of $9,375,000 below the 1995 
level, $47,875,000 below the President's budget, and 
$54,815,000 above the amount recommended by the House.
    This activity provides competitive grants, primarily to 
school districts, to improve the quality of instructional 
programs for limited English proficient students. Schools are 
permitted to select the instructional approach best suited to 
their students, except that no more than 25 percent of program 
funds may be used to support instruction that does not make use 
of the students native language. Funds may also be used to 
provide services for preschool children and parents to assist 
in the education of their children.

Support services

    The Committee bill recommends no funding for support 
services. The House also provided no funding for this purpose. 
The recommendation is $15,330,000 below the budget request and 
$14,330,000 below the amount appropriated in 1995. This program 
provides discretionary grants and contracts in four specific 
areas: research and evaluation, dissemination of effective 
instructional models; data collection and technical assistance; 
and a national clearinghouse to support the collection, 
analysis, and dissemination of information about programs for 
limited English proficient students.

Professional development

    The Committee recommends $15,144,000 for professional 
development, $10,036,000 below the 1995 level, and $13,836,000 
below the budget request. The House provided no funds for this 
purpose.
    These funds support the training and retraining of 
bilingual education teachers and teacher aides, graduate 
fellowships related to fields of bilingual education, and 
grants to institutions of higher education to improve bilingual 
teacher training programs.

Immigrant education

    The Committee recommends $50,000,000 for immigrant 
education, the same amount appropriated in 1995 and the amount 
recommended by the House. The administration requested 
$100,000,000 for this activity.
    The Immigrant Education Program provides financial support 
to offset the additional costs of educating recently arrived 
immigrant students who often lack proficiency in English and 
need special services to make the transition to the American 
education system. Federal dollars flow through State 
educational agencies to school districts enrolling a minimum of 
500 eligible immigrant students or where eligible immigrant 
children represent at least 3 percent of the enrollment. The 
Committee agrees with the administration and has included bill 
language to permit States to allocate all or any part of the 
funds to LEA's on a discretionary basis.

                           special education

Appropriations, 1995....................................  $3,252,846,000
Budget estimate, 1996...................................   3,342,126,000
House allowance.........................................   3,092,491,000

Committee recommendation

                                                           3,245,447,000

    The Committee recommends an appropriation of $3,245,447,000 
for special education. This is $7,399,000 less than the 1995 
appropriation, $96,679,000 below the administration request, 
and $152,956,000 over the House allowance.
    These programs, which are authorized by the Individuals 
with Disabilities Education Act [IDEA], provide assistance to 
ensure that all children with disabilities have access to a 
free appropriate public education, and that all infants and 
toddlers with disabilities have access to early intervention 
services. This assistance is provided through State grants 
which offset a portion of the costs incurred by State and local 
educational agencies in educating children with disabilities 
and developing and implementing statewide systems of early 
intervention services, and through a variety of discretionary 
programs that provide funds to meet designated Federal 
priorities.

Grants to States

    The Committee bill provides $2,323,837,000 for special 
education grants to States, the same amount recommended by the 
House, and $922,000 more than 1995 appropriation. This program 
supports formula grants to States to finance a portion of the 
cost of providing special education and related services for 
children with infants and toddlers with disabilities.
    The Committee's recommended funding level represents 
approximately 7 percent of the estimated average per-pupil 
expenditure and would provide an estimated $413 per child for 
the 5.6 million children expected to receive special education.
    The Committee has included bill language to restore to 
eligibility of the Republic of the Marshall Islands and the 
Federated States of Micronesia for funding under part B of the 
IDEA. The Committee notes that the Compact of Free Association 
with the Republic of the Marshall Islands and with the 
Federated States of Micronesia authorizes their continued 
participation in Federal education programs. The Committee 
reiterates its intention that Federal education moneys should 
continue to be made available to the Freely Associated States 
for the duration of their respective contracts.

Preschool grants

    The Committee recommends $360,409,000 for preschool grants, 
an increase of $144,000 over the 1995 appropriation, and the 
same as the House allowance. The preschool grant program 
provides formula grants to States based on the number of 
preschool children with disabilities, aged 3 through 5 years, 
who are served. The statute limits the share per child served 
to a maximum of $1,500.
    The amount provided by the Committee is approximately $660 
per child for the 546,000 preschoolers expected to receive 
special education and related services in the next school year.
    States must distribute at least 75 percent of their grant 
to local educational agencies and intermediate educational 
units. Twenty percent may be retained for development of a 
comprehensive delivery system for children from birth through 5 
years; for direct and support services for 3- through 5-year-
olds; and, at a State's discretion, to serve 2-year-olds with 
disabilities who will turn 3 during the school year.
    The administration requested $2,772,460,000 for the grants 
to States and preschool grants programs, an increase of 
$89,280,000 over the combined funding for the current programs. 
Separate estimates are not provided for these two programs.

Grants for infants and families

    The Committee bill provides $315,754,000 for the part H 
grants for infants and families program, the same amount 
recommended by the House, and $122,000 more than 1995 amount 
and the budget request. This program provides formula grants to 
States to implement statewide systems of coordinated, 
comprehensive, multidisciplinary interagency programs to 
provide early intervention services to all children with 
disabilities, aged 0 through 2, and their families.
    The Committee reiterates its strong commitment to this 
program as the principal component of the Federal strategy to 
ensure that infants and toddlers with disabilities have access 
to services needed to maximize their potential for success in 
their school-age years and beyond.

Program support and improvement

    For program support and improvement, the administration 
proposed $254,034,000, the same amount appropriated for 1995 
for the 14 special purpose fund programs expiring in 1995. The 
Committee recommends no funding for the President's request, 
which was based on proposed legislation, and continues funding 
for these programs under separate line items. The House also 
provided no funding for program support and improvement.

Deaf-blindness

    The Committee has included $12,832,000 for deaf-blind 
projects, the same as the 1995 appropriation and the House 
allowance.
    Deaf-blindness funds are used for technical assistance, 
research, and model demonstration projects for children who are 
both deaf and blind. The amount provided will support about 6 
new and 53 continuation awards.

Serious emotional disturbance

    The Committee bill provides $4,147,000 for the serious 
emotional disturbance program, the same as the 1995 level and 
the House allowance.
    This program supports projects to improve special education 
and related services for children and youth with serious 
emotional disturbance. These children remain significantly 
unserved or underserved by special education. The Committee 
level will support 19 awards focused on addressing the needs of 
children with serious emotional disturbance as well as 
preventing the development of serious emotional disturbance 
among children and youth with emotional and behavioral 
problems.

Severe disabilities

    The Committee bill provides $10,030,000 for the severe 
disabilities program, the same amount as appropriated in 1995 
and the House allowance. This program awards grants and 
contracts for projects to improve special education and early 
intervention services for children with severe disabilities. 
The amount recommended by the Committee will support 
approximately 40 awards for research, demonstration, and 
systems change activities.

Early childhood education

    The Committee recommends $25,167,000, the same appropriated 
in 1995. The House recommended no funding for this purpose.
    This program funds demonstration projects, technical 
assistance, and research to support States as they provide 
special education and early intervention services to infants, 
toddlers, and children with disabilities from birth through 8 
years of age. Special emphasis is placed on helping States 
implement the grants for infants and families and the preschool 
grants programs.

Secondary and transitional services

    The Committee bill includes $23,966,000 for secondary and 
transitional services, the same amount as appropriated in 1995 
and the House allowance.
    About two-thirds of these funds support joint efforts 
between State vocational rehabilitation agencies and State 
educational agencies to develop, implement, and improve systems 
to provide transition services for youth with disabilities from 
age 14 through the age they exit schools. Other activities 
include research, model demonstrations, and special projects. 
The amount provided would support up to 12 new grants for joint 
efforts of State vocational rehabilitation and educational 
agencies.

Postsecondary education

    The Committee recommends $8,839,000 for postsecondary 
education programs, the same as the 1995 level and the House 
allowance.
    This program supports efforts to improve postsecondary 
programs for persons with disabilities. The Committee level 
would support new and continuation funding for demonstration 
projects designed to improve educational outcomes of 
postsecondary education for individuals with disabilities.
    The Committee directs the Department to continue the 
current four centers for the deaf which are funded under 
section 625(a)(2) through fiscal year 1996.

Innovation and development

    The Committee recommends an appropriation of $14,000,000, a 
decrease of $6,635,000 from the 1995 appropriation. The House 
recommended no funding for this purpose. These funds support 
research and related activities to assist parents, 
professionals, and others providing early intervention, special 
education, and related services to children with disabilities, 
and to conduct research, surveys, and demonstrations related to 
the provision of services to children with disabilities.
    The Committee recognizes that the Hispanic population is 
the fastest growing minority population in the United States. 
Increasingly, students from this population are being diagnosed 
as having disabilities, particularly communicative and language 
disorders. The Committee directs the Department to support 
research and demonstration initiatives which support the 
development of culturally and linguistically sensitive 
normative and diagnostic data, assessment instruments, service 
procedures, and intervention programs for Hispanic youth.

Media and captioning services

    The Committee recommends $19,142,000 for media and 
captioning services, the same as the 1995 appropriation and the 
amount recommended by the House.
    The primary focus of this program is the captioning of 
commercial films and the closed captioning of television. In 
addition, funds are awarded to the National Theater of the Deaf 
and Recording for the Blind, Inc. [RFB].
    The amount recommended includes $3,600,000 for RFB and 
$1,500,000 for descriptive video.
    It has been brought to the Committee's attention that the 
delay in the most recent funding cycle for Recordings for the 
Blind has resulted in a gap in the funding. The Committee 
directs the Department to review the funding cycle and 
determine if RFB could be reimbursed for services provided 
during the funding delay.

Technology applications

    The Committee bill includes $9,993,000 for special 
education technology, a decrease of $869,000 below the 1995 
appropriation. The House provided no funding for this purpose.
    This program promotes expansion of the use of technology in 
the education of children with disabilities by supporting 
research, dissemination, and technical assistance related to 
the development, production, and marketing of technology for 
the education of children with disabilities.

Special studies

    The Committee provides $3,827,000, a decrease of $333,000 
below the 1995 appropriation. The House provided no funding for 
this activity.
    Special studies funds support grants and contracts to 
assess progress in implementing IDEA programs, as well as the 
effectiveness of State and local efforts to provide early 
intervention services and free and appropriate public education 
to children with disabilities. These activities help inform 
congressional policymaking and support program improvement 
efforts by State, local, and Federal agencies.

Personnel development

    The Committee recommends an appropriation of $91,339,000 
for personnel development, which is the same as the 1995 level. 
The House eliminated funding for this program.
    Personnel development funds are used to award grants to 
institutions of higher education, State educational agencies, 
and other nonprofit agencies to assist them in training 
personnel for careers in special education and early 
intervention services and to develop new teaching approaches.
    The Committee also encourages the Secretary, pursuant to 
the authority provided under section 631(c) of IDEA, to 
consider making career development awards for elementary and 
secondary general education faculty at schools and colleges of 
education, to better prepare the next generation of teachers to 
serve students with disabilities who spend some or all of their 
school day in a regular class.
    Children whose primary language is Spanish often have 
special needs with regard to the delivery of educational, 
related, and early intervention services. However, there are 
relatively few teachers, related services personnel, and early 
intervention personnel who are able to deal with the 
communication and cultural needs of these children. The 
Committee urges the Department to work more closely with 
Hispanic serving institutions of higher education to increase 
the number of Hispanic education personnel. Attention should be 
given to communicative disorders and other disabilities.

Parent training

    The Committee provides $13,535,000 for the parent training 
program, the same amount as appropriated in 1995 and the amount 
recommended by the House.
    Parent training grants are made to projects to train 
parents of children with disabilities to participate more 
effectively in meeting the educational needs of such children.

Clearinghouses

    The Committee recommends $1,989,000, a decrease of $173,000 
from the 1995 appropriation. The House bill eliminated funding 
for this purpose.
    This program supports the activities of three 
clearinghouses--the National Clearinghouse on the Education of 
Children With Disabilities, the National Clearinghouse on 
Postsecondary Education for Individuals With Disabilities, and 
the National Clearinghouse on Careers and Employment in Special 
Education.

Regional resource centers

    The Committee bill provides $6,641,000 for regional 
resource centers, a decrease of $577,000 from the 1995 
appropriation. The House terminated funding for this activity.
    This program supports six regional centers and one national 
coordinating center that provide technical assistance and 
training to States to improve their capacity to serve children 
with disabilities.

            rehabilitation services and disability research

Appropriations, 1995....................................  $2,393,352,000
Budget estimate, 1996...................................   2,456,937,000
House allowance.........................................   2,455,760,000

Committee recommendation

                                                           2,452,620,000

    The Committee recommends $2,452,620,000 for rehabilitation 
services and disability research, $59,268,000 more than the 
1995 appropriation, $3,140,000 below the House bill, and 
$4,317,000 below the administration request

Basic State grants

    The Committee provides $2,118,834,000 for vocational 
rehabilitation grants to States, which is the same as the 
administration request and the House allowance, and $64,689,000 
more than the 1995 appropriation.
    Basic State grant funds assist States in providing a range 
of services to help persons with physical and mental 
disabilities prepare for and engage in meaningful employment. 
Authorizing legislation requires States to give priority to 
persons with severe disabilities. Funds are allotted to States 
based on a formula that takes into account population and per 
capita income, and States must provide a 21.3-percent match of 
Federal funds. Beginning in 1994, States must use 1.5 percent 
of their allotments for innovation and expansion activities.

Technical assistance to States

    The Committee recommends $1,000,000 for technical 
assistance to States, the same amount recommended by the House 
and the administration. No funds were provided for this purpose 
in 1995. Funds support technical assistance activities of 
national scope and the provision of technical assistance to 
State vocational rehabilitation agencies in their efforts to 
improve the efficiency and effectiveness of programs.

Client assistance

    The Committee bill recommends $10,119,000 for the Client 
Assistance Program, the same amount recommended by the House, 
the administration, and $295,000 more than appropriated in 
1995.
    The Client Assistance Program funds State formula grants to 
assist vocational rehabilitation clients or client applicants 
in understanding benefits available to them and in their 
relationships with service providers. Funds are distributed to 
States according to a population-based formula, except each 
State is guaranteed a minimum grant of $100,000 if the 
appropriation exceeds $7,500,000. States must operate client 
assistance programs in order to receive vocational 
rehabilitation State grant funds.

Training

    The Committee provides $39,629,000 for training 
rehabilitation personnel, the same as the 1995 appropriation, 
the administration request, and the House allowance.
    The purpose of this program is to ensure that skilled 
personnel are available to serve the rehabilitation needs of 
individuals with disabilities. It supports training, 
traineeships, and related activities designed to increase the 
numbers of qualified personnel providing rehabilitation 
services. The program awards grants and contracts to States and 
public or nonprofit agencies and organizations, including 
institutions of higher education, to pay part of the cost of 
conducting training programs. Long-term, inservice, short-term, 
experimental, and innovative and continuing education programs 
are funded, as well as special training programs and programs 
to train interpreters for persons who are deaf and deaf-blind.

Special demonstration programs

    The Committee bill includes $23,942,000 for special 
demonstration programs for persons with disabilities, the same 
as the House allowance and the budget request, and $6,616,000 
less than appropriated in 1995.
    This program awards grants to States and nonprofit agencies 
and organizations to develop innovative methods and 
comprehensive services to help individuals with disabilities 
achieve satisfactory vocational outcomes. Special demonstration 
programs support projects for individuals with a wide array of 
disabilities.

Migratory workers

    The Committee recommends $1,421,000 for migratory workers, 
the same level appropriated in 1995, the budget request, and 
the House allowance.
    This program provides a 90-percent Federal match for 
comprehensive rehabilitation services to migrant and seasonal 
farmworkers with disabilities and their families. Some projects 
also develop innovative methods for reaching and serving this 
population. The program emphasizes outreach, specialized 
bilingual rehabilitation counseling, and coordination of 
vocational rehabilitation services with services from other 
sources.

Recreational programs

    The Committee provides $2,596,000 for recreational 
programs, the same as the 1995 appropriation, the 
administration request, and the House allowance.
    Recreational programs help finance activities such as 
sports, music, dancing, handicrafts, and art to aid in the 
mobility and socialization of individuals with disabilities. 
Grants are awarded to States, public agencies, and nonprofit 
private organizations, including institutions of higher 
education. Grants are awarded for a 3-year period with the 
Federal share at 100 percent for the first year, 75 percent for 
the second year, and 50 percent for the third year. Programs 
must maintain the same level of services over the 3-year 
period. The amount provided will fund approximately 29 projects 
in 1996.

Protection and advocacy of individual rights

    The Committee recommends $7,456,000 for protection and 
advocacy of individual rights, the same as the 1995 
appropriation, the budget request, and the House allowance.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities.

Projects with industry

    The Committee bill includes $22,071,000 for projects with 
industry, the same as the 1995 appropriation, the 
administration request, and the House bill.
    The Projects With Industry [PWI] Program is the primary 
Federal vehicle for promoting greater participation of business 
and industry in the rehabilitation process. PWI provides 
training and experience in realistic work settings to prepare 
individuals with disabilities for employment in the competitive 
job market. Postemployment support services are also provided. 
The program makes grants to a variety of agencies and 
organizations, including corporations, community rehabilitation 
programs, labor and trade associations, and foundations.

Supported employment State grants

    The Committee bill includes $38,152,000 for the Supported 
Employment State Grant Program, $1,616,000 more than the 1995 
appropriation and the same as the budget request and the House 
allowance.
    This program assists persons who may have been considered 
too severely disabled to benefit from vocational rehabilitation 
services by providing the ongoing support needed to obtain 
competitive employment. Short-term vocational rehabilitation 
services are augmented with extended services provided by State 
and local organizations. Federal funds are distributed on the 
basis of population. In 1996 an estimated 35,000 individuals 
will receive services and it is estimated that of that number 
approximately 9,500 will be rehabilitated.

Independent living State grants

    The Committee recommends $21,859,000 for independent living 
State grants, which is the same amount appropriated in 1995, 
the budget request, and the House allowance.
    The independent living State formula grants program 
provides funding to improve independent living services, 
support the operation of centers for independent living, 
conduct studies and analyses, and provide training and 
outreach.

Independent living centers

    For independent living centers, the Committee bill includes 
$41,749,000, which is $1,216,000 above the 1995 level, and the 
same as the budget request and the House bill.
    These funds support consumer-controlled, cross-disability, 
nonresidential, community-based centers that are designed and 
operated within local communities by individuals with 
disabilities. These centers provide an array of independent 
living services.

Independent living services for older blind individuals

    The Committee provides $8,952,000 for independent living 
services to older blind individuals, the same amount 
appropriated in 1995, the administration request, and the House 
allowance.
    This program provides discretionary grants on a competitive 
basis to State vocational rehabilitation agencies to assist 
persons aged 55 or older to adjust to their blindness by 
increasing their ability to care for their individual needs. 
Services may include the provision of eyeglasses or other 
visual aids, mobility training, braille instruction, guide 
services, reader services, and transportation.

Evaluation

    The Committee recommends $1,587,000 for evaluation 
activities, the same as the 1995 appropriation, the 
administration request, and the House allowance.
    These funds support evaluations of the impact and 
effectiveness of programs authorized by the Rehabilitation Act. 
The Department awards competitive contracts for studies to be 
conducted by persons not directly involved with the 
administration of Rehabilitation Act programs.

Helen Keller National Center

    The Committee bill includes $7,144,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, $208,000 more 
than appropriated in 1995, and the same as the budget request 
and the House allowance.
    The Helen Keller National Center consists of a national 
headquarters in Sands Point, NY, with a residential training 
and rehabilitation facility where deaf-blind persons receive 
intensive specialized services; a network of 10 regional field 
offices which provide referral and counseling assistance to 
deaf-blind persons; and an affiliate network of 37 agencies. At 
the recommended level the center would serve approximately 80 
persons with deaf-blindness at its headquarters facility and 
provide field services to approximately 2,600 persons.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $70,000,000 for the National 
Institute on Disability and Rehabilitation Research [NIDRR], 
the same amount appropriated in 1995, the same as the budget 
request and the House allowance.
    NIDRR develops and implements a comprehensive and 
coordinated approach to the administration and conduct of 
research, demonstration projects, and related activities 
concerning the rehabilitation of disabled persons, including 
the training of persons who provide rehabilitation services or 
who conduct rehabilitation research. The Institute awards 
competitive grants to support research in federally designated 
priority areas, including rehabilitation research and training 
centers, rehabilitation engineering research centers, research 
and demonstration projects, and dissemination and utilization 
projects. NIDRR also supports field-initiated research 
projects, research training, and fellowships.
    The amount provided includes $7,000,000 to continue the 
spinal cord injury centers initiated in fiscal year 1995.
    The Committee directs the Department to use $1,000,000 to 
enable the two active regional head injury centers to begin 
serving as national resources in order to assist States in 
improving the quality and cost effectiveness of services for 
victims of traumatic brain injury [TBI] the fastest growing 
cause of disability in the United States. The Committee directs 
the Rehabilitation Service Administration to work with the 
staffs of these regional centers to develop approved plans of 
operation, including appropriate evaluation measures, for 
demonstrating methods of organizing and coordinating State, 
private provider, and victim support resources to improve the 
quality of TBI services and for disseminating this information 
on a national basis.
    The Committee urges the Department to utilize funding to 
sustain the current levels and foci of NIDRR programs, with a 
clear emphasis upon those research initiatives most directly 
targeted to employment of persons with disabilities.
    The Committee believes that techniques such as state-of-
the-art electronic technology can be used to develop new 
assisted living programs in neighborhood settings. Computers 
and other electronic features could provide the disabled 
consumer with the maximum amount of individual freedom, safety, 
and productive work stations for private sector employment. 
Within the funds provided, the Committee urges the Department 
to provide support for new assisted living programs that 
develop and demonstrate state-of-the-art electronic technology. 
The Good Shephard Rehabilitation Hospital in Lehigh County, PA, 
would be especially suited to conduct a model demonstration in 
this area.

Technology assistance

    The Committee bill provides $36,109,000 for technology 
assistance, a decrease of $4,317,000 below the administration 
request, and $3,140,000 below the amount recommended by the 
House and the 1995 appropriation.
    The Technology Assistance Program is designed to improve 
occupational and educational opportunities and the quality of 
life for people of all ages with disabilities. It provides 
competitive grants to States to develop comprehensive, consumer 
responsive statewide programs that increase access to, and the 
availability of, assistive technology devices and services. The 
National Institute on Disability and Rehabilitation Research 
administers the program.

           Special Institutions for Persons With Disabilities

                 american printing house for the blind

Appropriations, 1995....................................      $6,680,000
Budget estimate, 1996...................................       6,680,000
House allowance.........................................       4,000,000

Committee recommendation

                                                               6,680,000

    The Committee recommends $6,680,000 for the American 
Printing House for the Blind [APH], the same as the budget 
request and the 1995 appropriation, and $2,680,000 more than 
the amount recommended by the House.
    This appropriation helps support the American Printing 
House for the Blind, which provides educational materials to 
legally blind students below the college level. The Federal 
subsidy provides about 40 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 
blind students. Materials provided include textbooks and other 
educational aids in braille, large type, and recorded form and 
microcomputer applications.

               national technical institute for the deaf

Appropriations, 1995....................................     $43,191,000
Budget estimate, 1996...................................      43,041,000
House allowance.........................................      39,737,000

Committee recommendation

                                                              43,041,000

    The Committee recommends an appropriation of $43,041,000 
for the National Technical Institute for the Deaf [NTID]. This 
amount is $150,000 less than appropriated in 1995, $3,304,000 
more than recommended by the House, and the same amount 
requested by the administration. Both the House and the 
administration recommended funding for this activity under a 
consolidated account.
    Operations.--The Committee recommends $42,705,000 for 
operations, the same as the 1995 level.
    The Institute, located on the campus of the Rochester 
Institute of Technology, was created by Congress in 1965 to 
provide a residential facility for postsecondary technical 
training and education for deaf students. NTID also provides 
support services for deaf students, trains professionals in the 
field of deafness, and conducts applied research.
    Endowment grant.--The Committee bill includes $336,000 for 
the endowment matching fund, the same as the 1995 level.
    The Committee continues to believe that the endowment 
matching fund is an important mechanism for generating private 
contributions that reduce NTID's dependence on Federal funding 
and strengthen its long-term financial security.
    Construction.--The Committee bill includes no funds for 
construction. In 1995, $150,000 was provided for this purpose.

                          gallaudet university

Appropriations, 1995....................................     $80,030,000
Budget estimate, 1996...................................      80,030,000
House allowance.........................................      72,028,000

Committee recommendation

                                                              80,030,000

    The Committee recommends $80,030,000 for Gallaudet 
University, the same amount appropriated in 1995 and the amount 
requested by the administration, and $8,002,000 more than 
recommended by the House. Both the House and the administration 
recommended funding for this activity under a consolidated 
account.
    University operations.--The Committee bill includes 
$54,244,000 for program operations, the same amount 
appropriated in 1995.
    Gallaudet University is a private, nonprofit institution 
offering college preparatory, undergraduate, and continuing 
education programs for deaf students, as well as graduate 
programs in fields related to deafness for hearing-impaired and 
hearing students. The university conducts basic and applied 
research related to hearing impairments and provides public 
service programs for the deaf.
    Precollege programs.--The Committee recommends $24,786,000 
for the Model Secondary School for the Deaf and the Kendall 
Demonstration Elementary School, the same amount appropriated 
in 1995.
    The Model Secondary School for the Deaf serves as a 
laboratory for educational experimentation and development, 
disseminates models of instruction for the deaf, and prepares 
deaf adolescents for postsecondary academic or vocational 
education. The Kendall Demonstration Elementary School develops 
and provides instruction for children from infancy through age 
15.
    Endowment grant.--The Committee bill also provides 
$1,000,000 for the Gallaudet University endowment matching 
fund, the same as the 1995 appropriation.
    The Committee believes that the endowment is an important 
means of generating more private assistance for Gallaudet and 
reducing the university's dependence on Federal funding.

                     VOCATIONAL AND ADULT EDUCATION

Appropriations, 1995....................................  $1,382,561,000
Budget estimate, 1996...................................   1,668,575,000
House allowance.........................................   1,162,788,000

Committee recommendation

                                                           1,273,627,000

    The Committee recommendation includes a total of 
$1,273,627,000 for vocational and adult education, consisting 
of $1,002,349,000 for vocational education, and $271,278,000 
for adult education.

                          Vocational education

    The Committee recommendation of $1,002,349,000 for 
vocational education is $175,739,000 less than the 
administration's request, $101,269,000 less than the fiscal 
year 1995 amount, and $98,430,000 above the House allowance.
    Basic grants.--The Committee has included $890,000,000 for 
basic grants, a decrease of $82,750,000 below the 1995 
appropriation, and $90,000,000 more than the House allowance. 
The administration request of $1,141,088,000 reflects proposed 
legislation for a new consolidated State grant program.
    Funds provided under the State grant program assist States, 
localities, and outlying areas in expanding and improving their 
programs of vocational education and providing equal access to 
vocational education for populations with special needs. 
Persons assisted range from secondary students in prevocational 
courses through adults who need retraining to adapt to changing 
technological and labor market conditions. Funds are 
distributed 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 in addition 
to services such groups are eligible to receive under other 
provisions of the Perkins Act.
    Tech-prep education.--The Committee recommends $100,000,000 
for tech-prep programs. This is $8,000,000 below the 1995 
appropriation, and the same amount recommended by the House. 
The administration requested no funding for this purpose. This 
program is designed to link academic and vocational learning 
and to provide a structured link between secondary schools and 
postsecondary education institutions. Funds are distributed to 
the States through the same formula as the basic State grant 
program. States then make planning and demonstration grants to 
consortia of local educational agencies and postsecondary 
institutions to develop and operate model 4-year programs that 
begin in high school and provide students with the 
mathematical, science, communication, and technological skills 
needed to earn a 2-year associate degree or 2-year certificate 
in a given occupational field. The Committee has included bill 
language permitting $350,000, within the funds provided for 
tech-prep, for completion of the national evaluation of this 
program.
    Tribally controlled postsecondary vocational 
institutions.--The Committee has provided $2,919,000 on a 
current-funded basis for tribally controlled postsecondary 
vocational institutions. This is the same as the funding 
provided by the House and the 1995 appropriation. This program 
provides grants for the operation and improvement of tribally 
controlled postsecondary vocational institutions to ensure 
continued and expanded educational opportunities for Indian 
students. Grantee institutions may use the funds for costs 
connected with training teachers, providing instructional 
services, purchasing equipment, administration, and operating 
and maintaining the institution.
    State councils.--The Committee recommends no funding for 
State councils on vocational education, a decrease of 
$8,848,000 below the 1995 appropriation. The House also 
provided no funding for this purpose. The administration 
requests no funding for this activity. Under this activity 
grants are allocated to States based on a modification of the 
basic formula grant. Each State must establish a State council 
that reviews and comments on its State vocational education 
plan, analyzes and reports on the allocation of funds and the 
availability of vocational education programs in the State, and 
evaluates State vocational education programs every 2 years. 
States may use a portion of their basic grants funding for 
State councils.
    National programs, research.--The Committee recommends 
$5,520,000 for national research programs, an increase of 
$4,520,000 over the amount recommended by the House, and 
$1,331,000 below the 1995 appropriation. The administration 
recommended $37,000,000 under a consolidated account. Of the 
funds provided, the Committee directs the Department to use 
$5,000,000 to support the National Center for Research in 
Vocational Education and the six curriculum coordination 
centers.
    The Center is the only federally funded center charged with 
the responsibility to conduct research and provide technical 
assistance to vocational educators. The results of the applied 
research done by the Center are converted into technical 
assistance to reform and improve vocational education 
instruction in our schools and colleges. The Committee believes 
that the work of the Center is critically important to provide 
state-of-the-art job-related instruction that, in turn, will 
strengthen our Nation's economy.
    National programs, demonstrations.--The Committee 
recommends no funding for this program, the same amount 
recommended by the House. No funds were provided for this 
purpose in 1995.
    National Occupational Information Coordinating Committee 
[NOICC].--The Committee recommends $3,910,000, which is 
$340,000 less than the 1995 appropriation for NOICC. The House 
recommended no funds for this purpose. This recommendation 
would continue funding for NOICC. NOICC and its affiliated 
State occupational information coordinating committees assist 
students, educators, and occupational planners in assessing 
current and future labor market conditions by assembling and 
disseminating occupational information.

                            Adult Education

    The Committee has included $271,278,000 for adult 
education, $7,672,000 less than the fiscal year 1995 
appropriation, $219,209,000 less than the administration 
request, and $12,409,000 more than recommended by the House.
    Adult education State programs.--For adult education State 
programs the Committee provides $250,000,000, which is 
$2,345,000 less than the 1995 appropriation, and the same 
amount recommended by the House. The administration's request 
of $479,487,000 reflects proposed legislation for a new adult 
education and family literacy State grant program.
    Funds are allocated to the States and outlying areas 
through formula grants to support programs that assist 
educationally disadvantaged adults in developing basic skills, 
including literacy, and in achieving certification of high 
school equivalency and the Secretary may also reserve funds 
under section 313(d). Direct and equitable access to Federal 
funds must be provided to all types of eligible institutions 
that have the ability to provide literacy services to adults 
and families. In addition, States must provide grants to public 
housing authorities for literacy programs and must develop a 
system of indicators of program quality.
    The grant formula is based, in part, on the number of 
persons aged 16 and over in a State who do not have a high 
school diploma and who are not required to be enrolled in 
school. For fiscal year 1995, Federal funds may support up to 
75 percent of each State's program. No more than 20 percent of 
a State's funds may be used for high school equivalency 
programs and no more than 5 percent may be used for 
administration. Within this framework, a State must use at 
least 10 percent of its grant to serve the incarcerated and 
institutionalized, must set aside at least 15 percent for 
experimental demonstrations and teacher training projects, and 
must give special attention to the needs of persons of limited 
English-speaking ability.
    Adult education national programs.--The administration 
recommended $11,000,000 under a consolidated request for 
national programs. The Committee concurs with the House in 
recommending $4,869,000, with these funds used only for the 
National Institute for Literacy. In past years funds have also 
supported a broad spectrum of program evaluations and State 
technical assistance activities.
    National Institute for Literacy.--The Committee agrees with 
the House and includes $4,869,000 for the National Institute 
for Literacy, authorized under section 384(c) of the Adult 
Education Act, the same amount appropriated in 1995 for this 
purpose. The Institute provides leadership and coordination for 
the national literacy effort by conducting research and 
demonstrations on literacy, providing technical assistance 
through a State capacity building grant program, establishing 
and maintaining a national center for adult literacy and 
learning disabilities, and awarding fellowships to outstanding 
individuals in the field to conduct research activities under 
the auspices of the Institute.
    State literacy resource centers.--The Committee bill 
includes no funding for the State literacy resource centers. No 
funds were provided in 1995 or recommended by the 
administration or the House. Grants have been made to States or 
groups of States to establish and maintain a network of State 
or regional adult literacy resource centers to assist public 
and private agencies in providing and coordinating literacy 
services. Each State or group of States receives an amount that 
is proportionate to the amount received under the Adult 
Education Basic State Grant Program.
    Workplace literacy partnerships.--The Committee provides 
$11,717,000 for workplace literacy partnerships grants, which 
is $1,019,000 less than the 1995 level, and $11,717,000 more 
than the House recommendation and the administration request. 
Funds provided will support competitive demonstration grants 
for exemplary education partnerships that provide literacy 
training to meet workplace needs. These demonstration projects 
are designed and operated by partnerships between a business, 
industry, labor organization, or private industry council, and 
a State education agency, local education agency, institution 
of higher education, school, employment and training agency, or 
community-based organization. Programs are designed to improve 
the productivity of the work force through improvement of 
workers' literacy skills. Services may include: providing adult 
secondary education, adult literacy and basic skills training, 
and literacy training for limited English-proficient adults; 
updating basic skills to reflect the changing needs of the 
workplace; improving the competency of adult workers in 
speaking, listening, reading, and problem solving; and 
providing educational counseling, transportation, and child-
care services. Federal funds may support up to 70 percent of 
the cost of each program.
    Literacy training for homeless adults.--The Committee 
provides no funding for literacy training for homeless adults. 
No funds were provided for this purpose in 1995 and neither the 
House nor the administration recommended funding for this 
program. Under this program discretionary grants have been made 
to State education agencies to carry out, either directly or 
through grants or contracts with local recipients, programs of 
literacy training and basic skills remediation for homeless 
adults. Programs are required to develop cooperative 
relationships with other service agencies to provide an 
integrated package of support services addressing the most 
pressing needs of homeless adults. In making awards to State 
education agencies, consideration is given to the States' 
estimates of the number of homeless adults expected to be 
served.
    Literacy programs for prisoners.--The Committee provides 
$4,692,000 for literacy programs for prisoners, a decrease of 
$408,000 below the 1995 appropriation, and an increase of 
$692,000 above the amount recommended by the House. The 
administration requested no funding for this purpose. This 
program provides funds to State and local correctional agencies 
to establish programs that, to the extent possible, use 
advanced technologies to assist persons incarcerated in prison, 
jail, or detention centers to achieve functional literacy and 
life skills.
    The Committee also urges the Department to take comments 
from practicing corrections educators to ensure that activities 
carried out under this authority address the most urgent needs 
of incarcerated individuals.

                      STUDENT FINANCIAL ASSISTANCE

Appropriations, 1995....................................  $7,617,970,000
Budget estimate, 1996...................................   7,651,415,000
House allowance.........................................   6,916,915,000

Committee recommendation

                                                           6,751,290,000

    The Committee recommends an appropriation of $6,751,290,000 
for student financial assistance. In combination with 
$715,000,000 in Pell grants carryover funding which was 
provided in previous appropriations, the Committee makes 
available $7,466,290,000 for student financial assistance.

Federal Pell Grant Program

    For Pell grant awards in the 1996-97 academic year, the 
Committee recommends $6,115,000,000.
    Pell grants provide need-based financial assistance that 
helps low- and middle-income students and their families pay 
the costs of postsecondary education and vocational training. 
Awards are determined according to a national need analysis 
formula that takes into account a student's family income and 
assets, household size, and the number of family members 
attending postsecondary institutions. Pell grants are 
considered the foundation of the Federal postsecondary student 
aid system and students must apply for a Pell grant before 
receiving a Federal family education loan.
    This funding amount, when coupled with carryover funding 
and additional program changes in the bill, is sufficient to 
raise the maximum Pell grant to $2,440, the highest level in 
the program's history and an increase of $100 over the maximum 
grant for 1995.
    The Committee has limited Pell grant recipients to 
3,768,000 in the 1995-96 award year. This cap will not deny 
awards to any eligible students and has been imposed to better 
reflect the actual number of students receiving grants and 
program costs.
    The Committee does not agree with the House in eliminating 
assistance to those students who currently qualify for grants 
of less than $600. Nor does the Committee eliminate the 
transition bump under which students who qualified for Pell 
grants in the range of $200 to $400 prior to 1992 now receive 
the minimum Pell award of $400.

Federal supplemental educational opportunity grants

    The Committee recommends $583,407,000 for Federal 
supplemental educational opportunity grants [SEOG], the same as 
the 1995 level, the budget request, and the House allowance.
    This program provides funds to postsecondary institutions 
for need-based grants to undergraduate students. Institutions 
must contribute 25 percent of SEOG awards, which are subject to 
a maximum grant level of $4,000. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell grant recipients.

Federal work-study programs

    The Committee bill provides $616,508,000 for the Federal 
Work-Study Program, the same as the 1995 level, the House 
allowance, and the administration request.
    This program provides grants to approximately 3,700 
institutions to help more than 700,000 undergraduate, graduate, 
and professional students meet the costs of postsecondary 
education through part-time employment. The average award is 
about $1,065. Work-study jobs must pay at least the minimum 
wage and institutions must provide 25 percent of student 
earnings. Institutions also must use at least 5 percent of 
their grants for community-service jobs.
    The Committee also notes that the 5-percent requirement may 
be waived by the Secretary if enforcing it would create a 
hardship for students at the institution requesting the waiver.
    The Committee also recommends that the Department use 
$1,500,000 of the work-study funds to carry out the provisions 
of section 448(f) of the Higher Education Act for work 
colleges.

Federal Perkins loans

    The Committee bill includes $100,000,000 for Federal 
Perkins loans capital contributions, which is $58,000,000 less 
than the 1995 appropriation and budget request, and an increase 
of $100,000,000 above the House allowance.
    The Federal Perkins Loan Program supports about 
$6,000,000,000 in student loan revolving funds built up with 
capital contributions to about 2,700 participating institutions 
over the past 30 years. Institutions use these revolving funds, 
which also include a 25-percent institutional match and student 
repayments, to provide low-interest (5 percent) loans that help 
financially needy students pay the costs of postsecondary 
education. The Committee has included the amount necessary to 
maintain the current loan volume level.
    The Committee bill also includes $20,000,000 for loan 
cancellations, $2,000,000 more than the 1995 level, and the 
same as the administration request and the House allowance. 
These funds reimburse institutional revolving funds on behalf 
of borrowers who perform statutorily specified types of public 
or military service, such as working in a Head Start Program, 
serving in the Peace Corps or VISTA, or teaching in a low-
income school.

State student incentive grants

    For the State Student Incentive Grant Program [SSIG], the 
Committee provides $31,375,000, which is $32,000,000 below the 
1995 appropriation, $31,375,000 more than the House allowance, 
and the same as the budget request.
    The SSIG Program is intended to encourage and expand need-
based State financial assistance to postsecondary students. 
States match SSIG appropriations dollar for dollar to provide 
State-based grant and work-study assistance to more than 
650,000 financially needy postsecondary students. States may 
use up to 20 percent of their SSIG allotment to support campus-
based work-learning jobs.

State Postsecondary Review Program

    The Committee recommends no funding for the State 
Postsecondary Review Program authorized by the Higher Education 
Amendments of 1992. This is consistent with Public Law 104-19 
which rescinds all 1995 funding for the program. The budget 
includes $25,000,000 for the program in 1996, a $5,000,000 
increase over the original 1995 appropriation. The program 
reimburses States for activities that supplement existing 
institutional licensing and review functions conducted by 
States as part of the process of establishing the eligibility 
of postsecondary institutions to participate in Federal student 
aid programs.

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

Appropriations, 1995....................................     $62,096,000
Budget estimate, 1996...................................      30,066,000
House allowance.........................................      30,066,000

Committee recommendation

                                                              30,066,000

    The Committee recommends $30,066,000 for discretionary 
Federal administrative expenses related to the Federal Family 
Education Loan [FFEL] Program, formerly known as the Guaranteed 
Student Loan Program.
    Funds appropriated for Federal administrative expenses will 
cover the fiscal year 1996 salaries and benefits, travel, 
printing, contracts, and other expenses associated with the 
program, including payment and claims processing, reducing loan 
default costs, and program monitoring. This discretionary 
administrative funding is included in the ``Federal family 
education loans'' appropriation account rather than under the 
Department's ``Salaries and expenses'' account pursuant to a 
requirement of the Federal Credit Reform Act of 1990.
    The FFEL Program is administered through State and private 
nonprofit guarantee agencies that insure loans directly, 
collect defaulted loans, and provide various services to 
lenders. The Federal Government supports the guarantee agencies 
by providing loan advances and reinsurance payments for 
borrower default, death, disability, and bankruptcy.
    The Federal Government also pays an interest subsidy to 
lenders, based on the borrower's interest rate, on behalf of 
Stafford loan student borrowers while they are in school and 
during certain grace and deferment periods. To be eligible for 
this subsidy, students must demonstrate financial need. Federal 
Stafford loans may be borrowed by eligible students, regardless 
of their schoolyear or dependency status. Borrowing limits are 
tied to the extent of need the cost of attendance minus 
expected family contribution and other aid as determined by an 
approved need analysis system.
    Under the HEA reauthorization of 1992, a new unsubsidized 
Stafford Loan Program for middle-income borrowers provides 
federally reinsured loans to borrowers who do not qualify for 
Federal interest subsidy payments under the need-based Stafford 
Loan Program. Except for the interest benefit, all other terms 
and conditions of the Federal Stafford Loan Program apply to 
the unsubsidized Stafford loans.
    Federal PLUS loans are made to parents of dependent 
undergraduate students. Interest rates for PLUS loans are 
usually higher than those for Federal Stafford loans, and the 
Federal Government does not pay the interest during in-school, 
grace, and deferment periods. No need analysis is required, but 
borrowing cannot exceed cost of attendance minus other aid.

                  FEDERAL DIRECT STUDENT LOAN PROGRAM

Appropriations, 1995....................................    $283,565,000
Budget estimate, 1996...................................     550,000,000
House allowance.........................................     320,000,000

Committee recommendation

                                                             378,000,000

    The Committee has included language to limit the overall 
amount available for section 458 of the Higher Education Act to 
$378,000,000, including $160,000,000 for payment of 
administrative cost allowances [ACA] to guaranty agencies. The 
Committee expects that the budget reconciliation process will 
establish a formula for payment of ACA, and directs the 
Department to make such payments in accordance with that 
formula. However, should such a formula not be enacted prior to 
March 31, 1996, the Committee directs the Department to submit 
a plan for payment of ACA on that date to the chairs of the 
Senate Committee on Labor and Human Resources and the House 
Committee on Economic and Educational Opportunities for their 
review and approval.
    Because the Committee's action will substantially reduce 
the amount available for administrative expenses associated 
with the William D. Ford Federal Direct Loan Program, the 
Committee has included language which prohibits the Department 
from spending limited resources for marketing, advertising, or 
promotion of the direct loan program, either directly or 
through contractual arrangements. The Committee is also aware 
that, through the budget reconciliation process, the 
administrative fees paid to institutions of higher education 
for participation in the direct loan program will likely be 
eliminated, and, therefore, directs that no funds be made 
available for that purpose.
    The Committee also supports an indefinite appropriation 
currently estimated at $1,038,453,000 to pay for loan subsidies 
in fiscal year 1996 associated with expanding the Federal 
Direct Student Loan Program to 50 percent of total loan volume 
in the 1996-97 academic year, as required by the Student Loan 
Reform Act of 1993. This amount is $216,797,000 more than the 
1995 level, and $460,057,000 less than the estimate provided in 
the administration's budget request submitted in February.
    In general, the same terms and conditions that apply to 
Federal Stafford, SLS, and PLUS loans under the Federal Family 
Education Loan Program, will also apply to direct loans.

                            HIGHER EDUCATION

Appropriations, 1995....................................    $919,370,000
Budget estimate, 1996...................................     820,772,000
House allowance.........................................     757,700,000

Committee recommendation

                                                             850,325,000

    The Committee recommends an appropriation of $850,325,000 
for higher education programs, a decrease of $69,045,000 less 
than the 1995 amount, $29,553,000 more than the budget request, 
and $92,625,000 above the House.

Aid for institutional development

    The Committee recommends $194,846,000 for aid for 
institutional development authorized by title III of the Higher 
Education Act, $34,810,000 less than the 1995 appropriation, 
$12,235,000 more than the budget request, and $22,860,000 above 
the House allowance.
    Strengthening institutions.--The Committee bill includes 
$55,450,000 for the part A Strengthening Institutions Program, 
$24,550,000 below the 1995 level, $15,450,000 more than the 
budget request, and $22,860,000 more than the House allowance.
    The part A program supports competitive, 5-year development 
grants for institutions with a significant percentage of 
financially needy students and low educational and general 
expenditures per student in comparison with similar 
institutions. Applicants may use part A funds to develop 
faculty, strengthen academic programs, improve institutional 
management, and expand student services. Twenty-five percent of 
part A funds in excess of $61,000,000 must be allocated to 
eligible institutions with over 60 percent minority enrollment. 
The Committee disagrees with the House on restricting part A 
funds to nonpublic institutions. The Committee directs the 
Department to continue all multiyear grants, but at a lower 
rate, so that no institution is eliminated from this program.
    Hispanic-serving institutions.--The Committee recommends 
$10,800,000 for the section 316 set-aside for institutions at 
which Hispanic students make up at least 25 percent of 
enrollment, $1,200,000 less than the 1995 level and the 
administration request, and the same as the House allowance. 
Institutions applying for section 316 funds must meet the 
regular part A requirements and show (1) that at least one-half 
of their Hispanic students are low-income, first-generation 
college students, and (2) that another one-quarter of their 
Hispanic enrollments are either low-income or first-generation 
college students. In addition to the regular part A purposes, 
funds may be used for acquisition of scientific or laboratory 
equipment, renovation of instructional facilities, and purchase 
of educational materials.
    Strengthening historically black colleges and 
universities.--The Committee provides $108,990,000 for part B 
grants, the same as the 1995 level, the budget request, and the 
House allowance.
    The part B Strengthening Historically Black Colleges and 
Universities [HBCU] Program makes formula grants to HBCU's 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. The minimum allotment is $500,000 for each 
eligible institution. Part B recipients are not eligible for 
awards under part A.
    Strengthening historically black graduate institutions.--
The Committee bill includes $19,606,000 for the part B, section 
326 program, the same as the 1995 level, the administration 
request, and the House allowance.
    The section 326 program provides 5-year grants to 
strengthen historically black graduate institutions [HBGI's]. 
The Higher Education Amendments of 1992 increased the number of 
recipients to 16 named institutions, but reserved the first 
$12,000,000 appropriated each year to the first five 
institutions included in the original authorization. Grants may 
be used for any part B purpose and to establish an endowment.
    Endowment challenge grants.--The Committee bill does not 
provide funding for part C endowment challenge grants, 
$8,060,000 less than the 1995 appropriation, and the same as 
the House allowance. The administration proposes to terminate 
the regular endowment challenge grant program and to change the 
underlying law to permit funding the HBCU set-aside at the 1995 
level without funding the underlying program.

Fund for the improvement of postsecondary education

    The Committee recommends $15,000,000 for the fund for the 
improvement of postsecondary education [FIPSE], which is 
$2,543,000 less than the 1995 appropriation and the 
administration request, and the same as the House allowance.
    FIPSE stimulates improvements in education beyond high 
school by supporting exemplary, locally developed projects that 
have potential for addressing problems and recommending 
improvements in postsecondary education. The fund is 
administered by an independent board that provides small, 
competitive grants and contracts to a variety of postsecondary 
institutions and agencies, including 2- and 4-year colleges and 
universities, State education agencies, community-based 
organizations, and other institutions and organizations 
concerned with education beyond high school.
    The Committee believes that an exemplary program is needed 
to encourage women and minorities to enter nontraditional 
careers in the fields of computer, architectural, civil, and 
mechanical engineering technologies, engineering graphics and 
design, computer-aided drafting and allied health technology. 
Many business and industrial communities have established 
relationships with postsecondary institutions to provide the 
type of career-oriented technical education programs described 
above. The Committee encourages the fund to conduct a 
competition to encourage postsecondary institutions to enhance 
their management, professional development, and academic 
programs to meet the technical education needs of the business 
and industrial communities and to foster strong relationships 
with these communities. An institution such as the Pennsylvania 
Institute of Technology would be especially suited in providing 
career-oriented technical education in the areas described 
above.

Dwight D. Eisenhower Leadership Program

    The Committee recommends no funding for the Dwight D. 
Eisenhower Leadership Program, $1,080,000 less than the 1995 
appropriation, and the same as the administration request and 
the House allowance.
    The Eisenhower leadership program was authorized by the 
Higher Education Amendments of 1992 to provide competitive 
grants to institutions of higher education and other 
organizations for the promotion of leadership skills in the 
areas of national and international affairs.

Minority teacher recruitment

    The Committee recommends $2,212,000 for the Minority 
Teacher Recruitment Program, which is $246,000 less than the 
1995 appropriation, $788,000 below the budget request, and the 
same as the House allowance.
    This program, authorized by the Higher Education Amendments 
of 1992, is designed to increase the numbers of African-
Americans, Hispanics, native Americans, and other minorities in 
the teaching profession. Partnership projects identify students 
with an interest in entering the teaching profession and 
provide support services such as scholarship funds, tutoring, 
and academic counseling. Teacher placement projects prepare 
minority students to become elementary and secondary 
schoolteachers and help place these students in schools with at 
least 50 percent minority enrollment.

Minority science improvement

    The Committee recommends $5,255,000 for the Minority 
Science Improvement Program [MSIP], $584,000 below the 1995 
level and the administration request, and the same as the House 
allowance.
    This program provides 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 education 
programs and increase the number of minority students in the 
fields of science, mathematics, and engineering.
    Of the funds appropriated, $1,000,000 shall be for grants 
to consortia of institutions of higher education with 
substantial enrollments of African-Americans, Latinos, and 
other minority groups, who enter into cooperative agreements, 
grants, and contracts with Federal agencies, and memoranda of 
understanding among such institutions, which result in 
proposals which engage public, private, and institutional 
resources in instructional and academic program grants to 
consortia.

Innovative projects for community service

    The Committee recommends no funding for innovative projects 
for community service, $1,423,000 below the 1995 appropriation, 
and the same as the administration request and the House 
allowance.
    Under this program, grants and contracts were awarded to 
institutions of higher education and other public agencies and 
nonprofit private organizations to support innovative projects 
to encourage student participation in community service 
projects, including literacy projects.

International education and foreign language studies

    The bill includes a total of $55,100,000 for international 
education programs, $3,973,000 less than the 1995 level and the 
budget request, and $1,183,000 below the House allowance.
    Domestic programs.--The Committee recommends $48,680,000 
for domestic program activities related to international 
education and foreign language studies, including international 
business education, under title VI of the HEA. This is 
$3,603,000 less than the 1995 appropriation, the administration 
request, and the House allowance.
    Domestic programs include national resource centers, 
undergraduate international studies and foreign language 
programs, international studies and research projects, 
international business education projects and centers, language 
resource centers, foreign periodicals program, and foreign 
language and area studies fellowships. The Committee has 
included sufficient funds to continue support for the American 
overseas research centers, which first received Federal funding 
in 1994.
    Overseas programs.--The bill includes $5,500,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This is $290,000 below the 1995 level and 
the budget request, and $1,500,000 above the House allowance.
    Under these overseas programs, grants are provided for 
group and faculty research projects abroad, doctoral 
dissertation research abroad, and special bilateral projects. 
Unlike other programs authorized by the Fulbright-Hays Act and 
administered by the U.S. Information Agency, these Department 
of Education programs focus on training American instructors in 
order to improve foreign language and area studies education in 
the United States.
    Institute for International Public Policy.--The Committee 
bill recommends $920,000 for the Institute for International 
Public Policy, a decrease of $80,000 below the 1995 level and 
the administration request. The House provided no funding for 
this purpose.
    This program is designed to increase the number of minority 
individuals in foreign service and related careers by providing 
a grant to a consortium of institutions for graduate level 
foreign language and international studies. An institutional 
match of 25 percent is required.

Cooperative education

    The Committee recommends no funding for the Cooperative 
Education Program, the same as the administration request and 
the House allowance. Congress provided $6,927,000 for phase out 
costs for the program in 1995.

Law school clinical experience

    The Committee includes $5,500,000 for law school clinical 
experience, which is $7,722,000 less than the 1995 level, and 
$5,500,000 above the House allowance and the administration 
request. This program, funded since 1978, supports 
discretionary grants to accredited law schools for paying up to 
90 percent of the costs of continuing, expanding, or 
establishing programs that provide students with clinical 
experience in the practice of law. These funds will provide the 
final year of funding for this program.

Urban community service

    The Committee recommends $9,200,000 for urban community 
service, $800,000 less than the 1995 appropriation, and 
$9,200,000 above the administration request and the House 
allowance. This program provides grants to urban universities 
to encourage community involvement in solving the social and 
economic problems of the urban area which they serve. Funds may 
be used to support cooperative projects that provide urban 
areas with applied research, planning services and specialized 
training, and other services that address high-priority needs 
of the urban area.

Student financial aid data base and information line

    The Committee bill includes no funding for the student 
financial aid data base and information line, the same as the 
House allowance and the budget request, and $496,000 less than 
was originally appropriated in 1995. H.R. 1944 contains a 
rescission of the entire 1995 appropriation.
    The Committee appropriated $500,000 in fiscal year 1994, 
and $496,000 in fiscal year 1995, for the development of a 
student financial aid data base to gather and disseminate 
information regarding financial resources available for higher 
education. The Committee looks forward to reviewing this study 
along with a progress report. Currently no comprehensive guide 
to financial resources exists. Some take advantage of this void 
by promising to help students, for a fee, but then not 
providing worthwhile information. Although the administration 
has not requested any new funds for a public data base, the 
Committee expects the Department to continue efforts to make 
such information widely available to students.

Interest subsidy grants

    The Committee recommends $16,712,000 for interest subsidy 
grants, $800,000 less than the 1995 level, and the same as the 
budget request and the House allowance.
    This appropriation is required to meet the Federal 
commitment to pay interest subsidies on approximately 340 loans 
made in past years for constructing, renovating, and equipping 
postsecondary academic facilities. No new interest subsidy 
commitments have been entered into since 1973 but subsidy 
payments on existing loans are expected to continue until the 
year 2013.

Federal TRIO programs

    The Committee bill includes $463,000,000 for Federal TRIO 
programs, the same as the 1995 appropriation, the 
administration request, and the House allowance.
    TRIO programs provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students: Upward Bound 
offers disadvantaged high school students academic services to 
develop the skills and motivation needed to continue their 
education; student support services provides remedial 
instruction and counseling to disadvantaged college students to 
help them complete their postsecondary education; talent search 
identifies and counsels individuals between ages 12 and 27 
regarding opportunities for completing high school and 
enrolling in postsecondary education; educational opportunity 
centers provide information and counseling on available 
financial and academic assistance to adults who are low-income 
and first-generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in 
postgraduate programs.
    The Committee agrees with the House on the importance of 
the ongoing evaluation of the TRIO programs and directs the 
Secretary to use $1,500,000 to fully fund the ongoing 
evaluation.
    The Committee urges the Department to provide outreach and 
support services to encourage Alaska Native students to seek a 
higher education and increase the college retention and 
graduation rates.

National early intervention scholarships and partnerships

    The Committee bill includes $3,108,000 for this program of 
grants to States for projects that provide mentoring, outreach, 
counseling, and academic support for students at risk of 
dropping out of school. This amount is the same as the 1995 
level and $3,108,000 above the House allowance and the 
administration request.
    This program is intended to provide incentives for States 
to combine TRIO-type outreach activities with a State guarantee 
of college tuition assistance that will encourage low-income 
elementary and secondary school students to stay in school, 
earn their high school diplomas, and pursue postsecondary 
education.

Bethune Memorial Fine Arts Center

    The Committee recommends $3,680,000 for the Bethune 
Memorial Fine Arts Center. This is $320,000 less than the 1995 
level and $3,680,000 above the administration request and House 
allowance.

Byrd honors scholarships

    The Committee recommends $29,117,000 for the Byrd Honors 
Scholarship Program, the same as the 1995 appropriation, 
$9,000,000 below the administration request, and $29,117,000 
above the House allowance.
    The Byrd Honors Scholarship Program is designed to promote 
student excellence and achievement and to recognize 
exceptionally able students who show promise of continued 
excellence. Funds are allocated to State education agencies 
based on each State's school-aged population. The State 
education agencies select the recipients of the scholarships in 
consultation with school administrators, teachers, counselors, 
and parents. The Higher Education Amendments of 1992 expanded 
the program from 1 to 4 years of scholarship support, and the 
amount provided will fund continuation awards to recipients who 
received their first-year awards in 1993, 1994, and 1995. The 
Committee has no objection to funding a new cohort of freshmen 
within existing resources.

National science scholars

    The Committee recommends an appropriation of $1,750,000 for 
national science scholars, $1,553,000 below the 1995 
appropriation and $1,750,000 above the administration request 
and the House allowance.
    This program provides up to 4 years of scholarship support 
intended to recognize student excellence and achievement in 
science, mathematics, and engineering and to encourage students 
to continue their studies in these fields at the postsecondary 
level. Two recipients, including at least one female, are 
selected from each congressional district.
    The amount recommended is sufficient for continuation costs 
in fiscal year 1996 for 1,769 grantees which received awards 
prior to fiscal year 1995.

Douglas teacher scholarships

    The Committee bill includes no funding for Douglas teacher 
scholarships, $299,000 less than the 1995 level, and the same 
as the House allowance and the administration request.

Olympic scholarships

    The Committee recommends no funding for the Olympic 
Scholarships Program authorized by section 1543 of the Higher 
Education Amendments of 1992, the same as the budget request 
and House allowance, and $1,000,000 less than the original 1995 
appropriation. Public Law 104-19 rescinds all 1995 funding for 
the program consistent with the President's request. This 
program would make funds available to U.S. Olympic education 
and training centers to provide need-based postsecondary 
student aid to athletes. The Committee believes that student 
athletes have sufficient access to need-based financial 
assistance through the wide variety of grant and loan programs 
funded by the Committee under title IV of the Higher Education 
Act.

Teacher Opportunity Corps

    The Committee does not recommend funding for the Teacher 
Corps Program, the same as the budget request and House 
allowance, and $1,875,000 below the original 1995 
appropriation. Public Law 104-19 rescinds all 1995 funding for 
the program consistent with the President's request.
    This program would provide competitive grants to State 
education agencies for programs designed to recruit teachers 
for schools with the highest levels of poverty and the lowest 
levels of student achievement. Teacher Corps members would 
receive up to 3 years of scholarship support and priority would 
be given to individuals from disadvantaged backgrounds and 
those who intend to teach special populations.

Harris graduate fellowships

    The Committee recommends $9,332,000 for the Harris graduate 
fellowships, $812,000 below the 1995 level, and $9,332,000 
above the budget request and the House allowance.
    This program provides competitive grants to postsecondary 
institutions to assist minority individuals and women who are 
underrepresented in master's, professional, and doctoral 
education programs. Funds for this program must be equally 
divided between doctoral and master's/professional students.

Javits fellowships

    The Committee includes $6,297,000 for Javits fellowships, 
which is $548,000 less than the 1995 appropriation and 
$6,297,000 above the administration request and the House 
allowance.
    This program provides fellowships to students of superior 
ability for doctoral study in the arts, humanities, and social 
sciences. The fellowships are awarded through a national 
competition and recipients pursue graduate study at the 
institutions of their choice.

Graduate assistance in areas of national need

    The Committee recommends $27,252,000 for graduate 
assistance in areas of national need, the same as the 1995 
level, the House allowance, and the budget request.
    This program awards competitive grants to graduate academic 
departments and programs for fellowship support in areas of 
national need as determined by the Secretary. The program is 
currently supporting study in mathematics, physics, biology, 
chemistry, engineering, and computer and information sciences. 
Recipients must demonstrate financial need and academic 
excellence, seek the highest degree in their fields, and plan 
teaching or research careers.

Faculty development fellowships

    The Committee recommends no funding for the Faculty 
Development Fellowships Program, which is $212,000 less than 
the 1995 appropriation, $3,732,000 below the administration 
request, and the same as the House allowance.
    The Faculty Development Fellowships Program provides grants 
to institutions of higher education to support two types of 
fellowships: experienced faculty development fellowships for 
talented college faculty from underrepresented groups who want 
to pursue doctoral degrees; and faculty professional 
development fellowships for faculty from underrepresented 
groups who want to participate in short-term professional 
development activities.

School, college, and university partnerships

    The Committee recommends no funding for the School, 
College, and University Partnerships Program, the same as the 
House allowance, and $3,893,000 less than the 1995 
appropriation and the budget request.
    The School, College, and University Partnerships Program 
promotes joint projects between institutions of higher 
education and high schools serving low-income students that 
will increase students' academic skills and enhance their 
prospects for postsecondary education or employment.

Legal training for the disadvantaged

    The Committee bill includes $2,964,000 for legal training 
for the disadvantaged, the same as the 1995 level, and 
$2,964,000 above the House level and budget request.
    Legal training for the disadvantaged supports pre-law 
school training and provides stipends for minority, low-income, 
or educationally disadvantaged college graduates to enter and 
complete law school. The program is administered through a 
noncompetitive grant to the Council on Legal Education 
Opportunity [CLEO].

                           howard university

Appropriations, 1995....................................    $204,663,000
Budget estimate, 1996...................................     195,963,000
House allowance.........................................     170,366,000

Committee recommendation

                                                             182,348,000

    The Committee recommends an appropriation of $182,348,000 
for Howard University, which is $22,315,000 less than the 1995 
appropriation, a decrease of $13,615,000 below the budget 
request, and $11,982,000 more than recommended by the House 
allowance.
    Howard University is located in the District of Columbia 
and offers undergraduate, graduate, and professional degrees 
through the 17 schools and colleges. The university also 
administers the Howard University Hospital, which provides both 
inpatient and outpatient care, as well as training in the 
health professions. Federal funds from this account support 
about 55 percent of the university's educational and general 
costs, excluding the hospital.
    Academic program.--The Committee bill provides $149,487,000 
for Howard's academic program, which is $7,043,000 below the 
1995 level, $8,843,000 below the budget request, and $8,610,000 
above the amount recommended by the House allowance.
    Endowment.--The Committee recommends $3,372,000 for the 
endowment program, $158,000 less than the 1995 appropriation 
and the budget request, and $3,372,000 above the amount 
recommended by the House.
    The Endowment Grant Program is designed to increase the 
financial strength of the university by stimulating private 
contributions. Federal funds must be matched by non-Federal 
contributions, and up to 50 percent of the income earned each 
year through the endowment may be used to cover operating 
expenses. Howard's Federal endowment has grown to approximately 
$130,000,000 since the program's inception in 1985.
    Research.--The Committee agrees with the House and 
recommended no funding for the Howard University research 
program. The administration had requested the $4,614,000 for 
this program, the same amount appropriated in 1995. This 
program funds postdoctoral fellowships and the purchase of 
equipment to improve the university's ability to acquire 
research grants.
    Howard University Hospital.--The Committee recommends 
$29,489,000 for the Howard University Hospital, the same as the 
1995 appropriation, the administration request, and the House 
allowance.
    The hospital 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 that trains 
physicians in 19 specialty areas. The Federal appropriation 
provides partial funding for the hospital's operations.
    Construction.--The Committee has not provided funding for 
construction projects at Howard University. Neither the House 
nor the administration recommended funding for this program. In 
1995 the appropriation was $5,000,000.

             college housing and academic facilities loans

Appropriations, 1995....................................        $757,000
Budget estimate, 1996...................................       1,027,000
House allowance.........................................         700,000

Committee recommendation

                                                                 700,000

    New loan subsidies.--The Committee agrees with the House 
and the administration and recommends no funding for new loan 
subsidies. No funds were provided for this purpose in 1995.
    This program makes loans directly to institutions of higher 
education for the construction, reconstruction, or renovation 
of housing and academic facilities. Interest rates are capped 
at 5.5 percent, and loans must be repaid within 30 years. 
Institutions must pay 20 percent of project costs with non-
Federal funds. No more than 12.5 percent of loan funds may be 
provided to educational institutions in any one State, and the 
statute requires the Secretary to give priority to projects 
involving the renovation or reconstruction of academic 
facilities that have not previously been renovated for an 
extended period of time.
    Federal administration.--The Committee bill includes 
$700,000 for Federal administration of the CHAFL program. The 
amount recommended is $57,000 less than the 1995 appropriation, 
$327,000 less than the administration request, and the same as 
the amount recommended by the House.
    These funds will be used to reimburse the Department for 
expenses incurred in managing the existing CHAFL loan portfolio 
during fiscal year 1996. These expenses include salaries and 
benefits, travel, printing, contracts (including contracted 
loan servicing activities), and other expenses directly related 
to the administration of the CHAFL program.

  historically black college and university capital financing program

Appropriations, 1995....................................        $346,000
Budget estimate, 1996...................................         166,000
House allowance.........................................         166,000

Committee recommendation

                                                                 166,000

    Federal administration.--The Committee recommends $166,000 
for Federal administration of the Historically Black College 
and University [HBCU] Capital Financing Program, the same as 
the administration request and the House allowance, and 
$180,000 less than the 1995 level.
    The HBCU Capital Financing Program will make capital 
available to HBCU's for 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.

            education research, statistics, and improvement

Appropriations, 1995....................................    $323,962,000
Budget estimate, 1996...................................     433,064,000
House allowance.........................................     250,238,000

Committee recommendation

                                                             322,601,000

    The bill includes $322,601,000 for educational research, 
statistics, assessment, and improvement programs. This amount 
is $1,361,000 below the 1995 appropriation, $110,463,000 below 
the administration request, and $72,363,000 over the House 
allowance. This account supports education research, 
statistics, and assessment activities, as well as a variety of 
other discretionary programs for educational improvement.
    Throughout the Department the Committee has recommended the 
elimination of many of the research and demonstration programs. 
The Committee has consolidated the research and demonstration 
funds within this account. This action has been taken in order 
to avoid duplication of research efforts and provide a more 
focused and coordinated approach to ensure that scarce Federal 
dollars are used in the most effective manner possible.
    The Committee acknowledges the importance of creating 
priorities and coordinating research efforts across the 
Department and encourages the Assistant Secretary of OERI and 
the Policy Board to expedite these activities.

Research

    The Committee recommends $90,000,000 for educational 
research, an increase of $3,800,000 over the 1995 
appropriation, $7,600,000 below the budget request, and 
$11,578,000 below the House allowance. Research activities are 
conducted by the Office of Educational Research and Improvement 
[OERI], which was reauthorized by the Educational Research, 
Development, Dissemination, and Improvement Act of 1994.
    These funds support research, development, dissemination, 
and technical assistance activities which 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.
    The Committee has included $41,000,000 for regional 
educational laboratories. This amount is the same as the 1995 
level. Of the amount provided, not less than 25 percent is to 
be used by the laboratories for the rural program. The 
Committee expects that all funds for the regional laboratories 
be released to the laboratories by December 1, 1995.
    The Committee has included $28,500,000 for national 
research centers. This amount is $4,500,000 less than the 1995 
level. These funds will support two existing centers--on 
reading and on the education of at-risk students--and eight new 
centers for which competition has already been announced. The 
priority research topics to be addressed by these centers were 
developed with the assistance of the National Research Policy 
and Priorities Board. The Committee is very concerned about the 
funding gap that is projected for the new research centers and 
instructs the Department to maintain groups of qualified 
researchers in current centers who are being consolidated into 
the larger centers as established in the new authorizing law.
    Within the total provided, the Committee has included 
$9,000,000 for the Educational Resources Information Center. 
This national information system is designed to provide users 
with ready access to an extensive body of education-related 
literature and material.
    The Committee is pleased that the Office of Education 
Research and Improvement is considering supporting research to 
quantify the degree to which involvement in mentoring programs 
contributes to the academic performance of at-risk children. 
The Committee urges the Department to place a high priority on 
this research and demonstration initiative, particularly the 
National Mentoring Coalition's R&D; agenda.

Statistics

    The Committee recommends $44,301,000 for the data gathering 
and statistical analysis activities of the National Center for 
Education Statistics [NCES], $3,852,000 below the 1995 
appropriation, $12,699,000 below the budget request, and 
$3,852,000 less than the amount provided by the House.
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
Technical assistance to State and local education agencies and 
postsecondary institutions is also provided by the Center.

Assessment

    The Committee recommends $32,517,000 for assessment, a 
decrease of $235,000 below the 1995 level, $240,000 below the 
House recommendation, and $5,483,000 less than the budget 
request. Of the funds recommended, $2,760,000 is for the 
National Assessment Governing Board.
    The National Center for Education Statistics uses these 
funds to administer the national assessment of educational 
progress [NAEP], a 20-year-old congressionally mandated 
assessment created to measure the educational achievement of 
American students. The primary goal of NAEP is to determine and 
report the status and trends over time in educational 
achievement, subject by subject. NAEP has been expanded in 
recent years to include State representative assessments as 
well.

Fund for the improvement of education

    The Committee bill provides $44,497,000 for the fund for 
the improvement of education [FIE], which is $10,747,000 above 
the 1995 appropriation, the administration request, and the 
House allowance. This program provides the Secretary with broad 
authority to support nationally significant programs and 
projects to improve the quality of education, help all students 
meet high academic standards, and contribute to the achievement 
of the national education goals. The statute also authorizes 
support for specific activities, such as counseling and 
mentoring, comprehensive health education, and environmental 
education.
    The Committee is aware of research demonstrating that music 
training improves spatial reasoning skills among preschool 
children. Therefore, the Committee urges the Department to fund 
demonstration grants to establish public-private partnerships 
between institutions of higher education and industry to 
support programs utilizing innovative technologies and 
practices for the professional development and retraining of 
teachers in music education. In awarding these grants, special 
emphasis should be given to institutions demonstrating a 
proficiency in working with local educational agencies to 
disseminate and use the highest quality research and knowledge 
about effective teaching practices.
    The Committee is concerned that many elementary and 
secondary schools lack the resources to obtain adequate 
scientific equipment. Some schools report having no equipment 
at all. If the United States is to remain competitive in the 
global market, it must continue to produce a technologically 
literate work force. Within the funds recommended, the 
Committee directs the Department to provide $3,000,000 for a 
discretionary program to carry out activities such as those 
that could be carried out as authorized by part E of title III 
of the Elementary and Secondary Education Act. These funds will 
provide for the purchase of equipment and materials necessary 
for hands-on instruction in mathematics and science.
    The Committee urges the Department to continue activities 
that promote gender-equity, leadership training, and school-to-
work programs that encourage women and girls to prepare to 
enter careers in which they have been underrepresented.
    The Committee urges the Secretary of Education to allow 
experimentation with same gender classes for low-income, 
educationally disadvantaged students. The limited information 
available suggests that same gender classes may make a 
difference in educational achievement levels for disadvantaged 
students.
    The Committee recognizes that the Hispanic population is 
the fastest growing population in the Nation. Many of these 
students are not performing at high levels. The Committee urges 
the Department to support research and demonstration 
initiatives which support the development of culturally and 
linguistically sensitive diagnostic data, assessment 
instruments, service procedures, and intervention programs for 
Hispanic youth.
    In keeping with the Department's research priority for 
early childhood development and education, the Committee urges 
the Department to provide $1,000,000 for an integrated delivery 
system of early childhood education, development, and related 
services. Funds would support a districtwide program which 
would coordinate existing title I, local education programs and 
Head Start services. The Jefferson County Public School 
system's Project Jump Start would be especially suited for a 
project such as the one described above.
    The Committee has provided $6,000,000 for the International 
Education Exchange Program authorized by section 601(c) of 
Public Law 103-227, an increase of $3,000,000 above the 1995 
level and the administration request. No funds were provided by 
the House for this activity. This program will provide grants 
or contracts to support educational exchanges between the 
United States and the countries of central and Eastern Europe. 
The exchanges will be focused on improving curriculum and 
teacher training in the areas of civics and government 
education and economic education. The Secretary is required to 
work closely with the Director of the U.S. Information Agency 
in designing and implementing the program.
    The increased funding will enhance the capacity of leading 
educators, scholars, and policymakers throughout the United 
States to assist leaders in the participating nations to 
develop the civic culture required for democracy and free 
market economies to flourish. It will also assist in the 
development and implementation of educational programs to 
broaden both student perceptions of civics, government, and 
economics.
    The Committee has included $2,000,000 for the extended time 
and learning and longer school year program authorized by title 
X, part L of the Elementary and Secondary Education Act. Funds 
will be used to study the feasibility of extending learning 
time within or beyond the school day or school year.
    The Committee further encourages the Secretary to support 
mobile technology demonstration programs in rural areas.

Civic education

    The Committee recommends $4,106,000 for the Center for 
Civic Education, a decrease of $357,000 below the 1995 
appropriation and the budget request, and $1,106,000 above the 
amount recommended by the House. This program provides a course 
of instruction at the elementary and secondary level on the 
basic principles of our constitutional democracy and the 
history of the Constitution and the Bill of Rights. Funds also 
may be used to provide advanced training for teachers 
concerning the Constitution and the Bill of Rights.

Eisenhower professional development Federal activities

    The Committee recommends $18,000,000 for the Eisenhower 
Professional Development Federal Activities Program, $3,356,000 
below the 1995 appropriation, and $17,000,000 below the budget 
request. The House recommended no funding for this program.
    This program supports activities of national significance 
contributing to the development and implementation of high-
quality professional development in the core academic subjects. 
Projects may be designed to develop teacher training programs, 
or disseminate information about exemplary programs of math and 
science instruction.
    Within the funds recommended, the Committee directs the 
Department to provide $5,000,000 for the National Board for 
Professional Teaching Standards.
    The Committee directs the Department to provide $5,472,000 
for the National Clearinghouse for Science, Mathematics, and 
Technology Education Materials, which maintains a permanent 
repository of mathematics and science education instructional 
materials and programs for elementary and secondary schools; 
disseminates information, programs, and instructional materials 
to the public, information networks, and regional consortiums; 
and coordinates with existing data bases containing mathematics 
and science curriculum and instructional materials.

Eisenhower regional mathematics and science education consortia

    The Committee has included $13,800,000 for the Eisenhower 
regional mathematics and science education consortia, 
$1,200,000 less than the 1995 level and the budget request. The 
House provided no funds for this purpose. This program supports 
grants to establish and operate regional consortia to 
disseminate exemplary mathematics and science instructional 
materials and provide technical assistance in the use of 
improved teaching methods and assessment tools to benefit 
elementary and secondary school students, teachers, and 
administrators.

21st century community learning centers

    The Committee has included $750,000 for the 21st century 
community learning centers, the same amount appropriated in 
1995. Neither the House nor the administration requested 
funding for this purpose. This program supports grants to rural 
and inner-city public elementary or secondary schools, or 
consortia of such schools, to enable them to plan, implement, 
or expand projects that benefit the educational, health, social 
service, cultural, and recreational needs of a rural or inner-
city community.

Javits gifted and talented students education

    The Committee has included $3,000,000 for the Javits Gifted 
and Talented Students Education Program, the same amount 
recommended by the House, $1,921,000 below the 1995 
appropriation, and $6,521,000 below the administration request.
    This program authorizes awards to State and local education 
agencies, institutions of higher education, and public and 
private agencies for research, demonstration, and training 
activities designed to enhance the capability of elementary and 
secondary schools to meet the special educational needs of 
gifted and talented students. Priority is given to projects 
that identify and serve gifted and talented students who are 
economically disadvantaged, limited English proficient, or 
students with disabilities. Some funds are set aside for a 
national center for research and development in the education 
of gifted and talented children and youth, which researches 
methods and techniques for identifying and teaching gifted and 
talented students.

Star schools

    For the Star Schools Program, the Committee recommends 
$25,000,000, the same amount appropriated in 1995, and a 
decrease of $5,000,000 below the budget request. The House 
provided no funds for this purpose.
    This program is designed to improve instruction in math, 
science, foreign languages, and other subjects such as 
vocational education, primarily by means of telecommunications 
technologies. The program supports eligible telecommunications 
partnerships organized on a statewide or multistate basis to 
develop and acquire telecommunications equipment, instructional 
programming, and technical assistance.
    The Committee urges the Department to provide funding for 
the most recent star school competition designed to advance 
adult literacy and the completion of requirements for a high 
school diploma or its equivalent. Funding of this competition 
will provide students nationwide, particularly adults, 
geographically isolated and or disadvantaged students with 
online access to interactive, accredited high school courses in 
support of continuing education and curriculum requirements 
relevant to achieving a secondary school diploma or its 
recognized equivalent.

National writing project

    The Committee bill provides $2,955,000 for the national 
writing project, $257,0000 below the 1995 appropriation. 
Neither the administration nor the House recommended funding 
for this program.
    These funds are awarded to the national writing project in 
Berkeley, CA, which in turn funds projects in 45 States to 
train teachers of all subjects how to teach effective writing.
    The Committee remains strongly supportive of the efforts of 
the national writing project [NWP] to improve the skills of our 
Nation's teachers. The NWP trained more than 166,000 teachers 
across the country at a cost of less than $20 per teacher. The 
Committee believes that funds for the NWP represent an 
important investment in our Nation's teachers and students.

National diffusion network

    The Committee bill includes $10,000,000 for the national 
diffusion network, which is $1,870,000 less than the 1995 
appropriation, and $4,480,000 below the budget request. The 
House provided no funding for this program.
    NDN facilitates school improvement by identifying and 
disseminating information about programs that work, bringing 
alternatives to the attention of educators throughout the 
Nation who are interested in improving their education 
programs, and providing training and followup technical 
assistance for those who decide to adopt a particular program. 
A program effectiveness panel reviews programs seeking 
inclusion in the NDN. The review focuses solely on the efficacy 
and transferability of the program.
    The Committee expects the Department to use a portion of 
the funds appropriated for the dissemination of exemplary 
mathematics and science education programs.

Ready to learn television

    The Committee recommends an appropriation of $6,440,000 for 
the Ready to Learn Television Program, a decrease of $560,000 
below the 1995 amount and the budget request. The House 
provided no funds for this purpose.
    This program would support the development and distribution 
of educational television programming designed to improve the 
readiness of preschool children to enter kindergarten and 
elementary school, consistent with the first national education 
goal that all children should start school ready to learn. The 
program also would support the development, production, and 
dissemination of educational materials designed to help 
parents, children, and caregivers obtain the maximum advantage 
from educational programming.

Educational technology

    The Committee recommends $25,000,000 for the technology 
program authorized as part A of title III of the ESEA. The 
amount recommended is the same amount provided by the House, 
$2,000,000 below the 1995 appropriation, and $68,000,000 below 
the administration's budget request.
    This activity supports the use of technology and 
technology-enhanced curricula and instruction to improve 
educational services.
    The Committee has included $15,000,000 for national 
challenge grants for technology. The purpose of this program is 
to develop first-class learner-based content that improves 
learner productivity through the use of quality courseware. The 
program would also support a small number of significant 
public-private partnerships to develop and deploy uses of 
technology so that direct benefits to students are demonstrated 
and marketable products are developed and tested.
    The Committee has also included $10,000,000 to continue the 
regional consortia. These consortia assist States and local 
educational agencies in the identification and procurement of 
resources necessary to implement technology plans, develop 
training resources for both elementary and secondary and adult 
education, provide referrals to sources of technical assistance 
and professional development, and assist institutions of higher 
education to establish preservice training programs in the 
appropriate use of educational technology.
    In recent years, much progress has been made in promoting 
gender-equitable learning, leadership training for women and 
girls, school-to-work programs helping women and girls enter 
careers in which they have been underrepresented, and the 
development, evaluation, and dissemination of educational 
materials that are gender-equitable. The Committee urges the 
Secretary to continue activities that promote educational 
equity for women and girls.

Telecommunications demonstration project for mathematics

    The Committee recommends $1,035,000 for the 
telecommunications demonstration project for mathematics, a 
decrease of $90,000 below the 1995 appropriation and a decrease 
of $1,215,000 below the administration's request. The House 
provided no funding for this purpose. Funds are used to carry 
out a national telecommunication-based demonstration project 
designed to train elementary and secondary schoolteachers in 
preparing all students for achieving State content standards in 
mathematics.

                               libraries

Appropriations, 1995....................................    $144,161,000
Budget estimate, 1996...................................     106,927,000
House allowance.........................................     101,227,000

Committee recommendation

                                                             131,503,000

    The Committee recommends an appropriation of $131,503,000 
for library programs, a decrease of $12,658,000 below the 1995 
appropriation, $24,576,000 above the administration's request, 
and $30,276,000 above the amount recommended by the House.

Public library services

    The Committee bill includes $83,227,000 for public library 
services under title I of the Library Services and Construction 
Act [LSCA], the same as the 1995 appropriation and the House 
amount, and $5,908,000 below the amount recommended by the 
administration.
    This program provides population-based formula grants to 
assist States in extending and improving public library 
services. Grants are also used to make library services more 
accessible to persons who, because of barriers such as age, 
residence, or physical disability, have had limited or no 
access to library services.

Public library construction

    The Committee recommends $16,369,000 for public library 
construction under title II of LSCA, a decrease of $1,423,000 
below the 1995 appropriation and the budget request. The House 
provided no funds for this purpose. This program provides 
population-based formula grants to States for public library 
construction, modification of existing library facilities, and 
purchase of equipment to improve access to library resources. 
Projects to remove architectural barriers and to reduce energy 
consumption are also permitted.

Interlibrary cooperation

    The Committee recommends $18,000,000 for interlibrary 
cooperation authorized by title III of LSCA, the same amount 
recommended by the House and a decrease of $5,700,000 below the 
amount appropriated in 1995. The administration requested no 
funding for this purpose.
    This program makes formula grants based on population to 
States to stimulate interlibrary cooperation and resource 
sharing among all types of libraries: school, academic, public, 
and other special libraries. Grants fund projects such as 
linking libraries to data bases through telecommunications 
systems, resource sharing projects not linked to automation, 
training of library personnel in new technologies, and 
preserving endangered library resources.

Library literacy programs

    The Committee bill includes $7,384,000 for library literacy 
programs, a decrease of $642,000 below the 1995 appropriation. 
Neither the House nor the administration requested funding for 
this program. Under this activity, grants are made to State 
library administrative agencies and local public libraries to 
promote adult literacy training in public libraries.

Library education and training

    The Committee provides $4,523,000 for library career 
training programs, a decrease of $393,000 below the 1995 level. 
The House and the administration recommends elimination of this 
program.
    The Library Education and Training Program, authorized 
under title II, part B, of the Higher Education Act, supports 
grants to institutions of higher education and library 
organizations to train or retrain individuals for service in 
all types of libraries.

Research and demonstrations

    The Committee bill includes $2,000,000 for library research 
and demonstrations, which is $4,500,000 less than the 1995 
appropriation. Neither the administration request nor the House 
bill provided funds for this program.
    This program provides discretionary grants and contracts to 
support projects to improve libraries and information 
technologies and to disseminate the results of these projects.
    The Committee has included bill language providing 
$1,000,000 to the Survivors of the Shoah Visual History 
Foundation for a project to document Holocaust survivor 
testimony. This nonprofit foundation plans to compile a 
multimedia archive that will encompass over 40,000 interviews 
and statements by Holocaust survivors.
    The Committee has also included bill language providing 
$1,000,000 for the final phase of the Portals demonstration 
project. The final phase of the project will provide for the 
upgrade of network capacity, allowing additional regional 
partners to join the consortia, and will permit the system to 
be expanded to maintain and improve efficiency and 
effectiveness of information delivery.

                        Departmental Management

                         program administration

Appropriations, 1995....................................    $355,476,000
Budget estimate, 1996...................................     370,844,000
House allowance.........................................     327,319,000

Committee recommendation

                                                             327,319,000

    The Committee recommends $327,319,000 for program 
administration, a decrease of $28,157,000 below the 1995 
appropriation, $43,525,000 below the budget request, and the 
same as the amount recommended by the House.
    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 an estimated 230 
Federal education programs. Support for program evaluation and 
studies and advisory councils is also provided under this 
activity.

Liaison for community and junior colleges

    Pursuant to the Higher Education Amendments of 1992, the 
Department appointed a liaison for community and junior 
colleges to serve as an advisor to the Secretary on matters 
affecting community and junior colleges. The Committee believes 
this position has enhanced the visibility and efforts of 
community colleges at the national level. The Committee urges 
the Secretary to fill the current vacancy by no later than 
January 1, 1996. The Committee also urges the Secretary to 
relocate this position from the Office of Vocational and Adult 
Education to the Office of the Secretary.
    The Committee is aware of a memorandum of understanding 
which has been executed between the State of Oregon and nine 
Federal partners including the Department of Education. The 
purpose of this partnership is to encourage and facilitate 
cooperation among Federal, State, and local entities to 
redesign and test an outcomes-oriented approach to 
intergovernmental service delivery. The Oregon Option 
experiment is focused on three areas of human investment: 
healthy children, stable families, and a highly developed and 
prepared work force. In working with the State of Oregon to 
reduce Federal barriers to service delivery, the Committee 
urges the Department to streamline and expedite regulatory 
processes where possible in order to help the State meet its 
performance outcomes.

                        office for civil rights

Appropriations, 1995....................................     $58,236,000
Budget estimate, 1996...................................      62,784,000
House allowance.........................................      53,951,000

Committee recommendation

                                                              55,451,000

    The Committee bill includes $55,451,000 for the Office for 
Civil Rights [OCR], $2,785,000 below the 1995 appropriation, 
$7,333,000 below the budget request, and $1,500,000 above the 
amount recommended by the House.
    The Office for Civil Rights 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 funded by the Department of 
Education. 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 civil rights requirements. Without the funds 
for staff and travel, OCR will be unable to investigate civil 
rights complaints from over 4,000 individuals.

                    office of the inspector general

Appropriations, 1995....................................     $30,390,000
Budget estimate, 1996...................................      34,066,000
House allowance.........................................      28,154,000

Committee recommendation

                                                              28,654,000

    The Committee recommends $28,654,000 for the Office of the 
Inspector General, $1,736,000 below the 1995 appropriation, 
$5,412,000 less than the 1996 budget request, and $500,000 over 
the amount recommended by the House. Congress passed 
legislation providing a special pay raise in 1996 for law 
enforcement personnel. The inspector general investigators 
involved in gathering data for prosecution of fraud in the 
student aid program received the same raise as other law 
enforcement officers. The additional funds provided by the 
Senate is necessary to cover the cost of complying with the new 
law.
    The Office of the Inspector General 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.

                        headquarters renovation

    The bill provides $7,000,000 for headquarters renovation, 
$13,000,000 below the amount requested by the administration. 
The House bill recommended no funds for this purpose and no 
appropriation was provided in 1995. The Committee has provided 
these funds to allow the General Services Administration to 
continue its long-range plan to move Federal agencies such as 
the Department of Education out of several expensive 
commercially leased buildings. By 1997, the Department of 
Education's headquarters located in FOB-6, will be renovated 
and nearly 1,000 employees, currently working in temporarily 
leased Federal and commercial space will reoccupy the building. 
The Committee recommends funding for the building renovation 
because the consolidation into one building will save over 
$2,000,000 a year in the Department's rental costs and 
$152,000,000 in other agencies rental costs over a 12-year 
period.

                           General Provisions

    The Committee concurs with the House and includes a 
provision (sec. 301), which has been included in the bill since 
1974, prohibiting the use of funds for the transportation of 
students or teachers in order to overcome racial imbalance.
    The Committee concurs with the House and includes a 
provision (sec. 302), which has been included in the bill since 
1977, prohibiting the transportation of students other than to 
the school nearest to the students home.
    The Committee concurs with the House and includes a 
provision (sec. 303), which has been included in the bill since 
1980, prohibiting the use of funds to prevent the 
implementation of programs of voluntary prayer and meditation 
in public schools.
    The Committee has deleted a provision included by the House 
regarding opportunity to learn standards (sec. 304).
    The Committee has modified a provision included in the 
House bill (sec. 305) regarding prohibiting administrative 
costs and prohibition of certain funds for direct lending.
    The Committee has deleted a provision included in the House 
bill (sec. 306) prohibiting the use of funds for certain 
committees and councils.
    The Committee has deleted a provision included in the House 
bill (sec. 307) regarding reporting or disclosure of student 
records from the juvenile justice system.
    The Committee has deleted a provision included in the House 
bill (sec. 308) prohibiting the Office for Civil Rights from 
using funds to enforce title IX regarding gender equity.
                       TITLE IV--RELATED AGENCIES

                      Armed Forces Retirement Home

Appropriations, 1995....................................     $59,317,000
Budget estimate, 1996...................................      59,120,000
House allowance.........................................      58,186,000

Committee recommendation

                                                              53,755,000

    The Committee recommends authority to expend $53,755,000 
from the Armed Forces Retirement Home trust fund for operation 
and construction activities at the U.S. Soldiers' and Airmen's 
Home and the U.S. Naval Home, $5,562,000 less than the 1995 
appropriation, $5,365,000 less than the budget request, and 
$3,614,000 less than the House allowance.
    The Committee recommends one single appropriation for the 
Armed Forces Retirement Home trust fund as requested by the 
Agency and as authorized in law, instead of separate 
appropriations for the U.S. Soldiers's and Airmen's Home and 
the U.S. Naval Home, as recommended by the House.
    The Committee concurs with the House recommendation that 
the Armed Forces Retirement Home Board base its fiscal year 
1997 budget request on the findings of the Board's long-term 
strategic study.

Operation and maintenance

    The Committee recommends $51,898,000 for the operation and 
maintenance of the Soldiers' and Airmen's Home and the U.S. 
Naval Home, $4,513,000 less than the 1995 appropriation, 
$5,171,000 less than the budget request, and $4,237,000 less 
than the House allowance.

Capital outlay

    The Committee recommends $1,857,000 for capital projects at 
the Soldiers' and Airmen's Home and the U.S. Naval Home, 
$1,049,000 below the fiscal year 1995 appropriation and 
$194,000 below the budget request and House allowance.

             Corporation for National and Community Service

                  domestic volunteer service programs

Appropriations, 1995....................................    $214,624,000
Budget estimate, 1996...................................     262,900,000
House allowance.........................................     182,767,000

Committee recommendation

                                                             200,892,000

    The Committee recommends an appropriation of $200,892,000 
for the domestic volunteer service programs of the Corporation 
for National and Community Service, $13,732,000 less than the 
1995 appropriation, $62,008,000 less than the budget request, 
and $18,125,000 more than the House allowance.

VISTA

    The Committee bill provides $43,884,000 for the Volunteers 
in Service to America [VISTA] Program, $3,816,000 less than the 
1995 level, $16,116,000 less than the budget request, and 
$18,281,000 more than the House allowance.
    VISTA is a 30-year-old program which provides capacity 
building for small-community based organizations. Vista 
volunteers raise resources for local projects, recruit and 
organize volunteers and establish and expand local community 
based programs in housing, employment, health, and economic 
development activities.

VISTA Literacy Corps

    The Committee bill includes $4,622,000 for the VISTA 
Literacy Corps, $402,000 less than the 1995 level, $1,578 less 
than the budget request, and $4,622,000. The House did not 
include funding for this program.
    This Committee has included funding to continue this 
program and encourages the Literacy Corps to continue to focus 
on workplace literacy.

National Senior Volunteer Corps

    The Committee bill provides $128,341,000 for the National 
Senior Volunteer Corps programs, $7,423,000 less than the 1995 
level, $40,059,000 less than the budget request, and the same 
as the House allowance.

Foster Grandparent Program

    The Committee recommends $62,237,000 for the Foster 
Grandparent Program, $5,575,000 less than the 1995 level, 
$16,573,000 less than the budget request, and the same as the 
House allowance.
    This program enables seniors age 60 and over to provide 
services to communities that they otherwise could not afford. 
The Foster Grandparent Program creates incentives for older 
Americans who work with at-risk youth.

Senior Companion Program

    For the Senior Companion Program, the Committee bill 
includes $31,155,000, $89,000 more than the 1995 level, 
$11,935,000 less than the budget request, and the same as the 
House allowance.
    This program enables low-income senior citizens to provide 
personal assistance and companionship primarily to adults, 
particularly the frail, homebound elderly. Senior Companions 
provide vital services to elderly Americans who would otherwise 
have to enter nursing homes. The volunteers also provide 
respite care to relieve caregivers.

Retired and Senior Volunteer Program

    The Committee bill provides $34,949,000 for the Retired and 
Senior Volunteer Program [RSVP], $759,000 less than the 1995 
level, $9,551,000 less than the budget request, and the same as 
the House allowance.
    This program involves persons age 55 and over in volunteer 
opportunities in their communities.

Senior Demonstration Program

    The Committee concurs with the House and does not provide 
separate funding for the Senior Demonstration Program.

Program support

    The Committee bill includes $28,667,000 for program 
support, $2,493,000 less than the 1995 level, $5,833 less than 
the budget request, and $156,000 less than the House allowance.

                  Corporation for Public Broadcasting

Appropriations, 1996....................................    $275,000,000
Appropriations, 1997....................................     260,000,000
Budget estimate, 1998...................................     296,400,000
House allowance.........................................     240,000,000

Committee recommendation

                                                             260,000,000

    The Committee recommends an appropriation of $260,000,000 
for the Corporation for Public Broadcasting, an advance 
appropriation for fiscal year 1998. This amount is the same as 
the fiscal year 1997 appropriation, $36,400,000 less than the 
budget request, and $20,000,000 more than the House allowance.
    The Committee directs CPB in allocating reduced funding to 
consider the impact on rural radio and TV studios, especially 
sole service providers, stations with minimal donor bases or 
service areas with limited video programming alternatives, and 
community radio stations. The Committee directs CBP to give 
priority to stations which serve rural, underserved, and 
unserved areas and sole service providers.

               Federal Mediation and Conciliation Service

Appropriations, 1995....................................     $31,344,000
Budget estimate, 1996...................................      33,290,000
House allowance.........................................      31,898,000

Committee recommendation

                                                              31,898,000

    The Committee recommends an appropriation of $31,898,000 
for the Federal Mediation and Conciliation Service [FMCS], 
$554,000 more than the 1995 appropriation, $1,392,000 less than 
the budget request, and the same as the House allowance.
    The Committee directs the FMCS to study the consolidation 
of the Service with the National Mediation Board. The study 
should include an analysis of the different functions of the 
two agencies, and the additional costs or cost savings 
associated with the suggested consolidation. The Commission 
should be prepared to report on its findings by the regular 
hearings on the fiscal year 1997 budget.
    The Committee has included gift language authority for the 
Director of the Federal Mediation and Conciliation Service as 
requested in the Agency's justification. The House did not 
include this consideration.
    The FMCS was established by Congress in 1947 to provide 
mediation, conciliation, and arbitration services to labor and 
management. FMCS is authorized to provide dispute resolution 
consultation and training to all Federal agencies.

            Federal Mine Safety and Health Review Commission

Appropriations, 1995....................................      $6,200,000
Budget estimate, 1996...................................       6,467,000
House allowance.........................................       6,467,000

Committee recommendation

                                                               6,200,000

    The Committee recommends an appropriation of $6,200,000 for 
the Federal Mine Safety and Health Review Commission, the same 
as the fiscal year 1995 appropriation, and $267,000 less than 
the budget request and House allowance.
    The Federal Mine Safety and Health Review Commission 
provides administrative trial and appellate review of legal 
disputes under the Federal Mine Safety and Health Act of 1977. 
The five-member Commission provides administrative appellate 
review of the Commission's administrative law judges decisions.

        National Commission on Libraries and Information Science

Appropriations, 1995....................................        $901,000
Budget estimate, 1996...................................         962,000
House allowance.........................................         450,000

Committee recommendation

                                                                 829,000

    The Committee recommends an appropriation of $829,000 for 
the National Commission on Libraries and Information Science, 
$72,000 less than the fiscal year 1995 appropriation, $133,000 
less than the budget request, and $370,000 more than the House 
allowance.
    In keeping with the rest of the bill, the Committee has 
reduced funding for the National Commission on Libraries and 
Information Science by 8 percent. The Commission determines the 
need for, and makes recommendations on, library and information 
services, and advises the President and Congress on the 
development and implementation of national policy in the 
library and information field. The Commission is studying the 
role of libraries in the emerging information infrastructure.

                     National Council on Disability

Appropriations, 1995....................................      $1,793,000
Budget estimate, 1996...................................       1,830,000
House allowance.........................................       1,397,000

Committee recommendation

                                                               1,793,000

    The Committee recommends an appropriation of $1,793,000 for 
the National Council on Disability, the same as the fiscal year 
1995 appropriation, $37,000 less than the budget request, and 
$396,000 more than the House allowance.
    The Council is mandated to make recommendations to the 
President, the Congress, the Rehabilitation Services 
Administration, and the National Institute on Disability and 
Rehabilitation Research on public issues of concern to 
individuals with disabilities. The Council monitors existing 
civil rights legislation and looks at emerging policy issues as 
they affect persons with disabilities and their ability to 
enter or re-enter the Nation's work force and to live 
independently.

                     National Education Goals Panel

Appropriations, 1995....................................................
Budget estimate, 1996...................................      $2,785,000
House allowance.........................................................

Committee recommendation

                                                               1,000,000

    The Committee recommends $1,000,000 for the National 
Education Goals Panel, $1,000,000 more than the 1995 
appropriation, $1,785,000 less than the budget request, and 
$1,000,000 more than the House allowance.
    Following the 1989 education summit in Charlottesville, the 
Governors and President Bush agreed on education goals for the 
Nation and created the National Education Goals Panel as an 
accountability mechanism to monitor and report on the Nation's 
progress toward reaching the goals. To date, the goals panel 
has issued four annual reports delineating national and State 
progress toward the national education goals. The goals panel 
members have recently initiated new efforts to collect and 
distribute information on the development of world class 
academic standards and the assessment of student achievement at 
the State level.

                     National Labor Relations Board

Appropriations, 1995....................................    $176,047,000
Budget estimate, 1996...................................     181,134,000
House allowance.........................................     123,233,000

Committee recommendation

                                                             176,047,000

    The Committee recommends an appropriation of $176,047,000 
for the National Labor Relations Board [NLRB], the same as the 
fiscal year 1995 appropriation, $5,087,000 less than the budget 
request, and $52,814,000 more than the House allowance.
    The NLRB is a law enforcement agency which resolves 
disputes under the National Labor Relations Act. The Committee 
has restored funding to the fiscal year 1995 level due to the 
uncontrollable number of cases which must be investigated, 
argued, and adjudicated in a timely manner by the NLRB.
    The Committee has deleted without prejucide House bill 
language that is legislative in nature and that should be 
addressed by the authorizing committee.
    The Committee is aware of concerns raised about the use of 
funds by the National Labor Relations Board for the 
investigation or prosecution of alleged unfair labor practices 
under section 8 of the National Labor Relations Act, where such 
charges are based, in whole or in part, on an employer's taking 
any adverse action against an individual who is an employee or 
agent or is otherwise working under the control and supervision 
of a labor organization. The Committee urges the NLRB to 
withhold action relating to such individuals or employers until 
such time as the U.S. Supreme Court has ruled on pending cases 
relating to these matters.

                        National Mediation Board

Appropriations, 1995....................................      $8,519,000
Budget estimate, 1996...................................       8,933,000
House allowance.........................................       8,000,000

Committee recommendation

                                                               7,837,000

    The Committee recommends an appropriation of $7,837,000 for 
the National Mediation Board, $682,000 less than the fiscal 
year 1995 appropriation, $1,096,000 less than the budget 
request, and $163,000 less than the House allowance.
    The National Mediation Board protects interstate commerce 
as it mediates labor-management relations in the railroad and 
airline industries under the Railway Labor Act. The Board 
mediates collective bargaining disputes, determines the choice 
of employee bargaining representatives through elections, and 
administers arbitration of employee grievances.
    The Committee directs the NMB to study the consolidation of 
the Service with the Federal Mediation and Conciliation 
Service. The study should include an analysis of the different 
functions of the two agencies, and the additional costs or cost 
savings associated with the suggested consolidation. The Board 
should be prepared to report on its findings by the regular 
hearings on the fiscal year 1997 budget.

            Occupational Safety and Health Review Commission

Appropriations, 1995....................................      $7,595,000
Budget estimate, 1996...................................       8,127,000
House allowance.........................................       8,200,000

Committee recommendation

                                                               7,595,000

    The Committee recommends an appropriation of $7,595,000 for 
the Occupational Safety and Health Review Commission, the same 
as the fiscal year 1995 appropriation, $532,000 less than the 
budget request, and $605,000 less than the House allowance.
    The Commission serves as a court to justly and 
expeditiously resolve disputes between the Occupational Safety 
and Health Administration [OSHA] and employers charged with 
violations of health and safety standards enforced by OSHA.

                  Physician Payment Review Commission

Appropriations, 1995....................................      $4,176,000
Budget estimate, 1996...................................       4,100,000
House allowance.........................................       2,923,000

Committee recommendation

                                                               3,842,000

    The Committee recommends the transfer of $3,842,000 from 
the Medicare trust funds to support operations of the Physician 
Payment Review Commission, $334,000 less than the fiscal year 
1995 level, $258,000 less than the budget request, and $919,000 
more than the House allowance. The Committee recommendation 
represents an 8-percent reduction below the fiscal year 1995 
enacted level, due to severe budgetary constraints.
    Established in 1986, the Physician Payment Review 
Commission is mandated to make recommendations to the Secretary 
of Health and Human Services and Congress, regarding Medicare 
payments for health services provided by physicians and other 
practitioners. The Commission is also mandated to consider 
policies related to controlling health costs. The Committee 
does not concur with the reduction as proposed by the House in 
anticipation of a merger of the Commission with the Prospective 
Payment Assessment Commission, but leaves that action to be 
addressed by the authorizing committee.

               Prospective Payment Assessment Commission

Appropriations, 1995....................................      $6,667,000
Budget estimate, 1996...................................       4,656,000
House allowance.........................................       3,267,000

Committee recommendation

                                                               4,294,000

    The Committee recommends the transfer of $4,294,000 from 
the Medicare trust funds for the operation of the Prospective 
Payment Assessment Commission [ProPAC], $373,000 less than the 
fiscal year 1995 level, $362,000 less than ProPAC's request, 
and $1,027,000 more than the House allowance.
    ProPAC provides objective analysis of the Medicare hospital 
prospective payment system, Medicare inpatient and outpatient 
payments to hospitals and excluded facilities, skilled nursing 
facilities, renal disease services, home health services, 
inpatient Medicaid payments, and Medicare's managed care 
programs. The Committee does not concur with the reduction as 
proposed by the House in anticipation of a merger of the 
Commission with the Physician Payment Review Commission, but 
leaves that action to be addressed by the authorizing 
committee.

                     Social Security Administration

                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 1995....................................     $25,094,000
Budget estimate, 1996...................................      32,641,000
House allowance.........................................      32,641,000

Committee recommendation

                                                              32,641,000

    The Committee recommends $32,641,000 for payments to Social 
Security trust funds, the same as the administration request 
and the House allowance.
    This amount includes $22,641,000 to reimburse the old age 
and survivors insurance and disability insurance 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, properly charged to the general funds.
    The fiscal year 1996 request for these mandatory payments 
decreases primarily because special payments for certain 
uninsured persons declines due to a declining beneficiary 
population.
    In addition, the Committee recommends $10,000,000 for 
mandatory administrative expenses, the same as the 
administration request and the House allowance, to reimburse 
the trust funds for costs the Social Security Administration 
incurs in continuing administrative activities required by the 
Coal Industry Retiree Health Benefits Program. Section 19141 of 
the Energy Policy Act of 1992 established the program which the 
Social Security Administration administers. These funds are 
available until expended.

                    SPECIAL BENEFITS FOR COAL MINERS

Appropriations, 1995....................................    $527,184,000
Budget estimate, 1996...................................     485,396,000
House allowance.........................................     485,396,000

Committee recommendation

                                                             485,396,000

    The Committee recommends an appropriation of $485,396,000 
for special benefits for disabled coal miners. This is in 
addition to the $180,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1995. The 
recommendation is the same as the administration request and 
the House allowance.
    These funds are used to provide monthly benefits to coal 
miners disabled by black lung disease and to their widows and 
certain other dependents, as well as to pay-related 
administrative costs.
    Social Security's major responsibility is for claims filed 
before July 1973, with the Department of Labor having 
responsibility for claims filed after that date. By law, 
increases in black lung benefit levels are tied directly to 
Federal pay increases. The year-to-year decrease in this 
account reflects a declining beneficiary population.
    The Committee recommends an advance of $170,000,000 for the 
first quarter of fiscal year 1997, the same as the 
administration request and the House allowance. These funds 
will ensure uninterrupted benefit payments to coal miners, 
their widows and dependents.

                      SUPPLEMENTAL SECURITY INCOME

Appropriations, 1995.................................... $21,226,620,000
Budget estimate, 1996...................................  18,803,993,000
House allowance.........................................  18,753,834,000

Committee recommendation

                                                          18,601,012,000

    The Committee recommends an appropriation of 
$18,601,012,000 for supplemental security income. This is in 
addition to the $7,060,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1996. The 
recommendation is $202,981,000 less than the administration 
request and is $152,822,000 less than the House allowance.
    These funds are used to pay benefits under the SSI Program, 
which was established to ensure a Federal minimum monthly 
benefit for aged, blind, and disabled individuals, enabling 
them to meet basic needs. It is estimated that approximately 
6.5 million persons will receive SSI benefits each month during 
fiscal year 1996. In many cases, SSI benefits supplement income 
from other sources, including Social Security benefits. The 
funds are also used to reimburse the trust funds for the 
administrative costs for the program with a final settlement by 
the end of the subsequent fiscal year required by law, support 
the referral and monitoring of certain disabled SSI recipients 
who are drug addicts or alcoholics and to reimburse State 
vocational rehabilitation services for successful 
rehabilitation of SSI recipients.
    Beneficiary services.--The Committee recommendation 
includes $176,400,000 for beneficiary services, the same as the 
administration request and the House allowance. This includes 
$142,000,000 to support the review and monitoring of SSI 
disabled recipients who are drug addicts or alcoholics. These 
funds will pay for referral and monitoring costs for recipients 
who are drug addicts and alcoholics and allow the Social 
Security Administration to suspend benefits to recipients who 
do not comply with treatment requirements.
    Research and demonstration projects.--The Committee 
recommendation includes $14,200,000 for research and 
demonstration projects conducted under sections 1110 and 1115 
of the Social Security Act. This is $13,500,000 less than 
fiscal year 1995 and $7,500,000 more than the administration 
request and the House allowance. This level maintains the 
Outreach Program at its current level, which helps make many 
low-income elderly persons aware of their eligibility for 
benefits.
    This initiative provides grants to public and private 
organizations to assist poor individuals, particularly the 
elderly, who are not receiving benefits for which they are 
eligible because they are unaware of their eligibility or lack 
access to a Social Security office. These funds target low-
income populations with high levels of nonparticipation in the 
Supplemental Security Income Program, people with limited 
access due to rural location or physical frailty, and sites 
such as veterans' hospitals which efficiently use the resources 
of cooperating agencies. The Committee encourages the agency to 
make new grants promptly, and to contract for grantmaking 
services where feasible to economize on use of regular staff.
    The Committee recommendation includes $1,500,000 for a 
demonstration program to foster economic independence among 
people with disabilities through disability sport, in 
connection with the Tenth Paralympic Games.
    The Committee recommends an advance of $9,260,000,000 for 
the first quarter of fiscal year 1997 to ensure uninterrupted 
benefit payments to these economically disadvantaged 
recipients.
    Investment proposals.--For the SSI portion of the 
automation investment, the Committee recommends $55,000,000, a 
reduction of $83,159,000 from the request and $12,000,000 less 
than the fiscal year 1995 appropriation. Total funding of 
$167,000,000 for this initiative is explained in the limitation 
on administrative expenses portion of this report.
    For the SSI portion of the disability investment 
initiative, the Committee recommends $147,678,000, which is 
$119,322,000 less than the request and $132,322,000 less than 
the 1995 level. Total funding of $407,000,000 for this 
initiative, as explained in the ``Limitation'' account, is 
$87,000,000 more than the 1995 enacted level.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 1995....................................  $5,553,337,000
Budget estimate, 1996...................................   6,209,402,000
House allowance.........................................   5,910,268,000

Committee recommendation

                                                           5,845,183,000

    The Committee recommends a program funding level of 
$5,845,183,000 for the limitation on administrative expenses, 
which is $364,219,000 less than the administration request and 
$65,085,000 less than the House allowance.
    This account provides resources from the Social Security 
trust funds to administer the Social Security retirement and 
survivors and disability insurance programs, and certain Social 
Security health insurance functions. As authorized by law, it 
also provides resources from the trust funds for certain 
nontrust fund administrative costs, which are reimbursed from 
the general funds. These include administration of the 
supplemental security income program for the aged, blind, and 
disabled; work associated with the Pension Reform Act of 1984; 
and the portion of the annual wage reporting work done by the 
Social Security Administration for the benefit of the Internal 
Revenue Service. The dollars provided also support automated 
data processing activities and fund the State disability 
determination services which make disability determinations on 
behalf of the Social Security Administration.
    The amount recommended is adequate to support a staffing 
level of approximately 66,126 work-years and 65,070 FTE's, 
which is approximately 388 FTE's below the 1995 current 
estimate, and is the same as the President's amended FTE 
request. Additionally, the limitation provides funding for 
computer support, resources for State disability agencies which 
make initial and continuing disability determinations, and 
other administrative costs. In 1996, about 51 million 
beneficiaries will receive a Social Security or supplemental 
security income check each month and cash payments are expected 
to exceed $375,000,000,000 during fiscal year 1996.
    The limitation includes $5,271,183,000 for routine 
operating expenses of the agency, which is $4,085,000 less than 
the House allowance, $47,219,000 less than the amount requested 
by the President, and $126,129,000 over the 1995 comparable 
amount. This increase is smaller than the $254,453,000 increase 
for 1995 over 1994, reflecting planned staffing reductions. 
These funds cover the mandatory costs of maintaining equipment 
and facilities, as well as staffing. The Committee expects that 
every effort will be made to reduce administrative overhead 
staffs in order to avoid further reductions to frontline field 
office personnel. The Commissioner should be prepared to 
discuss reductions made in administrative and central 
processing staff at the Committee's fiscal year 1997 
appropriations hearings next spring.
    Software development.--The Committee remains concerned that 
SSA's long-term operational and service delivery needs are 
fully addressed through proper software development. The 
Committee has, therefore, included $2,000,000 for this purpose 
and directs that SSA work with an industry-based consortium 
dedicated to improving software productivity, and with 
experience institutionalizing software processes and methods.
    Disability initiative.--The total limitation includes an 
additional $407,000,000 for the disability initiative to 
continue to reduce the volume of pending disability cases, 
which is an increase of $87,000,000 over the 1995 level. This 
is $127,000,000 less than the amount requested by the President 
and is the same as the House allowance. Significant 
productivity gains coupled with disability investment funds 
made available beginning in fiscal year 1994 have enabled SSA 
to reduce pending disability cases and improve processing 
times. In addition, this year's investment fund will be used to 
increase the level of continuing disability reviews.
    The Committee is supportive of SSA's efforts to redesign 
the disability process and urges the agency to move ahead with 
implementation of the disability reengineering program as soon 
as possible, to improve the process and reduce its cost.
    Automation initiative.--An additional $167,000,000 has been 
included within the limitation amount to fund the third year of 
the 5-year automation initiative requested by the President. 
This is an increase of $78,717,000 over fiscal year 1995, but 
is $190,000,000 less then the request and $61,000,000 less than 
the House allowance.
    The Committee recognizes the criticality of automation 
investments to maintain SSA's exemplary track record of 
productivity gains and service improvements. Together with 
unspent carryover funds, nearly $400,000,000 will be available 
for these activities in fiscal 1996. The reduction from the 
budget request recommended by the Committee is necessitated by 
severe budgetary constraints.
    The Committee directs the Social Security Administration to 
provide a summary of its current chronic fatigue and immune 
dysfunction syndrome surveillance projects to the Chronic 
Fatigue Syndrome Interagency Coordinating Committee within 90 
days. This data should be used to investigate obstacles to 
benefits for persons with CFIDS [CFS] and keep medical 
information updated. Last year, this Committee recommended that 
SSA establish a CFIDS [CFS] advisory committee to review 
current medical standards and investigate the training and 
information resource needs of regional SSA offices. Since SSA 
has not met this critical need voluntarily, the Committee 
directs SSA to do so within the next year. SSA can further 
serve CFIDS [CFS] claimants by including medically accurate, 
up-to-date information on CFIDS [CFS] in the listing of 
impairments and POMS manuals and reviewing this information 
biannually

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1995....................................     $10,446,000
Budget estimate, 1996...................................      27,217,000
House allowance.........................................      25,892,000
Senate allowance........................................      25,892,000

    The Committee recommends $25,892,000 for activities of the 
Office of the Inspector General. This is $1,325,000 less than 
the amount requested by the administration and the same as the 
House allowance. This includes a general fund appropriation of 
$6,790,000 together with an obligation limitation of 
$21,076,000 from the Federal old age and survivors insurance 
trust fund and the Federal disability insurance trust fund. The 
Committee notes that this represents an increase of $5,000,000 
over the 1995 adjusted level of $20,892,000, which is the 
annualized amount for the actual 6 months of funding provided 
for this new agency in fiscal 1995.

                       Railroad Retirement Board

                     dual benefits payments account

Appropriations, 1995....................................    $254,000,000
Budget estimate, 1996...................................     239,000,000
House allowance.........................................     239,000,000

Committee recommendation

                                                             239,000,000

    The Committee has provided a total of $239,000,000 for dual 
benefits, including $17,000,000 in income tax receipts on dual 
benefits as authorized by law. The Committee recommendation is 
the same as the budget request and the House allowance.
    The bill includes a contingency reserve of 2 percent which 
becomes available if the product of the number of recipients 
times the average benefit exceeds $239,000,000.
    This appropriation provides for vested dual benefit 
payments authorized by the Railroad Retirement Act of 1974, as 
amended by the Omnibus Reconciliation Act of 1981. This 
separate account, established for the payment of dual benefits, 
is funded by general fund appropriations and income tax 
receipts of vested dual benefits.

          federal payments to the railroad retirement account

Appropriations, 1995....................................        $300,000
Budget estimate, 1996...................................         300,000
House allowance.........................................         300,000

Committee recommendation

                                                                 300,000

    The Committee recommends $300,000 for interest earned on 
unnegotiated checks. This is the same as the fiscal year 1995 
appropriation, the budget request, and House allowance.

                      limitation on administration

Appropriations, 1995....................................     $90,912,000
Budget estimate, 1996...................................      92,700,000
House allowance.........................................      90,912,000

Committee recommendation

                                                              83,639,000

    The Committee recommends an appropriation of $83,639,000 
for administration of railroad retirement/survivor benefit 
programs. This amount is $7,273,000 below the fiscal year 1995 
appropriation, $1,788,000 below the budget request, and 
$7,273,000 below the House allowance.
    The Board administers comprehensive retirement-survivor and 
unemployment-sickness insurance benefit programs for the 
Nation's railroad workers and their families. This account 
limits the amount of funds in the railroad retirement and 
railroad unemployment insurance trust funds which may be used 
by the Board for administrative expenses.

                  special management improvement fund

Appropriations, 1995....................................      $1,640,000
Budget estimate, 1996...................................         659,000
House allowance.........................................         659,000

Committee recommendation

                                                                 659,000

    The Committee recommends $659,000 for the special 
management improvement fund, $981,000 below the fiscal year 
1995 appropriation, and the same as the budget request and 
House allowance.
    The Board and OMB entered into an agreement to establish 
the special management improvement fund in 1990 to address 
noted deficiencies in six key areas of Board operation. The 
Committee acknowledges the Board's particular success in the 
areas of fraud control and claims backlog. The Committee 
recommendation provides funding for the last year of the 
management improvement initiative.

           limitation on the office of the inspector general

Appropriations, 1995....................................      $6,682,000
Budget estimate, 1996...................................       6,700,000
House allowance.........................................       5,100,000

Committee recommendation

                                                               6,147,000

    The Committee recommends $6,147,000 for the Office of the 
Inspector General, $535,000 less than the 1995 appropriation, 
$553,000 less than the budget request, and $1,047,000 more than 
the House allowance.
    The Office of the Inspector General conducts audits and 
investigations, and reviews the progress of the management 
improvement initiative. The funds are derived from the railroad 
retirement and railroad unemployment insurance trust funds.
    The Committee urges the inspector general of the Railroad 
Retirement Board to focus greater resources on ensuring the 
integrity of the railroad unemployment and retirement trust 
funds.

                        U.S. Institute of Peace

Appropriations, 1995....................................     $11,500,000
Budget estimate, 1996...................................      11,500,000
House allowance.........................................       6,500,000

Committee recommendation

                                                              11,500,000

    The Committee recommends an appropriation of $11,500,000 
for the U.S. Institute of Peace, the same as the fiscal year 
1995 appropriation and the budget request, and $5,000 more than 
the House allowance.
    The Institute was established by the U.S. Institute of 
Peace Act (Public Law 98-525) in 1984. The Institute is an 
independent, nonprofit, national organization whose primary 
mission is to promote, through scholarship and education, 
international peace, and the resolution of conflicts without 
recourse to violence.
                      TITLE V--GENERAL PROVISIONS

    The Committee concurs with the House in retaining 
provisions which: authorize transfers of unexpended balances 
(sec. 501); limit funding to 1 year availability unless 
otherwise specified (sec. 502); limit lobbying and related 
activities (sec. 503); limit official representation expenses 
(sec. 504); prohibit funding of any program to carry out 
distribution of sterile needles for the hypodermic injection of 
any illegal drug unless the Secretary of HHS determines such 
programs are effective in preventing the spread of HIV and do 
not encourage the use of illegal drugs (sec. 505); state the 
sense of Congress about purchase of American-made equipment and 
products (sec. 506); clarify Federal funding as a component of 
state and local grant funds (sec. 507); and limit use of funds 
for abortion (sec. 508).
    The Committee recommends deletion of the House provision 
regarding state discretion on funding of abortion (sec. 509).
    The Committee agrees with the House in retaining provisions 
carried in last year's bill relating to transfer authority, 
obligation and expenditure of appropriations, and detail of 
employees (sec. 510).
    The Committee recommends deletion of a House provision 
prohibiting use of funds for human embryo research (sec. 511).
    The Committee recommends deletion of House language 
relating to accrediting agencies to establish standards which 
require that such accredited schools train obstetricians/
gynecologists in performance of abortions (sec. 512); and 
appropriate minimum length of stay for routine deliveries (sec. 
513). The Committee recommendation retains the prohibition on 
use of funds for an electronic benefit transfer task force 
(sec. 514). The Committee recommendation deletes the House 
provision pertaining to the consumer price index (sec. 515).
    The Committee concurs with the House general provision 
which prohibits funds made available in this Act to be used to 
enforce the requirements of the Higher Education Act of 1965 
with respect to any lender that has a loan portfolio that is 
equal to or less than $5,000,000 (sec. 516). It also concurs 
with House language which prohibits use of funds under the Pell 
Grant program as a result of certain default rate 
determinations specified by law (sec. 517).
    The Committee has deleted House provisions adjusting 
funding levels for certain accounts in the bill, which the 
Committee has incorporated directly into recommendations for 
the effected accounts (secs. 518 and 519).
    The Committee has included a provision, carried in last 
year's bill but not considered by the House, stipulating that 
no more than 1 percent of appropriations for salaries may be 
used to pay employee bonuses (sec. 520).
    The Committee has included language directing that OMB 
allocate this reduction among the agencies funded in this bill. 
The Committee expects that the allocation will be based on 
salaries and benefits appropriated in this act.

                                            BUDGETARY IMPACT OF BILL                                            
  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS  
                                                     AMENDED                                                    
                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays        
                                                             ---------------------------------------------------
                                                               Committee    Amount of    Committee    Amount of 
                                                               allocation      bill      allocation      bill   
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations                                                    
 to its subcommittees of amounts in the First Concurrent                                                        
 Resolution for 1996: Subcommittee on Labor, Health and                                                         
 Human Services, Education, and Related Agencies:                                                               
    Defense discretionary...................................  ...........  ...........  ...........  ...........
    Nondefense discretionary................................       62,744       62,744       68,680   \1\ 68,680
    Violent crime reduction fund............................           65           65           50           29
    Mandatory...............................................      205,210      200,961      205,680      192,039
Projections of outlays associated with the recommendation:                                                      
    1996....................................................  ...........  ...........  ...........  \2\ 178,099
    1997....................................................  ...........  ...........  ...........       31,590
    1998....................................................  ...........  ...........  ...........        6,912
    1999....................................................  ...........  ...........  ...........        1,100
    2000 and future year....................................  ...........  ...........  ...........           65
Financial assistance to State and local governments for 1996                                                    
 in bill....................................................           NA       27,227           NA        6,855
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.                                                          
\2\ Excludes outlays from prior-year budget authority.                                                          
                                                                                                                
NA: Not applicable.                                                                                             

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

    Paragraph 7 of rule XVI requires that Committee report 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 following items are identified pursuant to this 
requirement:
          Community service employment for older Americans, 
        $350,000,000;
          Health centers cluster, $756,518,000;
          Primary care medicine and related training cluster, 
        $70,298,000;
          Minority/disadvantaged health professions cluster, 
        $44,411,000;
          Area health education centers and other education 
        centers cluster, $28,363,000;
          Health professions work force cluster, $12,774,000;
          Nursing workforce development cluster, $52,776,000;
          Consolidated scholarships and loans cluster, 
        $135,213;
          Organ transplantation, $2,400,000;
          Health teaching facilities interest subsidy, 
        $411,000;
          Bone Marrow Program, $15,360,000;
          Alzheimer demonstration grants, $4,000,000;
          Pacific basin initiative, $2,000,000;
          AIDS programs, $662,847,000;
          Family planning, $193,349,000;
          HEAL loan limitation, $210,000,000;
          Vaccine injury compensation program trust fund, 
        $3,000,000;
          Childhood immunization, $465,497,000;
          Substance abuse and mental health programs, 
        $1,669,928,000;
          Adolescent family life, $6,144,000;
          Minority health, $18,981,000;
          Health services research, $69,284,000;
          Medical treatment effectiveness, $55,796,000;
          Child care development block grant, $934,642,000;
          Temporary childcare/crisis nurseries, $9,835,000;
          Abandoned infants assistance, $12,406,000;
          Native American programs, $35,000,000;
          Administration on Aging, $836,027,000;
          National Institute on Alcohol Abuse and Alcoholism, 
        $193,730,000;
          National Institute on Drug Abuse, $446,800.000;
          National Institute on Mental Health, $645,411,000; 
        and
          HCFA research, demonstration, and evaluation, 
        $60,677,000.

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

    Pursuant to paragraph 7(c) of rule XXVI, the accompanying 
bill was ordered reported from the Committee, subject to 
amendment and subject to the subcommittee allocation, by 
recorded vote of 24-3, a quorum being present.
        Yeas                          Nays
Chairman Hatfield                   Mr. Gramm
Mr. Stevens                         Mr. Gregg
Mr. Cochran                         Mr. Lautenberg
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. Gorton
Mr. Mack
Mr. Burns
Mr. Shelby
Mr. Jeffords
Mr. Bennett
Mr. Byrd
Mr. Inouye
Mr. Hollings
Mr. Johnston
Mr. Leahy
Mr. Bumpers
Mr. Harkin
Ms. Mikulski
Mr. Reid
Mr. Kerrey
Mr. Kohl
Mrs. Murray

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

    Paragraph 12 of rule XXVI requires that Committee reports 
on a bill or a joint resolution repealing or amending 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, the following 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.
    The Committee has no items to report under rule XXVI.

              DEFINITION OF PROGRAM, PROJECT, AND ACTIVITY

    During fiscal year 1996 for purposes of the Balanced Budget 
and Emergency Deficit Control Act of 1985 (Public Law 99-177), 
as amended, the following information provides the definition 
of the term ``program, project, and activity'' for departments 
and agencies under the jurisdiction of the Labor, Health and 
Human Services, and Education and Related Agencies 
Subcommittee. The term ``program, project, and activity'' shall 
include the most specific level of budget items identified in 
the Departments of Labor, Health and Human Services, and 
Education and Related Agencies Appropriations Act 1996, the 
accompanying House and Senate Committee reports, the conference 
report and accompanying joint explanatory statement of the 
managers of the committee of conference.
                      TITLE VI--POLITICAL ADVOCACY

    The Committee recommends deletion of House bill language 
relating to political advocacy; this is authorizing legislation 
that should not be included in this appropriations bill.
                 TITLE VII--DEFICIT REDUCTION LOCK-BOX

    The Committee recommends deletion of House bill language 
relating to creation of a deficit reduction lock-box; this is 
authorizing legislation that should not be included in this 
appropriations bill.

                                   - 

  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 1995 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL 
                                                                        YEAR 1996                                                                       
                                                                [In thousands of dollars]                                                               
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                        Senate Committee recommendation compared with (+
                                                                                                                             or -)                      
              Item                      1995        Budget estimate  House allowance     Committee    --------------------------------------------------
                                 appropriation \1\                                     recommendation        1995                                       
                                                                                                        appropriation   Budget estimate  House allowance
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                        
  TITLE I--DEPARTMENT OF LABOR                                                                                                                          
                                                                                                                                                        
    EMPLOYMENT AND TRAINING                                                                                                                             
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
    TRAINING AND EMPLOYMENT                                                                                                                             
          SERVICES \2\                                                                                                                                  
                                                                                                                                                        
Grants to States:                                                                                                                                       
    Adult training.............          996,813         1,054,813          830,000          830,000         -166,813         -224,813   ...............
    Dislocated worker                                                                                                                                   
     assistance................        1,228,550         1,396,000          850,000          884,000         -344,550         -512,000          +34,000 
    Proposed leg: Dislocated                                                                                                                            
     workers (non-add).........  .................        (660,000)  ...............  ...............  ...............       (-660,000)  ...............
    Proposed leg: Adult                                                                                                                                 
     Training (non-add)                                                                                                                                 
     transfer to Department of                                                                                                                          
     Education (Adult Literacy)  .................        (-84,161)  ...............  ...............  ...............        (+84,161)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
        Subtotal, Adults (non-                                                                                                                          
         add)..................        2,225,363         2,450,813        1,680,000        1,714,000         -511,363         -736,813          +34,000 
    Youth training.............          126,672           288,979          126,672          311,460         +184,788          +22,481         +184,788 
    Summer youth employment and                                                                                                                         
     training program..........          184,788           958,540   ...............  ...............        -184,788         -958,540   ...............
        (Summer of 1995) (non-                                                                                                                          
         add) \3\..............         (184,788)   ...............  ...............  ...............       (-184,788)  ...............  ...............
        (Carryover) (non-add)..  .................  ...............        (200,000)        (200,000)       (+200,000)       (+200,000)  ...............
        Job Corps (non-add)....       (1,089,460)       (1,227,714)      (1,121,010)      (1,093,942)         (+4,482)       (-133,772)        (-27,068)
        School-to-work (non-                                                                                                                            
         add)..................         (122,500)         (200,000)         (95,000)        (122,500)  ...............        (-77,500)        (+27,500)
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal, Youth (non-                                                                                                                         
           add)................        1,523,420         2,675,233        1,542,682        1,727,902         +204,482         -947,331         +185,220 
    Proposed leg: Skill Grants                                                                                                                          
     (Pell xfer) (non-add).....       (1,827,102)       (2,129,366)  ...............  ...............     (-1,827,102)     (-2,129,366)  ...............
Federally administered                                                                                                                                  
 programs:                                                                                                                                              
    Native Americans...........           59,787            61,871           50,000           55,004           -4,783           -6,867           +5,004 
    Migrants and seasonal                                                                                                                               
     farmworkers...............           79,967            78,303           65,000           73,570           -6,397           -4,733           +8,570 
    Job Corps:                                                                                                                                          
        Operations.............          957,431         1,029,632          972,475          972,475          +15,044          -57,157   ...............
        Construction and                                                                                                                                
         renovation............          132,029           198,082          148,535          121,467          -10,562          -76,615          -27,068 
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal, Job Corps..        1,089,460         1,227,714        1,121,010        1,093,942           +4,482         -133,772          -27,068 
    Youth Fair Chance..........  .................          49,785   ...............  ...............  ...............         -49,785   ...............
    Veterans' employment.......            8,880             8,880            7,300   ...............          -8,880           -8,880           -7,300 
    National activities:                                                                                                                                
        Pilots and                                                                                                                                      
         demonstrations........           33,186            35,522           19,022           35,258           +2,072             -264          +16,236 
        Research, demonstration                                                                                                                         
         and evaluation........            9,196            12,596            6,196            6,196           -3,000           -6,400   ...............
        Other..................           10,989            73,584            5,489           10,549             -440          -63,035           +5,060 
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal, National                                                                                                                            
           activities..........           53,371           121,702           30,707           52,003           -1,368          -69,699          +21,296 
                                ========================================================================================================================
          Subtotal, Federal                                                                                                                             
           activities..........        1,291,465         1,548,255        1,274,017        1,274,519          -16,946         -273,736             +502 
                                ========================================================================================================================
          Total, Job Training                                                                                                                           
           Partnership Act.....        3,828,288         5,246,587        3,080,689        3,299,979         -528,309       -1,946,608         +219,290 
                                ========================================================================================================================
Veterans homeless program \4\..  .................           5,011   ...............  ...............  ...............          -5,011   ...............
Glass Ceiling Commission \4\...              738               142              142              142             -596   ...............  ...............
Women in apprenticeship \4\....              744               744              610              684              -60              -60              +74 
National Center for the                                                                                                                                 
 Workplace \4\.................  .................  ...............  ...............  ...............  ...............  ...............  ...............
Skills Standards...............            4,500            12,000            4,000            4,000             -500           -8,000   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, National                                                                                                                                   
       activities, TES (non-                                                                                                                            
       add)....................          (59,353)         (139,599)         (35,459)         (56,829)         (-2,524)        (-82,770)        (+21,370)
School-to-work.................          122,500           200,000           95,000          122,500   ...............         -77,500          +27,500 
                                ========================================================================================================================
      Total, Training and                                                                                                                               
       Employment Services.....        3,956,770         5,464,484        3,180,441        3,427,305         -529,465       -2,037,179         +246,864 
      Subtotal, forward funded.       (3,955,288)       (5,458,587)      (3,179,689)      (3,426,479)       (-528,809)     (-2,032,108)       (+246,790)
COMMUNITY SERVICE EMPLOYMENT                                                                                                                            
 FOR OLDER AMERICANS \5\.......          396,060           410,500          350,000          273,000         -123,060         -137,500          -77,000 
                                                                                                                                                        
 FEDERAL UNEMPLOYMENT BENEFITS                                                                                                                          
         AND ALLOWANCES                                                                                                                                 
                                                                                                                                                        
Trade adjustment...............          274,400           279,600          279,600          279,600           +5,200   ...............  ...............
NAFTA activities...............  .................          66,500           66,500           66,500          +66,500   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total....................          274,400           346,100          346,100          346,100          +71,700   ...............  ...............
                                                                                                                                                        
  STATE UNEMPLOYMENT INSURANCE                                                                                                                          
     AND EMPLOYMENT SERVICE                                                                                                                             
           OPERATIONS                                                                                                                                   
                                                                                                                                                        
Unemployment Compensation                                                                                                                               
 (Trust Funds):                                                                                                                                         
    State Operations...........       (1,756,626)       (2,206,136)      (2,080,520)      (2,080,520)       (+323,894)       (-125,616)  ...............
    State integrity activities                                                                                                                          
     \6\.......................         (367,169)   ...............  ...............  ...............       (-367,169)  ...............  ...............
    National Activities \7\....          (17,328)          (17,824)         (10,000)         (10,000)         (-7,328)         (-7,824)  ...............
    Contingency................         (172,137)         (245,983)        (216,333)        (216,333)        (+44,196)        (-29,650)  ...............
    Contingency bill language                                                                                                                           
     (OMB estimate)............          (67,900)   ...............  ...............  ...............        (-67,900)  ...............  ...............
        Portion treated as                                                                                                                              
         budget authority \8\..             (812)   ...............  ...............  ...............           (-812)  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal,                                                                                                                                     
           Unemployment Comp                                                                                                                            
           (trust funds).......       (2,314,072)       (2,469,943)      (2,306,853)      (2,306,853)         (-7,219)       (-163,090)  ...............
Employment Service:                                                                                                                                     
    Allotments to States:                                                                                                                               
        Federal funds..........           25,254            24,177           23,452           23,452           -1,802             -725   ...............
        Trust funds............         (813,658)         (781,735)        (738,283)        (738,283)        (-75,375)        (-43,452)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal.............          838,912           805,912          761,735          761,735          -77,177          -44,177   ...............
    National Activities:                                                                                                                                
        Federal funds..........            1,934             1,934            1,876            1,876              -58              -58   ...............
        Trust funds............          (64,194)          (64,194)         (62,268)         (59,058)         (-5,136)         (-5,136)         (-3,210)
            Targeted jobs tax                                                                                                                           
             credit............          (10,250)   ...............  ...............  ...............        (-10,250)  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
              Subtotal.........           76,378            66,128           64,144           60,934          -15,444           -5,194           -3,210 
                                ========================================================================================================================
              Subtotal,                                                                                                                                 
               Employment                                                                                                                               
               Service.........          915,290           872,040          825,879          822,669          -92,621          -49,371           -3,210 
                  Federal funds           27,188            26,111           25,328           25,328           -1,860             -783   ...............
                  Trust funds..         (888,102)         (845,929)        (800,551)        (797,341)        (-90,761)        (-48,588)         (-3,210)
One-stop Career Centers........          100,000           200,000          100,000           92,000           -8,000         -108,000           -8,000 
                                ========================================================================================================================
      Total, State Unemployment        3,329,362         3,541,983        3,232,732        3,221,522         -107,840         -320,461          -11,210 
          Federal Funds........          127,188           226,111          125,328          117,328           -9,860         -108,783           -8,000 
          Trust Funds..........       (3,202,174)       (3,315,872)      (3,107,404)      (3,104,194)        (-97,980)        -211,678)         (-3,210)
ADVANCES TO UNEMPLOYMENT TRUST                                                                                                                          
 FUND AND OTHER FUNDS \9\......        1,004,485           369,000          369,000          369,000         -635,485   ...............  ...............
ADVANCES TO THE ESA ACCOUNT OF                                                                                                                          
 THE UNEMPLOYMENT TRUST FUND...  .................  ...............  ...............         -56,300          -56,300          -56,300          -56,300 
                                                                                                                                                        
     PROGRAM ADMINISTRATION                                                                                                                             
                                                                                                                                                        
Adult employment and training..           27,847            31,144           25,758           25,619           -2,228           -5,525             -139 
    Trust funds................           (2,481)           (2,637)          (2,295)          (2,283)           (-198)           (-354)            (-12)
Youth employment and training..           32,001            35,170           29,601           29,441           -2,560           -5,729             -160 
Employment security............            6,584             3,913            6,090            6,057             -527           +2,144              -33 
    Trust funds................          (40,399)             ,378)         (37,369)         (37,167)         (-3,232)        (-10,211)           (-202)
Apprenticeship services........           17,531            18,681           16,216           16,129           -1,402           -2,552              -87 
Executive direction............            6,313             6,605            5,840            5,808             -505             -797              -32 
    Trust funds................           (1,416)           (1,887)          (1,310)          (1,343)            (-73)           (-544)            (+33)
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Program                                                                                                                                    
       Administration..........          134,572           147,415          124,479          123,847          -10,725          -23,568             -632 
          Federal funds........           90,276            95,513           83,505           83,054           -7,222          -12,459             -451 
          Trust funds \10\.....          (44,296)          (51,902)         (40,974)         (40,793)         (-3,503)        (-11,109)           (-181)
                                ========================================================================================================================
      Total, Employment and                                                                                                                             
       Training Administration.        9,095,649        10,279,482        7,602,752        7,704,474       -1,391,175       -2,575,008         +101,722 
          Federal funds........        5,849,179         6,911,708        4,454,374        4,559,487       -1,289,692       -2,352,221         +105,113 
          Trust funds..........       (3,246,470)       (3,367,774)      (3,148,378)      (3,144,987)       (-101,483)       (-222,787)         (-3,391)
                                                                                                                                                        
     OFFICE OF THE AMERICAN                                                                                                                             
           WORKPLACE                                                                                                                                    
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Office of the Workplace                                                                                                                                 
 Programs......................            7,197            10,770   ...............  ...............          -7,197          -10,770   ...............
                                                                                                                                                        
  PENSION AND WELFARE BENEFITS                                                                                                                          
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Enforcement and compliance.....           53,672            65,163           49,647           50,988           -2,684          -14,175           +1,341 
Policy, regulation and public                                                                                                                           
 service.......................           12,154            12,412           11,242           11,546             -608             -866             +304 
Program oversight..............            3,485             3,607            3,224            3,206             -279             -401              -18 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, PWBA..............           69,311            81,182           64,113           65,740           -3,571          -15,442           +1,627 
                                                                                                                                                        
    PENSION BENEFIT GUARANTY                                                                                                                            
          CORPORATION                                                                                                                                   
                                                                                                                                                        
Program Administration subject                                                                                                                          
 to limitation (Trust Funds)...          (11,463)          (12,043)         (10,603)         (10,603)           (-860)         (-1,440)  ...............
Services related to                                                                                                                                     
 terminations not subject to                                                                                                                            
 limitations (non-add).........         (126,258)         (128,496)        (128,496)        (128,496)         (+2,238)  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, PBGC..............         (137,721)         (140,539)        (139,099)        (139,099)         (+1,378)         (-1,440)  ...............
                                                                                                                                                        
      EMPLOYMENT STANDARDS                                                                                                                              
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Enforcement of wage and hour                                                                                                                            
 standards.....................          101,071           116,943           88,921           96,017           -5,054          -20,926           +7,096 
Office of Labor-Management                                                                                                                              
 Standards.....................           23,997            31,075           22,197           23,997   ...............          -7,078           +1,800 
Federal contractor EEO                                                                                                                                  
 standards enforcement.........           58,928            63,831           54,508           55,982           -2,946           -7,849           +1,474 
Federal programs for workers'                                                                                                                           
 compensation..................           76,425            82,937           70,693           72,604           -3,821          -10,333           +1,911 
    Trust funds................           (1,057)           (1,669)            (978)            (978)            (-79)           (-691)  ...............
Program direction and support..           11,511            11,690           10,648           10,590             -921           -1,100              -58 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, salaries and                                                                                                                               
       expenses................          272,989           308,145          247,945          260,168          -12,821          -47,977          +12,223 
          Federal funds........          271,932           306,476          246,967          259,190          -12,742          -47,286          +12,223 
          Trust funds..........           (1,057)           (1,669)            (978)            (978)            (-79)           (-691)  ...............
                                                                                                                                                        
        SPECIAL BENEFITS                                                                                                                                
                                                                                                                                                        
Federal employees compensation                                                                                                                          
 benefits......................          254,000           214,000          214,000          214,000          -40,000   ...............  ...............
Longshore and harbor workers'                                                                                                                           
 benefits......................            4,000             4,000            4,000            4,000   ...............  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Special Benefits..          258,000           218,000          218,000          218,000          -40,000   ...............  ...............
                                                                                                                                                        
  BLACK LUNG DISABILITY TRUST                                                                                                                           
              FUND                                                                                                                                      
                                                                                                                                                        
Benefit payments and interest                                                                                                                           
 on advances...................          923,005           949,494          949,494          949,494          +26,489   ...............  ...............
Employment Standards Admin.,                                                                                                                            
 salaries and expenses.........           28,157            28,655           26,045           28,655             +498   ...............          +2,610 
Departmental Management,                                                                                                                                
 salaries and expenses.........           23,333            19,621           19,621           19,621           -3,712   ...............  ...............
Departmental Management,                                                                                                                                
 inspector general.............              310               310              287              310   ...............  ...............             +23 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Black Lung                                                                                                                              
       Disability Trust Fund,                                                                                                                           
       apprn...................          974,805           998,080          995,447          998,080          +23,275   ...............          +2,633 
Treasury administrative costs                                                                                                                           
 (indefinite)..................              756               756              756              756   ...............  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Black Lung                                                                                                                                 
       Disability Trust Fund...          975,561           998,836          996,203          998,836          +23,275   ...............          +2,633 
                                ========================================================================================================================
      Total, Employment                                                                                                                                 
       Standards Administration        1,506,550         1,524,981        1,462,148        1,477,004          -29,546          -47,977          +14,856 
          Federal funds........        1,505,493         1,523,312        1,461,170        1,476,026          -29,467          -47,286          +14,856 
          Trust funds..........           (1,057)           (1,669)            (978)            (978)            (-79)           (-691)  ...............
                                                                                                                                                        
 OCCUPATIONAL SAFETY AND HEALTH                                                                                                                         
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Safety and health standards....            9,031             9,471            8,354            8,579             -452             -892             +225 
Enforcement:                                                                                                                                            
    Federal Enforcement........          145,834           155,854           98,000          138,542           -7,292          -17,312          +40,542 
    State programs.............           70,615            75,915           65,319           67,084           -3,531           -8,831           +1,765 
Technical Support..............           18,883            21,668           17,467           17,939             -944           -3,729             +472 
Compliance Assistance..........           44,974            55,332           53,601           42,725           -2,249          -12,607          -10,876 
Safety and health statistics...           15,900            20,669           14,707           15,105             -795           -5,564             +398 
Executive direction and                                                                                                                                 
 administration................            7,263             7,594            6,537            6,682             -581             -912             +145 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, OSHA..............          312,500           346,503          263,985          296,656          -15,844          -49,847          +32,671 
                                                                                                                                                        
     MINE SAFETY AND HEALTH                                                                                                                             
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
Enforcement:                                                                                                                                            
    Coal.......................          107,550           112,957           99,484          107,550   ...............          -5,407           +8,066 
    Metal/nonmetal.............           42,296            46,862           39,124           42,296   ...............          -4,566           +3,172 
    Standards development......            1,339             1,008            1,008            1,339   ...............            +331             +331 
Assessments....................            3,781             3,712            3,497            3,781   ...............             +69             +284 
Educational policy and                                                                                                                                  
 development...................           15,064            14,865           13,934           15,064   ...............            +199           +1,130 
Technical support..............           22,097            23,575           20,440           22,097   ...............          -1,478           +1,657 
Program administration.........            8,519             9,127            7,667            8,519   ...............            -608             +852 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Mine Safety and                                                                                                                            
       Health Administration...          200,646           212,106          185,154          200,646   ...............         -11,460          +15,492 
                                                                                                                                                        
   BUREAU OF LABOR STATISTICS                                                                                                                           
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Employment and Unemployment                                                                                                                             
 Statistics....................          100,315           107,955          102,885           92,290           -8,025          -15,665          -10,595 
Labor Market Information (Trust                                                                                                                         
 Funds)........................          (54,102)          (56,350)         (50,220)         (49,774)         (-4,328)         (-6,576)           (-446)
Prices and cost of living......           93,066            99,224           93,956           85,621           -7,445          -13,603           -8,335 
Compensation and working                                                                                                                                
 conditions....................           61,189            63,855           54,625           56,294           -4,895           -7,561           +1,669 
Productivity and technology....            6,971             7,419            7,419            6,413             -558           -1,006           -1,006 
Economic growth and employment                                                                                                                          
 projections...................            4,181             4,487            4,487            3,847             -334             -640             -640 
Executive direction and staff                                                                                                                           
 services......................           26,723            25,842           22,072           24,585           -2,138           -1,257           +2,513 
Consumer Price Index Revision..            5,127            11,549           11,549           11,549           +6,422   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Bureau of Labor                                                                                                                            
       Statistics..............          351,674           376,681          347,213          330,373          -21,301          -46,308          -16,840 
          Federal Funds........          297,572           320,331          296,993          280,599          -16,973          -39,732          -16,394 
          Trust Funds..........          (54,102)          (56,350)         (50,220)         (49,774)         (-4,328)         (-6,576)           (-446)
                                                                                                                                                        
    DEPARTMENTAL MANAGEMENT                                                                                                                             
                                                                                                                                                        
     SALARIES AND EXPENSES                                                                                                                              
                                                                                                                                                        
Executive direction............           21,034            26,232           17,931           19,351           -1,683           -6,881           +1,420 
Legal services.................           61,954            69,570           57,307           58,838           -3,116          -10,732           +1,531 
    Trust funds................             (328)             (342)            (303)            (303)            (-25)            (-39)  ...............
International labor affairs....           12,272            12,950            5,850           11,290             -982           -1,660           +5,440 
Administration and management..           15,031            15,503           13,904           13,904           -1,127           -1,599   ...............
Adjudication...................           20,000            24,589           18,500           18,500           -1,500           -6,089   ...............
Promoting employment of people                                                                                                                          
 with disabilities.............            4,385             4,772            4,056            4,385   ...............            -387             +329 
Women's Bureau.................            8,371             8,973            7,743            7,743             -628           -1,230   ...............
Civil Rights Activities........            4,903             5,038            4,535            4,535             -368             -503   ...............
Chief Financial Officer........            4,750             5,120            4,394            4,394             -356             -726   ...............
Enforcement Automation.........            2,000    ...............  ...............  ...............          -2,000   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Salaries and                                                                                                                               
       expenses................          155,028           173,089          134,523          143,243          -11,785          -29,846           +8,720 
          Federal funds........          154,700           172,747          134,220          142,940          -11,760          -29,807           +8,720 
          Trust funds..........             (328)             (342)            (303)            (303)            (-25)            (-39)  ...............
                                                                                                                                                        
    VETERANS EMPLOYMENT AND                                                                                                                             
            TRAINING                                                                                                                                    
                                                                                                                                                        
State Administration:                                                                                                                                   
    Disabled Veterans Outreach                                                                                                                          
     Program...................          (83,601)          (83,643)         (79,682)         (76,913)         (-6,688)         (-6,730)         (-2,769)
    Local Veterans Employment                                                                                                                           
     Program...................          (77,593)          (77,632)         (73,854)         (71,386)         (-6,207)         (-6,246)         (-2,468)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, State                                                                                                                                   
       Administration..........         (161,194)         (161,275)        (153,536)        (148,299)        (-12,895)        (-12,976)         (-5,237)
Federal Administration.........          (21,108)          (23,017)         (19,525)         (19,419)         (-1,689)         (-3,598)           (-106)
National Veterans Training                                                                                                                              
 Institute.....................           (2,904)           (2,822)          (2,822)          (2,672)           (-232)           (-150)           (-150)
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Trust Funds.......         (185,206)         (187,114)        (175,883)        (170,390)        (-14,816)        (-16,724)         (-5,493)
REINVENTION INVESTMENT FUND....  .................           3,900   ...............  ...............  ...............          -3,900   ...............
                                                                                                                                                        
OFFICE OF THE INSPECTOR GENERAL                                                                                                                         
                                                                                                                                                        
Program activities.............           40,672            41,657           37,622           37,622           -3,050           -4,035   ...............
    Trust funds................           (3,908)           (3,908)          (3,615)          (3,615)           (-293)           (-293)  ...............
Executive Direction and                                                                                                                                 
 Management....................            7,356             7,595            6,804            6,804             -552             -791   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Office of the                                                                                                                              
       Inspector General.......           51,936            53,160           48,041           48,041           -3,895           -5,119   ...............
          Federal funds........           48,028            49,252           44,426           44,426           -3,602           -4,826   ...............
          Trust funds..........           (3,908)           (3,908)          (3,615)          (3,615)           (-293)           (-293)  ...............
                                ========================================================================================================================
      Total, Departmental                                                                                                                               
       Management..............          392,170           417,263          358,447          361,674          -30,496          -55,589           +3,227 
          Federal funds........          202,728           225,899          178,646          187,366          -15,362          -38,533           +8,720 
          Trust funds..........         (189,442)         (191,364)        (179,801)        (174,308)        (-15,134)        (-17,056)         (-5,493)
                                ========================================================================================================================
      Total, Labor Department                                                                                                                           
       \11\....................       11,947,160        13,261,011       10,294,415       10,447,170       -1,499,990       -2,813,841         +152,755 
          Federal funds........        8,444,626         9,631,811        6,904,435        7,066,520       -1,378,106       -2,565,291         +162,085 
          Trust funds..........       (3,502,534)       (3,629,200)      (3,389,980)      (3,380,650)       (-121,884)       (-248,550)         (-9,330)
                                                                                                                                                        
 TITLE II--DEPARTMENT OF HEALTH                                                                                                                         
    AND HUMAN SERVICES \12\                                                                                                                             
                                                                                                                                                        
 HEALTH RESOURCES AND SERVICES                                                                                                                          
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
 HEALTH RESOURCES AND SERVICES                                                                                                                          
                                                                                                                                                        
Consolidated health centers....  .................  ...............         756,518          756,518         +756,518         +756,518   ...............
Community health centers.......          616,555    ...............  ...............  ...............        -616,555   ...............  ...............
Migrant health centers.........           65,000    ...............  ...............  ...............         -65,000   ...............  ...............
Health care for the homeless...           65,445    ...............  ...............  ...............         -65,445   ...............  ...............
Public housing health service                                                                                                                           
 grants........................            9,518    ...............  ...............  ...............          -9,518   ...............  ...............
Health Centers Cluster                                                                                                                                  
 (proposed legislation)........  .................         756,399   ...............  ...............  ...............        -756,399   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Health Centers                                                                                                                          
       Activities..............          756,518           756,399          756,518          756,518   ...............            +119   ...............
National Health Service Corps:                                                                                                                          
    Field placements...........           41,979    ...............          41,979   ...............         -41,979   ...............         -41,979 
    Recruitment................           78,206    ...............          78,206   ...............         -78,206   ...............         -78,206 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, National Health                                                                                                                         
       Service Corps \13\......          120,185    ...............         120,185   ...............        -120,185   ...............        -120,185 
                                                                                                                                                        
    Health Professions \14\                                                                                                                             
                                                                                                                                                        
Consolidated Health Professions                                                                                                                         
 Education and Training........  .................  ...............         278,977   ...............  ...............  ...............        -278,977 
Finan. Assist. Cluster.........  .................  ...............  ...............         135,213         +135,213         +135,213         +135,213 
Primary Care Cluster...........  .................  ...............  ...............          70,298          +70,298          +70,298          +70,298 
Minority/Disadvantage Cluster..  .................  ...............  ...............          44,411          +44,411          +44,411          +44,411 
Area Health Education Cluster..  .................  ...............  ...............          28,363          +28,363          +28,363          +28,363 
H.P. Workforce Dev. Cluster....  .................  ...............  ...............          12,774          +12,774          +12,774          +12,774 
Nursing Cluster................  .................  ...............  ...............          52,776          +52,776          +52,776          +52,776 
Grants to communities for                                                                                                                               
 scholarships..................              474    ...............  ...............  ...............            -474   ...............  ...............
Health professions data system.              548    ...............  ...............  ...............            -548   ...............  ...............
Nurse loan repayment for                                                                                                                                
 shortage area service.........            2,044    ...............  ...............  ...............          -2,044   ...............  ...............
Research on health professions                                                                                                                          
 issues........................              600    ...............  ...............  ...............            -600   ...............  ...............
Workforce Development Cluster                                                                                                                           
 (proposed leg) \15\...........  .................         127,218   ...............  ...............  ...............        -127,218   ...............
Centers of excellence..........           23,040    ...............  ...............  ...............         -23,040   ...............  ...............
Health careers opportunity                                                                                                                              
 program.......................           25,350    ...............  ...............  ...............         -25,350   ...............  ...............
Exceptional financial need                                                                                                                              
 scholarships..................           10,542    ...............  ...............  ...............         -10,542   ...............  ...............
Faculty loan repayment.........              955    ...............  ...............  ...............            -955   ...............  ...............
Fin assistance for                                                                                                                                      
 disadvantaged HP students.....            5,895    ...............  ...............  ...............          -5,895   ...............  ...............
HPSL recapitalization..........            8,017    ...............  ...............  ...............          -8,017   ...............  ...............
Scholarships for disadvantaged                                                                                                                          
 students......................           17,376    ...............  ...............  ...............         -17,376   ...............  ...............
Minority/Disadvantaged Cluster                                                                                                                          
 (proposed leg)................  .................          89,450   ...............  ...............  ...............         -89,450   ...............
Family medicine training/                                                                                                                               
 departments...................           46,057    ...............  ...............  ...............         -46,057   ...............  ...............
General internal medicine and                                                                                                                           
 pediatrics....................           16,503    ...............  ...............  ...............         -16,503   ...............  ...............
Physician assistants...........            5,964    ...............  ...............  ...............          -5,964   ...............  ...............
Public health and preventive                                                                                                                            
 medicine......................            7,546    ...............  ...............  ...............          -7,546   ...............  ...............
Health administration                                                                                                                                   
 traineeships/projects.........              978    ...............  ...............  ...............            -978   ...............  ...............
Primary Care Medicine and                                                                                                                               
 Public Health Cluster                                                                                                                                  
 (proposed legislation)........  .................          76,055   ...............  ...............  ...............         -76,055   ...............
Area health education centers..           24,125    ...............  ...............  ...............         -24,125   ...............  ...............
Border health training centers.            3,509    ...............  ...............  ...............          -3,509   ...............  ...............
General dentistry residencies..            3,530    ...............  ...............  ...............          -3,530   ...............  ...............
Allied health special projects.            3,580    ...............  ...............  ...............          -3,580   ...............  ...............
Geriatric education centers and                                                                                                                         
 training......................            8,273    ...............  ...............  ...............          -8,273   ...............  ...............
Interdisciplinary traineeships.            3,880    ...............  ...............  ...............          -3,880   ...............  ...............
Podiatric medicine.............              615    ...............  ...............  ...............            -615   ...............  ...............
Chiropractic demonstration                                                                                                                              
 grants........................              936    ...............  ...............  ...............            -936   ...............  ...............
Enhanced Area Health Education                                                                                                                          
 Cluster (proposed legislation)  .................          38,783   ...............  ...............  ...............         -38,783   ...............
Advanced nurse education.......           11,642    ...............  ...............  ...............         -11,642   ...............  ...............
Nurse practitioners/nurse                                                                                                                               
 midwives......................           16,140    ...............  ...............  ...............         -16,140   ...............  ...............
Special projects...............            9,848    ...............  ...............  ...............          -9,848   ...............  ...............
Nurse disadvantaged assistance.            3,606    ...............  ...............  ...............          -3,606   ...............  ...............
Professional nurse traineeships           14,830    ...............  ...............  ...............         -14,830   ...............  ...............
Nurse anesthetists.............            2,574    ...............  ...............  ...............          -2,574   ...............  ...............
Nurse Education/Practice                                                                                                                                
 Initiatives Cluster (proposed                                                                                                                          
 legislation)..................  .................          56,750   ...............  ...............  ...............         -56,750   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Health                                                                                                                                  
       professions.............          278,977           388,256          278,977          343,835          +64,858          -44,421          +64,858 
Other HRSA Programs:                                                                                                                                    
    Hansen's disease services..           20,826            20,826           17,500           17,500           -3,326           -3,326   ...............
    Maternal and child health                                                                                                                           
     block grant...............          683,950           678,866          683,950          678,866           -5,084   ...............          -5,084 
    Healthy start..............          105,000           100,000           50,000          100,000           -5,000   ...............         +50,000 
    Organ transplantation......            2,629             2,629            2,400            2,400             -229             -229   ...............
    Health teaching facilities                                                                                                                          
     interest subsidies........              411               411              411              411   ...............  ...............  ...............
    Bone marrow program \16\...           15,360            15,360           15,360           15,360   ...............  ...............  ...............
    Rural outreach grants......           26,091    ...............          26,091           28,500           +2,409          +28,500           +2,409 
    State Offices of Rural                                                                                                                              
     Health....................  .................  ...............  ...............  ...............  ...............  ...............  ...............
    Rural Health Cluster                                                                                                                                
     (proposed legislation)....  .................          29,029   ...............  ...............  ...............         -29,029   ...............
    Trauma care................              293    ...............  ...............  ...............            -293   ...............  ...............
    Emergency medical services                                                                                                                          
     for children..............           10,000    ...............          10,000           11,000           +1,000          +11,000           +1,000 
    Emergency Medical Services                                                                                                                          
     (EMS) Cluster (proposed                                                                                                                            
     legislation)..............  .................          14,784   ...............  ...............  ...............         -14,784   ...............
    Black lung clinics.........            4,142    ...............  ...............           3,811             -331           +3,811           +3,811 
    Alzheimers demonstration                                                                                                                            
     grants....................            4,959    ...............           4,000            4,000             -959           +4,000   ...............
    Payment to Hawaii,                                                                                                                                  
     treatment of Hansen's                                                                                                                              
     Disease...................            2,976    ...............  ...............           2,738             -238           +2,738           +2,738 
    Pacific Basin initiative...            1,500    ...............  ...............           2,000             +500           +2,000           +2,000 
    Native Hawaiian health care            4,336    ...............  ...............           4,140             -196           +4,140           +4,140 
    Special Populations Cluster                                                                                                                         
     (proposed legislation)....  .................          17,259   ...............  ...............  ...............         -17,259   ...............
Acquired Immune Deficiency                                                                                                                              
 Syndrome (AIDS):                                                                                                                                       
    Education and training                                                                                                                              
     centers...................           16,287            16,287   ...............           8,000           -8,287           -8,287           +8,000 
    AIDS dental services.......            6,937             6,937            6,937   ...............          -6,937           -6,937           -6,937 
    Ryan White AIDS Programs:                                                                                                                           
        Emergency assistance...          356,500           407,000          379,500          379,500          +23,000          -27,500   ...............
        Comprehensive care                                                                                                                              
         programs..............          198,147           221,897          198,147          198,147   ...............         -23,750   ...............
        Early intervention                                                                                                                              
         program...............           52,318            62,568           52,318           52,318   ...............         -10,250   ...............
        Pediatric                                                                                                                                       
         demonstrations........           26,000            32,000           26,000           26,500             +500           -5,500             +500 
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal, Ryan White                                                                                                                          
           AIDS programs.......          632,965           723,465          655,965          656,465          +23,500          -67,000             +500 
                                ------------------------------------------------------------------------------------------------------------------------
          Subtotal, AIDS.......          656,189           746,689          662,902          664,465           +8,276          -82,224           +1,563 
Family planning................          193,349           198,982          193,349          193,349   ...............          -5,633   ...............
Rural health research..........            9,426             9,426   ...............          10,172             +746             +746          +10,172 
Health care facilities.........           10,000             2,000   ...............  ...............         -10,000           -2,000   ...............
Buildings and facilities.......              933               933              933              858              -75              -75              -75 
National practitioner data bank            9,000             6,000            6,000            6,000           -3,000   ...............  ...............
    User fees..................           -9,000            -6,000           -6,000           -6,000           +3,000   ...............  ...............
Program management \17\........          120,909           120,546          120,546          111,236           -9,673           -9,310           -9,310 
    Savings attributable to                                                                                                                             
     legislative proposal......  .................          (6,000)          (6,000)  ...............  ...............         (-6,000)         (-6,000)
Undistributed administrative                                                                                                                            
 reduction.....................  .................  ...............         -16,000   ...............  ...............  ...............         +16,000 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Health resources                                                                                                                           
       and services............        3,028,959         3,102,395        2,927,122        2,951,159          -77,800         -151,236          +24,037 
MEDICAL FACILITIES GUARANTEE                                                                                                                            
 AND LOAN FUND: Interest                                                                                                                                
 subsidy program...............            9,000             8,000            8,000            8,000           -1,000   ...............  ...............
HEALTH EDUCATION ASSISTANCE                                                                                                                             
 LOANS PROGRAM (HEAL):                                                                                                                                  
    New loan subsidies.........           22,050            18,044           13,500           13,500           -8,550           -4,544   ...............
    Liquidating account (non-                                                                                                                           
     add)......................          (17,990)          (42,000)         (42,000)         (42,000)        (+24,010)  ...............  ...............
    HEAL loan limitation (non-                                                                                                                          
     add)......................         (375,000)         (280,000)        (210,000)        (210,000)       (-165,000)        (-70,000)  ...............
    Program management.........            2,922             2,922            2,703            2,688             -234             -234              -15 
                                ------------------------------------------------------------------------------------------------------------------------
      Total, HEAL..............           24,972            20,966           16,203           16,188           -8,784           -4,778              -15 
                                                                                                                                                        
VACCINE INJURY COMPENSATION                                                                                                                             
 PROGRAM TRUST FUND:                                                                                                                                    
    Post-fiscal year 1988                                                                                                                               
     claims (trust fund).......           54,476            56,721           56,721           56,721           +2,245   ...............  ...............
    HRSA administration (trust                                                                                                                          
     fund).....................            3,000             3,000            3,000            3,000   ...............  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Vaccine injury                                                                                                                          
       compensation trust fund.           57,476            59,721           59,721           59,721           +2,245   ...............  ...............
VACCINE INJURY COMPENSATION:                                                                                                                            
 Pre-fiscal year 1989 claims                                                                                                                            
 (appropriation)...............          110,000           110,000          110,000          110,000   ...............  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Vaccine injury....          167,476           169,721          169,721          169,721           +2,245   ...............  ...............
                                ========================================================================================================================
      Total, Health Resources                                                                                                                           
       and Services Admin......        3,230,407         3,301,082        3,121,046        3,145,068          -85,339         -156,014          +24,022 
                                                                                                                                                        
  CENTERS FOR DISEASE CONTROL                                                                                                                           
                                                                                                                                                        
 DISEASE CONTROL, RESEARCH AND                                                                                                                          
            TRAINING                                                                                                                                    
Preventive Health Services                                                                                                                              
 Block Grant...................          157,918           154,338          157,918          132,918          -25,000          -21,420          -25,000 
Rape Prevention and Education                                                                                                                           
 (Non-Add).....................  .................  ...............         (35,000)         (35,000)        (+35,000)        (+35,000)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Preventive                                                                                                                              
       Health Services Block                                                                                                                            
       Grant...................          157,918           154,338          192,918          167,918          +10,000          +13,580          -25,000 
Prevention centers.............            7,724             7,724            7,724            8,224             +500             +500             +500 
Data initiative................  .................           6,000   ...............  ...............  ...............          -6,000   ...............
    1 percent evaluation funds                                                                                                                          
     (non-add).................  .................         (14,000)  ...............  ...............  ...............        (-14,000)  ...............
Immunization partnership grant                                                                                                                          
 (proposed legislation)........  .................         502,818   ...............  ...............  ...............        -502,818   ...............
Proposed legislation: Vaccine                                                                                                                           
 tax cut (non-add).............  .................        (-25,000)  ...............  ...............  ...............        (+25,000)  ...............
Childhood immunization.........          465,497    ...............         475,497          465,497   ...............        +465,497          -10,000 
HCFA vaccine purchase..........         (376,000)         (408,307)        (408,307)        (408,307)        (+32,307)  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, CDC/HCFA                                                                                                                                
       vaccine program.........         (841,497)         (408,307)        (883,804)        (873,804)        (+32,307)       (+465,497)        (-10,000)
1995 Vaccine rescission (non-                                                                                                                           
 add)..........................  .................  ...............  ...............        (-53,000)        (-53,000)        (-53,000)        (-53,000)
HIV/STD/TB partnership grant                                                                                                                            
 (proposed legislation)........  .................         848,331   ...............  ...............  ...............        -848,331   ...............
Acquired Immune Deficiency                                                                                                                              
 Syndrome (AIDS)...............          589,962    ...............         589,962          589,962   ...............        +589,962   ...............
Tuberculosis...................          119,582    ...............         119,582          119,582   ...............        +119,582   ...............
Sexually transmitted diseases..          105,242    ...............         110,242          106,242           +1,000         +106,242           -4,000 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Communicable                                                                                                                            
       diseases................          814,786           848,331          819,786          815,786           +1,000          -32,545           -4,000 
Chronic diseases partnership                                                                                                                            
 grant (proposed leg)..........  .................         243,498   ...............  ...............  ...............        -243,498   ...............
Chronic and environmental                                                                                                                               
 disease prevention............          139,754    ...............         150,000          139,754   ...............        +139,754          -10,246 
Breast and cervical cancer                                                                                                                              
 screening.....................          100,000    ...............         125,000          125,000          +25,000         +125,000   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Chronic                                                                                                                                 
       diseases................          239,754           243,498          275,000          264,754          +25,000          +21,256          -10,246 
Infectious disease.............           54,402            63,191           67,276           58,402           +4,000           -4,789           -8,874 
Lead poisoning prevention......           36,409            36,391           36,409           36,409   ...............             +18   ...............
Injury control.................           43,679            44,661           43,679           43,679   ...............            -982   ...............
Occupational Safety and Health                                                                                                                          
 (NIOSH):                                                                                                                                               
    Research...................          119,222           124,186           99,222          124,186           +4,964   ...............         +24,964 
    Training...................           12,898            12,898   ...............          12,898   ...............  ...............         +12,898 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, NIOSH..........          132,120           137,084           99,222          137,084           +4,964   ...............         +37,862 
Epidemic services..............           73,325            73,318           73,325           73,325   ...............              +7   ...............
National Center for Health                                                                                                                              
 Statistics:                                                                                                                                            
    Program operations.........           53,575            53,564           53,575           40,063          -13,512          -13,501          -13,512 
    1 percent evaluation funds                                                                                                                          
     (non-add).................          (27,862)          (27,862)         (27,862)         (40,063)        (+12,201)        (+12,201)        (+12,201)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, health                                                                                                                                  
       statistics..............           53,575            53,564           53,575           40,063          -13,512          -13,501          -13,512 
Buildings and facilities.......            3,575             3,575            4,353            4,575           +1,000           +1,000             +222 
Program management.............            3,067             3,067            3,067            3,067   ...............  ...............  ...............
Savings attributable to                                                                                                                                 
 legislative proposal..........  .................           6,000   ...............  ...............  ...............          -6,000   ...............
Undistributed administrative                                                                                                                            
 reduction.....................  .................  ...............         -31,000          -31,000          -31,000          -31,000   ...............
                                ========================================================================================================================
      Subtotal, Disease Control        2,085,831         2,183,560        2,085,831        2,052,783          -33,048         -130,777          -33,048 
Crime Bill Activities:                                                                                                                                  
    Rape prevention and                                                                                                                                 
     education.................  .................          35,000           35,000           35,000          +35,000   ...............  ...............
    Domestic violence community                                                                                                                         
     demonstrations............  .................           4,000            4,000            4,000           +4,000   ...............  ...............
    Crime victim study.........  .................             100              100              100             +100   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Crime bill                                                                                                                              
       activities..............  .................          39,100           39,100           39,100          +39,100   ...............  ...............
                                ========================================================================================================================
      Total, Disease Control...        2,085,831         2,222,660        2,124,931        2,091,883           +6,052         -130,777          -33,048 
                                                                                                                                                        
 NATIONAL INSTITUTES OF HEALTH                                                                                                                          
National Cancer Institute......        1,917,904         1,994,007        2,251,084        1,972,757          +54,853          -21,250         -278,327 
    Transfer, Office of AIDS                                                                                                                            
     Research..................         (218,504)         (225,790)  ...............        (222,719)         (+4,215)         (-3,071)       (+222,719)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................       (2,136,408)       (2,219,797)      (2,251,084)      (2,195,476)        (+59,068)        (-24,321)        (-55,608)
National Heart, Lung, and Blood                                                                                                                         
 Institute \18\................        1,241,547         1,279,096        1,355,866        1,266,465          +24,918          -12,631          -89,401 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (55,485)          (57,925)  ...............         (57,137)         (+1,652)           (-788)        (+57,137)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................       (1,297,032)       (1,337,021)      (1,355,866)      (1,323,602)        (+26,570)        (-13,419)        (-32,264)
National Institute of Dental                                                                                                                            
 Research......................          163,468           168,341          183,196          166,547           +3,079           -1,794          -16,649 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (11,745)          (12,309)  ...............         (12,142)           (+397)           (-167)        (+12,142)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (175,213)         (180,650)        (183,196)        (178,689)         (+3,476)         (-1,961)         (-4,507)
National Institute of Diabetes                                                                                                                          
 and Digestive and Kidney                                                                                                                               
 Diseases......................          726,274           748,798          771,252          740,818          +14,544           -7,980          -30,434 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (10,752)          (11,735)  ...............         (11,575)           (+823)           (-160)        (+11,575)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (737,026)         (760,533)        (771,252)        (752,393)        (+15,367)         (-8,140)        (-18,859)
National Institute of                                                                                                                                   
 Neurological Disorders and                                                                                                                             
 Stroke........................          629,463           648,255          681,534          641,347          +11,884           -6,908          -40,187 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (22,741)          (23,807)  ...............         (23,483)           (+742)           (-324)        (+23,483)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (652,204)         (672,062)        (681,534)        (664,830)        (+12,626)         (-7,232)        (-16,704)
National Institute of Allergy                                                                                                                           
 and Infectious Diseases.......          538,046           557,354        1,169,628          551,414          +13,368           -5,940         -618,214 
    Transfer, Office of AIDS                                                                                                                            
     Research..................         (558,411)         (596,018)  ...............        (587,912)        (+29,501)         (-8,106)       (+587,912)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................       (1,096,457)       (1,153,372)      (1,169,628)      (1,139,326)        (+42,869)        (-14,046)        (-30,302)
National Institute of General                                                                                                                           
 Medical Sciences..............          880,261           907,674          946,971          898,001          +17,740           -9,673          -48,970 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (24,664)          (26,135)  ...............         (25,780)         (+1,116)           (-355)        (+25,780)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (904,925)         (933,809)        (946,971)        (923,781)        (+18,856)        (-10,028)        (-23,190)
National Institute of Child                                                                                                                             
 Health and Human Development..          510,156           526,177          595,162          520,570          +10,414           -5,607          -74,592 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (58,667)          (60,713)  ...............         (59,887)         (+1,220)           (-826)        (+59,887)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (568,823)         (586,890)        (595,162)        (580,457)        (+11,634)         (-6,433)        (-14,705)
National Eye Institute.........          291,957           300,693          314,185          297,489           +5,532           -3,204          -16,696 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (8,633)           (9,125)  ...............          (9,001)           (+368)           (-124)         (+9,001)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (300,590)         (309,818)        (314,185)        (306,490)         (+5,900)         (-3,328)         (-7,695)
National Institute of                                                                                                                                   
 Environmental Health Sciences.          266,988           278,832          288,898          275,861           +8,873           -2,971          -13,037 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (5,745)           (6,051)  ...............          (5,969)           (+224)            (-82)         (+5,969)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (272,733)         (284,883)        (288,898)        (281,830)         (+9,097)         (-3,053)         (-7,068)
National Institute on Aging....          432,865           445,823          453,917          441,072           +8,207           -4,751          -12,845 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (1,715)           (1,785)  ...............          (1,761)            (+46)            (-24)         (+1,761)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (434,580)         (447,608)        (453,917)        (442,833)         (+8,253)         (-4,775)        (-11,084)
National Institute of Arthritis                                                                                                                         
 and Musculoskeletal and Skin                                                                                                                           
 Diseases......................          228,520           235,428          241,828          232,919           +4,399           -2,509           -8,909 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (2,879)           (3,039)  ...............          (2,998)           (+119)            (-41)         (+2,998)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (231,399)         (238,467)        (241,828)        (235,917)         (+4,518)         (-2,550)         (-5,911)
National Institute on Deafness                                                                                                                          
 and Other Communication                                                                                                                                
 Disorders.....................          167,381           172,399          176,502          170,562           +3,181           -1,837           -5,940 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (1,552)           (1,650)  ...............          (1,628)            (+76)            (-22)         (+1,628)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (168,933)         (174,049)        (176,502)        (172,190)         (+3,257)         (-1,859)         (-4,312)
National Institute of Nursing                                                                                                                           
 Research......................           48,180            50,159           55,831           49,624           +1,444             -535           -6,207 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (4,577)           (4,896)  ...............          (4,829)           (+252)            (-67)         (+4,829)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................          (52,757)          (55,055)         (55,831)         (54,453)         (+1,696)           (-602)         (-1,378)
National Institute on Alcohol                                                                                                                           
 Abuse and Alcoholism..........          180,326           185,712          198,607          183,733           +3,407           -1,979          -14,874 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (9,741)          (10,135)  ...............          (9,997)           (+256)           (-138)         (+9,997)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (190,067)         (195,847)        (198,607)        (193,730)         (+3,663)         (-2,117)         (-4,877)
National Institute on Drug                                                                                                                              
 Abuse.........................          290,041           298,738          458,441          295,554           +5,513           -3,184         -162,887 
    Transfer, Office of AIDS                                                                                                                            
     Research..................         (147,402)         (153,331)  ...............        (151,246)         (+3,844)         (-2,085)       (+151,246)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (437,443)         (452,069)        (458,441)        (446,800)         (+9,357)         (-5,269)        (-11,641)
National Institute of Mental                                                                                                                            
 Health........................          541,840           558,580          661,328          553,127          +11,287           -5,453         -108,201 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (89,435)          (93,556)  ...............         (92,284)         (+2,849)         (-1,272)        (+92,284)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (631,275)         (652,136)        (661,328)        (645,411)        (+14,136)         (-6,725)        (-15,917)
National Center for Research                                                                                                                            
 Resources \19\................          284,737           307,544          390,339          304,267          +19,530           -3,277          -86,072 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (64,630)          (68,370)  ...............         (67,440)         (+2,810)           (-930)        (+67,440)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (349,367)         (375,914)        (390,339)        (371,707)        (+22,340)         (-4,207)        (-18,632)
National Center for Human                                                                                                                               
 Genome Research...............          151,866           166,678          170,041          164,902          +13,036           -1,776           -5,139 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (1,000)           (1,000)  ...............            (986)            (-14)            (-14)           (+986)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (152,866)         (167,678)        (170,041)        (165,888)        (+13,022)         (-1,790)         (-4,153)
John E. Fogarty International                                                                                                                           
 Center........................           14,667            15,267           25,313           15,104             +437             -163          -10,209 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (9,108)           (9,694)  ...............          (9,562)           (+454)           (-132)         (+9,562)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................          (23,775)          (24,961)         (25,313)         (24,666)           (+891)           (-295)           (-647)
National Library of Medicine...          125,748           136,311          141,439          134,858           +9,110           -1,453           -6,581 
    Transfer, Office of AIDS                                                                                                                            
     Research..................           (2,946)           (3,162)  ...............          (3,119)           (+173)            (-43)         (+3,119)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (128,694)         (139,473)        (141,439)        (137,977)         (+9,283)         (-1,496)         (-3,462)
Office of the Director.........          214,465           230,256          261,488          233,151          +18,686           +2,895          -28,337 
    Transfer, Office of AIDS                                                                                                                            
     Research..................          (25,394)          (27,598)  ...............         (27,223)         (+1,829)           (-375)        (+27,223)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal.................         (239,859)         (257,854)        (261,488)        (260,374)        (+20,515)         (+2,520)         (-1,114)
Buildings and facilities.......          114,120           144,120          146,151          140,384          +26,264           -3,736           -5,767 
Office of AIDS Research........        1,335,726         1,407,824   ...............       1,388,678          +52,952          -19,146       +1,388,678 
                                ========================================================================================================================
      Subtotal, N.I.H..........       11,296,546        11,764,066       11,939,001       11,639,204         +342,658         -124,862         -299,797 
Administrative reduction.......  .................  ...............  ...............         -41,665          -41,665          -41,665          -41,665 
                                ========================================================================================================================
      Total N.I.H..............       11,296,546        11,764,066       11,939,001       11,597,539         +300,993         -166,527         -341,462 
                                ========================================================================================================================
                                                                                                                                                        
   SUBSTANCE ABUSE AND MENTAL                                                                                                                           
 HEALTH SERVICES ADMINISTRATION                                                                                                                         
Consolidated mental health and                                                                                                                          
 substance abuse demos.........  .................  ...............         141,889   ...............  ...............  ...............        -141,889 
Center for Mental Health                                                                                                                                
 Services:                                                                                                                                              
    Proposed legis: Mental                                                                                                                              
     Health Demonstrations.....  .................          53,092   ...............  ...............  ...............         -53,092   ...............
    Mental Health Block Grant..          275,420           304,617          275,420          226,281          -49,139          -78,336          -49,139 
    Children's mental health...           60,000            60,000           60,000           58,326           -1,674           -1,674           -1,674 
    Clinical training/AIDS                                                                                                                              
     training..................            5,394    ...............  ...............  ...............          -5,394   ...............  ...............
    Community support                                                                                                                                   
     demonstrations............           24,184    ...............  ...............  ...............         -24,184   ...............  ...............
    Grants to States for the                                                                                                                            
     homeless (PATH)...........           29,462    ...............  ...............          27,105           -2,357          +27,105          +27,105 
    Homeless services                                                                                                                                   
     demonstrations............           21,227    ...............  ...............  ...............         -21,227   ...............  ...............
    Protection and advocacy....           21,957            21,760           19,500           20,200           -1,757           -1,560             +700 
    AIDS demonstrations........            1,487    ...............           1,487   ...............          -1,487   ...............          -1,487 
    Consolidated Mental Health                                                                                                                          
     Demos.....................  .................  ...............  ...............          38,100          +38,100          +38,100          +38,100 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, mental health..          439,131           439,469          356,407          370,012          -69,119          -69,457          +13,605 
Center for Substance Abuse                                                                                                                              
 Treatment:                                                                                                                                             
    Proposed legis:                                                                                                                                     
     Consolidated Demos/                                                                                                                                
     Treatment.................  .................         236,694   ...............  ...............  ...............        -236,694   ...............
    Consolidated Demos.........  .................  ...............  ...............         108,300         +108,300         +108,300         +108,300 
    Substance abuse block grant                                                                                                                         
     \20\......................        1,234,107         1,294,107        1,234,107        1,125,807         -108,300         -168,300         -108,300 
    Treatment grants to crisis                                                                                                                          
     areas.....................           35,520    ...............  ...............  ...............         -35,520   ...............  ...............
    Treatment improvement                                                                                                                               
     demos:                                                                                                                                             
        Pregnant/post partum                                                                                                                            
         women and children....           54,228    ...............  ...............  ...............         -54,228   ...............  ...............
            Transfer from                                                                                                                               
             forfeiture fund                                                                                                                            
             (non-add).........          (10,000)   ...............  ...............  ...............        (-10,000)  ...............  ...............
        Criminal justice                                                                                                                                
         program...............           37,502    ...............  ...............  ...............         -37,502   ...............  ...............
        Designated populations.           23,561    ...............  ...............  ...............         -23,561   ...............  ...............
        Comprehensive community                                                                                                                         
         treatment program.....           27,277    ...............  ...............  ...............         -27,277   ...............  ...............
            Transfer from                                                                                                                               
             forfeiture fund                                                                                                                            
             (non-add).........           (4,000)   ...............  ...............  ...............         (-4,000)  ...............  ...............
        Training...............            5,590    ...............  ...............  ...............          -5,590   ...............  ...............
    AIDS demonstration and                                                                                                                              
     training:                                                                                                                                          
        Training...............            2,787    ...............  ...............  ...............          -2,787   ...............  ...............
        Linkage................            7,739    ...............  ...............  ...............          -7,739   ...............  ...............
        Outreach...............            7,500    ...............  ...............  ...............          -7,500   ...............  ...............
    Treatment capacity                                                                                                                                  
     expansion program \20\....            6,701    ...............  ...............  ...............          -6,701   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Substance Abuse                                                                                                                         
       Treatment...............        1,442,512         1,530,801        1,234,107        1,234,107         -208,405         -296,694   ...............
Center for Substance Abuse                                                                                                                              
 Prevention:                                                                                                                                            
    Proposed legis:                                                                                                                                     
     Consolidated Demos/                                                                                                                                
     Prevention................  .................         216,080   ...............           9,571           +9,571         -206,509           +9,571 
        (Transfer from DOE)                                                                                                                             
         \21\ (non-add)........  .................  ...............  ...............        (200,000)       (+200,000)       (+200,000)       (+200,000)
    Prevention demonstrations:                                                                                                                          
        High risk youth........           65,160    ...............  ...............  ...............         -65,160   ...............  ...............
        Pregnant women and                                                                                                                              
         infants...............           22,501    ...............  ...............  ...............         -22,501   ...............  ...............
        Other programs.........            6,643    ...............  ...............  ...............          -6,643   ...............  ...............
    Community partnership......          114,741    ...............  ...............  ...............        -114,741   ...............  ...............
    Prevention education/                                                                                                                               
     dissemination.............           13,465    ...............  ...............  ...............         -13,465   ...............  ...............
    Training...................           16,049    ...............  ...............  ...............         -16,049   ...............  ...............
    Consolidated Demos.........  .................  ...............  ...............  ...............  ...............  ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Substance Abuse                                                                                                                         
       Prevention..............          238,559           216,080   ...............           9,571         -228,988         -206,509           +9,571 
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Abuse                                                                                                                                   
       Prevention program level         (238,559)         (216,080)  ...............        (209,571)        (-28,988)         (-6,509)       (+209,571)
Program management.............           61,128            58,042           56,543           56,238           -4,890           -1,804             -305 
Savings attributable to                                                                                                                                 
 legislative proposal..........  .................           3,000   ...............  ...............  ...............          -3,000   ...............
                                ========================================================================================================================
      Total, Substance Abuse                                                                                                                            
       and Mental Health.......        2,181,330         2,247,392        1,788,946        1,669,928         -511,402         -577,464         -119,018 
                                                                                                                                                        
 ASSISTANT SECRETARY FOR HEALTH                                                                                                                         
              \22\                                                                                                                                      
                                                                                                                                                        
    OFFICE OF THE ASSISTANT                                                                                                                             
      SECRETARY FOR HEALTH                                                                                                                              
                                                                                                                                                        
Population affairs: Adolescent                                                                                                                          
 family life...................            6,698             6,144   ...............  ...............          -6,698           -6,144   ...............
Health Initiatives:                                                                                                                                     
    Office of Disease                                                                                                                                   
     Prevention and Health                                                                                                                              
     Promotion.................            4,604             4,601   ...............  ...............          -4,604           -4,601   ...............
    Physical fitness and sports                                                                                                                         
     \22\......................            1,407             1,406   ...............  ...............          -1,407           -1,406   ...............
    Minority health \22\.......           20,631            20,592   ...............  ...............         -20,631          -20,592   ...............
National vaccine program.......              996               995   ...............  ...............            -996             -995   ...............
Office of research integrity                                                                                                                            
 \22\..........................            3,863             3,858   ...............  ...............          -3,863           -3,858   ...............
Office of Women's Health \22\..            2,562             2,552   ...............  ...............          -2,562           -2,552   ...............
Emergency preparedness \23\....            2,180             2,374   ...............  ...............          -2,180           -2,374   ...............
Health care reform data                                                                                                                                 
 analysis......................            1,344    ...............  ...............  ...............          -1,344   ...............  ...............
Data development program \24\..  .................           3,856   ...............  ...............  ...............          -3,856   ...............
Health Service Management \22\                                                                                                                          
 \25\..........................           18,432            17,304   ...............  ...............         -18,432          -17,304   ...............
    Streamlining costs.........            1,500               785   ...............  ...............          -1,500             -785   ...............
National AIDS program office...            1,742             1,739   ...............  ...............          -1,742           -1,739   ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, OASH..............           65,959            66,206   ...............  ...............         -65,959          -66,206   ...............
                                                                                                                                                        
   RETIREMENT PAY AND MEDICAL                                                                                                                           
   BENEFITS FOR COMMISSIONED                                                                                                                            
            OFFICERS                                                                                                                                    
                                                                                                                                                        
Retirement payments............          124,213           129,808          129,808          129,808           +5,595   ...............  ...............
Survivors benefits.............            8,826             9,208            9,208            9,208             +382   ...............  ...............
Dependent's medical care.......           23,844            25,108           25,108           25,108           +1,264   ...............  ...............
Military Services Credits......            2,438             2,801            2,801            2,801             +363   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Retirement pay and                                                                                                                         
       medical benefits........          159,321           166,925          166,925          166,925           +7,604   ...............  ...............
                                                                                                                                                        
 AGENCY FOR HEALTH CARE POLICY                                                                                                                          
          AND RESEARCH                                                                                                                                  
                                                                                                                                                        
Health services research:                                                                                                                               
    Research...................           57,345            63,433           12,681           35,000          -22,345          -28,433          +22,319 
    1 percent evaluation                                                                                                                                
     funding (non-add).........          (18,300)          (39,284)         (34,284)         (34,284)        (+15,984)         (-5,000)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal including trust                                                                                                                          
       funds and 1 percent                                                                                                                              
       funds...................          (75,645)         (102,717)         (46,965)         (69,284)         (-6,361)        (-33,433)        (+22,319)
Medical treatment                                                                                                                                       
 effectiveness:                                                                                                                                         
    Federal funds..............           75,640            76,568           18,115           25,000          -50,640          -51,568           +6,885 
    Trust funds................           (5,796)           (5,796)  ...............          (5,796)  ...............  ...............         (+5,796)
    1 percent evaluation                                                                                                                                
     funding (non-add).........  .................          (6,000)  ...............         (25,000)        (+25,000)        (+19,000)        (+25,000)
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Medical                                                                                                                                 
       treatment effectiveness.          (81,436)          (88,364)         (18,115)         (55,796)        (-25,640)        (-32,568)        (+37,681)
Program support................            2,424             2,423            2,423            2,230             -194             -193             -193 
Administrative reduction.......  .................  ...............          -2,000   ...............  ...............  ...............          +2,000 
                                ========================================================================================================================
      Total, Health Care Policy                                                                                                                         
       and Research:                                                                                                                                    
          Federal Funds........          135,409           142,424           31,219           62,230          -73,179          -80,194          +31,011 
          Trust funds..........           (5,796)           (5,796)  ...............          (5,796)  ...............  ...............         (+5,796)
          Total, 1 percent                                                                                                                              
           evaluation funding                                                                                                                           
           (non-add)...........          (18,300)          (45,284)         (34,284)         (59,284)        (+40,984)        (+14,000)        (+25,000)
      Total, Health Care Policy                                                                                                                         
       and Research (non-add)..         (159,505)         (193,504)         (65,503)        (127,310)        (-32,195)        (-66,194)        (+61,807)
                                ========================================================================================================================
      Total, Public Health                                                                                                                              
       Service:                                                                                                                                         
          Federal Funds........       19,154,803        19,910,755       19,172,068       18,733,573         -421,230       -1,177,182         -438,495 
          Trust funds..........           (5,796)           (5,796)  ...............          (5,796)  ...............  ...............         (+5,796)
                                ========================================================================================================================
     HEALTH CARE FINANCING                                                                                                                              
         ADMINISTRATION                                                                                                                                 
                                                                                                                                                        
 GRANTS TO STATES FOR MEDICAID                                                                                                                          
                                                                                                                                                        
Medicaid current law benefits..       84,835,700        92,235,200       92,235,200       92,235,200       +7,399,500   ...............  ...............
Excess benefit budget authority        7,657,598    ...............  ...............  ...............      -7,657,598   ...............  ...............
State and local administration.        3,602,660         3,742,000        3,742,000        3,742,000         +139,340   ...............  ...............
Excess admin budget authority..          294,891    ...............  ...............  ...............        -294,891   ...............  ...............
Proposed legislation: Vaccine                                                                                                                           
 tax cut (non-add).............  .................        (-46,800)  ...............  ...............  ...............        (+46,800)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, Medicaid                                                                                                                                
       program level, fiscal                                                                                                                            
       year 1996...............       96,390,849        95,977,200       95,977,200       95,977,200         -413,649   ...............  ...............
      Carryover balance........       -7,150,074       -13,835,128      -13,835,128      -13,835,128       -6,685,054   ...............  ...............
      Less funds advanced in                                                                                                                            
       prior year..............      -26,600,000       -27,047,717      -27,047,717      -27,047,717         -447,717   ...............  ...............
                                ========================================================================================================================
      Total, request, fiscal                                                                                                                            
       year 1996...............       62,640,775        55,094,355       55,094,355       55,094,355       -7,546,420   ...............  ...............
          New advance, 1st                                                                                                                              
           quarter, fiscal year                                                                                                                         
           1997................       27,047,717        26,155,350       26,155,350       26,155,350         -892,367   ...............  ...............
                                ========================================================================================================================
                                                                                                                                                        
 PAYMENTS TO HEALTH CARE TRUST                                                                                                                          
             FUNDS                                                                                                                                      
                                                                                                                                                        
Supplemental medical insurance.       36,955,000        55,385,000       55,385,000       55,385,000      +18,430,000   ...............  ...............
Hospital insurance for the                                                                                                                              
 uninsured.....................          406,000           358,000          358,000          358,000          -48,000   ...............  ...............
Federal uninsured payment......           56,000            63,000           63,000           63,000           +7,000   ...............  ...............
DOD adjustment.................  .................         625,000          625,000          625,000         +625,000   ...............  ...............
SMI lapses.....................  .................       6,737,000        6,737,000        6,737,000       +6,737,000   ...............  ...............
Program management.............          129,758           145,000          145,000          145,000          +15,242   ...............  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Total, Payment to Trust                                                                                                                           
       Funds, current law......       37,546,758        63,313,000       63,313,000       63,313,000      +25,766,242   ...............  ...............
                                                                                                                                                        
       PROGRAM MANAGEMENT                                                                                                                               
                                                                                                                                                        
Research, demonstration, and                                                                                                                            
 evaluation:                                                                                                                                            
    Regular program, trust                                                                                                                              
     funds.....................          (45,146)          (58,000)         (40,000)         (40,000)         (-5,146)        (-18,000)  ...............
    Counseling program.........           (4,536)           (4,500)  ...............          (4,500)            (-36)  ...............         (+4,500)
    Rural hospital transition                                                                                                                           
     demonstrations, trust                                                                                                                              
     funds.....................          (17,584)   ...............         (10,000)         (16,177)         (-1,407)        (+16,177)         (+6,177)
    Essential access community                                                                                                                          
     hospitals, trust funds....           (2,000)   ...............  ...............  ...............         (-2,000)  ...............  ...............
    New rural health grants....              (37)           (2,000)  ...............  ...............            (-37)         (-2,000)  ...............
                                ------------------------------------------------------------------------------------------------------------------------
      Subtotal, research,                                                                                                                               
       demonstration, and                                                                                                                               
       evaluation..............          (69,303)          (64,500)         (50,000)         (60,677)         (-8,626)         (-3,823)        (+10,677)
Medicare Contractors (Trust                                                                                                                             
 Funds)........................       (1,609,671)       (1,631,100)      (1,604,767)      (1,584,767)        (-24,904)        (-46,333)        (-20,000)
State Survey and Certification:                                                                                                                         
    Medicare certification,                                                                                                                             
     trust funds...............         (145,800)         (162,100)        (152,000)        (134,500)        (-11,300)        (-27,600)        (-17,500)
    Proposed legislation.......  .................         (-8,800)  ...............  ...............  ...............         (+8,800)  ...............
Federal Administration:                                                                                                                                 
    Trust funds................         (354,394)         (396,222)        (354,394)        (354,394)  ...............        (-41,828)  ...............
    Less current law user fees.            (-124)            (-128)           (-128)           (-128)             (-4)  ...............  ...............
                                ========================================================================================================================
      Subtotal, Federal                                                                                                                                 
       Administration..........         (354,270)         (396,094)        (354,266)        (354,266)             (-4)        (-41,828)  ...............
Undistributed administrative                                                                                                                            
 reduction.....................  .................  ...............        (-26,500)        (-28,341)        (-28,341)        (-28,341)         (-1,841)
                                ========================================================================================================================
      Total, Program management       (2,179,044)       (2,253,794)      (2,134,533)      (2,105,869)        (-73,175)       (-147,925)        (-28,664)
                                ========================================================================================================================
PROPOSED LEG: UNDOCUMENTED                                                                                                                              
 ALIENS ASSISTANCE (NON-ADD)                                                                                                                            
 \26\..........................  .................        (150,000)  ...............  ...............  ...............       (-150,00