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                                                       Calendar No. 589
104th Congress                                                   Report
                                 SENATE

   2d Session                                                   104-368
_______________________________________________________________________


 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION AND 
               RELATED AGENCIES APPROPRIATION BILL, 1997

                                _______
                                

               September 12, 1996.--Ordered to be printed

_______________________________________________________________________


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

                              R E P O R T

                        [To accompany H.R. 3755]

    The Committee on Appropriations, to which was referred the 
bill (H.R. 3755) making appropriations for the Departments of 
Labor, Health and Human Services, and Education and related 
agencies for the fiscal year ending September 30, 1997, and for 
other purposes, reports the same to the Senate with amendments 
and recommends that the bill as amended do pass.


Amount of budget authority

Amount of House bill....................................$285,217,745,000
Amount of Senate bill under House bill..................      22,925,000
                    --------------------------------------------------------
                    ____________________________________________________
      Total bill as reported to Senate.................. 285,194,820,000
Amount of adjusted appropriations, 1996................. 263,772,305,000
Budget estimates, 1997.................................. 293,595,292,000
The bill as reported to the Senate:
    Over the adjusted appropriations for 1996...........  21,422,515,000
    Under the budget estimates for 1997.................   8,400,472,000


                            C O N T E N T S

                              ----------                              
                                                                   Page
Budget estimates.................................................     4
Title I--Department of Labor:
    Employment and Training Administration.......................     7
    Pension and Welfare Benefits Administration..................    22
    Pension Benefit Guaranty Corporation.........................    22
    Employment Standards Administration..........................    23
    Occupational Safety and Health Administration................    26
    Mine Safety and Health Administration........................    27
    Bureau of Labor Statistics...................................    28
    Departmental management......................................    29
    Assistant Secretary for Veterans' Employment and Training....    30
    Office of the Inspector General..............................    31
Title II--Department of Health and Human Services:
    Health Resources and Services Administration.................    32
    Centers for Disease Control and Prevention...................    51
    National Institutes of Health................................    69
    Substance Abuse and Mental Health Services Administration....   125
    Agency for Health Care Policy and Research...................   131
    Health Care Financing Administration.........................   133
    Administration for Children and Families.....................   140
    Administration on Aging......................................   156
    Office of the Secretary......................................   159
Title III--Department of Education:
    Education reform.............................................   168
    Education for the Disadvantaged..............................   169
    Impact aid...................................................   173
    School improvement programs..................................   174
    Bilingual and immigrant education............................   179
    Special education............................................   181
    Rehabilitation services and disability research..............   185
    Special institutions for persons with disabilities:
        American Printing House for the Blind....................   190
        National Technical Institute for the Deaf................   190
        Gallaudet University.....................................   191
    Vocational and adult education...............................   191
    Student financial assistance.................................   194
    Federal family education loan program........................   196
    Higher education.............................................   196
    Howard University............................................   203
    College housing and academic facilities loans................   204
    Historically black college and university capital financing 
      program....................................................   204
    Education research, statistics, and improvement..............   205
    Libraries....................................................   212
    Departmental management......................................   214
    Office for Civil Rights......................................   215
    Office of the Inspector General..............................   215
Title IV--Related agencies:
    Armed Forces Retirement Home.................................   217
    Corporation for National and Community Service...............   217
    Corporation for Public Broadcasting..........................   219
    Federal Mediation and Conciliation Service...................   219
    Federal Mine Safety and Health Review Commission.............   219
    National Commission on Libraries and Information Science.....   220
    National Council on Disability...............................   220
    National Labor Relations Board...............................   221
    National Mediation Board.....................................   221
    Occupational Safety and Health Review Commission.............   221
    Physician Payment Review Commission..........................   222
    Prospective Payment Assessment Commission....................   222
    Railroad Retirement Board....................................   223
    Social Security Administration...............................   224
    U.S. Institute of Peace......................................   228
Title V--General provisions......................................   230
Budgetary impact of bill.........................................   232
Compliance with standing rules of the Senate.....................   232
Comparative statement of new budget authority....................   242
       Summary of Budget Estimates and Committee Recommendations

    For fiscal year 1997, the Committee recommends total 
current year budget authority of $285,194,820,000 for the 
Department of Labor, Health and Human Services, and Education, 
and Related Agencies. Of this amount, $65,898,000,000 is 
discretionary and $219,296,820,000 is mandatory funding.

                           allocation ceiling

    Consistent with Congressional Budget Office scorekeeping, 
the recommendations result in full use of the $65,723,000,000 
in discretionary budget authority pursuant to section 602(b) of 
the Congressional Budget Act of 1974, as amended. In addition, 
the recommendations include $175,000,000 in budget authority 
for the Social Security Administration to conduct continuing 
disability reviews provided consistent with Public Law 104-124 
and Public Law 104-193.

                         Highlights of the Bill

    Drug abuse.--A total of $2,497,821,000 is included for drug 
abuse prevention treatment, and research activities, an 
increase of 6.8 percent over the amount provided in 1996, 
including $556,000,000 for safe and drug free schools and 
communities, an increase of $90,000,000 over 1996.
    Crime activities.--The bill recommends $123,000,000 for 
violent crime reduction activities, more than double the 1996 
enacted level and the House allowance; included is $60,000,000 
for battered women's shelters.
    Teen pregnancy prevention initiative.--The bill includes 
$11,000,000 for teen pregnancy prevention initiatives, 
combining activities of the Centers for Disease Control, family 
planning, and adolescent family life programs.
    Pell grants.--The Committee bill includes $5,342,000,000 
for the Federal Pell Grant Program. The amount provided will 
allow the increase in the maximum Pell grant to be raised to 
$2,500, an increase of $30 over the 1996 amount.
    Education for individuals with disabilities.--The Committee 
bill provides $3,262,315,000 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 
$2,516,447,000 for rehabilitation programs, an increase of 
$60,355,000 above the amount provided in 1996. These funds are 
essential for individuals with disabilities seeking employment.
    Family planning.--The Committee bill recommends by the last 
request level $198,452,000, for the family planning program. 
These funds support primary health care services at over 4,000 
clinics nationwide.
    National Institutes of Health.--The Committee bill includes 
$12,414,580,000 for the National Institutes of Health, an 
increase of $487,018,000 above the amount provided in 1996.
    Grants for disadvantaged children.--The Committee bill 
provides $6,730,348,000 for grants to disadvantaged children, 
the same as the 1996 level.
    Services for older Americans.--The Committee recommendation 
includes $1,336,009,000 for programs authorized under the Older 
Americans Act, including $469,874,000 for nutrition services 
and $373,000,000 for employment programs.
    Head Start.--The Committee recommendation of $3,600,000,000 
for the Head Start Program represents an increase of 
$30,671,000 over the 1996 enacted level.
    Womens health.--The Committee bill provides $12,500,000 for 
programs focused on prevention and education and the 
advancement of women's health initiatives.
    Breast cancer screening.--The Committee bill provides 
$139,670,000, an increase of $15,000,000 over the 1996 level.
    AIDS.--The Committee bill provides $1,460,312,000, an 
increase of $28,404,000 over the budget request for AIDS 
research at the National Institutes of Health. The bill also 
includes $854,252,000 for Ryan White programs, an increase of 
$96,850,000, and $589,080,000 for AIDS prevention programs at 
the Centers for Disease Control and Prevention.
    Rape prevention.--The bill provides $35,000,000 for rape 
prevention programs at the Centers for Disease Control and 
Prevention, an increase of $6,458,000 over 1996.
    Low-income home energy assistance.--The Committee 
recommendation includes $1,000,000,000 for heating and cooling 
assistance for this coming year. The Committee has also 
recommended $1,000,000,000 for the fiscal year 1998 advance 
appropriation. Also included is bill language permitting up to 
$300,000,000 in additional funding to meet emergencies.
    Community services block grant.--The Committee bill 
includes $414,600,000, a 6-percent increase over 1996 for the 
community services block grant program.
    Child care and development block grant.--The Committee 
recommendation provides $956,120,000 for child care services, 
compared to $934,642,000 in the 1996 appropriation. This is in 
addition to the $1,967,000,000 appropriated in recently enacted 
welfare reform legislation for child care.
    Infectious disease.--The Committee bill recommends 
$86,153,000 within the Centers for Disease Control and 
Prevention to combat the growing threat of infectious disease. 
The amount recommended is an increase of 39 percent over the 
fiscal year 1996 amount.
    Social Security Administration.--The Committee bill 
recommends $6,357,198,000, an increase of nearly $500,000,000 
over the 1996 level, which expands both the automation and 
disability initiatives at the Social Security Administration.
    Job Corps.--The Committee bill provides $1,138,685,000 for 
the Job Corps, an increase of $44,743,000 over the 1996 level.
    School-to-work.--The bill includes $360,000,000 for school-
to-work programs, an increase of $10,000,000 over the 1996 
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 justification.
    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.
    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.

                           transfer authority

    The Committee has included bill language permitting 
transfers up to 1 percent between discretionary appropriations 
accounts, as long as no such appropriation is increased by more 
than 3 percent by such transfer; however, the Appropriations 
Committees of both Houses of Congress must be notified at least 
15 days in advance of any transfer. Similar bill language was 
carried in last year's bill for the Department of Labor, and 
has been included in both House and Senate versions of this 
year's Labor-HHS-Education bill for all three Departments.
    Prior Committee notification is also required for actions 
requiring the use of general transfer authority 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.
                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

Appropriations, 1996....................................  $4,146,278,000
Budget estimate, 1997...................................   5,080,060,000
House allowance.........................................   4,166,482,000

Committee recommendation

                                                           4,202,739,000

    The Committee recommends $4,202,739,000 for this account 
which provides funding authorized primarily by the Job Training 
Partnership Act [JTPA]. This is $36,257,000 more than the House 
allowance and $56,461,000 more than the 1996 level.
    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 forward-funded on a July to June cycle. Funds 
provided for fiscal year 1997 will support the program from 
July 1, 1997 through June 30, 1998.
    Adult training--title II-A.--For the Adult Training Program 
under title II-A of the JTPA, the Committee recommends 
$845,000,000. This is $102,000,000 less than the budget 
request, the same as the House allowance, and $5,000,000 less 
than the 1996 comparable level. The Adult Training Program is 
designed to prepare economically disadvantaged 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.
    To promote greater flexibility in local decisionmaking, the 
Committee has included bill language that allows service 
delivery areas to transfer funds provided between the title II-
A Adult Training Program and title III Dislocated Worker 
Assistance Program, if such transfer is approved by the 
Governor. The Committee is aware of concerns that work 
participation requirements under welfare reform legislation 
could foster such transfers to the detriment of services 
available to dislocated workers. The Committee is also aware of 
concerns that national reserve account funds may be used to 
provide services that could have been provided with funds that 
had been transferred from title III to II-A. Because of these 
concerns, the Committee has chosen to limit the transfer 
authority to 50 percent and will closely monitor its 
implementation to determine whether further transfer authority 
is warranted in fiscal year 1998.
    Youth training--title II-C.--For the Youth Training Program 
under title II-C of the act, the Committee recommends 
$126,672,000. This is the same as the budget request, the House 
allowance and the 1996 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.
    Summer youth employment and training--title II-B.--For the 
Summer Youth Program under title II-B of the act, the Committee 
recommends $625,000,000. This is $246,000,000 below the budget 
request, and the same as the House allowance and the 1996 
comparable level. 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 that allows service 
delivery areas to transfer funds between the title II-C year-
round youth program and the title II-B summer program, if such 
transfer is approved by the Governor.
    The Committee recognizes the severe problems facing out-of-
school youth in communities with high poverty and unemployment 
and is aware of the interrelatedness of poverty, juvenile 
crime, child abuse and neglect, school failure, and teen 
pregnancy. Many serious problems faced by youth tend to cluster 
in the same individual and reinforce one another, yet current 
programs are fragmented and uncoordinated. For example, a 
recent GAO study identified 131 Federal programs, administered 
by 16 different departments and other agencies, that may be 
used to benefit at-risk or delinquent youth. Accompanying these 
problems is a shortage of safe, community-based settings for 
at-risk and delinquent youth where they can develop close 
relationships with dependable adults and the perception of 
meaningful opportunities in mainstream society. The Committee 
urges the Secretary to work with high poverty communities in 
implementing youth development initiatives and helping 
coordinate the many sources of Federal assistance.
    Dislocated worker assistance.--The Committee recommends 
$1,100,000,000 for dislocated worker programs. This is 
$193,000,000 below the budget request, and the same as the 
House allowance and the 1996 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. 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.
    The Committee includes 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.
    The Committee is aware that there are sufficient funds 
within the discretionary amounts available under title III to 
continue funding of the microenterprise grants at the level in 
effect for fiscal year 1995.
    The Committee understands that technology centers have been 
very successful and helpful at providing technical assistance 
to businesses in a variety of areas, including plastics, 
pollution prevention, hydraulics, electrical maintenance worker 
training or printing. The Committee encourages the Department 
to expand this program, using the existing infrastructure 
throughout the Midwest to train and retrain the incumbent 
worker in such training programs as environmental standards/
painting, printing and graphic arts, industrial electricity/
industrial electronics/industrial maintenance, and hydraulics 
and pneumatics. A partnership of labor unions, technology 
centers and Government would provide both the support and the 
expertise to train and retrain workers and will be a driving 
force in the retention of workers, increase job security, and 
in improving wage rates for today's manufacturing workers. This 
partnership will help achieve worker outreach and recruitment, 
outreach and recruitment of firms, joint training, models and 
mentors for workers, and recruitment of a highly qualified pool 
of trainers to achieve the necessary level of proficiency for 
these workers.
    The Committee is concerned that the Department may not be 
taking advantage of cost-effective services for job search 
assistance offered by the private outplacement sector. Private, 
for-profit outplacement firms have repeatedly told this 
Committee and the Department that they offer job search and 
other reemployment assistance to dislocated workers through 
employer-funded programs at significantly lower costs per 
worker and higher placement rates than those currently realized 
at the State and local level and that these private sector 
services could be provided to workers served through dislocated 
worker assistance. The Committee does not believe that the 
title III program should take business away from private 
companies that provide comparable services more cost 
effectively. The Committee encourages the Department to 
undertake partnerships with the outplacement industry to 
demonstrate how the private, for-profit sector can serve the 
needs of those dislocated workers who are not being provided 
outplacement benefits by their employers. In addition, the 
Department needs to be able to track the amount of funds spent 
for outplacement and job search assistance in this program, 
including the amount per participant, and the placement rates 
for those workers served.
    Native Americans.--For native American programs, the bill 
provides $52,502,000. This is $2,502,000 above the budget 
request and the House allowance, and the same as the 1996 
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 $70,285,000. This is 
$5,285,000 above the budget request and the House allowance, 
and $1,000,000 above the 1996 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 notes that both Senate bill 143 and H.R. 
1617, as passed by the Senate and the House respectively, 
include an authorization for a Migrant and Seasonal Farmworker 
Program centrally administered from the national level. The 
Committee supports this view.
    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 1997.
    The Committee reminds the Department that applicants for 
funding under the JTPA section 402 program must demonstrate a 
prior existing capacity to specifically serve the employment 
and training needs of migrant and seasonal farmworkers, and 
further reminds the Department of applicable provisions of the 
current law that states that the Secretary shall provide 
services to farmworkers through public agencies and private 
nonprofit organizations with a ``previously demonstrated 
capability to administer effectively a diversified 
employability development program for migrant and seasonal 
farmworkers.''
    The Committee directs the Department of Labor to use the 
increase provided to continue the Farmworker Housing Program at 
the rate in effect in fiscal year 1995.
    Job Corps.--For the Job Corps, the Committee recommends 
$1,138,685,000 for program year 1997. This is $14,824,000 less 
than the budget request, the same as the House allowance, and 
an increase of $44,743,000 above the 1996 comparable level. The 
amount in the bill includes $1,064,824,000 for operations to 
support 119 centers, including four new centers scheduled to 
open during fiscal year 1997. The amount in the bill also 
includes $73,861,000 for facility construction, rehabilitation, 
and maintenance at existing centers. The Committee urges the 
Secretary to relocate centers housed in facilities that cannot 
be upgraded or enhanced at their existing location. Priority 
should be given to centers in which the physical condition of 
the facility is a major deterrent to the center's performance.
    The Department should examine low-cost options for serving 
more at-risk youth through Job Corps, such as expanding slots 
at existing high-performing centers or constructing satellite 
centers in proximity to existing high-performing centers.
    The Committee also urges the Department to explore the 
opportunities presented by State charter school laws which 
permit the establishment of legally independent schools of 
choice, operated as nonprofit corporations. Establishing Job 
Corps centers as residential charter schools could lower the 
per slot cost to the Department by capturing the State and 
local per pupil educational expenditure for school-age, in-
State participants. The Committee requests the Department to 
report on its progress in this area.
    The Committee agrees with the House in requesting the 
Department to identify emerging occupations that are consistent 
with Job Corps' population and upgrade the vocational offerings 
at centers in order to create career opportunities in new and 
emerging growth industries. The Committee also agrees with the 
House in requesting the Department to identify regional and 
national employers and establish effective working 
relationships that will increase students' career 
opportunities. In order to provide cost-effective services, the 
Department should establish greater linkage opportunities and 
interaction with State work force development systems.
    The Committee notes the concerns expressed by the General 
Accounting Office in its June 1995 report on the Job Corps 
Program. GAO is concerned about a number of issues, among them 
the fact that only a little more than one-third of students 
complete their vocational training courses, the validity of job 
placement data is questionable, students are not remaining long 
in their initial jobs after placement, and the effectiveness of 
national vocational training contractors. The Committee will 
continue to follow these concerns closely in the coming year 
and wants the Department to take whatever steps necessary to 
improve the program.
    The Committee is aware of concerns about the quality of 
tools, equipment, and curricula at Job Corps centers and 
requests the Secretary to conduct a needs assessment so that 
the Committee will be aware of funding needs in these areas 
before the fiscal year 1998 appropriations cycle.
    Veterans employment.--The Committee recommends $7,300,000 
for special veterans employment programs. This is the same as 
the budget request, the House allowance, and the 1996 
comparable level. These funds provide special employment and 
training programs designed to meet the unique needs of 
disabled, Vietnam-era, and recently separated veterans.
    School-to-work.--The Committee recommends $180,000,000 for 
school-to-work. This is $20,000,000 below the budget request, 
an increase of $5,000,000 above the House allowance, and 
$10,000,000 more than the 1996 comparable level. The school-to-
work program is intended to provide 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.
    The Committee is aware of school-to-work initiatives that 
expose students to career opportunities in the retail 
industries, while strengthening the behaviors and academic 
accomplishments of participating students through the 
integration of business and educational needs. The Committee 
urges the Department to explore funding such initiatives under 
the auspices of national trade associations.
    National activities.--For national activities $52,685,000 
is provided. This is $304,247,000 less than the budget request, 
$23,470,000 above the House allowance, and $5,860,000 above the 
1996 comparable level. The bill includes funding for research 
and evaluation, $6,196,000; pilots and demonstrations, 
$33,000,000; labor market information, $5,489,000; the National 
Occupational Information Coordinating Committee, $8,000,000; 
skill standards, $4,000,000; and women in apprenticeship, 
$610,000.
    Recognizing the limitations of traditional research and 
evaluation approaches, the Committee urges the Secretary to 
ensure that solution-focused research be conducted. Funding 
mechanisms like JTPA do not support uniform program practices 
serving homogeneous populations. Instead, a variety of local 
service providers undertake a combination of programs and 
services to target a wide variety of youth and youth problems. 
Rather than look at the outcomes of all these efforts in 
combination, the Committee recommends that research be used to 
understand the hows and whys of existing practices and that 
exemplary practices be scrutinized closely. Therefore, the 
Committee recommends that future research be directed to: (1) 
Document how funds are used to serve high-risk youth (rather 
than assume that it is directed well to dropouts and other 
high-risk youth), and compare these practices to what existing 
research suggests would be best practices; (2) identify 
possible exemplary models and evaluate them to learn if they do 
yield positive outcomes relative to other more traditional 
approaches; (3) investigate how the existing funding and 
service delivery mechanisms may be inhibiting effective service 
delivery; and (4) conduct an ongoing assessment of States that 
are currently in the process of changing their current 
education, employment, and training programs into a 
consolidated comprehensive work force development system.
    The Committee disagrees with the House in placing the 
pilots and demonstration activity on phase out path. Activities 
funded under this account support projects aimed at meeting the 
critical needs of economically disadvantaged youth and adults 
and are essential to determining effective practices. Under 
pilots and demonstrations, the Committee has provided 
$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.
    With regard to the National Occupational Information 
Coordinating Committee [NOICC], the Committee encourages NOICC 
to explore furthering its mission through the sale of products, 
fees for service, and receipt of funds from private sources. 
Also, 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 
1997 for the continuation of such programs.
    The Committee has provided no funding for the proposed jobs 
for residents or incumbent worker demonstration programs, new 
discretionary job training initiatives proposed by the 
President totaling $65,000,000. Concerning the opportunity 
areas for youth initiative, begun by the administration in 
fiscal year 1996, the Committee disagrees with the 
administration's request for line-item funding of $250,000,000 
but expects the Department to continue using a portion of 
funding available under pilots and demonstrations to support 
this initiative.
    The opportunity areas for out-of-school youth initiative 
targets resources to high-poverty areas for the purpose of 
increasing employment rates for out-of-school youth in such 
areas. The initiative involves a comprehensive approach to 
improving the immediate and long-term employment prospects of 
such youth with a strong emphasis on private sector involvement 
(including job commitments by employers) and significant links 
to the school system, State and local agencies, and those 
community-based organizations most knowledgeable about the 
populations to be served. This concentrated approach seeks to 
assist in reducing crime, substance abuse, welfare dependency, 
and other problems associated with the pervasive youth 
unemployment that plagues these areas. The Committee is aware 
of efforts in Philadelphia and Washington, DC, to combat 
pervasive youth unemployment, dropping out of school, and 
juvenile crime through comprehensive, community-based 
activities, and urges the Secretary to give full and fair 
consideration to proposals from the relevant agencies in these 
cities.
    The Committee is aware of efforts of Lehigh University's 
Iacocca Institute, in conjunction with the National Coalition 
for Advanced Technology Centers, to create work force 
development education curricula specifically focused on the 
Nation's manufacturing sector. The Committee believes that the 
Department needs to undertake more aggressive efforts to foster 
initiatives between centers of excellence and U.S. 
manufacturers to promote work force training so as to bolster 
worker productivity, and in turn, help improve U.S. global 
competitiveness and lower the Nation's manufactured goods trade 
deficit. The Committee encourages full and fair consideration 
of a proposal from this organization for use in expanding its 
existing manufacturing work force development pilot project. 
Funds should be used to develop manufacturing work force 
curricula that can be used nationwide, including a component 
that seeks to assist moving current welfare recipients to full-
time employment in the manufacturing sector.
    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 that the Eisenhower Foundation 
proposes 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 new replications would combine the argus model 
with the capital commitment model, in which trainees are placed 
in jobs repairing telecommunications equipment. The new 
replications would be evaluated using a control group design. 
The Committee encourages full and fair consideration of a 
proposal from this organization.
    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 residing in rural communities, with an 
emphasis on vocations that benefit these communities, such as 
child care workers and teachers.
    The Committee recognizes that, due to the geographical 
isolation associated with rural communities in the States of 
Alaska and on the Hawaiian Island of Lanai, disadvantaged 
populations residing in these areas generally lack access to 
skill training programs, education opportunities, and other 
self-development initiatives. The Committee also recognizes 
that limited access to human development services has 
contributed to the increase in negative health and social 
indicators, such as high rates of poverty, unemployment, school 
dropouts, teen pregnancy, substance abuse, and mental illness. 
Therefore, the Committee strongly urges the use of $400,000 of 
Job Training Partnership Act pilot and demonstration funds to 
support a 24-month comprehensive initiative that awards grants 
to improve the training and employment opportunities for adults 
and youth on the Hawaiian Island of Lanai and in native 
villages in the State of Alaska.
    The Committee is aware of interest by the Community 
Transportation Association of America in establishing a 
national joblinks employment transportation center to improve 
coordination of transportation systems with efforts to train 
and employ individuals on public assistance. The activities 
include development of a data base, technical materials, onsite 
technical assistance, and demonstrations in 10 States (of which 
4 are predominantly rural) on coordination of transportation 
with job creation and job referral programs. The Committee 
encourages full and fair consideration of a proposal from this 
organization.
    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 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 Committee has included language to authorize the 
Secretary of Labor to waive requirements (with limited 
exceptions) of the Job Training Partnership Act and the Wagner-
Peyser Act to facilitate the implementation of State plans for 
improving work force development systems. Many States and local 
communities have begun such reform efforts, such as the 
establishment of One-Stop Career Centers systems, to enhance 
the skills and employment prospects of their workers. This 
language allows the Secretary to waive requirements of JTPA and 
Wagner-Peyser that are determined to impede these efforts. In 
exchange for the greater flexibility provided by such waivers, 
the language requires that the State execute a memorandum of 
understanding with the Secretary of Labor identifying the 
outcomes the State intends to achieve and other measures that 
will ensure appropriate accountability for the use of Federal 
funds.
    The Committee is aware that Utah has recently passed a law 
which consolidates its work force and welfare programs into a 
single department--the Department of Work Force Services. This 
new Department is designed to achieve simplification, 
efficiency, and improved service. Utah's innovative approach is 
uniquely suited to demonstrate a State-based solution to work 
force and welfare program consolidation. The administration is 
encouraged to facilitate the State of Utah's plans to 
consolidate work force and welfare programs, particularly with 
regard to the waiver process.
    In addition, the Committee has included language requiring 
the Secretary to establish a work force flexibility (work-flex) 
partnership demonstration program, which would be similar to 
the ed-flex demonstration program that is currently being 
carried out by the Department of Education. A similar work-flex 
program was included in the Senate-passed version of the Work 
Force Development Act (Senate bill 143), but has not been 
enacted into law. Under the program, the Secretary is to 
authorize up to six States to waive statutory or regulatory 
requirements applicable to service delivery areas and substate 
areas in the State under titles I-III of JTPA and the 
requirements of the Wagner-Peyser Act, with the same limited 
exceptions that would apply to the Secretary's general waiver 
authority described above. In order to participate, States 
would have to submit and have approved by the Secretary a State 
plan for the provision of employment and training activities in 
the State. The plan would include a description of the process 
by which local areas are to apply for and have waivers approved 
by the State, the requirements of the Wagner-Peyser Act to be 
waived, the outcomes the State intends to achieve and other 
appropriate accountability measures.
    The Committee believes that the new waiver authority 
contained in these two provisions could make a significant 
contribution to encouraging States to make innovative changes 
in their work force development systems that will enhance the 
employability of current and future workers, in anticipation of 
broader consolidation reform efforts at the Federal level.
    As States assume more responsibility for the administration 
of employment training programs, the Committee encourages ETA 
to help facilitate those efforts. The Committee remains deeply 
concerned about the fragmentation and administrative 
duplication that exists among Federal employment training 
programs. This situation makes it difficult for Federal and 
State officials to carry out oversight responsibilities. The 
Committee is pleased to learn that the ETA is taking steps to 
address the myriad of issues associated with this problem. 
Along these lines, ETA is urged to proceed with efforts to 
undertake a pilot study aimed at improving information 
technology system problems common to many States. If 
successful, this pilot study will help improve communication 
within and among States, facilitate performance reporting, 
increase the effectiveness of program oversight, and decrease 
administrative costs.

            community service employment for older americans

Appropriations, 1996....................................    $373,000,000
Budget estimate, 1997...................................     350,000,000
House allowance.........................................     373,000,000

Committee recommendation

                                                             373,000,000

    The Committee recommends $373,000,000, the same as the 
House allowance and $23,000,000 above the budget request for 
community service employment for older Americans. The Committee 
recommends 75 percent of the funds for national sponsors, 
compared to 65 percent allowed by the House; the remainder is 
for State sponsors. This 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 1997 
appropriation will support the effort from July 1, 1997, 
through June 30, 1998. An estimated 86,000 persons will be 
served with these funds. These funds are to be distributed in 
the same manner as currently authorized under the Older 
Americans Act, unless this law is subsequently altered.
    The Committee, recognizing that the Older Americans Act has 
not yet been reauthorized for fiscal year 1997, 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. Bill language is also included to 
facilitate transfer of this program to the Administration on 
Aging in HHS following enactment of authorizing legislation; 
such transfer should include necessary Federal administrative 
costs.
    The Committee recognizes the efforts of the authorizing 
committee to complete its work on the reauthorization of the 
Older Americans Act, and specifically its work on the Senior 
Community Service Employment Program [SCSEP].
    The Department of Labor [DOL] funds 10 national 
organizations as program sponsors as well as State agencies for 
employment/community service programs for older workers. Under 
current law, a hold harmless amount is reserved for the 
national sponsors to be able to maintain their 1978 level of 
activities in each State. The amount appropriated in excess of 
funds required to maintain those activities is to be 
distributed to States according to their relative per capita 
income and percentage of the population aged 55 and over. The 
law calls for 55 percent of excess funds to be awarded to 
States, and the remaining 45 percent to the national 
organizations. Funds are not awarded to organizations on a 
competitive basis; therefore, other organizations are not 
afforded an opportunity to apply for funding and offer 
innovative ways to meet SCSEP goals. The national 
appropriations process has, since the inception of SCSEP, 
directed 78 percent of the SCSEP funds to sponsors and 22 
percent to the State-run programs. The Committee noted that the 
authorizing committee is moving toward shifting this program 
entirely to the States.
    The Committee understands that it is the intent of the 
authorizing committee to reform SCSEP within the Older 
Americans Act while maintaining its important focus on seniors' 
needs. The Committee recognizes that the authorizing committee 
intends the Federal administration to be moved from the Labor 
Department to the Department of Health and Human Services 
[HHS]. It also recognizes the authorizing committee intends to 
change this program by allowing States to run it as a 
competitive grant program. The pending authorizing legislation 
would allow States to choose how to structure the program to 
best meet the diversity of needs that may exist within their 
population.
    The issues driving the significant changes to the SCSEP 
program were identified by two GAO reports. A February 1994 
report, ``Department of Labor: Noncompetitive, Discretionary 
Grants'' discussed the use of the Labor Department's 
Procurement Review Board [PRB] which reviews all grants awards 
above $25,000; the SCSEP program is exempted from the normal 
departmental procedures applied to all other similar grants. 
Further congressional concern about this program, prompted GAO 
to issue a second report in November 1995, ``Department of 
Labor: Senior Community Service Employment Program Delivery 
Could Be Improved Through Legislative and Administrative 
Actions.''
    The Committee has a particular concern in regard to the 
Senior Community Service Employment Program and actions by 
grantees that could be interpreted as being in violation of the 
Lobbying Disclosure Act of 1995. It has come to the attention 
of the Committee that a number of the grantees receiving funds 
under this program may be engaging in prohibited activities. 
The passage of the Craig/Simpson amendment to the Lobbying 
Disclosure Act of 1995 forbids the delivery of any Federal 
grant to such organization described in section 501(c)(4) of 
the Internal Revenue Code of 1986 which is engaged in lobbying 
activities as defined by the Lobbying Disclosure Act.
    The Committee would like to emphasize that grants should be 
given only to recipients in compliance with this law. In 
addition, it should be noted that organizations receiving these 
funds that are organized, or have reorganized, as 501(c)(3)'s 
are subject to caps on lobbying expenditures as a consequence 
of this organization or reorganization. The Committee would 
like to remind all recipients of SCSEP grants that these funds 
are intended to provide direct support to qualified senior 
citizens who participate in the program, and are not intended 
to function as a means of subsidizing political activities.

              Federal unemployment benefits and allowances

Appropriations, 1996....................................    $346,100,000
Budget estimate, 1997...................................     324,500,000
House allowance.........................................     324,500,000

Committee recommendation

                                                             324,500,000

    The Committee recommends $324,500,000, the same as the 
budget request and House allowance, and a decrease of 
$21,600,000 below the 1996 enacted level for Federal 
unemployment benefits and allowances. These are entitlement 
funds.
    The trade adjustment line item has two activities totaling 
$276,100,000 in fiscal year 1997.
    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 $191,000,000. This is the 
same as the budget request and House allowance, and an increase 
of $8,000,000 above the 1996 comparable level. These funds will 
permit payment of benefits, averaging $215 per week, to 35,200 
workers for 1997. Of these workers, 18,900 will participate in 
training programs, receiving benefits for an average of 28 
weeks. The remaining 16,300 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 $85,100,000 for this 
activity. This is the same as the budget request and House 
allowance, and a decrease of $11,500,000 below the 1996 
comparable level. These funds will provide services for an 
estimated 23,600 workers.
    For NAFTA activities, $48,400,000 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 $20,000,000 
for this activity. This is the same as the budget request and 
House allowance, and a decrease of $14,000,000 below the 1996 
comparable level. These funds will provide 3,700 eligible 
workers an average of 24 weeks of benefits each, at an average 
weekly amount of $224.
    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 $28,400,000 for 
this activity. This is the same as the budget request and House 
allowance, and a reduction of $4,100,000 below the 1996 
comparable level. These funds will provide training for an 
estimated 7,400 workers.

     state unemployment insurance and employment service operations

Appropriations, 1996....................................  $3,237,522,000
Budget estimate, 1997...................................   3,561,525,000
House allowance.........................................   3,222,191,000

Committee recommendation

                                                           3,232,015,000

    The Committee recommends $3,232,015,000 for this account. 
This is $329,510,000 below the budget request, an increase of 
$9,828,000 above the House allowance, and a decrease of 
$5,507,000 below the 1996 comparable level. Included in the 
total availability is $3,099,736,000 authorized to be drawn 
from the ``Employment Security Administration'' account of the 
unemployment trust fund, and $132,279,000 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 
$2,345,808,000. 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 2,828,000. This second 
contingency amount would fund the administrative costs of 
unemployment insurance workload over the level of 2,828,000 
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 in total, and provides an increase 
of $38,955,000 over the fiscal year 1996 level. The allowance 
includes $2,119,475,000 for State operations, a decrease of 
$105,499,000 below the budget request, an increase of 
$42,740,000 above the House, and an increase of $38,955,000 
above the 1996 comparable level. In addition, the allowance 
includes $10,000,000 for the national activities, the same as 
the budget request and 1996 comparable level, and an increase 
of $1,500,000 above the House.
    For the employment service, the Committee recommends 
$776,207,000 which includes $22,279,000 in general funds 
together with an authorization to spend $753,928,000 from the 
``Employment Security Administration'' account of the 
unemployment trust fund. These amounts are $71,971,000 less 
than the budget request, $9,828,000 more than the House 
allowance, and $44,462,000 less than the 1996 comparable level.
    Included in the recommendation for the employment service 
is $723,648,000 for State grants, available for the program 
year of July 1, 1997, through June 30, 1998. This is 
$58,654,000 below the budget request, the same as the House 
allowance, and a decrease of $38,087,000 below the 1996 
comparable level. Also included is $52,559,000 for national 
activities. This is $6,375,000 below the budget request, 
$9,824,000 over the House allowance, and a decrease of 
$6,375,000 below the 1996 comparable level. Further, the 
recommendation includes $110,000,000 for one-stop career 
centers, which is $40,000,000 less than the budget request, the 
same as the House allowance and the 1996 comparable level.
    The Committee strongly urges the Department of Labor, out 
of the appropriation for one-stop career centers, to give 
priority consideration to the funding of the city of 
Gainesville, FL, in any future competition for investments in 
local governments to demonstrate innovative approaches to the 
delivery of services in a one-stop setting. The Gainesville 
regional job training/job development initiative is an 
innovative partnership that would streamline and consolidate a 
host of Federal and State job training resources throughout the 
north central Florida region in an effort to increase the 
availability of such services to rural areas via electronic 
linkage.
    The Committee has included bill language, requested by the 
administration, clarifying that funds may be used for certain 
activities authorized by the Wagner-Peyser Act, the Trade Act, 
the Immigration Act, and the Immigration and Nationality Act.
    Funding for the employment services and unemployment 
insurance programs are important priorities for the State of 
Alaska. Past funding reductions in employment services have 
necessitated layoffs and threaten the ability of the Alaska 
Employment Service to serve employers and job seekers 
throughout Alaska. Reductions in the Unemployment Insurance 
Program will negatively impact the State's equipment, 
automation and technology needs. The State is especially 
concerned about the push for devolution of UI administration to 
the States. If devolution is to take place, it is essential 
that the six States which receive UI funds in excess of their 
FUTA collections be held harmless.
    The Committee believes the work opportunity tax credit 
[WOTC] which is established under the recently enacted Small 
Business Job Protection Act provides important resources to 
create new jobs, particularly for those Americans who would 
otherwise be dependent on welfare. Therefore, the Committee 
recommendation includes $10,000,000 for this newly authorized 
initiative. The Secretary of Labor is urged to look closely at 
the implementation of this program, in view of concerns raised 
by the Office of the Inspector General.
    The Committee recommendation for Employment Service 
national activities, excluding the work opportunity tax credit 
program, is $42,559,000, a reduction of $14,499,000 below the 
fiscal 1996 enacted level. The reduction is primarily related 
to the foreign labor programs, which the Office of the 
Inspector General has recommended be eliminated as they 
currently exist.

        advances to the unemployment trust fund and other funds

Appropriations, 1996....................................    $369,000,000
Budget estimate, 1997...................................     373,000,000
House allowance.........................................     373,000,000

Committee recommendation

                                                             373,000,000

    The Committee recommends $373,000,000, the same as the 
budget request and House allowance, and an increase of 
$4,000,000 over the 1996 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 1997 
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.

                           program operations

Appropriations, 1996....................................    $123,847,000
Budget estimate, 1997...................................     125,681,000
House allowance.........................................     121,370,000

Committee recommendation

                                                             121,370,000

    The Committee recommendation includes $81,393,000 in 
general funds for this account, as well as authority to expend 
$39,977,000 from the ``Employment Security Administration'' 
account of the unemployment trust fund, for a total of 
$121,370,000. This is $4,311,000 less than the budget request, 
the same as the House allowance, and $2,477,000 less than the 
1996 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.

              Pension and Welfare Benefits Administration

                         SALARIES AND EXPENSES

Appropriations, 1996....................................     $67,126,000
Budget estimate, 1997...................................      85,449,000
House allowance.........................................      66,083,000

Committee recommendation

                                                              71,783,000

    The Committee recommendation provides $71,783,000 for this 
account, which is $13,666,000 less than the budget request, an 
increase of $5,700,000 above the House allowance, and an 
increase of $4,657,000 over the 1996 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 Committee recommendation includes $6,000,000 for first 
year costs of the administration's $11,000,000, 2-year request 
for the development of a new system devoted to processing form 
5500 series financial data required under the Employee 
Retirement Income Security Act. When completed, this project 
will enable employees to submit annual benefit plan reports 
electronically, reducing the cost, paperwork burden, and 
enhancing protection of pension funds. Processing the estimated 
1 million form 5500 returns each year currently costs 
$25,000,000: this new system is expected to result in savings 
of $57,000,000 over the next 5 years. The new system will be 
developed and managed by the Department of Labor. The Committee 
intends for the Internal Revenue Service and the Department of 
Labor to continue to share the ongoing operating costs of the 
system in the same manner as under the current system.
    The Committee recommendation does not include $300,000 
added during House floor action, relating to genetic 
discrimination in health and pension plans; this can be 
addressed in conference.

                  PENSION BENEFIT GUARANTY CORPORATION

    The Corporation's estimate for fiscal year 1997 includes 
benefit payments of $945,400,000, multiemployer financial 
assistance of $6,120,000, administrative expenses limitation of 
$12,043,000, and services related to terminations expenses of 
$128,496,000. In the administrative expenses activity, the 
Committee recommendation includes $10,345,000. In the services 
related to terminations activity, the Committee recommends 
$125,375,000. The total of $135,720,000 is the same as the 
House allowance, but unlike the House, services related to 
terminations are not subject to limitation. The spending limit 
exemption for PBGC's service related to terminations activity 
(nonlimitation) was established to provide the Corporation with 
the flexibility to quickly address unanticipated terminations 
of large pension plans. In addition to ensuring that there 
would be no interruption in benefits, this flexibility has 
increased the Corporation's collection of moneys owed. Any 
change in the nonlimitation spending is subject to OMB review 
and reapportionment. To ensure an appropriate degree of 
congressional oversight, the Labor Department and PBGC shall 
notify this Committee prior to application to OMB for 
additional funding. Such notification would provide, in 
writing, the amount, reason for, and necessity for the PBGC 
request.
    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, 1996....................................    $264,698,000
Budget estimate, 1997...................................     305,913,000
House allowance.........................................     264,405,000

Committee recommendation

                                                             263,155,000

    The Committee recommendation includes $263,155,000 for this 
account. This is $42,758,000 less than the budget request, a 
decrease of $1,250,000 below the House allowance, and a 
decrease of $1,543,000 below the 1996 comparable level. The 
bill contains authority to expend $983,000 from the special 
fund established by the Longshore and Harbor Workers' 
Compensation Act; the remainder are general funds. In addition, 
an amount of $26,071,000 is available by transfer from the 
black lung disability trust fund. This is the same as the 
request and the House allowance, and $1,122,000 less than the 
1996 comparable level.
    The Committee recommendation includes a $3,750,000 increase 
over the House allowance for implementation of the budget 
request to improve the integrity and accuracy of prevailing 
wage and fringe benefits determinations under the Davis-Bacon 
and related acts. These additional resources are needed to 
establish feasibility and then develop new methods of 
determining prevailing wages through econometric modeling based 
on available wage data. The new methods would privatize the 
collection and analysis of construction industry wage data, and 
develop the improvements to verify accuracy of current Davis-
Bacon wage surveys.
    The Committee believes that in developing and implementing 
a wage determination for flightcrews operating pursuant to U.S. 
Postal Service dedicated air service contracts, the Secretary 
should give full consideration to the methodologies utilized in 
the past. The wage determination should also take into account 
the segmented nature of the aviation industry when evaluating 
available data regarding the wages paid crews flying similar 
aircraft in the private sector.

                            SPECIAL BENEFITS

Appropriations, 1996....................................    $218,000,000
Budget estimate, 1997...................................     213,000,000
House allowance.........................................     213,000,000

Committee recommendation

                                                             213,000,000

    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.
    The bill includes $213,000,000, the same as the budget 
request and House allowance, and a decrease of $5,000,000 below 
the 1996 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 1997, 
including anticipated reimbursements from Federal agencies of 
$1,876,000,000, is $2,737,054,000, a decrease of $63,000,000 
below the 1996 comparable level.
    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 worker's 
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 $11,390,000 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.
    The Committee recommendation does not include a House floor 
amendment which added $5,000,000 for enforcement of wage and 
hour standards; this activity will be considered in conference.
    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].

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 1996....................................    $997,362,000
Budget estimate, 1997...................................   1,008,000,000
House allowance.........................................   1,008,000,000

Committee recommendation

                                                           1,008,000,000

    The bill includes authority to obligate $1,008,000,000 from 
the black lung disability trust fund in fiscal year 1997. This 
is an increase of $10,638,000 above the 1996 comparable level.
    The total amount available for fiscal year 1997, will 
provide $496,665,000 for benefit payments, and $45,979,000 and 
$356,000 for administrative expenses for the Departments of 
Labor and Treasury, respectively. Also included is $465,000,000 
for interest payments on advances. In fiscal year 1996, 
comparable obligations for benefit payments are estimated to be 
$505,494,000 while administrative expenses for the Departments 
of Labor and Treasury, respectively, are $47,112,000 and 
$756,000. For fiscal 1996, interest payments on advances are 
estimated at $444,000,000.
    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 77,000 people will be receiving black 
lung benefits financed from the trust fund by the end of fiscal 
year 1996. This compares with an estimated 81,500 receiving 
benefits in fiscal year 1996.
    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 
$373,000,000 in fiscal year 1997. 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, 1996....................................    $303,810,000
Budget estimate, 1997...................................     340,851,000
House allowance.........................................     297,734,000

Committee recommendation

                                                             299,134,000

    The Committee recommendation includes $299,134,000 for this 
account. This is $41,717,000 less than the budget request, 
$1,400,000 more than the House allowance, and a decrease of 
$4,676,000 below the 1996 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 OSHA funding by 
approximately 2 percent below the fiscal year 1996 enacted 
level, except for compliance assistance activities, which are 
maintained at the current funding level.
    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 also allowed $750,000 for this activity.
    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.
    A number of OSHA standards require that certain products 
and equipment used in the workplace be tested and certified by 
a laboratory that has been recognized and accredited by OSHA 
under its Nationally Recognized Testing Laboratory [NRTL] 
Program. This program was established by regulation by OSHA in 
1988 to facilitate the utilization of private sector testing 
and certification expertise in fulfilling its obligation to 
promote worker safety. The program is intended to give 
employers and employees confidence that the equipment they 
purchase and use is safe and will meet the required safety 
standards. The NRTL Program and the cost-free services it 
provides confers economic benefit to businesses of all sizes by 
recognizing their qualifications to test and certify products 
used in the workplace. Currently, all of the costs incurred by 
OSHA for providing these services are taken out of the agency's 
appropriations. However, as the agency has downsized, it has 
not been able to allocate sufficient funds to the program to 
avoid a backlog of applications for NRTL status, and that 
backlog continues to grow as additional applications are 
received from both domestic and foreign laboratories. This 
language will allow OSHA to charge fees for these services and 
use those fees to offset the costs of meeting the needs of the 
program.
    The Committee is aware of the significant accomplishments 
of the Office of Occupational Health Nursing and recognizes it 
as the principal source of occupational health nursing 
expertise necessary as OSHA continues to develop, review, and 
analyze policies, guidelines, standards, and compliance 
activities. The Committee is concerned that the Office has not 
been fully staffed. The Committee considers this a priority and 
has provided sufficient funding for the Directorate of 
Technical Support for this to be accomplished. Moreover, the 
Committee believes the nurse internship program has a very 
valuable function and support continuation of at least six 
slots allocated to this program.
    The Committee is very pleased with OSHA's efforts in 
placing high priority on the voluntary protection programs 
[VPP] and other voluntary cooperative programs. The agency's 
work in reducing the VPP application backlog and its commitment 
to eliminate this backlog is particularly noteworthy. The 
Committee expects OSHA to continue to place high priority on 
the VPP, assuring prompt review and processing of VPP 
applications from interested employers and employees. 
Cooperative voluntary programs, especially the VPP, are an 
important part of OSHA's ability to assure worker safety and 
health and should be administered in conjunction with an 
effective strong enforcement program.
    The Committee is aware of concerns regarding the 
enforcement of section 1926.28(a) of title 29 of the Code of 
Federal Regulations, particularly as it pertains to the wearing 
of protective clothing by construction workers. This regulation 
is designed to prevent hazardous construction materials, such 
as hot tar and asphalt, from coming into contact with bare 
flesh. Nevertheless, during periods of hot weather, wearing 
such protective clothing could itself present a risk to workers 
by causing heat exhaustion. The Committee recommends that OSHA 
review this regulation and issue guidance to both State and 
Federal OSHA compliance staffs. Such guidance should clarify 
the application of this rule and ensure that any risks posed by 
protective clothing are considered in determining the 
applicability of section 1926.28(a). OSHA should report to the 
Committee within 120 days from the beginning of fiscal year 
1997 on the actions it has taken with regard to this matter.
    The Committee is concerned about the enforcement of State 
occupation safety and health standards by States operating 
OSHA-approved State plans, particularly where such standards 
differ significantly from Federal standards and may impose an 
undue burden on interstate commerce. The Committee believes 
that California's enforcement of its hazard communication 
standard, which incorporates portions of proposition 65, may 
impose such a burden. OSHA is directed to expedite its review 
and approval, or rejection, of California's hazard 
communication/proposition 65 standard, and to provide a report 
to the Committee on this matter, by no later than January 1, 
1997.

                 Mine Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 1996....................................    $195,724,000
Budget estimate, 1997...................................     204,182,000
House allowance.........................................     191,810,000

Committee recommendation

                                                             195,724,000

    The Committee recommendation includes $195,724,000 for this 
account. This is $8,458,000 less than the budget request, an 
increase of $3,914,000 above the House allowance, and the same 
as the 1996 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 has deleted a provision in the House bill 
which would have prevented consolidation of a mine safety and 
health technology center. Subsequent to the House action, MSHA 
has made a convincing case that the consolidation is essential 
to continue to provide expert technical advice and assistance, 
without a reduction in the delivery of services, including 
timely onsite assistance during mine emergencies. In addition, 
MSHA's analysis shows that there will be cost savings after the 
consolidation. The Committee recognizes that such decisions 
should be made to promote the mission of MSHA and should be 
consistent with the goals and objectives of the agency and 
relatively free of outside influence.
    The Committee concurs with the House in retaining bill 
language 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.

                       Bureau of Labor Statistics

                         SALARIES AND EXPENSES

Appropriations, 1996....................................    $343,069,000
Budget estimate, 1997...................................     372,431,000
House allowance.........................................     354,700,000

Committee recommendation

                                                             351,330,000

    The Committee includes $351,330,000 for this account, which 
is $21,101,000 less than the budget request, $3,370,000 less 
than the House allowance, and $8,261,000 more than the 1996 
comparable level. This includes $51,665,000 from the Employment 
Security Administration account of the unemployment trust fund, 
and $299,665,000 in Federal funds. The Bureau of Labor 
Statistics is the principal fact finding agency in the Federal 
Government in the broad field of labor economics.
    The Committee recommendation includes one-half of the House 
Committee increases over the fiscal year 1996 enacted levels, 
except for Consumer Price Index activities.
    The Committee concurs with the budget request and House 
allowance of $16,145,000 for the Consumer Price Index revision; 
this effort should remain the highest priority for the Bureau.

                        Departmental Management

                         SALARIES AND EXPENSES

Appropriations, 1996....................................    $142,350,000
Budget estimate, 1997...................................     146,537,000
House allowance.........................................     137,801,000

Committee recommendation

                                                             142,508,000

    The Committee recommendation includes $142,508,000 for this 
account, which is $4,029,000 less than the budget request, an 
increase of $4,707,000 above the House allowance, and $158,000 
above the 1996 comparable level. This consists of $142,211,000 
in general funds, and authority to transfer $297,000 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, as well as 
the 1996 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 a 2-percent 
across-the-board reduction for departmental management 
administrative activities, due to severe budgetary constraints. 
However, for the Women's Bureau, and promoting employment of 
people with disabilities, the recommendation is the same as the 
fiscal year 1996 enacted level.
    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 $3,800,000 of the amount available to the 
Department of Labor for fiscal year 1997 may be allocated for 
this purpose, subject to the normal reprogramming requirements.
    The Committee has included bill language, carried in last 
year's bill permitting transfers of up to 1 percent between 
appropriations, up to a maximum increase of 3 percent, subject 
to a 15-day notification period.
    The Committee intends that the Women's Bureau continue 
support for technical assistance and training on displaced 
homemaker programming through effective programs such as the 
Women Work Program. This assistance is critical as State and 
local agencies develop and implement new models for work force 
development.
    The Committee applauds the Department for its desire to 
streamline regulations and provides $2,000,000 to the Office of 
the Secretary for the purposes of evaluating the practical 
application of construction regulations to residential 
construction.
    The Committee recommendation includes $1,000,000 for a 
Commission on Retirement Income Policy; the legislation 
establishing this Commission is included in title VI of this 
bill.
    The Committee recommendation includes funds within 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 Committee remains concerned by the large and growing 
problem of child exploitation around the world. The 
International Labor Organization [ILO] this year estimated that 
hundreds of millions of children are in full-time employment, 
often in abusive and harmful conditions. The Committee supports 
the continued work of the Bureau of International Labor Affairs 
to report on developments regarding abusive and exploitative 
child labor. In previous reports, the Bureau has documented 
abusive and exploitative child labor in manufacturing, mining, 
agricultural, and fisheries exports to the United States. It is 
currently completing a study on efforts by U.S. garment 
manufacturers and retailers to avoid the use of abusive and 
exploitative child labor in their imports.
    The Committee notes the positive work being done by the 
International Labor Organization's International Program for 
the Elimination of Child Labor [IPEC], including funds made 
available to the Secretary of Labor by this Committee. The 
Committee has provided $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 requests that the Bureau complete a report by 
July 15, 1997, that contains an analysis of the efforts of U.S. 
importers in additional sectors where exploitative child labor 
is a problem to stop the import of such products including 
through codes of conduct, monitoring efforts, new methods of 
production, and sourcing and labeling. The sectors reviewed 
shall be based upon those products identified in volumes I and 
II of ``By the Sweat and Toil of Children,'' including leather 
goods, gems, sporting goods, and hand-knotted carpets.

        Assistant Secretary for Veterans Employment and Training

Appropriations, 1996....................................    $170,390,000
Budget estimate, 1997...................................     178,870,000
House allowance.........................................     181,949,000

Committee recommendation

                                                             174,225,000

    The Committee recommendation includes $174,225,000 to be 
expended from the Employment Security Administration account of 
the unemployment trust fund. This is $4,645,000 less than the 
budget request, $7,724,000 less than the House allowance, and 
$3,835,000 above the 1996 comparable level.
    For State grants the bill provides $79,453,000 for the 
Disabled Veterans Outreach Program and $73,255,000 for the 
Local Veterans Employment Representative Program. These amounts 
include one-half the increase allowed by the House over the 
1996 enacted level.
    For Federal administration, the Committee recommends 
$19,517,000, an increase of $98,000 over the fiscal year 1996 
level. The Committee supports the concept of the Transition 
Assistance Program administered jointly with the Department of 
Defense which assists soon-to-be-discharged service members in 
transitioning into the civilian work force, and concurs with 
the House allowance of $2,300,000.
    In addition, the Committee recommends $2,000,000 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 administration requested elimination of the 
Institute.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1996....................................     $48,041,000
Budget estimate, 1997...................................      48,087,000
House allowance.........................................      46,481,000

Committee recommendation

                                                              46,481,000

    The bill includes $46,481,000 for this account, which is 
the same as the House allowance, $1,606,000 below the budget 
request, and $1,560,000 below the 1996 comparable level. The 
bill includes $42,938,000 in general funds, and authority to 
transfer $3,543,000 from the Employment Security Administration 
account of the unemployment trust fund. In addition, an amount 
of $287,000 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.

                     ADDITIONAL GENERAL PROVISIONS

    General provisions bill language is included to: Prohibit 
the payment of more than $125,000 to Job Corps contractor 
employees (sec. 101); permit transfers of up to 1 percent 
between appropriations (sec. 102); and permit contracting out 
of Job Corps civilian conservation centers that fail to meet 
performance standards (sec. 103). These provisions are the same 
as in the House version of the bill.
    The House general provision that would prevent disbursement 
of Labor Department funds without the approval of the Chief 
Financial Officer has been deleted (sec. 104). The House 
general provision (sec. 105) on paper balers has been deleted 
since Congress has subsequently passed authorizing legislation, 
an amended version of H.R. 1114, the Balers and Compactors 
Safety Standards Modernization Act. Also deleted is the House 
provision on enforcement of rules governing driving by 
employees under age 18 (sec. 106). A new section 107 has been 
added exempting inmates from minimum wage and overtime 
requirements of the Fair Labor Standards Act.
           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     health resources and services

Appropriations, 1996....................................  $3,076,740,000
Budget estimate, 1997...................................   3,113,483,000
House allowance.........................................   3,082,190,000

Committee recommendation

                                                           3,213,096,000

    The Committee recommends an appropriation of $3,213,096,000 
for health resources and services. This is $52,613,000 above 
the administration request, $130,906,000 over the House amount, 
and $136,356,000 more than the fiscal year 1996 allowance.
    Health Resources and 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 again 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 $778,000,000 for the consolidated health 
centers, which is $19,868,000 above the 1996 level, $24,124,000 
below the House allowance, and $20,876,000 above the 
administration request for this grouping of programs.

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. Of the 
clients served by community health centers, about 44 percent 
are children and 66 percent have incomes below the poverty 
line.
    The Committee intends that additional resources above last 
year's level be reasonably allocated to provide increases in 
grant levels for existing grantees and to initiate new centers 
in underserved communities.
    The Committee reiterates its concern that social, cultural, 
and language barriers make it difficult to effectively provide 
primary health care to Hispanic populations in some States. The 
Committee strongly encourages HRSA to establish new centers, 
especially in communities with significant Hispanic 
populations. The Committee is aware of proposals by the Cabot 
Westside Clinic of Kansas City, MO, and the Community Health 
Center of Finney County, Garden City, KS, and encourages full 
and fair consideration of proposals from these organizations.
    Of the amount provided for consolidated health centers, the 
Committee has included bill language making available a total 
of up to $8,000,000 for loan guarantees for loans made by non-
Federal lenders for the construction, renovation, and 
modernization of facilities that are owned and operated by 
health centers and, subject to authorization, for loans made to 
health centers for the costs of developing and operating 
managed care networks or plan, both to be administered by the 
Bureau of Primary Health Care; and directs that funds collected 
through loan origination fees shall be deposited in the 
appropriate credit program account for authorized costs of such 
loan.
    Assuming enactment of legislation pending in the Senate 
authorizing loan guarantees for managed care networks and plan, 
it is anticipated that with the full amount provided for this 
activity, up to $80,000,000 in loans could be made available 
for health-center renovations and managed care network 
formation, assuming a subsidy rate of 10 percent for Federal 
funds appropriated.

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.

Native Hawaiian health care

    The Committee again includes the legal citation in the bill 
for the Native Hawaiian Health Care Program. The House bill 
does not include the citation. The Committee has included 
funding for the consolidated health centers line so that health 
care activities funded under the Native Hawaiian Health Care 
Program can be supported under the broader community health 
centers line. The Committee expects that not less than 
$3,105,000 be provided for these activities in fiscal year 
1997.
    The purpose of this activity is to improve the health 
status of native Hawaiians by making primary care, health 
promotion, and disease prevention services available through 
the support of native Hawaiian health systems. Services 
provided include health screening, nutrition programs, and 
contracting for basic primary care services. This activity also 
supports a health professions scholarship program for native 
Hawaiians and administrative costs of Papa Ola Lokahi, a 
consortium of native Hawaiian health care organizations.
    Despite recent advances, the health status of native 
Hawaiians continues to lag behind that of the national 
population. A recent report from the National Cancer Institute 
ranked native Hawaiians second in the Nation for cancer 
mortality rates, and further suggests that they may not be 
obtaining the quality of care that other populations receive.

National Health Service Corps: Field placements

    The Committee provides $37,244,000 for field placement 
activities, which is the same as the 1996 level and the House 
allowance. The administration requested funding in a 
consolidated program cluster. The funds provided for this 
program are used to support the activities of National Health 
Service Corps obligors 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.
    The Committee is aware that the NHSC has conducted a pilot 
project to place mental health and behavioral professionals, 
including psychologists, in community and migrant health 
centers. The Committee urges the NHSC to contact States and 
community entities in order to continue this effort to develop 
additional sites for mental health providers, particularly in 
areas already designated mental health manpower shortage areas.

National Health Service Corps: Recruitment

    The Committee provides $78,189,000 for recruitment 
activities, which is $3,000,000 above the 1996 level and the 
same as the House allowance. The administration requested 
funding in a consolidated program cluster. This program 
provides major benefits to students (full-cost scholarships or 
sizable 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 
reiterates its intention that funds provided be used to support 
multiyear, rather than single-year, commitments.
    The Committee intends that $3,000,000 of funds appropriated 
for this activity be used for State offices of rural health. 
The Committee continues to be 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. The Committee recommends that HRSA 
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 is concerned about the low number of dental 
recipients in the NHSC scholarship program and loan repayment 
awards, despite a significant increase in the number of 
dentists needed to service designated dental health professions 
shortage areas. The Committee urges the NHSC to enhance dental 
participation in the program.

                           HEALTH PROFESSIONS

    For all HRSA health professions programs, the bill includes 
$265,124,000, which is $6,549,000 more than the fiscal year 
1996 appropriation and $27,326,000 less than the House 
allowance. The administration requested funding in consolidated 
program clusters, including the National Health Service Corps.

Grants to communities for scholarships

    The Committee provides $474,000 for grants to communities 
for scholarships, which is the same as the 1996 level and 
$58,000 below the House allowance. The administration requested 
funding in a consolidated program cluster. 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.

Health professions data and analysis

    The Committee provides $212,000 for health professions data 
and analysis, which is the same as the 1996 level and $26,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. This program supports the 
collection and analysis of data on the labor supply in various 
health professions and on future work force configurations.

Research on certain health professions issues

    The Committee has included $450,000 for research on certain 
health professions issues, which is $450,000 more than the 
House allowance and the 1996 level. The administration 
requested funding in a consolidated program cluster. This 
program supports research on the extent to which debt has a 
detrimental effect on students entering primary care 
specialties; the effects of federally funded education programs 
for minorities attending and completing health professions 
schools; and the effectiveness of State investigations in 
protecting the health of the public. The Committee understands 
there are three centers for health professions research that 
are current grantees. Only one center received funding for this 
activity last year. The Committee intends that the amount 
provided be distributed equally to current grantees and urges 
that grantees seek outside funding to continue their activities 
once their grant periods are completed.

Nurse loan repayment for shortage area service

    The Committee provides $2,197,000 for nurse loan repayment 
for shortage area service, which is $235,000 above the 1996 
level and the same as the House allowance. The administration 
requested funding in a consolidated program cluster. 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.

Centers of excellence

    The Committee provides $22,072,000 for centers of 
excellence, which is the same as the 1996 level and $2,646,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. 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 institutions that are designated as centers of excellence 
are private institutions whose mission is to train 
disadvantaged minority students for service in underserved 
areas. Located in poor communities and usually with little 
State funding, they serve the health care needs of their 
patients often without remuneration.

Health careers opportunity program

    The Committee provides $23,918,000 for the health careers 
opportunity program, which is the same as the 1996 level and 
$2,867,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. This 
program provides funds to medical and other health professions 
schools for recruitment of disadvantaged students and 
preprofessional school preparations.

Exceptional financial need scholarships

    The Committee provides $10,120,000 for exceptional 
financial need scholarships, which is the same as the 1996 
level and $1,213,000 below the House allowance. The 
administration requested funding in a consolidated program 
cluster. This program provides scholarship assistance to 
exceptionally needy students enrolled in schools of medicine, 
osteopathic medicine, or dentistry who agree to practice 
primary care for 5 years after completing training.

Faculty loan repayment

    The Committee provides $947,000 for faculty loan repayment, 
which is the same as the 1996 level and $114,000 below the 
House allowance. The administration requested funding in a 
consolidated program cluster. 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.

Financial assistance for disadvantaged health professions students

    The Committee provides $5,999,000 for financial assistance 
for disadvantaged health professions students, which is the 
same as the 1996 level and $719,000 below the House allowance. 
The administration requested funding in a consolidated program 
cluster. 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.

Scholarships for disadvantaged students

    The Committee provides $16,677,000 for scholarships for 
disadvantaged students, which is the same as the 1996 level and 
$1,999,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 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 continues to intend that all health 
professions disciplines made eligible by statute be able to 
participate in the scholarships program.

Family medicine training

    The Committee provides $44,002,000 for family medicine 
training and departments, which is the same as the 1996 level 
and $5,275,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 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

    The Committee provides $15,741,000 for general internal 
medicine and pediatrics, which is the same as the 1996 level 
and $1,887,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 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

    The Committee provides $5,697,000 for physician assistants, 
which is the same as the 1996 level and $683,000 below the 
House allowance. The administration requested funding in a 
consolidated program cluster. This program supports planning, 
development, and operation of physician assistant training 
programs.

Public health and preventive medicine

    The Committee provides $7,148,000 for public health and 
preventive medicine, which is the same as the 1996 level and 
$857,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 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.

Health administration traineeships and special projects

    The Committee provides $978,000 for health administration 
traineeships and special projects, which is the same as the 
1996 level and $117,000 below the House allowance. The 
administration requested funding in a consolidated program 
cluster. 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.
    With escalation in health care costs and the rapid changes 
in the structure of the U.S. health care system, the Committee 
notes the increasing importance of assuring that our health 
care facilities, systems, and networks are managed by 
administrators who are trained in the latest management 
techniques.

Area health education centers

    The Committee provides $26,000,000 for area health 
education centers, which is $2,877,000 above the 1996 level and 
$2,495,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 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 programs to extend 
AHEC programs with 50 percent Federal funding.
    The Committee continues to be impressed with the various 
AHEC models operated in a variety of States. 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 Committee recognizes the role of a variety of 
professions in the provision of primary care services, 
including allied health professionals and social workers. The 
Committee urges HRSA to diversify the mix of providers trained, 
particularly for work in underserved communities as part of an 
interdisciplinary primary care team. The Committee further 
urges HRSA to collaborate with SAMHSA to support 
interdisciplinary health professions training projects for 
practice in managed care and other settings.
    With promising biomedical advances in research on chronic 
fatigue and immune dysfunction syndrome [CFIDS], there is an 
urgent need to begin active clinical care education programs 
for physicians and other health care professionals. The 
Committee strongly urges HRSA to conduct an inventory of CFIDS-
related resources for AHEC's and design appropriate training 
curricula.
    Within the amount provided for area health education 
centers, the Committee urges the support of programs designed 
to encourage high school students, especially those from 
underserved rural areas, to pursue careers in the health 
professions. The Committee is aware of the medical scholars 
program of the University of Idaho, in association with the 
WAMI (Washington, Alaska, Montana, and Idaho) cooperative 
medical program of the University of Washington School of 
Medicine, and urges its full and fair consideration of its 
proposal.

Border health training centers

    The Committee provides $3,350,000 for border health 
training centers, which is the same as the 1996 level and 
$402,000 below the House allowance. 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.

General dentistry residencies

    The Committee provides $3,381,000 for general dentistry 
residencies, which is the same as the 1996 level and $405,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. 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. General dentistry residents receive extensive 
clinical experience providing primary care in community-based 
settings allowing graduates to rely less on specialists. These 
residents are important in many rural and underserved inner-
city areas where oral health is often unavailable.

Allied health advanced training and special projects

    The Committee provides $3,424,000 for allied health special 
projects, which is the same as the 1996 level and $410,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. This program provides funds 
to assist schools or programs with projects designed to plan, 
develop, or expand postbaccalaureate 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, and 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 professionals experiencing shortages, such as medical 
technologists and cytotechnologists.

Geriatric education centers and training

    The Committee provides $7,933,000 for geriatric education 
centers and training, which is the same as the 1996 level and 
$951,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. This 
program supports grants to health professions schools to 
establish geriatric education centers and to support geriatric 
training projects.

Rural health interdisciplinary training

    The Committee provides $4,154,000 for rural health 
interdisciplinary training, which is $445,000 above the 1996 
level and the same as the House allowance. The administration 
requested funding in a consolidated program cluster. 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.

Podiatric primary care training

    The Committee provides $605,000 for podiatric medicine, 
which is the same as the 1996 level and $73,000 below the House 
allowance. The administration requested funding in a 
consolidated program cluster. The program provides grants to 
hospitals and schools of podiatric medicine for residency 
training in primary care.

Chiropractic demonstration grants

    The Committee provides $916,000 for chiropractic 
demonstration grants, which is the same as the 1996 level and 
$110,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. The 
program provides grants to colleges and universities of 
chiropractic to carry out demonstration projects in which 
chiropractors and physicians collaborate to identify and 
provide effective treatment of spinal and lower back 
conditions.

Advanced nurse education

    The Committee provides $11,134,000 for advanced nurse 
education, which is the same as the 1996 level and $1,335,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. 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

    The Committee provides $17,588,000 for nurse practitioners 
and nurse midwife education, which is $2,128,000 above the 1996 
level and the same as the House allowance. The administration 
requested funding in a consolidated program cluster. 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.

Nursing special projects

    The Committee provides $9,436,000 for nursing special 
projects, which is the same as the 1996 level and $1,131,000 
below the House allowance. The administration requested funding 
in a consolidated program cluster. This program supports 
projects to increase the supply of nurses meeting the health 
needs of underserved areas; demonstrate methods to improve 
access to nursing services in nontraditional settings; and 
demonstrate innovative nursing practices.

Nurse disadvantaged assistance

    The Committee provides $3,867,000 for nurse disadvantaged 
assistance, which is $414,000 above the 1996 level and the same 
as the House allowance. The administration requested funding in 
a consolidated program cluster. 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

    The Committee provides $14,235,000 for professional nurse 
traineeships, which is the same as the 1996 level and 
$1,707,000 below the House allowance. The administration 
requested funding in a consolidated program cluster. 
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

    The Committee provides $2,469,000 for nurse anesthetists, 
which is the same as the 1996 level and $296,000 below the 
House allowance. The administration requested funding in a 
consolidated program cluster. Grants are awarded to eligible 
institutions to provide traineeships for licensed registered 
nurses to become certified registered nurse anesthetists 
[CRNA]. The program also supports fellowships to enable CRNA 
faculty members to obtain advanced education.

                          other hrsa programs

Hansen's disease services (Carville)

    The Committee has included $17,094,000 for the Hansen's 
Disease Program, which is the same as the 1996 level, $723,000 
above the administration request, 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 provide for regionalized 
care for Hansen's disease patients on an outpatient basis.

Maternal and child health block grant

    The Committee recommends $678,204,000 for the maternal and 
child health [MCH] block grant. This is the same as the fiscal 
year 1996 appropriation and $2,857,000 below the administration 
request and the House allowance.
    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 percentage 
split as the basic block grant formula.
    The hemophilia treatment centers program serves as a model 
in the management of chronic diseases, demonstrating cost-
effective health outcomes. The Committee encourages the 
Maternal and Child Health Bureau to work collaboratively with 
the Centers for Disease Control and Prevention to ensure that 
the treatment center network is utilized in critical data 
collection, surveillance, patient notification, and outreach 
related to blood and blood products usage.
    The Committee is pleased with the Bureau's efforts in 
working with the National Institute of Child Health and Human 
Development's back to sleep campaign for sudden infant death 
syndrome [SIDS], and by its effort to understand the need for 
SIDS services through the nationwide survey of sudden infant 
death services. The Committee recommends that the MCH Bureau 
initiate establishment of the SIDS program support center as 
recommended by the nationwide survey.
    The Committee commends the Office of Adolescent Health for 
working to develop an integrated, multidisciplinary approach, 
and urges its continued emphasis on using the expertise of a 
variety of health professions, including nursing. The Committee 
further urges that special attention be devoted toward 
addressing adolescents' mental health problems, including 
depression, violence, and suicide. The Committee commends the 
close working relationship between the Office of Adolescent 
Health and the Carnegie Council on Adolescent Development, and 
urges the implementation of the Carnegie Council's 
recommendations.
    The Committee is concerned that almost one-half of the 
States have fluoridation rates below 60 percent. Fluoridation 
is one of the most cost-effective public health measures that 
our Nation can undertake. Currently, it costs between 20 and 50 
cents per person per year to provide fluoridation. The National 
Institute of Dental Research estimates that preventive 
dentistry, including fluoridation, has saved nearly 
$100,000,000,000 in the United States in potential dental care 
expenses between 1979 and 1989. The Committee expects the MCH 
Bureau to develop an implementation plan for increased 
fluoridation and urges it to allocate SPRANS funds to assist 
those States with fluoridation levels below 25 percent. 
Sufficient SPRANS funds are available to initiate this 
important public health activity.

Healthy start initiative

    The Committee recommends $96,000,000 for the healthy start 
infant mortality initiative. This amount is $3,184,000 above 
the fiscal year 1996 amount, $96,000,000 more than the House 
allowance, and $21,162,000 more than the administration 
request.
    The Committee does not concur with the House language 
terminating the Healthy Start Program in fiscal year 1997. 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. The initiative was expanded 
in fiscal year 1994 by a special projects program, which 
supported an additional seven urban and rural communities to 
implement infant mortality reduction strategies and 
interventions.
    While these projects have made substantial progress in the 
reduction of infant mortality, there remain significant 
challenges to sustain the gains already attained. Abrupt 
termination of the program will likely result in increases in 
infant mortality in the targeted project areas. While the 
Committee is aware of the original timeframe of the program, it 
places its highest priority toward averting and reducing infant 
mortality through sustainable means in areas with continued 
critical needs.
    The funds provided by the Committee would provide the 
opportunity to replicate the best models from the demonstration 
phase of the initiative and propagate the lessons learned with 
more than 300 urban and rural communities with a high rate of 
infant mortality. Within this amount, funds would be available 
to existing projects for: the continued support of successful 
strategies and interventions; the utilization of these projects 
as resource centers for other health providers, including 
managed care organizations; and for the initiation of projects 
in new communities with high incidence of infant mortality. 
Existing sites include those initially approved in 1991 but not 
funded until 1994. Funds are also included for the awarding of 
new community-based projects to replicate successful strategies 
and interventions toward infant mortality reduction, especially 
in conjunction with individual programs already underway.

Organ procurement and transplantation

    The Committee provides $2,296,000 for organ transplant 
activities. This is the same as the administration request, 
$227,000 more than the fiscal year 1996 appropriation, and 
$104,000 below 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 concurs with House report language in 
requesting HRSA to identify potential ways that the program 
could attain financial self-sufficiency.

Health teaching facilities interest subsidies

    The Committee recommends $297,000 for interest subsidies 
for three health professions teaching facilities. This is the 
same as the administration request and the House allowance, and 
$114,000 less than the fiscal year 1995 appropriation. This 
program continues support of interest subsidies and loan 
guarantees for three loans for construction of health 
professions teaching facilities under a now discontinued Public 
Health Service Act authority. The remaining Federal commitment 
on these loans will expire in the year 2004.

National bone marrow donor program

    The Committee has included $15,272,000 for the national 
bone marrow donor program. This is $60,000 below the 
administration request and the same as the fiscal year 1996 
level and the House allowance. The National Bone Marrow Donor 
Registry is a network, operated under contract, that helps 
patients suffering from leukemia or other blood diseases find 
matching volunteer unrelated bone marrow donors for 
transplants. The program also conducts research on the 
effectiveness of unrelated marrow transplants and related 
treatments.
    The Committee is pleased that the National Bone Marrow 
Registry is increasingly meeting the needs of a significant 
proportion of those in need of allogenic bone marrow 
transplants. In addition, the bone marrow program is continuing 
to increase the size and diversity of the registry of potential 
donors. Continued progress is critical to improving the chances 
of finding a matched marrow donor for patients of all races and 
ethnic heritage.

Rural health outreach grants

    The Committee recommends $27,797,000 for health outreach 
grants. This amount is the same as the fiscal year 1996 level, 
$2,457,000 lower than the administration request, and 
$23,797,000 above 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 rural telemedicine projects.
    The Committee urges the continuation of the grant to the 
Canton-Potsdam Hospital of New York, which supports a 
consortium of local organizations that provides community-based 
cardiopulmonary resuscitation training.
    The Committee understands that the Graham Children's Center 
at Mission Hospital in Asheville, NC, operates a special 
vehicle, the ``Tooth Bus,'' that provides dental services to 
medically underserved children in the Appalachia region of the 
State. The Committee recognizes the importance of dental care 
to young children in impoverished areas and urges the center's 
proposal be given full and fair consideration for support.

Emergency medical care for children

    The Committee provides $12,500,000 for emergency medical 
services for children. This is the same as the House allowance 
and $1,745,000 above the 1996 level. The administration 
requested funding in an emergency medical services cluster. The 
program supports demonstration grants for the delivery of 
emergency medical services to acutely ill and seriously injured 
children.

Black lung clinics

    The Committee includes $4,000,000 for black lung clinics. 
This is $189,000 more than the fiscal year 1996 amount and 
$100,000 above the House allowance. The administration 
requested funding in a consolidated program cluster. This 
program funds clinics which treat respiratory and pulmonary 
diseases of 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 $6,000,000 for Alzheimer's 
demonstration grants, which is $2,020,000 above the 1996 level 
and the same as the House allowance. The administration 
requested funding in a consolidated program cluster. Through 
matching grants, this program has proved to be an effective 
tool in stimulating States to design and implement support 
services to families struggling to care for individuals with 
Alzheimer's disease.
    The Committee is aware that consideration is being given to 
transferring the program elsewhere in the Department. In light 
of the program's demonstrated success in stimulating State and 
local service networks, and the need to enhance access to 
community health centers, the Committee believes this program 
should remain in HRSA in order to avoid unnecessary disruption 
or uncertainty in program activities.
    The Committee encourages HRSA to consider testing methods 
for improving health care delivery to Alzheimer patients by 
linking projects with primary health care providers such as 
community and migrant health centers. Such methods might 
include: training care providers in dementia assessment and 
treatment; providing technical assistance to community health 
centers to enhance their capacity for dementia diagnosis, 
treatment, and care; and encouraging models for disease 
management and consultation among caregivers.

Payment to Hawaii, treatment of Hansen's disease

    The bill includes $2,045,000 for the treatment of persons 
with Hansen's disease in the State of Hawaii. This is the same 
as the 1996 level and the House allowance. The Committee 
continues to urge 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. Such an 
option would encourage current residents to consider 
transitioning out of the facility.

Pacific basin initiative

    The Committee provides $1,000,000 for the Pacific basin 
initiative, which is $200,000 below the 1996 level. The House 
did not provide funding for this activity. The program conducts 
various prevention-oriented and health professions training for 
service in the Pacific basin region. HRSA is requested to begin 
addressing the pressing health needs of rural Hawaii, 
particularly in conjunction with the training institutions of 
the University of Hawaii and its interisland distance learning 
efforts.
    The Committee is pleased that an Institute of Medicine 
study on the Pacific Basic Medical Officer Program has begun.

Traumatic brain injury demonstration grants

    The Committee provides $3,000,000 for traumatic brain 
injury demonstration grants. This is a new activity. H.R. 248, 
legislation authorizing this program has been enacted into law 
as Public Law 104-166. This program authorizes HRSA to award 
grants to the States for demonstration projects to improve 
access to health care and other services associated with the 
treatment of traumatic brain injury. States are required to 
establish State advisory boards to advise and make 
recommendations to the States on methods to improve services 
coordination, and to encourage citizen participation. States 
also are required to provide matching non-Federal funds at rate 
not less than $1 for each $2 of Federal funds provided under 
the grant.
    The authorizing legislation defines traumatic brain injury 
to mean an acquired injury to the brain, including anoxia due 
to near-drowning, but not including brain dysfunction caused by 
congenital or degenerative disorders nor birth trauma. The 
Secretary of HHS may revise the definition as necessary.

                  acquired immune deficiency syndrome

                        Ryan White AIDS programs

    The Committee provides $854,252,000 for Ryan White AIDS 
programs. This is $41,437,000 below the administration request, 
$96,850,000 above the 1996 level, and $42,000,000 over the 
House allowance.

Emergency assistance--title I

    The Committee recommends $401,700,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic. This 
amount is $10,000,000 above the fiscal year 1996 amount and the 
same as the House allowance. It is $22,243,000 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 
through supplemental competitive grants. No new areas are 
expected to be eligible for funding under title I in 1997.

Comprehensive care programs--title II

    The Committee has provided $332,847,000 for HIV health care 
and support services. This amount is $17,107,000 below the 
administration request, $72,000,000 above the 1996 level, and 
$42,000,000 above 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. 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.
    The Committee is encouraged by the advent of protease 
inhibitor therapy in combination with other medications for 
patients with HIV. The Committee continues to be concerned by 
the high costs of new medications for AIDS, and, in 
anticipation of higher demand for these treatments, has 
approved bill language for $117,000,000 for AIDS medications, 
compared to $52,000,000 provided for this purpose in fiscal 
year 1996. The administration submitted an amended budget 
request to include a total of $117,000,000 for State ADAP 
programs, an increase of $65,000,000 over the original request, 
and accompanied by equivalent proposed offsets.

Early intervention program--title III-B

    The Committee recommends $61,918,000 for early intervention 
grants. This is the same as the House allowance, $5,000,000 
above the 1996 level, and $2,650,000 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.
    To the extent practicable, the Committee encourages HRSA to 
fairly allocate the increase for title III-B between existing 
grantees and new providers. The Committee understands that 
existing grantees have been level-funded throughout the history 
of the CARE Act. By providing additional funds to current 
grantees, the Committee intends to undergird the HIV care 
infrastructure already established in title III-B clinics. The 
Committee also supports expansion of the number of communities 
receiving assistance from this title. The Committee understands 
that HRSA is conducting a grant-review process expected to 
identify qualified new grantees in underserved rural and urban 
areas.

Pediatric AIDS demonstrations--title IV

    The Committee recommends $34,000,000 for title IV pediatric 
AIDS demonstrations, which is the same as the House allowance 
and the administration request, and $5,000,000 above the 1996 
amount. 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.
    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 affirms the purpose of title IV to support 
programs that provide or arrange for innovative comprehensive 
HIV care for children, youth, women, and families with or 
affected by HIV/AIDS in association with voluntary 
participation in research programs. The Committee is encouraged 
by efforts to expand access to services for HIV-infected 
pregnant women. The Committee urges that a majority of title IV 
funding increases be awarded to existing comprehensive HIV-care 
projects in order to handle increased demand for services and 
that particular attention be paid to the needs of youth and 
women who now constitute the fastest growing group of people 
living with HIV/AIDS in the United States.

AIDS dental services

    The Committee provides $7,500,000 for AIDS dental services, 
which is $563,000 above the administration request and the 1996 
level, and is the same as the House level. 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.

AIDS education and training centers

    The Committee recommends $16,287,000 for the AIDS education 
and training centers [AETC's]. This amount is $4,287,000 above 
the 1996 level and the same as the administration request and 
the House allowance. 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.

Family planning

    The Committee recommends $198,452,000 for the title X 
family planning program. This is the same as the administration 
request and $5,860,000 above both the 1996 level and the House 
allowance. Title X grants support primary health care services 
at more than 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.

Rural health research

    The Committee recommends $9,553,000 for the Office of Rural 
Health Policy. This is $200,000 more than the fiscal year 1996 
level and $1,669,000 more than the administration request and 
the House allowance. The funds provided support for 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. The Committee remains strongly supportive of all 
existing rural telemedicine projects. Sufficient funding is 
available for the final year of the West Virginia telemedicine 
project at a level consistent with the average annual award of 
the project's previous 3-year grant cycle fiscal year 1992-94.

Health care facilities

    The Committee provides $13,000,000 for health care 
facilities, which is $7,000,000 below the 1996 level, 
$11,000,000 above the administration request, and $13,000,000 
over the House allowance. Funds are made available to public 
and private nonprofit entities for construction or 
modernization of outpatient medical facilities. Sufficient 
funds are provided for the modernization of a pediatric care 
center that combines patient care, research activities and 
teaching functions, and provides care for indigent and at-risk 
children.
    Sufficient funds are also provided for the construction of 
a health care center dedicated to the specialized needs of the 
elderly. The Committee understands that the University of 
Kansas Elder Care Center has many meritorious characteristics 
that would optimize the delivery of health care services to the 
elderly, and urges the full and fair consideration of its 
proposal.
    Funds are also available to complete the second phase of 
the project funded last year in this account that would 
establish a facility addressing the socioeconomic and medical 
needs of women in medically underserved populations.

Buildings and facilities

    The Committee recommends $828,000 for buildings and 
facilities, the same as the administration request, $2,000,000 
below the House allowance, and $87,000 above the fiscal year 
1996 amount. These funds provide for routine repairs and 
improvements at the Gillis W. Long Hansen's Disease Center 
located at Carville, LA.

National practitioner data bank

    The Committee has not provided funding for the national 
practitioner data bank, which is the same as the House 
allowance, the administration request, and the fiscal year 1996 
level. The Committee and the administration assume that 
$6,000,000 will be provided entirely through the collection of 
user fees and will cover the full cost of operating the data 
bank. Traditional bill language is included to ensure that user 
fees are collected to cover all costs of processing requests 
and providing such information to data bank users.

Program management

    The Committee recommends $112,949,000 for program 
management activities for fiscal year 1997. This is the same as 
the administration request and $891,000 above the 1996 level 
and the House allowance.

               medical facilities guarantee and loan fund

Appropriations, 1996....................................      $8,000,000
Budget estimate, 1997...................................       7,000,000
House allowance.........................................       7,000,000

Committee recommendation

                                                               7,000,000

    The Committee recommends $7,000,000 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 1996 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. The bill includes 
language, as in prior years, which prohibits commitments for 
new loans or loan guarantees in fiscal year 1997.

                   health education assistance loans

    The Committee recommends guarantee authority of 
$140,000,000 for new HEAL loans in fiscal year 1997, which is 
the same as the President's request and the House level and 
$70,000,000 below the fiscal year 1996 level.
    The Committee recommends $14,481,000 to liquidate 1997 
obligations from loans guaranteed before 1992, which is the 
same as the administration request and the House allowance and 
$14,481,000 above the 1996 appropriation. In addition, the 
Committee provides $477,000 to pay default claims arising from 
loans guaranteed in 1997, which is the same as the 
administration request and $351,000 above the 1996 
appropriation.
    For administration of the HEAL Program, the Committee 
recommends $2,688,000, which is the same as the 1996 
appropriation and the House allowance, and $7,000 below the 
administration request.
    The HEAL Program insures loans to students in the health 
professions and helps to ensure graduate student access to 
health professions education, especially among minority, 
disadvantaged students, and those from behavioral and mental 
health fields. 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 
anticipates that the need for the HEAL Program will decline as 
loan limits for guaranteed student loans have been raised by 
the Department of Education.

                 vaccine injury compensation trust fund

Appropriations, 1996....................................    $169,721,000
Budget estimate, 1997...................................     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 administrative costs. This amount is the same 
as both the budget request, the House allowance, and the fiscal 
year 1996 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 the administration request, the House 
allowance, and the fiscal year 1996 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, 1996....................................  $2,011,916,000
Budget estimate, 1997...................................   2,239,258,000
House allowance.........................................   2,187,018,000

Committee recommendation

                                                           2,209,948,000

    For the Centers for Disease Control and Prevention, the 
Committee provides $2,209,948,000, which is $98,032,000 above 
the 1996 level, $12,310,000 below the administration request, 
and $22,930,000 above the House allowance.
    The Committee views the disease prevention and health 
promotion activities of the Centers for Disease Control and 
Prevention [CDC] as a sound investment. Preventive health 
interventions 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. The 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. 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 Americans. Public health experts 
estimate that about one-half of the deaths which occur in the 
United States every year are considered preventable, as are 
many of the illnesses.
    The Committee commends the Director's efforts to promote 
behavioral and social sciences research at CDC and for creating 
the position of Assistant Director for Behavioral and Social 
Sciences. The Committee believes that such research is integral 
to the CDC mission. With the Committee's support, a similar 
office of behavioral and social sciences research was created 
at the National Institutes of Health. It has proven effective 
in identifying promising new directions for research. The 
Committee requests the Director to provide a status report on 
CDC's activities relating to behavioral and social sciences 
research.

Preventive health and health services block grant

    The Committee recommends $136,081,000 for the preventive 
health and health services block grant, $9,148,000 less than 
the President's request and the 1996 appropriation and 
$20,919,000 less than the House allowance. The Committee 
recommendation includes 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 services 
block grant. This amount is $6,458,000 over the 1996 
appropriation and the full amount authorized by the act for 
fiscal year 1997.
    The preventive health services 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.

Prevention centers

    The Committee recommends $8,099,000 for prevention centers. 
This is $993,000 over the President's request and the House 
allowance and is the same as the fiscal year 1996 
appropriation.
    CDC's Prevention Centers Program provides grants to 
academic programs to support 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 Committee 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 $106,299,000 for sexually 
transmitted disease prevention and control, $1,000,000 more 
than the House allowance and the fiscal year 1996 
appropriation. Since no action has been taken by the 
authorizing committee, funds have been provided under current 
law and not through TB/STD partnership grant as proposed in the 
President's budget.
    Because of the high rates of STD's in adolescents and young 
adults, and their facilitation of HIV transmission, sexually 
transmitted diseases continue to be one of the most formidable 
health challenges facing the United States. The mission of the 
STD 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.
    The Committee recommendation provides a $1,000,000 increase 
in funding for CDC's STD prevention efforts. The Committee 
notes the results of recent research reported in the New 
England Journal of Medicine regarding the link between cervical 
chlamydial infection and pelvic inflammatory disease. This 
research demonstrated that routine screening for chlamydia 
reduces the incidence of pelvic inflammatory disease. In light 
of these findings, the Committee instructs the CDC to maintain 
support for, and evaluate whether additional resources can be 
given to, the regional infertility demonstration projects. In 
addition, the Committee urges the CDC to give consideration to 
using its existing research funds to support a replication of 
this research.
    In light of changes occurring in the financing of health 
care, the Committee strongly urges CDC to assure that State and 
local STD programs maximize all potential sources of income, 
while assuring that these sources of payment do not represent 
barriers to STD screening and treatment. The sources of income 
include: private insurance, Medicaid, patient fees, payments 
from managed care health plans, and other sources as 
appropriate.

Immunization

    The Committee recommends $467,890,000 for immunization 
activities in fiscal year 1997 authorized under section 317 of 
the Public Health Service Act, the same as the House allowance 
and the fiscal year 1996 appropriation. Since no action has 
been taken by the authorizing committee, funds have been 
provided under current law and not through an immunization 
partnership grant as proposed in the President's budget.
    The Omnibus Reconciliation Act [OBRA] of 1993 established 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 
$523,952,000 for the purchase and distribution of vaccines for 
a total immunization recommendation of $991,842,000, an 
increase of $114,193,000 over fiscal year 1996.
    The appropriate administration of safe and effective 
vaccines remains the most cost-effective method of preventing 
human suffering and reducing economic costs associated with 
vaccine-preventable diseases. Through the immunization program, 
the 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, $139,393,000 is provided 
for the purchase of vaccine under the 317 program, the same as 
the President's request. Of the funds made available for 
vaccine purchase, 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 expects the 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 1997. CDC must ensure that all of 
these funds are used in each State for WIC immunization 
activities unless CDC can document that assessment and referral 
in a State's WIC sites are taking place without the need for 
specific funds. CDC should collaborate with the National 
Association of WIC Directors and with State immunization 
directors in setting the criteria for assessment, referral, and 
annual reporting of WIC coverage.
    As in previous years, the Committee expects the 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 
requests that the CDC provide technical assistance to the 
States for this purpose.
    The Committee recommendation assumes the continuation of 
the bonus program to improve immunization rates. Using State-
specific immunization coverage data, CDC will provide 
$33,000,000 in 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.
    The Committee recommends that $47,227,000 be made available 
within the funds provided 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 $20,000,000 over the 1996 
level, and the same as the President's request. The Committee 
is aware of the progress that has been made in eradicating 
polio, and the real prospect 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 savings in human and financial costs. To further 
support this effort, the Committee urges the CDC to allocate 
additional FTE's to the global eradication effort.
    During the past 4 years, CDC has supported several school-
based hepatitis B vaccination projects to determine the 
feasibility of delivering vaccine in this setting. The 
Committee understands that in response to language in the 
conference agreement to the fiscal year 1996 omnibus continuing 
resolution--encouraging the CDC to expand its school-based 
adolescent immunization effort--CDC is encouraging States to 
utilize these settings to further adolescent immunization. The 
Committee requests that the CDC be prepared to report on 
actions taken, and resources devoted, in fiscal year 1996-97 to 
encourage States to implement school-based adolescent 
immunization programs during the fiscal year 1998 hearings.

Infectious diseases

    The Committee's recommendation includes $86,153,000 for 
infectious diseases activities, $1,667,000 less than the 
President's request, $4,000,000 more than the House allowance, 
and $24,000,000 over the 1996 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.
    Infectious diseases and tropical infectious diseases are 
appearing or reappearing in the United States with increasing 
incidence. As the Institute of Medicine [IOM] reported in 1992, 
the United States is unprepared to monitor traditional 
infectious diseases and new and emerging infectious diseases. 
In response to the IOM report, the CDC developed a strategy 
which consists of four major goals for revitalizing our ability 
to identify, contain, and prevent emerging diseases: (1) 
surveillance; (2) applied research; (3) prevention and control; 
and (4) developing infrastructure.
    Funds provided in fiscal year 1996 are enabling CDC to 
begin to address the highest priorities. Most of CDC's effort 
has been directed at surveillance. The increase provided for 
fiscal year 1997 offers an opportunity for the CDC to focus on 
the remaining three goals of the strategic plan. In particular, 
the Committee encourages the CDC to vigorously pursue the 
applied research and infrastructure goals of the plan.
    Twenty-five million Americans suffer from ulcer disease, 
requiring more than 1 million hospitalizations annually. The 
Committee is aware of the 1994 NIH Consensus Development 
Conference which concluded that the bacterium helicobacter 
pylori causes most ulcers, not stress or diet as previously 
believed, and that most ulcers can be cost-effectively cured by 
eradicating H.pylori. The Committee is concerned, however, 
about whether the H.pylori discovery has been adequately 
disseminated to physicians, other health providers, and 
patients. Therefore, the Committee has provided sufficient 
funds for CDC to initiate a trans-department public education 
campaign to foster more effective communication between 
consumers and physicians on H.pylori and its link to ulcer 
disease. The Committee requests a report within 120 days on 
CDC's plans to conduct such an effort and the appropriate 
design of the campaign.
    The Committee remains committed to protecting the Nation's 
blood supply and urges the CDC and other agencies of the Public 
Health Service to take all necessary steps to ensure a safe 
blood supply and blood products as called for in the recent 
Institute of Medicine report regarding the contamination of the 
blood supply in the early eighties and its impact particularly 
on persons with hemophilia. The Committee encourages that, 
within available funds, the CDC provide support for 
implementing a comprehensive blood safety surveillance effort 
in the hematologic diseases intervention unit. The critical 
components of this effort should include: (a) active 
surveillance including a serum bank to monitor, detect, and 
warn of adverse effects among blood product recipients; (b) 
patient-related outreach activities; and (c) collaborative 
activities with other PHS agencies to address continuing safety 
concerns over possible viral or pathogenic contamination and 
related medical risks for persons with bleeding disorders. In 
carrying forward with this effort, the Committee encourages the 
CDC to work closely with national organizations, such as the 
National Hemophilia Foundation, with experience in this field. 
The Committee also urges the CDC to maintain the current 
hemophilia prevention of complications and risk reduction 
activities.
    The Committee is aware that CDC now estimates that 3.9 
million people are infected with hepatitis C, and that young 
adolescents are the largest group of people at risk of being 
infected with hepatitis B. The Committee encourages CDC to make 
hepatitis C a research priority as an emerging infectious 
disease and urges the CDC to support additional epidemiological 
studies to better identify the causes of these diseases. 
Additionally, the Committee has learned that the American Liver 
Foundation [ALF] answered 150,000 liver disease inquiries last 
year from patients, family members and physicians, a fourfold 
increase over the previous year. Responding to this growing 
demand for information on liver diseases may be beyond the 
resources of a private nonprofit organization. The Committee 
encourages the CDC to actively pursue a collaborative 
information effort with the ALF.
    The Committee encourages the CDC to consider establishing a 
demonstration program to establish, implement, and evaluate 
models to improve surveillance, prevention, and control of 
hospital acquired infections and drug resistance. Demonstration 
grantees could also serve as training sites for infection 
control practitioners and hospital epidemiologists.

Tuberculosis elimination

    The Committee's recommendation provides $119,303,000 for 
CDC's activities to prevent or control tuberculosis. This is 
the same as the House allowance and the fiscal year 1996 
appropriation. The President's budget proposed consolidation of 
these funds into an 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 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.
    The Committee notes the alarming increases within our 
Nation's correctional facilities in the number of TB and 
multidrug resistant TB cases; and encourages the CDC to work 
with not-for-profit organizations, like the National Commission 
on Correctional Health Care, that work with Federal, State, 
local health care, and corrections officials to evaluate and 
control the risks associated with the spread of TB within 
correctional facilities.

Chronic and environmental disease prevention

    The Committee's recommendation includes $155,000,000 for 
chronic and environmental disease prevention activities, the 
same as the House allowance and $11,256,000 over the 1996 
appropriation. The President's budget proposed a partial 
consolidation of these funds into a chronic disease partnership 
grant. Since no action has been taken by the authorizing 
committee, funding for chronic and environmental disease 
prevention activities has been provided under current law 
authorities.
    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.
    In fiscal year 1995, the Committee provided funding to 
initiate demonstration grants for the development of community 
partnership coalitions for the prevention of teen pregnancies. 
The Committee is pleased with the 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 third 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 in fiscal 
year 1997.
    The incidence of diabetes continues to increase 
dramatically, affecting more than 16 million persons in 
America. Recent research has demonstrated conclusively that 
controlling blood sugar levels prevents diabetes-related 
complications. The CDC supports local diabetes prevention and 
control programs in all but nine States and territories. The 
Committee supports this work and has included sufficient funds 
to enable the CDC to expand its diabetes prevention effort.
    The Committee also is aware of an innovative pilot project 
aimed at reducing the incidence and costs of diabetic related 
illness utilizing preventive health services. The Committee 
understands that the project would link Medicare patients who 
have diabetes to an electronic public health reminder system. 
This system would alert patients and/or their physicians who 
were overdue for regularly scheduled preventive health 
evaluations. The project would be a collaborative effort with a 
State medical association, State health division and the Health 
Care Financing Administration. The Committee encourages the CDC 
to give strong consideration to supporting this preventive care 
electronic facilitation service project within the funds 
provided.
    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 recommendation includes the President's 
request for the continuation of the Hanford thyroid morbidity 
study. The Hanford thyroid morbidity study is supported by CDC 
in its eighth year and is nearing completion. This research 
will be the only pivotal data in existence to determine the 
long-term health effects in people who were exposed to 
radioactive iodine from the Hanford site. The U.S. Department 
of Energy [DOE] provided supplemental funding in fiscal years 
1995 and 1996 and is finalizing an agreement with CDC to 
provide support for fiscal year 1997. The study is scheduled 
for completion in 1998 (9 years from its 1989 initiation) and 
the funds provided for the CDC will enable this critical 
project to remain on schedule.
    The Committee notes the work of the CDC, the National 
Institute of Child Health and Human Development, and the Health 
Resources and Services Administration in developing a model 
guideline for death scene protocol for sudden infant death 
syndrome. The Committee encourages continued development and 
publication of these guidelines.
    The Committee has provided sufficient funds to expand the 
Cancer Registries Program. The information gleaned from this 
registry could be a key component in winning the war against 
cancer.
    Prostate cancer now is the most commonly diagnosed cancer 
in America, and the impact on minority men is disproportionate. 
The Committee encourages the CDC to continue its prostate 
cancer awareness and outreach program targeted to high-risk 
populations. Furthermore, the Committee encourages the CDC to 
work with public and private nonprofit organizations with 
experience in cancer research education to maximize the 
effectiveness of the program.
    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. As 
it has for the past several years, the Committee requests CDC 
to utilize a portion of the funds in this account to support 
counteradvertising aimed at reducing the rate of 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 recommendation includes 
sufficient funds to expand support for the research on mild 
mental retardation, including the expansion of Project Begin.
    Last year, the Committee urged the CDC to continue its data 
collection efforts on the frequency and impact of arthritis, 
including that regarding special populations. The Committee 
notes a recent report by the CDC regarding the prevalence and 
impact of arthritis in the United States by race and ethnicity. 
The study found that arthritis was the most common self-
reported condition among Caucasians, the second most common 
among Hispanics, and the third most common among African-
Americans. The Committee urges CDC to continue its support of 
efforts that will reduce the occurrence of and the activity 
limitation attributable to arthritis for groups at greatest 
risk, including support of the CDC's State-based behavioral 
risk factor surveillance system.
    The Committee is aware that the CDC has moved the oral 
health activities from division status to program status due to 
budgetary constraints. The Committee recognizes, however, the 
contribution of oral health to overall health status, the 
significant health care expenditures directed to oral 
conditions that are largely preventable, and the importance of 
strong scientific leadership on oral health issues. The 
Committee, therefore, urges the CDC to reinstate the dental 
program as a division in fiscal year 1997 and believes 
sufficient funds are available to accomplish this objective. In 
the interim, the Committee urges the CDC to implement an 
organizational structure that provides the oral health program 
independence and flexibility in operation and creative support 
for basic administrative functions, thus freeing up the maximum 
resources for programmatic activities.
    The Committee understands that Malama, an innovative, 
culturally sensitive community partnership program has been 
very successful in addressing the prenatal care needs of 
minorities in rural Hawaii. The original project did not 
include teen pregnancies. The Committee urges the CDC to 
support the replication of this project to include teen 
pregnancies as it believes that this vulnerable population 
could benefit from this model.
    Heart attack, stroke, and other cardiovascular diseases are 
America's foremost cause of death and a leading cause of 
disability. Many of the 954,000 deaths each year from 
cardiovascular diseases are preventable, but most States lack 
the resources to implement broad-based, integrated efforts to 
prevent cardiovascular diseases. The Committee encourages CDC 
to launch a comprehensive national cardiovascular disease 
prevention and control program, with an emphasis on underserved 
populations, to educate the public about preventing 
cardiovascular diseases, track and monitor disease rates and 
risk factors, and help States implement community-based 
programs to promote physical activity and healthy diet.
    The Committee is concerned about the public health hazard 
posed by volcanic emissions, especially in Hawaii, and, 
therefore, encourages CDC to work with NINR and NIEHS in 
determining the environmental, physical, and mental effects of 
volcanic emissions that might result in higher levels of 
cancer, asthma, and other serious illnesses.
    The Committee remains supportive of the CDC's chronic 
fatigue and immune dysfunction syndrome [CFIDS] surveillance 
projects. The Committee encourages the CDC to include outreach 
to minority populations, adolescents, and children. 
Furthermore, the Committee encourages CDC to consider 
conducting education programs for health care professionals as 
well as initiating studies on rates of CFIDS among health care 
workers, family members of CFIDS patients, and pregnant women.
    The Committee is aware of the success of persons with limb 
loss in returning to the workplace following traumatic 
amputation surgery and acknowledges the important role access 
to rehabilitation information and services play in the 
amputation rehabilitation process. The Committee understands 
that existing information sources, however, are not equipped to 
handle the increasing demand for these services. The Committee 
recommendation includes sufficient funds for the CDC to provide 
one-time support for development of a National Limb Loss 
Information Center. Funds should be provided for the expansion 
of information dissemination capabilities and public education 
activities to improve upon the current system of amputation 
rehabilitative care delivery by affording consumers improved 
information regarding their care. The Committee intends that 
the CDC give priority consideration to an established national 
organization with experience in providing educational and 
support services to individuals with limb loss.
    With the support of this Committee, CDC initiated an effort 
to advance early intervention in epilepsy, a chronic 
neurological condition afflicting 2.5 million people in the 
United States. The Committee understands that CDC, working with 
national physician and patient organizations in epilepsy, is 
planning a consensus conference on effective epilepsy treatment 
and on development of patient-based evaluation of treatment. 
The Committee encourages the CDC to maintain support for this 
important effort.
    Although colorectal cancer is a common cause of ostomy 
surgery, the lack of reliable information in this area hampers 
the coordination of research and limits the effectiveness of 
patient outreach and education efforts. The Committee 
encourages the CDC to work with the National Patient Ostomy 
Organization to help establish a unified data base as part of 
CDC's colon cancer outreach and education activities in order 
to better direct Federal efforts to reduce the incidence of 
digestive disease.

Lead poisoning

    The Committee's recommendation includes $36,188,000 for 
lead poisoning prevention activities, the same as the 
President's request, the House allowance, and the 1996 
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 $139,670,000 for 
breast and cervical cancer mortality prevention activities, 
$5,000,000 above the House allowance and $15,000,000 more than 
the 1996 appropriation.
    The Committee views the Breast and Cervical Cancer 
Mortality Prevention Program as one of its highest priorities. 
While some progress has been made in reducing deaths from 
breast cancer, many 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 populations of women have not showed 
reductions in deaths from breast cancer, in large measure due 
to not having access to preventive services such as screening 
mammograms and pap smears.
    In fiscal year 1996, all 50 States and 13 American Indian 
tribal organizations will receive resources for comprehensive 
programs. 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.
    A recent NIH consensus conference documented the link 
between cervical cancer and the sexually transmitted human 
papilloma virus [HPV]. It has been estimated that over 90 
percent of cervical cancer cases result from this infection. 
The Committee encourages the breast and cervical cancer 
program, in collaboration with the CDC STD program, to develop 
a demonstration project on the link between HPV infection and 
cervical cancer. The project could examine how to identify and 
screen women at high risk of HPV infection and what 
surveillance strategies should be employed to assure early 
detection of cervical cancer in HPV-infected women.

Injury control

    The recommendation by the Committee includes $40,598,000 
for injury control efforts. This is $2,600,000 less then the 
President's request, the same as the House allowance, and 
$2,600,000 less than the fiscal year 1996 appropriation.
    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 concurs with the recommendation of the House 
that the CDC convene a study with the Institute of Medicine 
[IOM] on injury control and prevention. The study should: (1) 
reassess and characterize the problem of injury in the United 
States; (2) describe, assess, and evaluate the response of 
public and private agencies, especially the CDC National Center 
for Injury Prevention and Control to the recommendations of the 
IOM's ``Injury in America'' and subsequent reports; and (3) 
make recommendations intended to further develop the field and 
to reduce the burden of injury in the Nation.
    The Committee supports the extramural research program of 
the Center which funds 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 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 Committee encourages the Center to maintain support for 
the existing regional injury control research centers and to 
give consideration to providing increased support for the two 
recently approved centers to levels more commensurate with the 
other regional centers.
    Each year, approximately 300 bicyclists 17 years and 
younger are fatally injured, and over 150,000 are treated in 
hospital emergency rooms for bicycle-related head injuries. 
Research carried out at an NCIPC-supported center has shown 
that 85 percent of these head injuries can be prevented by the 
use of bicycle helmets. The Committee, therefore, encourages 
the NCIPC to expand support for comprehensive, community-based 
efforts throughout the country to promote the use of bicycle 
helmets. Such efforts should involve private and public 
partners, and include organizations interested in child health, 
safety, brain injury prevention, and cycling.
    The Committee recognizes that the Center is best positioned 
to provide leadership on the development of trauma care systems 
which save lives, prevent disability, and reduce costs. The 
NCIPC has committed limited resources to trauma system 
development by conducting evaluation research and uniform data 
collection. The Committee commends the Center for this effort 
and encourages the Center to augment the effort with a strong 
technical assistance program for States interested in working 
on trauma system development.
    The Committee understands that over 3 million children a 
year are victims of abuse and neglect and urges the Center to 
extend its focus on violence by supporting an initiative 
directed to the prevention of physical and emotional injuries 
associated with child maltreatment and neglect. Further, the 
Committee encourages the NCIPC to focus the initiative on 
establishing innovative training and service delivery models 
that prepare health professionals, including social workers, to 
work more effectively with abused and neglected children in a 
variety of settings. The Committee encourages the NCIPC to 
collaborate with relevant national organizations and with 
academic institutions, including schools of social work, in the 
development and implementation of this initiative.
    The Committee supports the work of NCIPC-supported programs 
related to child safety issues, and has included sufficient 
funds to continue funding for the child safety programs 
supported through the Center. The Committee is pleased with 
efforts to develop national guidelines for child safety, and 
encourages the Center to continue to support these efforts 
until guidelines are implemented nationally to provide 
improvements in safety guidelines for children across the 
Nation.
    The Committee recommendation maintains the proviso included 
in the House bill prohibiting the use of funds to advocate or 
promote gun control.
    The recommendation includes an additional $6,000,000 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. These funds will support community 
programs on domestic violence.

Occupational safety and health

    The Committee's recommendation includes $136,584,000 for 
the National Institute for Occupational Safety and Health 
[NIOSH], the same as the President's request and $7,961,000 
more than the House allowance and the 1996 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 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.
    Funds above the 1996 level have been provided for NIOSH to 
support intramural research on work-related diseases at the 
laboratory in Morgantown and the Committee understands that 
sufficient FTE's are available within the Department to fully 
staff their research program.
    The recommendation includes sufficient funds to continue 
the farm health and safety initiative at the fiscal year 1996 
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 3.5 
million 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 be maintained at not less than the level of 
funding provided in fiscal year 1996. The Committee also is 
pleased to note that this program has led to educational 
campaigns to prevent such problems as work injuries and 
fatalities among farm children, toxic chemical exposures, and 
traumatic injury and deaths involving farm machinery.
    Children as young as 5 years of age participate in farm 
work, and account for about 20 percent of the fatal injuries 
and 30 percent of nonfatal injuries associated with production 
agriculture. To address the complex issue of childhood 
agricultural injury prevention, the Committee understands that 
a group of agricultural community representatives formed the 
National Committee for Childhood Agricultural Injury 
Prevention. Through their efforts, a national plan for action 
to promote the health and safety of children exposed to 
agricultural hazards was developed. The Committee encourages 
NIOSH, with guidance provided by representatives of key Federal 
agencies, farm operator organizations, farmworker 
organizations, and agribusinesses, to build upon the work of 
this Committee, and implement a national action plan to promote 
childhood agricultural injury prevention.
    The Committee is aware of concern over the lack of 
standards and certification of personal protective clothing and 
equipment used by firefighters and emergency response 
personnel. The Committee encourages NIOSH to review these 
concerns and be prepared to report to the Committee on the 
feasibility and cost of implementing testing, certification of 
personal protective clothing, and equipment for firefighters 
and emergency response personnel during the fiscal year 1998 
budget hearing.
    On June 8, 1995, NIOSH published a revised respirator 
certification standard, capping 12 years of development. The 
Committee understands that during that period, manufacturers 
invested millions of research and development dollars to 
produce new technology that is more protective, more efficient, 
and meets the standards of the new rule. To ensure prompt 
access to new, more protective technology, the Committee urges 
NIOSH to process certification applications within 90 days of 
submission.
    NIOSH supports 14 university-based education resources 
centers. These centers are multidisciplinary university-based 
occupational health and research centers. Support also is 
provided to smaller, single-discipline training project grants 
for training in various occupational health therapies. The 
Committee encourages NIOSH to continue support for these 
important activities.
    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.
    Because of high injury rates in forestry and fishing, as 
well as farming, the Committee supports increased funding for 
an agricultural health and safety center in the Northwest that 
addresses these important economic sectors.
    Concerns have been brought to the attention of the 
Committee regarding the design of a multiyear study, jointly 
funded by NIOSH and the National Cancer Institute, to examine 
the health effects of diesel fumes on workers in underground 
noncarbon mines. The Committee believes this is an important 
area of inquiry, and urges the Director of NIOSH and of the 
National Cancer Institute to make certain that the study meets 
the highest standard of scientific peer review in order to 
ensure that it provides a definitive answer to the question of 
whether diesel exhaust adversely affects the health of workers.

Mine safety and health

    The recommendation includes $32,000,000 to finalize the 
transfer of the former U.S. Bureau of Mines mine safety and 
health research activities to NIOSH as proposed by the 
President's budget. This is $32,000,000 above both the House 
allowance and the 1996 appropriation. The former Bureau of 
Mines research activities address a broad spectrum of issues 
which target worker safety, disaster prevention, and health in 
the mining industry.
    While NIOSH has had responsibility for occupational safety 
and health research aimed at industry in general, the Committee 
understands that many mine safety and health research needs are 
either unique to mining or require mining-specific emphasis. 
The Committee, therefore, expects the NIOSH to preserve the 
integrity of the mine safety and health research unit of the 
Bureau so that the collective experience and expertise of that 
group can be maintained within NIOSH. To further ensure the 
maintenance of this unit and its mission, the Committee 
recommends that NIOSH move forward with establishing a new 
Associate Director for Mine Safety and Health Research who 
reports directly to the NIOSH Director.
    The Committee understands that NIOSH plans to appoint an 
Acting Associate Director while launching a national search for 
a permanent Associate Director. The Committee believes that the 
Associate Director should be an individual whose education and 
experience relates to mine safety and health, such as mining 
engineering, and safety and health system design and 
implementation. The Committee urges the Director to move ahead 
expeditiously with the search process.
    The Committee also understands that a transition of this 
kind naturally raises concerns from within industry and the 
mine worker community about the continuity and direction of the 
research program and urges NIOSH to quickly establish strong 
and effective communications and liaison with its constituents. 
To assist in carrying out its oversight function of NIOSH's 
newly acquired management responsibility for mine safety and 
health research, the Committee requests the Director prepare 
and submit a report detailing the completion of the transfer, 
the management structure, the number of FTE's, the current 
research portfolio, and future research plans prior to the 
fiscal year 1998 budget hearings.

Traumatic brain injury

    Traumatic brain injury has become the No. 1 killer and 
cause of disability of young people in this country. The 
Committee has provided $3,000,000 to support the activities 
authorized by section 4(a)(1)(A) of Public Law 104-166, the 
Traumatic Brain Injury Act. Funds will be used to support 
studies in collaboration with State and local health-related 
agencies to: (1) determine the incidence and prevalence of 
traumatic brain injury; and (2) develop a uniform reporting 
system under which States report incidents of traumatic brain 
injury. Funds also will be used to identify common therapeutic 
interventions which are used for the rehabilitation of 
individuals with such injuries, and develop practice guidelines 
for the rehabilitation of traumatic brain injury at such time 
as appropriate scientific research becomes available.

Epidemic services

    The Committee's recommendation includes $69,813,000 for 
epidemic services, $2,400,000 over the President's request and 
the House allowance and $2,403,000 over the 1996 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.
    Consistent with the decision of the Secretary of Health and 
Human Services, the Committee recommendation includes an 
increase of $2,400,000 for CDC to continue screening refugees 
entering the United States for conditions that may require 
treatment. CDC has carried out these public health 
responsibilities for the last 1\1/2\ decades as mandated by the 
Refugee Health Act of 1980 through the transfer of funds from 
the Office of Refugee Resettlement. The Committee agrees with 
the Secretary that CDC must provide refugee medical screening 
and other health services prior to resettlement in this country 
in order to help protect the United States against emerging and 
reemerging infectious diseases and has provided the 
appropriation directly to the CDC for fiscal year 1997.
    The Committee notes the alarming health conditions that 
exist within our Nation's correctional facilities and 
encourages the CDC to work with not-for-profit organizations, 
like the National Commission on Correctional Health Care, that 
work with Federal, State, and local health care and corrections 
officials to evaluate and control the epidemiological risks 
associated with health care within correctional facilities.

Health statistics

    Included in the recommendation of the Committee is 
$33,000,000 in Federal funds for health statistics. Also 
included is $53,063,000 to be provided from PHS 1 percent 
evaluation funds. This brings the total available to the CDC 
for health statistics to $86,063,000. This is $2,400,000 less 
than the President's request and the House allowance and 
$8,602,000 more than the fiscal year 1996 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. The recommendation also 
includes increased funds to implement the national health and 
nutrition examination survey [NHANES]. NHANES is the only 
national source of objectively measured health status data, and 
is essential to interpreting information from other survey 
components. The survey is an important part of national 
surveillance capability for infectious diseases, behavioral and 
environmental risk factors to health, undiagnosed preventable 
illnesses, nutritional status, and other critical issues. 
NHANES was most recently conducted from 1988-94, and the CDC 
plans to convert the survey to a continuous monitoring survey 
beginning in 1998.

Human immunodeficiency virus

    The Committee recommendation includes $589,080,000 for HIV/
AIDS activities, $10,000,000 less than the House allowance and 
$5,000,000 over the fiscal year 1996 appropriation. Since no 
action has been taken by the authorizing committee, funds have 
been provided under current law, instead of through an HIV 
partnership grant as proposed in the budget request.
    The Committee commends CDC for it's reorganization and 
creation of the National Center for HIV, STD, and TB 
Prevention, which has strengthened and enhanced CDC's ability 
to prevent and control the spread of HIV, TB, and STD's. This 
reorganization consolidates CDC's HIV/AIDS scientific and 
prevention programs into a single division thereby 
strengthening the science base of CDC's prevention activities. 
The Committee expects the CDC to continue to strengthen the 
link between epidemiology/surveillance activities and the 
development and implementation of program activities. The 
Committee encourages CDC to provide greater technical 
assistance and support to State and local health departments 
and community-based organizations for more targeted and 
effective prevention programs.
    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 encouraged by the preliminary results from 
projects in Philadelphia and Baltimore where women at high risk 
or already HIV positive are changing their risky behaviors. The 
Committee recommendation includes sufficient funds to continue 
these projects for 1 year and to produce materials necessary 
for the replication of these projects in other communities and 
other high-risk populations.
    There is clear epidemiological data that several sexually 
transmitted diseases, most notably syphilis, dramatically 
increase the risk of transmission of HIV. Certainly, this has 
been the experience in the Southeastern region of the country, 
where extremely high syphilis rates have led to dramatic 
increase in AIDS cases. The Committee encourages the HIV and 
STD divisions to work collaboratively on a strategy to reduce 
both HIV and syphilis, and other STD rates, particularly in the 
Southeastern region of the United States.
    The Committee understands the Department is continuing to 
support research, reviewing the effect of clean needle exchange 
programs on reducing HIV transmission, and on whether such 
programs encourage illegal drug use. The Committee requests 
that the Secretary provide a report by February 15, 1997, on 
the status of current research projects, an itemization of 
previously supported research, and the findings to date 
regarding the efficacy of needle exchange programs for reducing 
HIV transmission, and not encouraging illegal drug use.

Building and facilities

    The Committee recommendation includes $7,553,000 for repair 
and renovation of CDC facilities, $800,000 below the 
President's request and the House allowance and $3,200,000 more 
than the fiscal year 1996 appropriation. The increase of 
$3,200,000 will be used to design and build a 15,000 net square 
foot biosafety level 3 laboratory to enable the CDC to begin 
the renovation of laboratories that are more than 35 years old. 
The new space is essential in order to avoid interruption of 
vital testing of pathogens for infectious disease programs 
during the renovation period.
    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 
$2,637,000, the same as the President's request, the House 
allowance, and the fiscal year 1996 appropriation.
    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.
    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.

Violent crime reduction trust fund

    The Committee recommendation includes $41,000,000 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 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, and $6,000,000 for grants to public and private 
nonprofit organizations to support community programs to 
prevent domestic violence.
    The $35,000,000 for rape prevention and services will be 
used by States to support rape crisis centers and State 
coalitions to support rape crisis hotlines, victim counseling, 
professional training of police officers and investigators, and 
education programs in colleges and secondary schools. The 
Committee urges CDC to ensure that States receiving funds from 
the grants for assistance to victims of sexual assault, as 
provided by the Violence Against Women Act, support State 
sexual assault coalitions and community-based rape crisis 
centers whose work is focused on ending sexual violence, 
operating hotlines for victims of sexual violence and their 
families, and those which provide crisis intervention, 
advocacy, and self-help services to victims. The Committee also 
urges that similar nongovernmental nonprofit agencies show a 
demonstrated effectiveness in carrying out work achieving these 
goals in order to receive funds. In addition, the Committee 
urges that CDC ensure that the States, pursuant to targeting 
education programs as required by the act, use at least 25 
percent of the State's allocation for rape crisis centers and 
sexual assault coalitions to provide rape prevention and 
education for middle, junior, and high school-aged youth in 
both school and nonschool settings.
    The Committee understands that CDC continues to support 
research on violence against women and commends these efforts. 
The Committee also understands that violence against women 
living in rural communities poses problems that are uniquely 
different from those experienced by women in urban communities. 
As CDC develops strategies to strengthen the research base on 
violence against women, the Committee encourages CDC to support 
research on violence against women in rural communities.

                     National Institutes of Health

    The Federal investment in biomedical research at the 
National Institutes of Health continues to be regarded by the 
Committee as one of its highest priorities. The Committee has 
again worked hard to recommend funding for the NIH which 
reflects its strong commitment to medical research while also 
maintaining support for other essential primary and preventive 
health programs. The fiscal year 1997 recommendation for the 24 
Institutes, centers, and divisions which comprise the National 
Institutes of Health totals $12,414,580,000 and, in the view of 
the Committee, is sufficient to provide the Federal support 
necessary to maintain a stable biomedical research enterprise 
in this Nation. The recommendation is $487,018,000 over the 
1996 level, $38,019,000 over the President's request, and 
$332,623,000 less than the House allowance.
    The Committee commends the Director for steps the NIH has 
taken to streamline the agency's administrative practices. In 
particular, the Committee applauds steps taken by the NCI, 
NHLBI, NIAID, NIGMS, and NCHGR to reorganize and streamline 
both organizational and administrative functions. The Committee 
believes, however, that greater efficiencies can be identified 
and implemented in the administrative structure and management 
of the National Institutes of Health. The constraints on 
discretionary spending that will confront this Committee in the 
years ahead demand that an aggressive long-term strategy for 
streamlining agency organizational functions and reducing 
administrative costs be developed and implemented. Particular 
consideration should be given to the consolidation of functions 
across Institutes, such as personnel, legislation, planning and 
evaluation, contracting, grant administration, and public 
affairs.
    The Committee is concerned about the future supply of the 
Nation's health researchers, and believes that NIH continue 
efforts to ensure a stable supply of highly qualified research 
scientists. The National Academy of Sciences, in its latest 
report, recommended that NIH increase the number of scientists 
in behavioral science, nursing research, health services 
research, and oral health research. The Committee encourages 
NIH to make a focused effort to train young scientists in these 
critical areas and to consider small grant programs to provide 
support to new investigators.

                       NATIONAL CANCER INSTITUTE

Appropriations, 1996....................................  $2,248,000,000
Budget estimate, 1997...................................   2,280,931,000
House allowance.........................................   2,385,741,000

Committee recommendation

                                                           2,326,096,000

    The Committee recommends an appropriation of $2,326,096,000 
for the National Cancer Institute [NCI]. This is $45,165,000 
more than the administration's request, $78,096,000 more than 
the fiscal year 1996 appropriation, and $59,645,000 less than 
the House allowance. The comparable numbers for the budget 
estimate and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The 1996 
appropriation and 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 survival.--Improvements in prevention, early 
diagnosis and detection, and treatment have improved the 
overall cancer survival rate from 38 percent 25 years ago to 
over 50 percent today. Furthermore, exciting breakthroughs have 
been reported just within the last 2 years, such as the 
discovery of the BRCA1 breast cancer gene, the identification 
of a gene that suppresses the ability of prostate cancer cells 
to metastasize in animals, and the identification of the FHIT 
gene which is involved in cancers of the lung, esophagus, 
stomach, and colon.
    Research agenda.--The Committee commends the NCI on its 
efforts to support a balanced cancer research agenda--one which 
includes basic, clinical, and translational research and which 
includes research in cancer prevention, control, and 
survivorship. The Committee also emphasizes that, within this 
balanced approach to cancer research, there should be 
flexibility in the use of these funds to address high priority 
initiatives and to fund quality research programs and their 
applications.
    The Committee has reviewed the report of the NCI Director, 
``The Nation's Investment in Cancer Research,'' and is very 
pleased to provide additional funds to undertake some of the 
new and exciting approaches described in this document. The 
Committee agrees that new technologies will be needed to allow 
researchers, physicians, and patients to benefit from the vast 
amounts of information that are certain to be available in the 
near future as a result of our expanding knowledge of cancer 
genetics and molecular biology. The Committee encourages the 
NCI to develop and implement the strategies necessary to 
achieve investment opportunities and looks forward to hearing 
about progress in these areas at next year's hearing.
    The NCI also is to be commended for efforts to direct 
special attention to novel proposals, particularly for patient-
oriented research grants. Researchers are gaining tremendous 
insight into how cancer works, but this knowledge will not 
benefit the cancer patient unless researchers have the 
resources and skills to translate this information from the 
bench to the bedside. The decision to provide a second review 
of novel and patient-oriented grants within 10 points of the 
payline sends a positive message to both the patient and the 
research community.
    Infrastructure reforms.--The Committee supports the NCI in 
its efforts to respond to and implement the reforms recommended 
by the Bishop-Calabresi report of the National Cancer Advisory 
Board. The Committee applauds the actions on the part of the 
NCI, and the NIH as a whole, to maximize the effective use of 
limited research dollars in our ongoing national effort to cure 
cancer.
    Cancer centers program.--The Committee continues to 
strongly support the NCI-sponsored cancer centers program. This 
network is a national treasure and needs to continue to be 
strengthened and expanded.
    Breast cancer.--While recent statistics show a drop in 
deaths between 1989 and 1992, still breast cancer is expected 
to strike over 180,000 American women this year. The Committee 
believes 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 and urges the Institute to continue to strengthen its 
budgetary commitment to breast cancer research.
    The Committee understands that the San Francisco Bay, CA, 
area has one of the highest rates of breast cancer incidence in 
the world and mortality rates significantly higher than State 
and national levels. Regional variations in cancer rates can 
provide important information about environmental contributions 
to breast cancer. Epidemiologic investigations are needed to 
identify novel risk factors, including environmental exposures, 
which may be contributing to the high incidence and mortality 
rates of breast cancer in these areas. The Committee encourages 
the Institute, in collaboration with the National Institute of 
Environmental Health Sciences, to support research on the risk 
factors for the high breast cancer incidence and mortality 
rates in the San Francisco Bay area, and explore the 
feasibility of mapping disease rates along with environmental 
exposure information.
    In addition to the San Francisco Bay area, the Committee 
also recognizes that the incidence of breast cancer is 
significantly higher than the national average in the 
Northeastern States of Rhode Island, Pennsylvania, New 
Hampshire, and Maine. The mortality rate is approximately 12 
percent higher for women with breast cancer living in these 
States than for women residing in the Midwestern and Western 
United States. For example, according to the Centers for 
Disease Control [CDC], New Hampshire has the ninth highest per 
capita mortality rate at 39.7 deaths per 100,000. This rate is 
disproportionately even higher in Coos County, NH; concern has 
been expressed that there may be an environmental cause related 
to this tragic problem. The Committee hopes that NCI will work 
with other agencies in a coordinated manner toward the goal of 
eliminating all causes of breast cancer.
    In addition to the importance of studies of regional 
variations in cancer rates, the Committee appreciates that 
future advances in our knowledge about breast cancer will also 
result from a more complete understanding of the breast cancer 
genome. The Committee is supportive of the NCI's initiative to 
gather more complete information regarding genetic damage, cell 
signal pathways, and a number of other factors, and how these 
factors can lead to a greater understanding of environmental 
factors and their relationship to breast cancer.
    The Committee requests that the NCI be prepared to provide 
an update of progress on research on the risk factors for high 
breast cancer incidence and mortality rates in the San 
Francisco Bay area, as well as the Institute's cancer genome 
anatomy project during the fiscal year 1998 budget hearings.
    Over the past 3 years, breast cancer research has benefited 
from the increased involvement of lay breast cancer advocates 
who represent, are accountable to, and report to organizations 
representing the affected community. The involvement of these 
consumers at all levels of decisionmaking that affects their 
lives has helped foster new and innovative breast cancer 
research funding designs and research projects. While 
maintaining the highest quality assurance through peer review, 
consumer involvement has helped to ensure that all breast 
cancer research reflects the experiences and wisdom of 
individuals from the scientific and lay communities. The 
Committee encourages NCI to continue to give consideration to 
increasing the involvement of consumers in decisionmaking 
related to breast cancer research, and to be prepared to report 
to the Committee on progress that the Institute is making 
toward that goal at the fiscal year 1998 hearings.
    Sufficient funds have been included to support the 
implementation of the national action plan on breast cancer at 
the fiscal year 1996 level. Leadership for the implementation 
of this multiagency initiative has been carried out by the 
Office of Women's Health in coordination with participating 
agencies.
    Cancer prevention and control.--The Committee recognizes 
the important role of behavior in preventing cancer and 
reducing its effects. New scientific data indicates that 
psychosocial and complementary medicine interventions improve 
the quality of life and increase treatment compliance for 
cancer patients. The Committee urges the NCI conduct an inter-
Institute initiative of basic and applied research on the 
psychosocial factors involved in treating cancer, AIDS, 
diabetes, heart disease, and other diseases with a behavioral 
component. The Committee intends that grants for such research 
be made to cancer centers which have personnel and facilities 
to conduct psychosocial and complementary medicine research 
projects on diverse ethnic and racial populations.
    Behavioral research review.--The Committee is pleased that 
as part of a plan to refine its priorities, the NCI has 
undertaken a review of its behavioral research portfolio and 
solicited the advice of behavioral researchers about the most 
important areas for research support. The Committee looks 
forward to the report that will ensue from the National Cancer 
Advisory Board on this issue.
    Clinical research.--The Committee remains concerned about 
the status of clinical research. The ability of physician 
researchers to conduct clinical investigations, and of patients 
to have access to state-of-the-art treatment in the context of 
clinical trials, is threatened by the refusal of third-party 
payers to cover the cost of routine patient care in such 
trials. In this regard, the Committee commends the NCI for 
taking an important first step toward correcting the problem of 
appropriate reimbursement for the care provided to patients 
enrolled in peer-reviewed clinical trials by negotiating an 
agreement with the Department of Defense [DOD]. The agreement 
provides coverage for patient care to enrollees in DOD health 
care programs participating in phase II or phase III clinical 
trials that have been approved by NCI, an NCI-funded cancer 
center, or one of NCI's cooperative groups.
    The Committee understands that NCI is also in the process 
of negotiating similar arrangements with other Federal agencies 
involved in the support of health care services. In negotiating 
these agreements, the Committee urges the NCI to be mindful of 
other quality mechanisms outside NCI. For example, a number of 
trials involving leukemia have been approved by the National 
Heart, Lung, and Blood Institute. In addition, the review 
processes of the Food and Drug Administration, in granting 
investigational new drug exemptions, are second to none in 
their rigor. Finally, the Committee encourages the NCI to 
consider including phase I studies under the current, and 
future agreements with third-party payers.
    Extramural construction.--The Committee recognizes that a 
key aspect of our national research capacity is our research 
infrastructure. Research facilities play an important role in 
supporting state-of-the-art research initiatives, which enable 
rapid translation of research progress form the bench to the 
bedside. The Committee recommends that the NCI reserve 
$7,000,000 for meritorious extramural construction needs in 
cancer research.
    The Committee urges that these funds be awarded to newly 
solicited grant applications with special priority given to 
applications devoted toward construction of new facilities to 
consolidate clinical research laboratory research activities in 
comprehensive cancer centers. Special priority should be given 
to comprehensive cancer centers with construction underway or 
facilities soon to be completed where awards from this 
appropriation will provide finished laboratory research space 
which could not otherwise be completed at this time within 
funds available. The Committee further expects that the awards 
made with these funds will be at least equivalent in amount to 
the standard awards for construction projects provided through 
the National Center for Research Resources.
    Ataxia-telangiectasia.--The Committee continues to view 
research on this rare genetic disorder as a high priority, not 
only because of the severe impact of the disease on children, 
but also because of the relevance of A-T research to many 
fields, including breast cancer. The Committee is pleased with 
the intramural and extramural projects the Institute has 
supported, and the sharing of reagents and resources by the 
scientific community. The Committee encourages the NCI to 
support additional studies on A-T heterozygotes with increased 
emphasis on the development of A-T therapies.
    Gynecologic cancers.--The Committee encourages NCI to 
continue to expand its efforts in basic and applied gynecologic 
cancer research, specifically the implementation of the 
recommendations from the NIH consensus conferences on ovarian 
and cervical cancer. The Committee also encourages the NCI to 
give consideration to utilizing the SPORE mechanism to support 
research on gynecologic cancers.
    Prostate cancer.--According to the American Cancer Society, 
more than 314,000 new cases of prostate cancer will be 
diagnosed in 1996, making it the most commonly diagnosed 
cancer. Over 41,000 men will die from this disease this year. 
The Committee believes that prostate cancer research should be 
among the NCI's highest priorities in order to decipher the 
mysteries of this complex disease.
    Neurofibromatosis.--Enormous advances in research on 
neurofibromatosis have recently occurred, including discovery 
of the NF1 and NF2 genes, developing animal models and a 
diagnostic blood test and prenatal testing for NF. NF also 
offers the potential for significant advances in broader areas, 
like tumor suppressor genes, and for other disorders, such as 
many of the most common cancers, brain tumors, and learning 
disabilities. Accordingly, the Committee encourages the 
National Cancer Institute [NCI] to continue to pursue an 
aggressive program in basic and clinical research in NF and 
urges the NCI to employ novel approaches in the clinical 
development of NF research, including the use of: requests for 
applications, as appropriate; the national cooperative drug 
discovery group program; and small business innovation research 
grants. The Committee requests that the NCI be prepared to 
report on the status of its NF research program, including 
progress in implementing the recommendations in this and last 
year's Committee reports, at its hearings on the fiscal 1998 
budget.
    Bionutrition.--NCI continues to be a leader in the 
nutrition research area. Diet is second only to smoking in its 
association with cancer. The Committee encourages NCI to 
continue its leadership in nutrition research, particularly 
with regard to women's health issues including breast cancer. 
The Committee believes that clinical research units and general 
clinical research centers can provide an excellent focus for 
the intensive study of how nutrition can affect the tissues of 
human subjects to become less susceptible to cancer.
    Cancer in minorities.--There remains an unacceptably high 
incidence of cancer among the native Hawaiian population. The 
Committee commends NCI for its recently released report which 
documents that native Hawaiians rank second in the Nation in 
cancer mortality rates. Hawaiian males are second only to 
African-American males in overall cancer death rates, while 
cancer-related mortality rates of Hawaiian women are equal to 
those of African-American women, ranked only behind Alaskan 
women. The Committee encourages continued research emphasis in 
these high-priority areas and expresses its gratitude for the 
work the Institute has done with the Hawaii Cancer Center.
    Developing cancer centers.--The Committee urges the 
Institute with a portion of its increased funds to promote 
improved instrumentation and equipment at developing cancer 
centers in regions without existing comprehensive cancer 
centers, including giving consideration to issuing an RFP for 
equipment and instrumentation which is needed to measure levels 
of cancer causing chemicals in humans, and equipment needed to 
measure the activities of cancer genes in human breast tumors. 
It is critical that the physical as well as the grant resources 
be made available to compliment developing cancer centers. The 
NCI, in coordination with the NCRR should do everything 
feasible to encourage the continued development of cancer 
centers that serve rural and minority populations with a high 
incidence of cancer. The Committee expects that such programs 
will be discussed during the fiscal year 1998 hearings.
    H.pylori infection.--The Committee urges the Institute to 
give consideration to joining in the trans-Institute research 
effort on H.pylori infection initiated by the NIDDK and the 
Office of Research on Minority Health. Further research is 
needed on the connection between this bacteria and gastric 
cancer.
    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.
    Brain tumors.--The Committee continues its strong concern 
about the incidence of brain cancer. Malignant primary tumors 
in adults occur at a rate of more than 17,500 per year. The 
most common of these tumors are usually lethal within 12 
months. The Committee reiterates its support for the NCI, in 
concert with the NINDS, to fund up to five centers of 
excellence in brain tumor research. These centers will conduct 
basic, translational, and clinical research to determine the 
cause, mechanisms of development, diagnosis, and treatment of 
primary and secondary brain tumors. The Committee believes that 
there should be a maximum of information exchange and 
collaboration among the centers' investigators.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 1996....................................  $1,354,946,000
Budget estimate, 1997...................................   1,378,670,000
House allowance.........................................   1,438,265,000

Committee recommendation

                                                           1,403,557,000

    The Committee recommendation includes $1,403,557,000 for 
the National Heart, Lung, and Blood Institute [NHLBI]. This is 
$24,887,000 more than the administration's request, $48,611,000 
more than the fiscal year 1996 appropriation, and $34,708,000 
less than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The 1996 
appropriation and the House allowance did not include an 
appropriation for the Office of AIDS Research.
    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.--The Committee recognizes the 
seriousness of heart attack, stroke, and other cardiovascular 
diseases and is deeply concerned that, despite progress, 
cardiovascular diseases have remained America's No. 1 killer of 
men and women since 1919 and a major cause of disability. The 
Committee believes that additional cardiovascular research is 
critical and intends that within the funds provided for the 
Institute that high priority be given to research on 
cardiovascular diseases.
    Heart failure.--Heart failure kills more than 45,000 of its 
victims each year and is the leading cause of hospitalization 
for Americans age 65 and older. Because current treatment only 
slows the course of the underlying diseases, the Committee 
encourages the Institute to expand research in cellular and 
molecular techniques that offer promise for new methods to 
restore heart function.
    Nutrient supplements to prevent cardiovascular diseases.--
Elevated levels of homocysteine, an amino acid normally found 
in the body, appear to increase the risk of heart attack, 
stroke, peripheral vascular disease, and other cardiovascular 
diseases. The Committee understands the Institute has under 
consideration a clinical trial to assess the effects of folic 
acid, vitamin B6 and vitamin B12 in preventing 
cardiovascular diseases by reducing homocysteine levels, and is 
supportive of moving ahead in this area of inquiry.
    Hemophilia.--Last year the Committee called upon NHLBI to 
strengthen its hemophilia research efforts in gene therapy and 
in seeking a cure for this serious bleeding disorder. The 
Committee also recommended the Institute conduct a study of the 
scope of hemophilia vulnerability to blood contaminants and 
specifically Creuzfeldt-Jakob disease [CJD]. In light of the 
results of the Institute of Medicine study calling attention to 
the importance of research support to ensure a safe blood 
supply, the Committee encourages the NHLBI to expand its 
hemophilia research activities, including the CJD study. The 
Committee also requests that NIH/NHLBI work collaboratively 
with CDC and FDA to address all hemophilia research, 
epidemiology, surveillance, and patient outreach aspects 
necessary to ensure maximum safety and integrity of the U.S. 
blood supply.
    Bionutrition.--Diet is a major risk factor for heart 
disease, hypertension and stroke. The NHLBI has been a leader 
in research regarding nutrition as a prevention strategy for 
heart disease and hypertension. The Committee encourages the 
NHLBI to devote more attention to research and to educating the 
public on the relationship of obesity to hypertension since, 
according to data from the Framingham study, 70 percent of 
hypertension in men and 65 percent in women can be attributed 
primarily to obesity. Recently, NHLBI research has shown a 
relationship between homocysteine and heart disease and stroke. 
The Committee encourages further research by NHLBI on the role 
of folic acid; which affects homocysteine levels, to prevent 
heart disease and stroke.
    Transfusion medicine.--The Committee is pleased to see that 
the NHLBI plans to establish a network of umbilical cord blood 
banks transplant centers. These facilities will provide a 
resource for research designed to determine whether transplants 
of stem and progenitor cells from umbilical cord blood are a 
clinically acceptable alternative therapy for patients 
suffering from leukemia, aplastic anemia, combined immune 
deficiency, and inborn errors of metabolism. The Institute has 
also demonstrated its commitment to a safer and more 
efficacious blood supply by funding three specialized centers 
of research in transfusion medicine. The Committee encourages 
the NHLBI to support research initiatives to improve the 
viability and function of transfused platelets. The Committee 
is pleased that the NHLBI is supporting the viral activation 
transfusion study [VATS] to determine if transfusion hastens 
the progression of HIV disease. The Committee also encourages 
the NHLBI to fund additional transfusion medicine initiatives 
to understand the basic aspects of immune responses following 
blood transfusion.
    Primary pulmonary hypertension [PPH].--PPH is a progressive 
fatal disease whose mostly female victims are of all ages and 
races, involves deadly deterioration of the heart and lungs, 
and literally robs these people of their very life's breath. 
The Committee urges the Institute to expand its support of 
research devoted specifically to PPH gene therapy, basic 
research, and clinical trials of promising pharmaceuticals.
    Asthma.--Children under the age of 18 and African-Americans 
suffer disproportionately from asthma. The NHLBI has taken a 
leading role in basic, clinical, and health education research 
on asthma. Model self-management approaches to asthma developed 
during the 1980's have demonstrated that patient education and 
involvement is crucial to achieve optimal control of asthma. 
The National Asthma Education and Prevention Program has proven 
to be an effective program for controlling asthma and to 
disseminating information about management approaches. 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. An example of this is 
the Open Airways for Schools Program supported by NHLBI.
    The Committee understands that five centers are in the 
final phase of an NHLBI-sponsored study to develop, implement, 
and evaluate interventions to control asthma morbidity among 
African-American and Hispanic children. Intermediate findings 
suggest that it is possible to develop a pattern of preventive 
and continuing care for a population which has traditionally 
been difficult to reach with preventive public health programs. 
If this intervention is found to reduce emergency room 
utilization and hospitalization rates, its widespread 
application could greatly reduce the economic burden of asthma.
    The Committee urges the Institute to continue to make 
minority and children-related research a priority, and it 
requests that the Director be prepared to provide an update on 
these efforts at next year's hearings.
    Specialized centers of research.--An impressive array of 
scientific opportunities in the areas of fibrotic lung disease, 
asthma, and lung development can be expected to lead to 
translation of basic science into clinical applications. The 
Committee recognizes that the NHLBI has made significant 
contributions to clinical research through its specialized 
centers of research programs. The Committee, therefore, 
encourages the NHLBI to support as many specialized centers of 
research in these areas as possible.
    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. The Committee is pleased with demonstrated progress 
in the sleep disorders education campaign and urges continued 
development of this important campaign. The Committee 
recommends continued development of a plan for scientific 
collaboration among the National Center and other NIH 
Institutes through the implementation of the recently approved 
national sleep disorders research plan. Continued development 
of the National Center's research portfolio is expected through 
the issuance of request for applications, joint programs, and 
multiinstitute collaboration as outlined in the national sleep 
disorders research plan.
    Sarcoidosis.--Sarcoidosis is an inflammatory disease that 
can lead to fibrosis, or scarring, of the lung. It occurs in 
about 40 to 100,000 American blacks compared with about 5 in 
100,000 whites, and black 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.
    Creutzfeldt-Jakob disease.--The recent outbreak of 
Creutzfeldt-Jakob disease [CJD], better known as mad cow 
disease has brought this disorder to the public forefront. The 
handling of this potential health hazard is complex since the 
identity of the transmissible agent is not known and many basic 
facts regarding the pathogenesis of CJD are poorly understood 
due primarily to the lack of an adequate experimental animal 
model. The Committee understands that the squirrel monkey is 
presently considered to be the best experimental animal model 
for CJD and encourages the Institute to expand support for CJD 
research into early diagnostic techniques, preventive 
strategies, and therapeutic interventions.
    Cooley's anemia.--The Committee continues to strongly 
support the research efforts of NHLBI in the areas of Cooley's 
anemia. Hepatitis is a major concern of Cooley's anemia 
patients and the problem warrants further research into 
hepatitis C and other strains aimed at developing vaccines. The 
Committee has learned that hormonal therapy as a medical 
treatment is becoming recognized as more and more of a 
necessity for patients who are now living through their teens. 
The Committee requests that the Institute give consideration to 
convening a workshop of experts in the field to develop plans 
for research into the long-term effects of this therapy.
    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 diseases, as well as clinical 
research aimed at prevention and treatment of its hematological 
consequences.

                 NATIONAL INSTITUTE OF DENTAL RESEARCH

Appropriations, 1996....................................    $182,293,000
Budget estimate, 1997...................................     186,781,000
House allowance.........................................     195,596,000

Committee recommendation

                                                             190,184,000

    The Committee recommendation includes $190,184,000 for the 
National Institute of Dental Research [NIDR]. This is 
$3,403,000 more than the administration's request, $7,261,000 
more than the fiscal year 1996 appropriation, and $5,412,000 
less than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The 1996 
appropriation and 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.
    Temporomandibular joint disorders [TMJ].--The Committee 
continues its strong interest in research on temporomandibular 
joint disorders. The Committee remains concerned about the need 
for greater consensus regarding the number of people impacted 
by TMJ, and on the most appropriate treatment modalities for 
TMJ. The Committee is aware of the findings and recommendations 
of the NIH Technology Assessment Conference statement on the 
management of temporomandibular disorders issued this past 
spring. The Committee encourages the NIDR to take the necessary 
steps needed to carry out the recommendations of the conference 
and urges the Institute to work with the relevant Institutes of 
the NIH, the Office of Women's Health, and AHCPR in developing 
a short- and long-term research plan into TMJ.
    Bone disorders.--The Committee is pleased with the growth 
of research on osteoporosis, Paget's disease, and osteogenesis 
imperfecta and encourages the Institute to consider using a 
portion of the increased funding for fiscal year 1997 to 
further expand and intensify its research programs on these 
bone diseases which effect over 30 million women, men, and 
children.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 1996....................................    $770,582,000
Budget estimate, 1997...................................     784,923,000
House allowance.........................................     819,224,000

Committee recommendation

                                                             799,582,000

    The Committee recommends an appropriation of $799,582,000 
for the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK]. This is $14,659,000 more than the 
administration's request, $29,000,000 more than the fiscal year 
1996 appropriation, and $19,642,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
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.
    Diabetes.--Diabetes takes the lives of more than 400,000 
Americans each year. The number of Americans with diabetes has 
increased at the alarming rate of 50 percent since 1983. 
African-Americans are twice as vulnerable, and native Americans 
and Hispanics are disproportionately affected by diabetes. 
Given the enormous economic and personal costs of diabetes, the 
Committee urges the NIH to review the growth rate in diabetes 
research funding over the past few years to assess whether this 
field is receiving appropriate support. The Committee expects 
the NIH and the NIDDK to be prepared to discuss this issue 
during the fiscal year 1998 hearings.
    The Committee is aware that an array of research 
possibilities were outlined by the National Diabetes Research 
Coalition [NDRC] in its document entitled ``Diabetes Research: 
A National Opportunity--The Blueprint for the Cure.'' The 
Committee believes that a significant investment in this 
research now could materially alleviate, delay, and prevent 
diabetes and its complications and urges the NIDDK to redouble 
its efforts on all facets of diabetes research.
    The Committee urges the Institute to support an aggressive 
research program directed at the development of engineered 
biomaterials for diabetes management.
    The Committee continues to be concerned about the high 
incidence of diabetes among native Americans, native Hawaiians, 
and Pacific islanders, particularly residents of the 
Commonwealth of the Northern Marianas Islands where about 50 
percent of the population has diabetes. The Committee urges the 
Director to develop specific interventions, using a 
multidisciplinary approach, to target these high-risk 
populations.
    The Committee believes that the NIDDK should pay particular 
attention to the inordinately high prevalence of diabetes in 
the Hispanic population and the native American population. The 
Committee understands Hispanics develop diabetes 3 to 5 times 
more often than the general population, and native Americans 
develop diabetes 10 times more often. The Committee believes 
that the Hispanic and native American populations constitute 
one of the highest priorities in diabetes research, and 
stresses the need for expanded NIDDK research activities in 
these areas.
    Liver disease.--The Committee is aware that liver diseases 
affects 25 million people. Therefore, the Committee is pleased 
that NIDDK and NIAID will sponsor a consensus conference on 
chronic hepatitis C in 1997. The Committee encourages other 
efforts by NIDDK to prevent, treat, and cure liver diseases, 
including convening a national scientific meeting to review the 
research agenda developed by the American Liver Foundation and 
produce an action plan for a well-focused liver research 
program for 1997 and beyond. The action plan should include to 
the extent possible all Institutes now conducting liver disease 
research.
    Cooley's anemia.--The Committee has long supported research 
in the area of Cooley's anemia. Due to the red blood cell 
transfusions the patients must undergo, iron builds up in the 
major organs. The effective removal of this iron chelating drug 
requires an assessment of the iron overload. Therefore, the 
Committee urges NIDDK to move forward in an effort to develop 
an accurate, noninvasive test for iron overload that can be 
utilized for Cooley's anemia patients, as well as for patients 
with conditions such as hemachromatosis and iron deficiency 
anemia. The Committee has also long supported research aimed at 
developing an iron chelator that patients could take orally. 
The Committee continues to strongly support the ongoing 
toxicity research.
    Bionutrition.--The Committee is encouraged by the 
leadership of NIDDK in the nutrition and obesity research 
areas. The cloning of genes involved in animal obesity opens 
the way for the study of molecular genetics in human obesity, 
which the Committee hopes will remain a high priority of the 
NIDDK. The Committee encourages the Institute to expand its 
work on pharmacology and obesity management. Furthermore, the 
Committee was encouraged by the NIDDK cosponsorship of a 
research conference on the current role of nutrition support 
and encourages NIDDK to take steps implementing the research 
agenda developed by the conference including the use of 
nutrient pharmacology and the role of anabolic treatments, such 
as human growth hormones, in the treatment of wasting diseases 
such as critical illness, AIDS, and cancer.
    Urological diseases.--The Committee continues to be pleased 
with the growth of research on urological diseases which are a 
significant health burden. The Committee encourages the NIDDK 
to increase support for new research grants in the basic 
science of the prostate, including growth factors and their 
influence on prostate cancer and benign prostatic hypertrophy, 
and prostatitis. The Committee is concerned that no progress 
has been reported on the development of a urological disease 
data base. Such a data base could be a valuable tool for 
establishing research priorities. The Committee also urges the 
Institute to expand its activities in the area of women's 
urological health by working collaboratively with the Office of 
Research on Women's Health, in particular by placing special 
emphasis on grants related to interstitial cystitis, urinary 
incontinence, and urinary tract infections. Finally, the 
Committee is concerned about the heavy impact of prostate 
disease on minority populations and urges the NIDDK to expand 
support for research in this area.
    Interstitial cystitis.--The Committee has a strong interest 
in research into interstitial cystitis, a very painful and 
disabling bladder disease. It is pleased that in fiscal year 
1996 the NIDDK funded individual research grants focusing in 
interstitial cystitis, and also encouraged that the 
interstitial cystitis data base continues to progress and 
expand the understanding of the disease. The Committee 
encourages the Institute to utilize a portion of the increased 
funds to support further interstitial cystitis research as well 
as to expand the next phase of the national interstitial 
cystitis data base. The Committee also requests that the NIH 
continue to address the problem of the lack of urological 
expertise on the NIH study sections which review urological 
grants including interstitial cystitis.
    Polycystic kidney disease.--Polycystic kidney disease [PKD] 
affects some 600,000 Americans and is the third leading cause 
of kidney failure, annually generating more than 2,000 
additional cases of end stage renal disease. Rapid research 
progress in recent years has resulted in identification and 
complete sequencing of the gene that causes 90 percent of PKD 
and its protein product has also been discovered. The Committee 
understands that scientists worldwide agree that PKD science is 
mature and that discoveries leading to a treatment and 
ultimately a cure are now forseeable. The Committee, therefore, 
urges the NIDDK to increase support for PKD research, including 
giving consideration to the establishment of up to four 
interdisciplinary basic research centers on progressive renal 
failure with emphasis on polycystic kidney disease.
    Prostatitis.--The Committee understands that symptomatic 
prostatitis will affect 50 percent of American men during their 
lifetimes. It also is the cause of over 1.8 million physician 
visits per year. While reasonable theories exist as to why 
prostatitis might be causing benign prostatic hypertrophy or 
prostate cancer, additional research is required. The Committee 
urges NIDDK to increase support for prostatitis and has 
provided sufficient funds within the recommendation to expand 
support for research on the various forms of prostatitis.
    Cystic fibrosis.--The Committee is encouraged by the 
progress being made to develop gene therapy for cystic fibrosis 
[CF]. To date, more than 90 patients have been treated with 
this innovative therapy. The knowledge learned from these first 
studies has clearly provided scientists with critical 
information to pave the way to curing fatal illnesses. The 
Committee applauds both the NIDDK and the NHLBI for announcing 
the recent research program initiative in CF. The overwhelming 
response to this initiative reflects the wealth of scientific 
opportunities that are available in CF research. Funds have 
been made available in fiscal year 1997 to assure maximal 
support of meritorious applications. In addition, the Committee 
encourages both Institutes to continue to seek opportunities to 
expand the centers and programs of excellence in CF. The 
scientific advances being made in these centers are writing an 
outstanding success story of a partnership between the NIH and 
the Cystic Fibrosis Foundation.
    Digestive diseases.--Diseases of the digestive system 
continue 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 and treatment 
progress made to treat peptic ulcers through the use of 
antimicrobial agents and antisecretory agents to combat the 
H.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 diseases and bringing 
this critical knowledge gained, to the bedside to improve 
patient care. Clinical research opportunities that exist 
include transjugular intralepaitic portal-systemic shunts 
[TIPS] for variceal bleeding, treatment and prevention of 
recurrence of H.pylori, bleeding ulcers, and hepatic assist 
devices for fulminant hepatic failure.
    The Committee continues to be concerned about the 
prevalence of inflammatory bowel diseases, including Crohn's 
disease and ulcerative colitis, as well as with irritable bowel 
syndrome. These extremely complex disorders represent the major 
cause of morbidity from intestinal illness. The Committee 
recommends that the Institute continue its investigations into 
the genetic structure of IBD as well as the roles played by 
environmental factors and the immune system in the development 
of the disease. Additionally, the Committee recommends that the 
NIDDK maintain adequate support for irritable bowel syndrome/
functional bowel disorders research and give priority 
consideration to funding IBS education/scientific symposiums.
    H.pylori eradication.--Twenty-five million Americans suffer 
from ulcer disease. The Committee is aware of the 1994 
Consensus Development Conference which concluded that the 
bacterium Helobacter pylori causes most ulcers, not stress or 
diet as previously believed, and that most ulcers can be cost-
effectively cured by eradicating H.pylori.
    The Committee commends the NIDDK/NIAID/ORMH for joining in 
a trans-Institute initiative for further study of H.pylori 
infection and its relationship to peptic ulcer disease and 
gastric cancer. Further research in this area offers exciting 
possibilities for more progress in understanding and treating 
these disorders. Additionally, the Committee commends the 
Institute for attracting the American Digestive Health 
Foundation as a partner in this important effort.
    Bone diseases.--The Committee is pleased with the growth of 
research on osteoporosis, Pagent's disease, and osteogenesis 
imperfecta and encourages the NIDDK to further expand and 
intensify its research programs on these bone diseases.
    Kidney disease.--The number of patients with end stage 
renal disease [ESRD] now exceeds 300,000 in this country, and 
the number of increases by 8 percent per year. The most common 
cause of ESRD are diabetes, hypertension, and 
glomerulonephritis. Recent advances in basic and clinical 
research have led to treatments which slow the progression of 
kidney disease. The Committee encourages the Institute to 
continue and expand its research programs in the basic and 
clinical sciences to further elucidate the mechanisms which 
cause progressive kidney disease and to define new ways to 
treat or prevent these diseases.
    Human tissues.--Last year the conferees stated their 
support for the creation of a multi-Institute initiative to 
expand access to alternative resources to the use of animals in 
research, particularly through ensuring access to human tissues 
and organs. The Committee understands that human tissues are 
particularly important to researchers studying diabetes, and 
other diseases under the purview of the Institute. Accordingly, 
the Committee urges the NIDDK to give consideration to 
supporting programs that provide human tissues and organs to 
researchers.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 1996....................................    $680,902,000
Budget estimate, 1997...................................     695,098,000
House allowance.........................................     725,478,000

Committee recommendation

                                                             707,959,000

    The Committee recommends an appropriation of $707,959,000 
for the National Institute of Neurological Disorders and Stroke 
[NINDS]. This is $12,861,000 more than the administration's 
request, $27,057,000 more than the fiscal year 1996 
appropriation, and $17,519,000 less than the House allowance. 
The comparable numbers for the budget estimate and the 
Committee recommendation include funds to be transferred from 
the Office of AIDS Research. The fiscal year 1996 appropriation 
and 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.
    Parkinson's disease.--The Committee continues to urge the 
Institute to intensify its efforts to identify the factors 
contributing to the development of Parkinson's disease and to 
develop new methods of treating, delaying, or preventing this 
devastating illness. Last year's international workshop, 
sponsored by NINDS in collaboration with NIA, NIEHS, and NIMH, 
identified several high priority areas for future study. The 
Committee is pleased with the followup to date to this 
workshop, which includes program announcements inviting 
research grant applications in genetic factors and cell death 
and injury, a collaborative intramural effort focusing on 
genetics, and efforts to confirm and extend current criteria 
for diagnosis of Parkinson's disease for use in research 
studies. The Committee notes, however, that the workshop also 
documented other areas of promising research, the pressing need 
for new ideas in Parkinson's research, and the importance of 
stimulating investigators in different, but related, fields to 
focus on Parkinson's disease.
    The Committee expects the Institute to continue its efforts 
to advance understanding of Parkinson's disease, and improve 
the outlook for patients and their families. The Committee 
urges the NINDS to give consideration to the sponsorship of 
workshops on specific topics, including those areas identified 
in the Parkinson's disease research planning workshop. The 
Committee also encourages the Institute to consider the use of 
new funding mechanisms to recognize innovative approaches and 
attract new investigators into the field. One such mechanism 
could be extended funding of selected investigators working in 
Parkinson's disease. Additionally, the Committee urges the 
NINDS to give consideration to utilizing the centers mechanism 
as a means of stimulating research progress on this disorder. 
The Committee requests the NIH submit a progress report on 
these efforts prior to the fiscal year 1998 hearings.
    Neurofibromatosis.--Enormous advances in research on 
neurofibromatosis have recently occurred, including discovery 
of the NF1 and NF2 genes, developing animal models and a 
diagnostic blood test and prenatal testing for NF. NF also 
offers the potential for significant advances in broader areas, 
like tumor suppressor genes, and for other disorders, such as 
many of the most common cancers, brain tumors, and learning 
disabilities. Accordingly, the Committee encourages the 
Institute to continue to pursue an aggressive program in basic 
and clinical research in NF and urges the NINDS to employ novel 
approaches in the clinical development of NF research, 
including the use of: requests for applications, as 
appropriate; the national cooperative drug discovery group 
program; and small business innovation research grants. The 
Committee requests that the Institute be prepared to report on 
the status of its NF research program, including progress in 
implementing the recommendations in this and last year's 
Committee reports, and at its hearings on the fiscal 1998 
budget.
    Stroke.--Stroke remains America's No. 3 killer, the leading 
cause of serious disability and a major contributor to late-
life dementia. Stroke will cost the United States an estimated 
$23,000,000,000 to $30,000,000,000 in medical expenses and lost 
productivity in 1996. The Committee believes the Institute 
should view stroke research as one of its highest priorities 
and supports the expansion of its stroke education program and 
the initiation of innovative approaches to improve stroke 
diagnosis, treatment, rehabilitation and prevention as 
identified by the National Advisory Neurological Disorders 
Stroke Council in ``Progress and Promise 1992: Status Report of 
the Decade of the Brain.''
    Lou Gehrig's disease.--Amytrophic lateral sclerosis [ALS], 
commonly referred to as Lou Gehrig's disease, is a progressive, 
fatal, neurological disease for which no cure exists. The first 
real clue to a cause of the disease recently occurred with the 
identification of a gene defect linked to some cases of 
familial ALS. The Committee understands that recent clinical 
research resulted in the first compound to alter the course of 
the disease, but that much more needs to be done to capitalize 
on these recent developments to treat and cure this disease. To 
sustain this momentum, the Committee encourages NINDS to 
increase support for 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 continue to take the steps necessary to assure that a 
vigorous research program is sustained and expanded.
    Dystonia.--The Committee continues to be pleased with NINDS 
efforts to encourage extramural 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.--Alzheimer's disease is a bewildering, 
frightening, and costly degenerative brain disease that strikes 
almost 10 percent of the population over 65 years old. The 
Committee strongly encourages the Institute to expand its 
research on understanding, preventing, and treating of 
Alzheimer's disease.
    Movement disorders.--The Committee has become increasingly 
aware of debilitating movement disorders such as Parkinson's 
disease, Huntington's disease, various forms of dystonia, 
progressive supranuclear palsy, and others that have 
traditionally not been in the mainstream scientific 
investigation. To reverse this trend, the Committee is 
recommending that the Institute give consideration to the 
establishment of a NINDS program of research centers dedicated 
to movement disorders which would focus on, but not be limited 
to, the various disorders described above.
    Behavioral research.--The Committee is pleased to learn 
that NINDS supports a wide range of basic and applied 
behavioral research through all four of its extramural 
divisions. The Committee believes that such research is central 
to the Institute's mission and strongly encourages the 
Institute to expand its efforts to better understand the role 
of behavior in preventing and treating diseases and injuries of 
the brain. While the Committee is impressed by the advances 
that have been achieved in brain imaging technology, the 
Committee believes that similar advances must be achieved in 
behavioral research in order to reduce the devastating public 
health toll taken by brain injuries and disorders.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 1996....................................  $1,168,483,000
Budget estimate, 1997...................................   1,208,730,000
House allowance.........................................   1,256,149,000

Committee recommendation

                                                           1,229,009,000

    The Committee recommends an appropriation of $1,229,009,000 
for the National Institute of Allergy and Infectious Diseases 
[NIAID]. This is $20,279,000 more than the administration's 
request, $60,526,000 more than the fiscal year 1996 
appropriation, and $27,140,000 less than the House allowance. 
The comparable numbers for the budget estimate and the 
Committee recommendation include funds to be transferred from 
the Office of AIDS Research. The fiscal year 1996 appropriation 
and 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.--NIAID's support for tuberculosis research is 
critical in developing improved diagnostic tests, and 
treatments in response to the reemergence of tuberculosis in 
the United States. NIAID-supported researchers have begun to 
understand multidrug-resistant tuberculosis and hope to develop 
methods to quickly determine which drug therapy is appropriate 
for MDRTB strains, so a patient can begin an appropriate 
treatment therapy immediately, thus reducing the risk of 
transmitting the disease to others. The Committee urges the 
NIAID to increase its already diligent efforts to diagnose, 
prevent, and treat this disease.
    Asthma.--NIAID has aggressively pursued the complex and 
growing problem of asthma through the national cooperative 
inner-city asthma study and through the Asthma, Allergic, and 
Immunologic Diseases Cooperative Research Centers Program. Each 
program contributes to the base of knowledge needed to 
intervene appropriately. It is hoped that better intervention 
strategies will lead to reduced emergency room visits, reduced 
hospitalizations, and less days absent from school.
    Liver disease.--The Committee understands that last year 
the CDC revised its estimate of the number of people infected 
with hepatitis C by 11 percent or from 3.5 to 3.9 million 
people. The Committee is, therefore, pleased that the NIAID and 
the NIDDK will sponsor a consensus development conference on 
chronic hepatitis C in 1997 and urges the involvement of other 
NIH institutes, as appropriate. In view of the rapid growth of 
hepatitis C, the Committee urges that hepatitis C be made a 
research priority as an emerging infectious disease and that 
the NIAID give consideration to supporting additional hepatitis 
C cooperative research centers.
    Hemophilia.--The Committee is pleased with the efforts of 
the NIAID to maximize funding of the HIV/AIDS clinical trials 
for persons with hemophilia through the treatment centers 
network and expects that this program will continue to provide 
access to the newly available drugs including protenhase 
inhibitors.
    Chronic fatigue and immune dysfunction syndrome [CFIDS].--
The National Institute of Allergy and Infectious Diseases is 
the lead Institute on CFIDS research. The Committee again 
expresses support for a vigorous CFIDS research program and 
urges NIH to appoint a CFIDS coordinator to provide leadership 
on CFIDS and cultivate the interest of institutes not currently 
engaged in the study of CFIDS.
    Primary immune deficiency diseases.--While science has made 
great progress against AIDS in the last 15 years, the Committee 
has heard persuasive testimony that there is a need to attain a 
more thorough understanding of the basic biology of the immune 
system. The Committee notes that the recent ``Report of the NIH 
AIDS Research Program Evaluation Working Group of the Office of 
AIDS Research Advisory Council'' supports this approach and 
encourages the NIH to increase support for research on the 
human immune system.
    The Committee also notes that, in addition to AIDS, this 
research holds great promise for success against many of the 
primary immune deficiencies, genetic disorders that affect up 
to 1 million people, mostly children, in the United States.
    Scientists have long recognized that understanding how the 
immune system is compromised and the biology of immunocompetent 
cells will directly benefit those suffering from many other 
infectious and genetic diseases, as well. The Committee 
supports assertively following this path to encourage a more 
cohesive research agenda, stretching Federal research dollars, 
and reducing duplication through joint collaborations with the 
scientific community, foundations, and associations.
    Creutzfeldt-Jakob disease.--The recent outbreak of 
Creutzfeldt-Jakob disease [CJD], better known as mad cow 
disease has brought this disorder to the public forefront. The 
handling of this potential health hazard is complex since the 
identity of the transmissible agent is not known and many basic 
facts regarding the pathogenesis of CJD are poorly understood 
due primarily to the lack of an adequate experimental animal 
model. The Committee understands that the squirrel monkey is 
presently considered to be the best experimental animal model 
for CJD and encourages the Institute to expand support for CJD 
research into early diagnostic techniques, preventive 
strategies, and therapeutic interventions.
    H.pylori infection.--The Committee commends the NIAID/
NIDDK/ORMH for joining in a trans-Institute initiative for 
further study of H.pylori infection and its relationship to 
peptic ulcer disease and gastric cancer. Further research in 
this area offers exciting possibilities for more progress in 
understanding and treating these disorders. Additionally, the 
Committee commends the Institute for attracting the American 
Digestive Health Foundation as a partner in this important 
effort.
    New and emerging infections.--The Committee believes that 
it is essential that the national strategy to address the 
threat of new and reemerging diseases be broad based, 
incorporating research as well as surveillance activities. 
Biomedical research supported by the NIH/NIAID forms the 
foundation upon which surveillance and response are ultimately 
based, providing the basic research tools (diagnostics, 
vaccines, and therapies) necessary to detect and limit the 
impact of new and reemerging infections. Ongoing research 
support also contributes to the scientific training 
infrastructure required to maintain the capability to identify 
and control new diseases, both nationally and internationally.

             National Institute of General Medical Sciences

Appropriations, 1996....................................    $946,896,000
Budget estimate, 1997...................................     963,623,000
House allowance.........................................   1,003,722,000

Committee recommendation

                                                             980,622,000

    The Committee recommendation includes $980,622,000 for the 
National Institute of General Medical Sciences [NIGMS]. This is 
$16,999,000 more than the administration's request, $33,726,000 
more than the fiscal year 1996 appropriation, and $23,100,000 
less than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The 1996 
appropriation and 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 encourages the Institute to 
continue 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.
    Trauma.--The Committee recognizes that injury is a leading 
public health problem: the leading cause of death for Americans 
under age 45, and the fourth leading cause of death overall. In 
recognition of this fact and the chronic shortage of basic and 
clinical investigators in trauma research, the Committee 
encourages the Institute to preserve and augment existing 
trauma and burn research training grants.

    NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT [NICHD]

Appropriations, 1996....................................    $594,547,000
Budget estimate, 1997...................................     603,650,000
House allowance.........................................     631,989,000

Committee recommendation

                                                             615,244,000

    The Committee recommends an appropriation of $615,244,000 
for the National Institute of Child Health and Human 
Development [NICHD]. This is $11,594,000 more than the 
administration's request, $20,697,000 more than the fiscal year 
1996 appropriation, and $16,745,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
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.
    Sudden infant death syndrome [SIDS].--SIDS, the leading 
cause of death for infants under 1 year of age, continues to be 
a concern of the Committee. The Committee is pleased to learn 
that the Institute's back to sleep campaign, convincing parents 
to put babies to sleep on their backs or sides, rather than on 
their stomachs, has reduced the number of SIDS deaths in the 
Nation. This campaign has played a major role in the 4 percent 
decline in infant mortality in 1993-94, to an alltime low of 
7.9 per 1,000 live births. To continue this progress, the 
Committee has urges the NICHD to make funding available for the 
third year of the second SIDS 5-year research plan. These 
plans, developed in collaboration with the SIDS scientific and 
advocacy community, have provided guidance, structure, and 
support to the NICHD SIDS research program.
    This back to sleep campaign also illustrates the value of 
behavioral and social science research: meta-analyses of SIDS 
studies revealed the role of sleeping position in infant 
deaths; the concept of changing parents' behavior toward their 
babies and changing what pediatricians tell parents is based on 
the social psychology of attitude change research and 
persuasive communication; and the intervention itself--changing 
sleeping position--is a behavioral one. The Committee 
encourages NICHD to continue its efforts to reach all 
populations to reduce SIDS deaths.
    Demographic research.--The Committee commends NICHD for the 
sustained excellence of its demographic research program. 
Recent initiatives have contributed to knowledge about the role 
of fathers in families, the effects of family change on 
children, the causes of spiraling out-of-wedlock childbearing, 
and the determinants and consequences of immigration. The 
objective information derived from these studies and from 
innovative survey data supported by NICHD is essential to 
policymakers faced with hard choices about social policies and 
programs. The Committee urges the Institute to continue to give 
high priority to demographic research and data.
    National Center for Medical Rehabilitation Research 
[NCMRR].--NCMRR continues to take advantage of remarkable 
advances in bioengineering in its application 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 to 
dedicate a portion of the fiscal year 1997 increase in the NIH-
wide small business innovation research [SBIR] grant program to 
such research and development. The Committee expects that such 
funding should be coordinated by the NCMRR within the National 
Institute of Child Health and Human Development.
    Traumatic brain injury and rehabilitation.--The Committee 
notes the enactment of Public Law 104-166, legislation to 
provide for expanded studies and the establishment of 
innovative programs with respect to traumatic brain injury. 
Sufficient funds have been included for the NCMRR to conduct a 
national consensus conference on managing traumatic brain 
injury and related rehabilitation concerns as authorized by 
section 4(b) of Public Law 104-166.
    Training.--As part of its effort to ensure the future 
supply of essential research personnel, the Committee 
encourages the NICHD to support an initiative such as B/START 
(behavioral science track awards for rapid transition), aimed 
at younger behavioral science researchers.
    Learning disabilities.--The Committee is pleased to 
recognize the important discoveries NICHD has made in 
identifying the causes of and best interventions for reading 
disabilities. The Committee commends this research, and 
encourages its dissemination, including working with the 
Department of Education to utilize the information 
dissemination networks of the Department.
    Low birth weight infants.--Each year in the United States 
over 50,000 babies are born weighing less than 3 pounds. Most 
of these infants require breathing assistance with a respirator 
for at least several days. The Committee understands that a 
relatively new form of respirator called high-frequency 
oscillatory ventilation has been used to care for low birth 
weight infants with respiratory problems. Many investigators 
believe this will decrease the incidence of pulmonary 
complications; however, the research evidence to date is split 
on whether this form of therapy is superior to conventional 
respirator therapy. The Committee understands that a large 
study group, consisting of intensive care nurseries in the 
United States, Canada, and the United Kingdom, are developing a 
proposal to test these two therapies and encourages the NICHD 
to give strong consideration to supporting this research.
    The second decade of life.--The Committee urges NICHD to 
increase its support for basic research on the second decade of 
life, a period that is associated with the documented rise in 
psychosocial disorders over the past 50 years, including crime, 
alcohol and drug abuse, depression, anorexia and bulimia, and 
suicide. The Committee encourages NICHD to collaborate with 
NIMH, NINR, and other institutes on this research.
    Behavioral and social science.--The Committee commends 
NICHD for its support of research on behavioral and 
psychological development. Three areas are particularly 
notable: biobehavioral research, which focuses on the 
interactions between biological factors and behavioral factors 
in development; learning disabilities, which is yielding 
information to advance early diagnosis and treatment of these 
conditions; and child care. The Committee encourages NICHD to 
continue to place a high priority on behavioral research, 
particularly regarding elements of child care that enhance 
healthy development.
    H.pylori infection.--The Committee urges the Institute to 
give consideration to joining in the trans-Institute research 
effort on H.pylori infection initiated by the NIDDK and the 
Office of Research on Minority Health. Further research is 
needed on the connection on H.pylori transmission in childhood 
and the pathogenesis of H.pylori infection in children.
    Infertility and contraceptive research.--The Committee 
continues to place high priority on research to combat 
infertility and speed the development of improved 
contraceptives. The Committee urges NICHD to continue 
aggressive activities in this area, including individual 
research grants and those of the infertility and contraceptive 
research centers.
    Autism research.--Autism effects 400,000 persons with 
associated costs of $13,000,000,000 annually. Given the 
enormous cost to society of caring for an autistic person and 
the tremendous hardships it imposes on families, the Committee 
strongly supports an aggressive Autism Research Program. 
Further the Committee encourages NIH to expand support for 
research on this severe disorder, including funding more basic 
and patient-oriented research, and giving consideration to 
establishing a collaborative genetic resource that could enable 
more scientists to work in the field. The Committee understands 
that there is an existing coordinating resource, the human 
biological data exchange, and urges that consideration be given 
to funding this resource. The Committee recognizes that the 
recent NICHD/NIDCD neurology and genetics RFA was an important 
step forward. Finally, the Committee recommends that 
consideration be given to the NICHD establishing an autism 
research coordinating committee comprised of the Institutes of 
the NIH presently supporting autism research. This committee 
would set a research agenda, eliminate redundancy, promote the 
field, and collaborate with the family volunteer organizations 
concerned with autism.

                         NATIONAL EYE INSTITUTE

Appropriations, 1996....................................    $313,933,000
Budget estimate, 1997...................................     319,207,000
House allowance.........................................     333,131,000

Committee recommendation

                                                             325,152,000

    The Committee recommends an appropriation of $325,152,000 
for the National Eye Institute [NEI]. This is $5,945,000 more 
than the administration's request, $11,219,000 more than the 
fiscal year 1996 appropriation, and $7,979,000 less than the 
House allowance. The comparable numbers for the budget estimate 
and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The fiscal year 
1996 appropriation and 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.
    The NEI has made great progress in developing measurements 
of vision function and quality of life for the major causes of 
blindness and visual disability. The Institute is encouraged to 
extend this work into areas of refractive error in order to 
measure the effectiveness of interventions in this area from 
the patient's perspective. Because millions of people suffer 
from various degrees of visual impairment, sensitive research 
measures to assess functional gains or losses is extremely 
important to adequately addressing these problems in the 
future.
    The Institute has made progress in obtaining information on 
the impact of eye disease and visual impairment in the U.S. 
population. Most serious eye diseases occur in the elderly and 
with a doubling of this population expected by the year 2020, 
it is extremely important that the Institute quantify the 
impact of vision-related problems in more detail. This 
information is important in the development of strategies to 
address this increasing need and so that research to address 
these problems can be focused more precisely. These data 
provide a means for establishing a baseline on the 
effectiveness of eye care interventions that have resulted from 
NEI-supported research, and for assessing the impact of future 
research advances.
    Age-related macular degeneration [AMD].--Age-related 
macular degeneration is the leading cause of severe visual 
impairment and blindness in the United States. The Institute 
has made great progress in this area through advances in cell 
and molecular biology. Additionally, genetics research and 
advances in the development of growth factors hold great 
promise for new treatments for this disease. The NEI is urged 
to accelerate and encourage research in this area, and to 
report the status of research in age-related macular 
degeneration and prospects for the future to the Committee.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 1996....................................    $288,378,000
Budget estimate, 1997...................................     295,142,000
House allowance.........................................     308,258,000

Committee recommendation

                                                             300,853,000

    The Committee recommends an appropriation of $300,853,000 
for the National Institute of Environmental Health Sciences 
[NIEHS]. This is $5,711,000 more than the administration's 
request, $12,475,000 more than the fiscal year 1996 
appropriation, and $7,405,000 less than the House allowance. 
The comparable numbers for the budget estimate and the 
Committee recommendation include funds to be transferred from 
the Office of AIDS Research. The fiscal year 1996 appropriation 
and 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.
    Parkinson's disease.--The Committee is supportive of the 
Institute of the work the NIEHS has initiated 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 notes the outstanding work 
of the NIEHS-supported environmental health sciences research 
centers. Clearly, the sound scientific data that is generated 
at the NIEHS-supported centers helps provide the information on 
which the best public policy decisions are made. The Committee 
also continues to support the international environmental 
health initiative, begun last year by the Fogarty International 
Center, and urges continued NIEHS support.
    Volcanic emissions.-- The Committee continues to be 
concerned about the public health aspects of volcanic emissions 
[VOG] in Hawaii and urges the Institute to continue to 
collaborate with NINR in a multidisciplinary approach to this 
problem. The Committee appreciates the initial efforts of NIEHS 
to work with the University of Hawaii.
    Superfund Basic Research Program.--The Committee supports 
this program whose funding is passed through the Environmental 
Protection Agency [EPA] to the National Institute of 
Environmental Health Sciences [NIEHS] as established in section 
311 of the Superfund Amendments and Reauthorization Act [SARA] 
of 1986. The NIEHS administers the Superfund Hazardous 
Substance Basic Research Program which supports university and 
medical school research to understand the public health 
consequences of local hazardous waste sites, as well as to 
develop better methods for remediation. The primary purpose of 
the program are to: provide the science base needed to make 
accurate assessments of the human health risks; determine which 
contaminated sites must be cleaned up first and to what extent 
cleanup is needed; and, cleanup contaminated sites in the most 
cost-effective manner. This is the only university-based 
research program that brings together biomedical and 
engineering scientists for this purpose and we commend the EPA 
and the NIEHS for their cooperative efforts.
    National Toxicology Program [NTP].--The NTP was established 
to provide information to health, regulatory and research 
agencies, and the general public about potentially toxic 
chemicals, as well as to strengthen the science base of 
toxicology. In recent years, the NTP has made great strides 
toward incorporating more information on dose-response 
relationships and mechanisms that are so critical for improved 
risk assessment. Strengthening the science base of risk 
assessment decisions has been the crux of risk assessment 
legislation in the 104th Congress. Risk assessment is the 
cornerstone of environmental decisionmaking. In toxicology, 
where human health is at stake, a sound research base is 
essential in guiding public policy, improving public health, 
and effectively addressing environmentally related diseases.
    Environmental disparities.--There has been an increased 
recognition in the scientific and public health community that 
minority and disadvantaged populations are disproportionately 
subjected to a variety of health hazards, including air 
pollution. Its relationship to asthma and other pulmonary 
disorders is beginning to be well documented. To help examine 
these problems, NIEHS is encouraged to convene a national 
scientific summit on air quality issues faced by the Nation's 
urban communities, and working closely with the public health 
and scientific community.
    Asthma.--Asthma is one of the most prevalent chronic 
diseases of children, yet neither the cause nor cure for this 
disease is close to discovery. The relationship between asthma 
and environmental factors is beginning to emerge as a critical 
link in understanding this complex disorder. NIEHS is 
encouraged to continue its leadership role in studying 
environmental aspects of asthma and is also encouraged to 
continue to forge scientific collaboration with NIAID and NHLBI 
on this important health problem.
    Marine toxin standards.--In fiscal year 1994, Congress 
recognized the need to establish standards for marine food 
safety; and in fiscal year 1995 the Committee recommended that 
NIEHS support research to evaluate natural marine toxins and 
their effect upon human health. The Committee encourages NIEHS 
to expand this important research by establishing disease-
related environmental health science centers. Such centers 
should integrate aspects of basic science focusing upon 
molecular structures of marine toxins and applied science 
focusing upon safety assessment of food sources and clinical 
diagnosis. This information should be disseminated to domestic 
and international public health officials as well as consumers.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 1996....................................    $453,541,000
Budget estimate, 1997...................................     463,365,000
House allowance.........................................     484,375,000

Committee recommendation

                                                             472,074,000

    The Committee recommendation includes $472,074,000 for the 
National Institute on Aging [NIA]. This is $8,709,000 more than 
the administration's request, $18,533,000 more than the fiscal 
year 1996 appropriation, and $12,301,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
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.--The Committee continues its strong 
interest in expanding support for research on Alzheimer's 
disease. Much progress has been made over the last decade 
through the aggressive Alzheimer's Disease Research Program 
undertaken by the NIH, and the strong leadership provided by 
the NIA. The Committee urges the Institute to maintain that 
leadership and expects that research on Alzheimer's disease 
will continue to be the Institute's top priority.
    Behavioral and demographic research.--The aging and 
retirement of the baby boom generation, when coupled with 
increasing life expectancy at older ages, will be transforming 
demographic and economic watershed for this country. National 
Institute on Aging studies, such as the health and retirement 
study, asset and health dynamics survey, and the national long-
term care survey, provide important data for monitoring and 
understanding this demographic transformation including the 
impact on the Social Security, Medicaid, and Medicare systems. 
The Committee expects the NIA to: support its demographic 
research program, support analyses of its various data sets, 
and to play a leadership role across other Federal agencies in 
preparing for the sweeping demographic transition of the aging 
baby boom.
    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 commends the Institute for 
convening a cardiovascular aging panel to identify high-
priority research areas related to aging and cardiovascular 
function. Within the increase provided, the Committee 
encourages the NIA to expand support for high-priority research 
identified by the special panel.
    Training.--As part of its effort to ensure the future 
supply of essential research personnel, the Committee 
encourages the NIH to support an initiative such as B/START 
(behavioral science track awards for rapid transition), aimed 
at younger behavioral science researchers.
    Applied gerontology centers.--The Committee encourages 
NIA's commitment to the Edward R. Roybal applied gerontology 
centers, where research critical to the functional independence 
of our elderly citizens is being conducted, as recommended in 
the NIA human capital initiative report, ``Vitality for Life.'' 
Scientists in these centers are involved in such topics as 
developing ways to help older citizens use medications 
correctly, training older workers in technology-driven work 
environments, training older adults to use computers generally, 
and developing visual screening tasks for older drivers along 
with training techniques to improve attention and prevent 
accidents. The Roybal centers represent the important 
translation of many years of basic NIH research into 
applications that improve the lives of older Americans.
    Nutrition and the elderly.--Diet and nutrition are risk 
factors regarding many conditions of the elderly including 
osteoporosis, frailty, and sarcopenia. The Committee urges the 
Institute to continue and expand efforts related to 
malnutrition among the elderly and on the role of caloric 
restriction on conditions of the elderly.
    Bone diseases.--The Committee notes the growth of research 
on osteoporosis, Paget's disease, and osteogenesis imperfecta 
and encourages the Institute to consider further expansion and 
intensification of its research programs on these bone 
diseases.
    Alzheimers disease research centers.--The NIA's Alzheimers 
Disease Research Centers Program has yielded important 
contributions to improving understanding of the disease. The 
centers mechanism can provide unique opportunities for 
investigators from diverse disciplines to collaborate on 
investigations, yielding fresh ideas for study and new 
knowledge. The Committee is aware of a proposal by Rockefeller 
University to establish an Alzheimers disease research center 
and urges the NIA to give strong consideration to adding 
Rockefeller University to its network of Alzheimers disease 
research centers, subject to its proposal meeting the 
scientific and technical requirements of peer-review.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 1996....................................    $242,655,000
Budget estimate, 1997...................................     247,141,000
House allowance.........................................     257,637,000

Committee recommendation

                                                             251,760,000

    The Committee recommends an appropriation of $251,760,000 
for the National Institute of Arthritis and Musculoskeletal and 
Skin Diseases [NIAMS]. This is $4,619,000 more than the 
administration's request, $9,105,000 more than the fiscal year 
1996 appropriation, and $5,877,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
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.
    Osteoporosis.--The Committee is pleased with the important 
strides that have been made with the establishment of an 
osteoporosis and related bone disease national resource center 
under the Musculoskeletal Disease Program. The purpose of the 
center is to expand the awareness, knowledge, and understanding 
of the prevention, early detection, and treatment of 
osteoporosis, Paget's disease, osteogenesis imperfecta, and 
related bone diseases and to broaden the knowledge base to 
enhance primary prevention of these diseases. The Committee 
urges the NIAMS to build upon this initiative by expanding 
support for the resource center's activities in order to allow 
the center to continue to broaden its information services.
    The Committee also notes the growth of research on 
osteoporosis, Paget's disease, and osteogenesis imperfecta and 
encourage the Institute to further expand and intensify its 
research programs on these bone diseases.
    Fibromyalgia.--Fibromyalgia syndrome [FMS] is a clinically 
diagnosed disorder which is poorly understood and difficult to 
treat. Epidemiology studies have shown FMS to affect more than 
5 million Americans, 90 percent of them women. It is a syndrome 
of debilitating, chronic, widespread pain, fatigue, sleep 
disturbance, and other associated disorders. Recent research 
has disclosed biochemical abnormalities not present in healthy 
controls. What is not known is how these abnormalities relate 
to the origin of the illness or even if they are unique or 
critical to the disease process. The Committee commends the 
Institute for its collaborative role in helping to set up the 
expanded special emphasis panel for chronic fatigue syndrome so 
that it will also include expert reviewers in the overlapping 
field of fibromyalgia syndrome. The Committee also commends 
GNOMES for taking the initiative to host a second scientific 
workshop. Now that an official grant review process is in 
place, the Committee urges the Institute to aggressively 
solicit researchers in the field of FMS and related pain 
disorders to submit applications to the newly expanded special 
emphasis panel. Collaboration with other Institutes is 
recommended to help fund research on FMS and related disorders.
    Epidermolysis bullosa [EB].--The Committee is aware of 
progress in identifying the genes associated with EB and urges 
the Institute to continue to support an accelerated research 
program on EB.
    Repetitive motion injuries.--The Committee has learned that 
the national rate of reported cases of repetitive motion 
injuries has increased dramatically. However, there still 
exists an inadequate science base to effectively address this 
problem. The Institute is encouraged to pursue the research 
opportunities identified at the 1994 workshop.
    Scleroderma research.--Scleroderma, a chronic, degenerative 
autoimmune disorder that leads to the overproduction of 
collagen which hardens the connective tissue and damages the 
organs involved, is estimated to affect 500,000 people in the 
United States. The Committee urges the NIAMS to support an 
aggressive basic and clinical research program on scleroderma, 
including working collaboratively with the Scleroderma Research 
Foundation to expand support and maximize research 
opportunities supported by the public and private sectors. The 
Committee also believes the NIAMS should give strong 
consideration to establishing a national scleroderma patient 
registry through building upon the existing regional registry.
    Musculoskeletal tumors.--The Institute is encouraged to 
expand existing research in the area of musculoskeletal tumors, 
particularly in the development of allografts and other tissues 
as substitutes for removed limbs destroyed by tumors or lost as 
a consequence of trauma.
    Trauma.--Of the 61 million injuries that occur each year, 
33 million are musculoskeletal in nature. The tremendous costs 
of lost productivity and emergency medical care for 
musculoskeletal trauma, and our inability to totally prevent 
disability from injury warrant research in this area. The 
Committee encourages the NIAMS to increase its emphasis on 
musculoskeletal trauma in order to advance our understanding of 
injuries to muscles, tendons, and ligaments and will lead to 
advances in the healing and repair of damaged bone and tissue.
    Growth plate injuries.--The Committee understands that 15 
percent of all children's fractures involve the growing part of 
the bone. Damage to the growth plate results in deformities and 
shortened limbs. The Institute is urged to support research 
directed toward controlling and understanding bone growth and 
the damage to the growing bone, and treatment modalities, such 
as leg lengthening. The Committee also encourages the NIAMS and 
the NICHD to disseminate information to parents regarding the 
possibility of damage to the growth plate as a result of 
injury.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 1996....................................    $176,383,000
Budget estimate, 1997...................................     180,816,000
House allowance.........................................     189,243,000

Committee recommendation

                                                             184,437,000

    The Committee recommends an appropriation of $184,437,000 
for the National Institute on Deafness and Other Communication 
Disorders [NIDCD]. This is $3,621,000 more than the 
administration's request, $8,054,000 more than the fiscal year 
1996 appropriation, and $4,806,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The 1996 appropriation and 
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. The Committee is pleased with continued NIDCD 
intramural and extramural study into spasmodic dysphonia and 
encourages continued aggressive effort in this promising 
scientific area.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 1996....................................     $55,814,000
Budget estimate, 1997...................................      56,966,000
House allowance.........................................      59,715,000

Committee recommendation

                                                              58,014,000

    The Committee recommends an appropriation of $58,014,000 
for the National Institute of Nursing Research [NINR]. This is 
$1,048,000 less than the administration's request, $2,200,000 
more than the fiscal year 1996 appropriation, and $1,701,000 
more than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The 1996 
appropriation and the House allowance did not include an 
appropriation for the Office of AIDS Research.
    Mission.--The NINR supports research and training in the 
biological and behavioral aspects of critical national health 
problems. Research seeks to reduce the burden of illness and 
disability by understanding and easing the effects of acute and 
chronic illness; to improve quality of life by preventing or 
delaying the onset of disease or slowing its progression; to 
establish better approaches to promoting health and preventing 
disease; and to improve clinical environments by testing 
interventions that influence patient health outcomes and reduce 
costs and demand for care.
    Cognitive impairment.--The Committee believes cognitive 
impairment is a serious public health problem urgently 
requiring increased research attention. This harmful symptom 
frequently accompanies many disorders, such as AIDS, 
Alzheimer's disease, and stroke. Cognitive impairment adds 
substantially to the devastating effects of illness suffered by 
individuals and families, and contributes significantly to 
escalating health care costs. The Committee is pleased that the 
NINR plans to provide increased emphasis on brain research, 
especially on preventing or delaying cognitive impairment, and 
on aiding family caregivers as they cope with their relatives' 
maladies and their own changed life circumstances. The 
Committee recommends continued multidisciplinary research 
collaboration with the National Institute on Aging.
    Genetic screening.--Genetic screening for a variety of 
disorders is already available, including for diseases with no 
known treatment or cure. These genetic advances urgently 
necessitate interpretive research to reveal how to use this new 
knowledge effectively and ethically. The Committee supports 
NINR's plans for an aggressive research focus on genetic 
screening, including interventions to help individuals make 
decisions about participation in screening that include 
considerations of the social, ethical, and financial 
consequences. The Committee believes more information is needed 
about the efficacy of lifestyle changes to forestall or prevent 
disease expression. Interventions must be developed to help 
individuals make these adjustments to improve their chances for 
prolonged good health. The Committee strongly urges the NINR to 
continue close collaboration with the National Center of Human 
Genome Research on these critical issues.
    Managing pain.--Pain is costly for individuals and our 
society, accounting for millions of dollars each year in lost 
productivity and health care expenses. It also can interfere 
significantly with recovery from illness. The Committee 
commends NINR for taking the lead in a major NIH-wide 
initiative to combat pain, and appreciates NINR's focus on 
determining pain levels in infants, children, and others who 
cannot express themselves effectively. The complexity of this 
condition compels a multidisciplinary research approach to 
better understand such factors as pain control mechanisms, the 
effect of genetic, neuroendocrine, and neuroimmune changes on 
how people experience pain, and prevention strategies to keep 
painful sensations from becoming permanently established.
    Minority health--The Committee understands that malama, the 
innovative and culturally sensitive community partnership 
program developed for rural Hawaii, has been very successful, 
however, replication in additional community sites is necessary 
from a research perspective to establish the potential cost 
benefits of this type of program statewide. The Committee 
encourages the Institute to extend this program using a 
multidisciplinary approach to further validate this model.
    Volcanic emissions.--Significant health problems appear to 
be related to VOG. The Committee strongly encourages the 
Institute to collaborate with the NIEHS to address research 
issues involving public health concerns using an 
interdisciplinary approach.
    Treatment issues.--The Committee notes that some treatments 
can be as detrimental to recovery as disease conditions. The 
Committee recommends that NINR continue basic and clinical 
research activities to ease harmful side effects of treatment, 
such as nausea, depression, and fatigue, that can impede or 
halt the return to improved health. Another problematic 
treatment issue involves patients who avoid treatment regimens, 
which can result in serious consequences for their own health 
and others. The Committee believes it is imperative that 
strategies be developed through nursing research to curtail 
noncompliance with recommended treatments.
    Prevention and treatment of chronic wounds.--Pressure sores 
and chronic wounds, which can result in serious systemic 
infection, affect up to 15 percent of all hospitalized patients 
and up to 35 percent of nursing home patients. The Committee is 
pleased that the NINR continues to actively address this major 
health care problem and encourages further study on prevention 
and management of chronic wounds, including the exploration of 
the cellular and biochemical processes associated with these 
conditions.
    Older people and exercise.--Many studies have shown that 
physical activity is important to the health of people of all 
ages. Yet the impact of regular exercise on older adults, who 
often are not physically fit, needs to be better understood. 
The Committee appreciates NINR's commitment to determining the 
relationship between regular physical activity and improved 
health and more independent, injury-free living for elderly 
persons. It is encouraging that other nursing research is 
uncovering other benefits of exercise, such as a possible 
reduction in risk of a future stroke for stroke patients who 
exercise regularly.
    Adolescents and young adults.--The Committee notes that the 
second decade of life is accompanied by higher rates of 
psychosocial disorders than later years, and encourages NINR to 
cooperate with NICHD, NIMH, and other relevant Institutes on 
research about adolescents and young adults.

           National Institute on Alcohol Abuse and Alcoholism

Appropriations, 1996....................................    $198,401,000
Budget estimate, 1997...................................     202,614,000
House allowance.........................................     212,079,000

Committee recommendation

                                                             206,341,000

    The Committee recommends an appropriation of $206,341,000 
for the National Institute on Alcohol Abuse and Alcoholism. 
This is $3,727,000 more than the administration's request, 
$7,940,000 more than the fiscal year 1996 appropriation, and 
$5,738,000 less than the House allowance. The comparable 
numbers for the budget estimate and the Committee 
recommendation include funds to be transferred from the Office 
of AIDS Research. The fiscal year 1996 appropriation and the 
House allowance did not include a direct 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 
decrease 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.--Fetal alcohol syndrome is the 
leading known cause of mental retardation in the United States. 
Research funded by NIAAA has led to important discoveries on 
the molecular mechanisms underlying alcohol-induced birth 
defects, the effects of moderate drinking during pregnancy on 
the intelligence and behavior in offspring, and strategies for 
the prevention of drinking during pregnancy. The Committee 
recommends that funds be made available to implement the 
recommendations of the recently published Institute of Medicine 
report to increase research on fetal alcohol syndrome.
    Training.--Since behavioral factors are integral to 
alcoholism and alcohol abuse, the Committee encourages NIAAA to 
begin an initiative to support newer behavioral researchers, 
such as B/START (behavioral science track awards for rapid 
transition).
    Behavioral research.--The Committee is interested to learn 
that Project MATCH, the Institute's clinical trial of patient-
treatment matching and treatment effectiveness, is approaching 
completion, and requests that the NIAAA be prepared to report 
the results of this important research during the fiscal year 
1998 budget hearings.
    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, 1996....................................    $458,112,000
Budget estimate, 1997...................................     466,325,000
House allowance.........................................     487,341,000

Committee recommendation

                                                             474,136,000

    The Committee recommends an appropriation of $474,136,000 
for the National Institute on Drug Abuse [NIDA]. This is 
$7,811,000 more than the administration's request, $16,024,000 
more than the fiscal year 1996 appropriation, and $13,205,000 
less than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The fiscal 
year 1996 appropriation and the House allowance did not include 
a direct 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.
    Research supported by the National Institute on Drug Abuse 
[NIDA] continues to provide the scientific bases for the 
development of effective biomedical, behavioral, and 
psychosocial approaches to the prevention and treatment of drug 
abuse. NIDA continues to make extraordinary progress building 
upon the scientific advances of the past two decades.
    Neuroscience.--The Committee applauds NIDA for its recent 
breakthroughs in research on drug abuse and addiction. The 
Committee recognizes that neuroscience research has 
fundamentally changed our understanding of addiction and that 
this understanding provides the foundation for new kinds of 
treatments. Research supported by NIDA has made tremendous 
progress in identifying the neurobiological bases of all 
aspects of addiction, including craving, which is one of the 
major factors that can precipitate relapse. Among the most 
remarkable accomplishments of the past year was the successful 
immunization of animals against the psychostimulant effects of 
cocaine. NIDA-supported researchers have also made substantial 
progress that is critical in directing their efforts to 
identify potential anticocaine medications. The Committee 
expects that neuroscience research to continue to be a top 
priority and encourages NIDA to continue its research efforts 
in this area.
    Medications.--As a result of NIDA's research program, basic 
research now has progressed to the point where at least six 
molecular targets have been identified, now allowing NIDA to 
strategically focus its research on antiaddiction medications. 
The Committee commends NIDA for progress in medications 
development and urges NIDA to continue research aimed at 
developing effective medications for the treatment of 
addictions, particularly for cocaine. The Committee is pleased 
to note that NIDA has issued a program announcement to 
encourage expedited transition of ground-breaking research from 
advanced preclinical findings to applied clinical applications. 
The Committee recognizes this is an extremely valuable tool in 
advancing the discovery and development of medications for 
cocaine addiction.
    Methamphetamine.--Methamphetamine represent the most 
commonly used synthetic drug in the United States. The 
Committee is concerned that there is mounting evidence of a 
growing methamphetamine epidemic, which bears the potential of 
becoming a truly national epidemic. The Committee recognizes 
NIDA's strong history of funding research on amphetamines and 
methamphetamine; however, there is a urgent need at present for 
attention to treatments of human populations, particularly 
those in the Western United States, including rural 
populations, and those who have been infected with HIV. A most 
pressing priority is the development of effective 
pharmacological treatments for methamphetamine abusers, in 
conjunction with behavioral treatments and prevention efforts. 
The Committee encourages NIDA to continue this critical 
research area as well as develop new mechanisms to expedite 
research on methamphetamine.
    Research centers.--The Committee commends NIDA for 
encouraging applications for comprehensive research center 
grants to support research training, continuing education for 
health care professionals, dissemination of information to the 
public, and conduct of both basic and clinical research. The 
Committee notes that in fiscal year 1996, NIDA supported two 
new research centers and looks forward to NIDA's continuing 
commitment to this approach.
    The Committee strongly encourages NIDA to support 
multidisciplinary comprehensive approaches to underserved 
populations including minorities, rural populations, children, 
women, and those already infected with HIV and at an elevated 
risk for HIV. The Committee hopes that such centers will be 
representative of the varying regional epidemiological profiles 
of drug problems in the United States; including consideration 
of methamphetamine abuse in at least some of the centers.
    Behavioral research.--The Committee understands that 
behavioral research is essential to solving problems of drug 
abuse and addiction, and that behavioral and psychosocial 
interventions are the most frequently administered treatments 
for drug addiction and in some cases, are the only available 
treatment. The Committee commends NIDA for expanding both its 
basic and clinical behavioral science activities in order to 
better identify who may be at risk for falling victim to drugs, 
and to develop effective approaches for breaking the cycle of 
addiction. Of particular interest are NIDA's behavioral 
therapies development program, which applies the same 
controlled evaluation process as is used in evaluating new 
medications to the assessment of behavioral therapies. The 
Committee also commends NIDA's initiatives in the fight against 
AIDS/HIV because of the increasing link between HIV infection 
and drug use and related behaviors.
    The Committee understands that NIDA is in the process of 
expanding innovative community-based epidemiological and 
ethnographic research in relation to HIV transmission and 
prevention. The Committee encourages NIDA to continue to place 
high priority in this area of research, particularly with 
regard to documentation of the growing methamphetamine epidemic 
in the West, Midwest, and South.
    The Committee notes that NIDA has initiated the B/START 
program to increase the supply of young investigators in 
behavioral science. The Committee is pleased to see that NIDA 
has initiated this program, which invites newly independent 
investigators to submit applications for small scale pilot 
research projects related to the behavioral science mission.
    Treatment and prevention.--Drug abuse treatment and 
prevention techniques must be grounded in research in order to 
be effective with patients, providers, and insurers. The 
Committee urges NIDA to continue its efforts to strengthen the 
scientific basis for treatment and prevention interventions, 
and recommends that NIDA conduct research on ways to prevent 
drug use, interrupt the progression of drug abuse, reduce the 
likelihood of relapse, and lessen the adverse health and social 
consequences of drug abuse.
    Social work services.--The Committee commends NIDA's 
support for research on families and drug abuse, behavioral and 
psychosocial treatment research, and health services. The 
Committee also applauds NIDA for its initial effort to increase 
the number of social work researchers conducting drug abuse 
research, and encourages NIDA to expand these efforts in fiscal 
year 1997.
    Information dissemination.--The Committee believes that 
disseminating research findings in a timely manner is essential 
to the mission of NIH. Therefore, the Committee commends NIDA 
for hosting a series of town meetings with educators, health 
care providers, State and local antidrug coalitions, and civic 
organizations to disseminate research findings and foster 
information exchange.
    Advanced instrumentation.--The Committee understands that 
magnetic resonance imaging hold great promise for enhancing our 
understanding of mental illness. The Committee encourages the 
Institute to support advanced instrumentation projects related 
to the study, diagnosis, and treatment of mental disorders.
    Medical applications of marijuana.--During the fiscal year 
1997 budget hearings, the Committee received testimony 
regarding the possible therapeutic applications of marijuana on 
certain medical conditions. Furthermore, the Committee was 
advised that while research on the therapeutic use of marijuana 
has been conducted on disorders, such as HIV wasting syndrome, 
multiple sclerosis, glaucoma, and on relieving the side effects 
of chemotherapy, further research is needed to conclusively 
answer questions of efficacy, particularly in comparison with 
existing conventional therapies.
    The Committee understands that the NIH currently is 
supporting studies on the effects of marijuana on human 
performance and health. However, no studies are being 
supported, or marijuana provided, for trials examining its 
possible therapeutic benefit. The Committee encourages the 
Institute to review its policy with regard to support of 
studies examining possible medical benefits of marijuana, which 
have Food and Drug Administration approval to ensure that the 
scientific questions of the medical applications can be 
investigated and resolved.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 1996....................................    $660,514,000
Budget estimate, 1997...................................     671,205,000
House allowance.........................................     701,247,000

Committee recommendation

                                                             683,375,000

    The Committee recommends an appropriation of $683,375,000 
for the National Institute of Mental Health [NIMH]. This is 
$12,170,000 more than the administration's request, $22,861,000 
more than fiscal year 1996 appropriation, and $17,872,000 less 
than the House allowance. The comparable numbers for the budget 
estimate and the Committee recommendation include funds to be 
transferred from the Office of AIDS Research. The fiscal year 
1996 appropriation and the House allowance did not include a 
direct 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. 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. One result 
of the Federal research investment has been a growing 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 Committee notes that the NIMH is celebrating the 50th 
anniversary of the act authorizing its creation. President 
Harry Truman signed the National Mental Health Act on July 3, 
1946, and in so doing began the fundamental research efforts 
that have led to a virtual revolution in understanding mental 
illnesses as brain disorders. This, in turn, has provided the 
foundation for painstaking, yet steady, progress toward 
reversing the pattern of stigma, discrimination, and neglect 
that contributed to human suffering. Thanks to the research 
supported by the NIMH, the scientific base of knowledge has 
been developed and has led to the development of effective 
treatments for even the most severe mental disorders. The 
Committee is encouraged that basic biomedical and behavioral 
scientific research continues to yield unprecedented amounts of 
information about the human brain and its role in mental 
disorders.
    Research reviews.--The Committee encourages the new 
Director of NIMH in his efforts to scrutinize the Institute's 
research portfolio as part of his commitment to reconsider the 
Institute's priorities and overall direction. The Committee 
expects to be briefed on the results of his review.
    The Committee believes it is important that the Institute 
continue its mission with regard to basic clinical, scientific, 
and services research for individuals suffering from severe, 
biologically based mental illnesses such as schizophrenia, 
bipolar disorder, major depression, obsessive-compulsive 
disorder, and panic disorder. The Committee believes the new 
Director should pay particular attention to updating the four 
research plans relevant to these brain disorders: the national 
plan for schizophrenia research, national plan for research on 
children and adolescent mental disorders, approaching the 21st 
century: opportunities for NIMH neuroscience research, and 
caring for people with severe mental disorders: a national plan 
of research to improve services. The Committee expects to be 
briefed on the results of his review.
    Equity study.--The Committee notes with great interest the 
testimony of the Director of NIMH regarding the provision of 
equitable insurance coverage for individuals with a mental 
illness, and is encouraged by his assertion that: ``There is * 
* * no biomedical justification for policies that judge mental 
disorders as being in any way less real or less deserving of 
treatment''--an assertion based on dramatic research advances 
in our understanding of the biological bases of these unfairly 
stigmatized brain disorders. The Committee is most interested 
in the potential costs and savings to be generated by providing 
parity in health insurance coverage for individuals with a 
mental illness, particularly those that are severe and clearly 
identifiable, diagnosable, and treatable. The Committee 
requests that the Institute to request its National Advisory 
Mental Health Council to report what is known about the costs 
of providing such equitable coverage for these illnesses, and 
on the Institute's current research efforts to investigate 
managed care arrangements as they pertain to mental health, and 
submit the report under the authority of section 406(g) of the 
Public Health Service Act.
    Emergency medical services for children.--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.
    Clinical experiences.--The Committee appreciates that a 
great deal of basic behavioral research that can be brought to 
bear on the most serious of mental disorders and encourages 
NIMH to develop mechanisms to build a generation of basic 
behavioral researchers who are sensitive to clinical issues. 
For example, the Committee encourages the Institute to give 
consideration to allowing nonclinical graduate students in 
psychology and other behavioral sciences to have research 
experiences on NIMH grants in medical settings. Similarly, for 
clinical psychology programs, particularly those housed outside 
of medical schools, the Committee encourages NIMH to provide 
student support for research in settings in which severe mental 
disorders are the focus.
    Research plans.--The Committee is pleased that NIMH 
supported the development of a behavioral science research plan 
aimed at reducing depression, schizophrenia, and other severe 
mood and anxiety disorders. The plan, reducing mental 
disorders: a behavioral science research plan for 
psychopathology, was developed under the auspices of the human 
capital initiative and has been endorsed by an impressive range 
of scientific organizations. The Committee urges NIMH to use 
the plan in determining its research priorities, and requests 
the Institute to be prepared to report on how it intends to use 
this plan during the fiscal year 1988 hearings. Finally, the 
Committee reiterates its support for the National Advisory 
Mental Health Council's report, ``Basic Behavioral Science 
Research for Mental Health: A National Investment.'' In 
particular, the Committee supports recommendations to fund more 
investigator-initiated behavioral research, provide new funding 
mechanisms for longitudinal behavioral research, and expand 
study sections for the best possible review of behavioral 
science.
    Social work research.--The Committee commends NIMH for 
funding its fourth social work research development center, and 
urges NIMH to give consideration to expanding the number of 
centers. The Committee also requests that NIMH be prepared to 
report on the implementation of the recommendations of the 1991 
NIMH task force report on ``Social Work Research'' at its 
fiscal year 1998 budget hearings.
    The second decade of life.--The Committee notes that the 
incidence of psychosocial disorders is higher among individuals 
in their second decade of life than in older people. 
Accordingly, the Committee urges NIMH to join with NICHD, NINR, 
and other Institutes to support basic research on this period 
of the lifespan.
    Rural mental health.--The Committee is pleased with the 
work of the rural mental health research centers and encourages 
the NIMH to continue the initiative in rural mental health.
    Victims of torture.--The Committee is aware that within the 
United States there is a significant number of persons who have 
been tortured by foreign governments. The Committee encourages 
NIMH to support research in methods of treating victims of 
torture and give consideration to supporting a systematic study 
of the torture victim population in the United States.
    Advanced instrumentation.--The Committee understands that 
magnetic resonance imaging hold great promise for enhancing our 
understanding of mental illness. The Committee encourages the 
Institute to support advanced instrumentation projects related 
to the study, diagnosis, and treatment of mental disorders.
    Brain banks.--It has been brought to the Committee's 
attention that brain banks play an important role in enhancing 
the understanding of mental illness. The Committee encourages 
NIMH to give consideration to increasing storage capabilities 
and to the establishment of a national consortium data bank.
    Suicide and the elderly.--The NIMH is to be congratulated 
for its research on the underlying causes of elderly suicide, 
especially efforts which address the impact of late life 
depression on suicidal behavior. With growing evidence 
suggesting that the suicide rate among the elderly is on the 
rise, the Committee is encouraged by this ongoing effort and 
welcomes continued activity on this area of research.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 1996....................................    $390,298,000
Budget estimate, 1997...................................     377,599,000
House allowance.........................................     416,523,000

Committee recommendation

                                                             395,852,000

    The Committee recommends an appropriation of $395,852,000 
for the National Center for Research Resources [NCRR]. This is 
$18,253,000 more than the administration's request, $5,554,000 
more than the fiscal year 1996 appropriation, and $20,671,000 
less than the House allowance. The comparable numbers for the 
budget estimate and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The fiscal 
year 1996 appropriation and the House allowance did not include 
a direct 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.
    The Committee commends the NCRR for its efforts to 
streamline extramural programs into biomedical technology, 
clinical research, comparative medicine, and research 
infrastructure. The Committee is concerned that the reduction 
in science education, construction, and minority programs in 
the fiscal year 1997 President's budget does not allow the 
Center to maintain the balance in the Center's programs 
necessary to meet the needs of the research community. 
Therefore, the Committee urges NCRR to allocate resources more 
equitably across the Center's extramural programs in fiscal 
year 1997.
    Shared resources.--The Committee is aware of the recent 
positive review of the Center's Shared Instrumentation Grants 
Program and encourages the NCRR to expand its support for 
shared resources. 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.
    Minority programs.--The Committee continues to be committed 
to programs for enhancement of minority participation in 
research. The Committee expects the NCRR to work closely with 
centers of excellence to improve the research infrastructure of 
minority institutions capable of improving the disparity in the 
health status of the minority populations they serve.
    Extramural facilities.--The Committee has included 
$10,000,000 for extramural biomedical facility renovation and 
construction, $27,000,000 less than recommended by the House 
and $10,000,000 above the amount requested by the 
administration. These funds are to be awarded on a competitive 
basis consistent with sections 481(A) and 481(B) of the Public 
Health Service Act.
    Human genetics research is one of the fastest growing areas 
in biomedical science. In recent years, the Committee has 
expanded dramatically support for genetic research supported by 
the NIH. However, the Committee understands that extraordinary 
cost of state-of-the-art facilities has slowed the ability of 
many academic medical to conduct genetic research. The 
Committee, therefore, urges the NCRR to give priority in the 
review and award process to extramural construction proposals 
in genetic research facilities from institutions with 
demonstrated expertise in human genetics. The Committee also 
urges that priority consideration be given to construction 
proposals located at a medical center with demonstrated 
expertise in human genetics and which has also been recognized 
as a Center for Health Promotion and Disease Prevention. The 
Committee further believes that an excellent site for such a 
center would be at the Howell Heflin Human Genetics Center at 
the University of Alabama at Birmingham.
    The Committee is aware of a proposal from the Medical 
College of Virginia/Virginia Commonwealth University to 
construct a center for the study of intractable epilepsy 
research building and that the school of pharmacy at the 
University of Montana is proposing to expand its biomedical 
research facilities. The Committee urges the Director to give 
full and fair consideration proposals from these institutions.
    The Committee also is aware of the work of institutions 
located in federally designated empowerment zones, such as the 
Cancer Center of Southern New Jersey at Cooper Hospital/
University Medical Center, who are making efforts to provide 
expanded access for minorities to clinical trials for the 
treatment of cancers that impact on minority populations, 
particularly breast, lung, and colorectal cancers. The 
Committee urges the Director to give full and fair 
consideration to proposals from these institutions.
    Finally, the Committee is aware of the high-quality 
research in environmental health, cancer, and infectious 
disease proposed to be housed at Columbia University's Center 
for Disease Prevention. The Committee urges the NCRR to give 
full and fair consideration to a proposal from Columbia 
University for completion of the Center for Disease Prevention.
    The Committee has again reserved $2,500,000 of the amounts 
available for extramural construction for the renovation and 
construction requirements of regional primate centers as 
authorized by section 481(B) of the Public Health Service Act.
    The Committee notes with great concern that the NCRR has, 
notwithstanding the availability of quality applications, 
failed to fulfill the requirement under section 481(A) of the 
Public Health Service Act that 25 percent of total funding 
appropriated under the section be directed to National Centers 
of Emerging Excellence. The Committee expects the NCRR to take 
a more proactive role in fulfilling this important statutory 
requirement.
    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 urges the NCRR 
to work with the NDRI to assure the maintenance of this 
important research resource.
    IDeA grants.--The Committee has provided $2,600,000 for the 
Institutional Development Award [IDeA] Program authorized by 
section 402(g) of the Public Health Service Act. This is 
$500,000 over both fiscal year 1996 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 High Magnetic Field Laboratory.--The Committee is 
aware of a major Federal interagency investment in the National 
High Magnetic Field Laboratory in Tallahassee, FL, which has 
tremendous potential for biomedical research, training and 
treatment in magnetic resonance imaging [MRI], cellular and 
structural biology, and a broad range of other research 
possibilities. The laboratory is currently funded by the 
Department of Energy, the National Science Foundation, and 
other sources. The Committee encourages the NCRR to enter into 
an interagency financial and research participation agreement 
with the Florida-based National High Magnetic Field Laboratory 
so the benefits of this important research may be more fully 
shared and applied to the research needs of NIH.
    Clinical research.--The Committee is deeply interested in 
addressing all facets of the challenges confronting our 
Nation's clinical research effort. Toward that end, the 
Committee provides funds within the ``Buildings and 
facilities'' account of the NIH to begin the replacement of the 
aging intramural clinical research center on the NIH campus. 
The Committee is no less concerned about the need to strengthen 
the extramural clinical research infrastructure. The general 
clinical research centers around the country serve as locally 
accessible research centers for investigators and patients. The 
Committee recommendation includes $5,000,000 over the 
President's request for the general clinical research centers 
and their important training programs.
    Cancer centers.--The Committee urges NCRR to work closely 
with NCI to examine the physical needs of cancers centers, 
especially those centers that serve rural and minority 
populations with a high incidence of cancer.

               NATIONAL CENTER FOR HUMAN GENOME RESEARCH

Appropriations, 1996....................................    $169,768,000
Budget estimate, 1997...................................     179,875,000
House allowance.........................................     189,267,000

Committee recommendation

                                                             181,837,000

    The Committee recommendation includes $181,837,000 for the 
National Center for Human Genome Research [NCHGR]. This is 
$1,962,000 more than the administration's request, $12,069,000 
more than the fiscal year 1996 appropriation, and $7,430,000 
less than the House allowance. The comparable numbers for the 
budget estimate, and the Committee recommendation include funds 
to be transferred from the Office of AIDS Research. The fiscal 
year 1996 appropriation and the House allowance did not include 
a direct 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 discrimination.--The Committee commends the NCHGR 
for its leadership in research and policy development related 
to the important ethical, legal, and social implications of the 
human genome project and human genetics research. The Committee 
is particularly pleased with the attention to genetic 
discrimination in health insurance and the development of 
concise, cogent policy recommendations. The Committee supports 
the NCHGR's of ongoing efforts to examine many of the other 
important issues related to human genetics research and its 
consequences including: the appropriate use of genetic tests; 
the use of genetic information in the workplace; human subjects 
concerns, such as informed consent in genetic research; the 
education of health professionals about genetics and its 
application in health care; and the protection of genetic 
privacy. The Committee also supports efforts to include a 
diverse group of interested parties in all of its research and 
policy development activities.
    Primary immune deficiency diseases.--More than 70 primary 
immune deficiency diseases have been identified by researchers 
to date. Research into the human genome has resulted in the 
discovery of the genetic defects that result in 17 of these 70 
diseases, in which the body is incapable of fighting off 
infection. Discovering the defective genes that cause each 
disease is a critical step toward early and accurate diagnosis 
and treatment, which can relieve great suffering, and 
eventually toward prevention and cure. With 500,000 diagnosed 
cases and another 500,000 estimated as undiagnosed, the 
Committee notes the advances that have occurred in research 
into primary immune deficiency diseases as a clear example of 
the prospects that result from the research of NCHGR and 
strongly encourages the Center to continue to focus on the 
identification and sequencing of genes that cause genetic-based 
illnesses.

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

Appropriations, 1996....................................     $25,327,000
Budget estimate, 1997...................................      25,547,000
House allowance.........................................      26,707,000

Committee recommendation

                                                              26,707,000

    The Committee recommends an appropriation of $26,707,000 
for the Fogarty International Center [FIC]. This is $1,160,000 
more than the administration's request, $1,380,000 more than 
the fiscal year 1996 appropriation, and the same as the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
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.
    The Committee notes the significant accomplishments 
recorded by FIC programs and the important new initiatives 
identified in the Center's long-range plan. These timely 
efforts focus on new and reemerging infectious diseases, 
reproductive health, and environmental threats to health of 
Americans arising from beyond our borders. In pursuing these 
issues, especially developing these efforts in collaboration 
with other NIH and Federal components, the Center plays a 
uniquely important role among health agencies. The Committee is 
pleased with the Center's response to last year's Committee 
report directing the Center to give increased priority to 
developing a program to deal with the global problem of new and 
reemerging infectious diseases, and is pleased with the 
Center's initiation of an international training and research 
program on new and reemerging infectious diseases.
    TB and lung disease.--The Committee notes the increased 
collaboration of the Fogarty International Center with the 
International Union Against Tuberculosis and Lung Disease 
[IUATLD]. The Fogarty International Center's support for the 
IUATLD-sponsored meeting of national laboratories from around 
the world is a positive step forward. The Committee encourages 
FIC to develop research and training programs, in collaboration 
with the IUATLD, to combat the growing global TB epidemic.
    Infectious diseases.--The recent reemergence of the Ebola 
virus, drug-resistant malaria, tuberculosis, and other 
infectious diseases, demonstrates the continuing need for 
international efforts to detect and contain diseases before 
they become global epidemics. The Committee encourages the 
Center to devote additional funding for the furtherance of this 
important initiative.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 1996....................................    $140,936,000
Budget estimate, 1997...................................     146,579,000
House allowance.........................................     150,093,000

Committee recommendation

                                                             145,164,000

    The Committee recommends an appropriation of $145,164,000 
for the National Library of Medicine [NLM]. This is $1,415,000 
less than the administration's request, $4,228,000 more than 
the 1996 appropriation, and $4,929,000 less than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and the House allowance did not include a direct 
appropriation for the Office of AIDS Research.
    Mission.--The National Library of Medicine is the Federal 
institution that for more than 150 years has collected, 
organized, preserved, and disseminated the world's output of 
biomedical literature in all forms. As a result of this 
activity the library is the world's largest library of the 
health sciences, its holdings numbering more than 5 million 
items. The NLM, as part of the National Institutes of Health, 
has pioneered in creating innovative methods to disseminate 
bibliographic information. Basic to the mission of the NLM is a 
wide-ranging research program to improve how medical 
information is communicated. This responsibility is aided by a 
grants program and by specialized services in toxicology, 
environmental health, and biotechnology.
    Health information infrastructure.--The Committee is 
impressed with the library's efforts to use the national 
information infrastructure as a means for improving biomedical 
communication for health care, clinical research, medical 
education, and public health. Since fiscal year 1993 the NLM 
has been a leader in developing and demonstrating the utility 
of technologies related to the high-performance computing and 
communications initiative. A number of major projects have been 
initiated and the Committee commends the library for plans to 
enhance these projects selectively and to support several new 
technology-based projects. The Committee also looks forward to 
the completion of the Institute of Medicine study designed to 
identify key criteria for evaluating the impact of telemedicine 
on cost, quality, and access to health care.
    Outreach.--The NLM sponsors outreach initiatives that 
successfully reach American health professionals in a variety 
of work settings, particularly settings in hard to reach rural 
and minority communities. The new health information 
infrastructure, including the internet, now makes it possible 
for the NLM to deliver more information, to more users, and at 
lower cost, than ever before. The Committee urges that, with 
additional funds, the library expand support for these 
important outreach activities to health professionals working 
in medically underserved communities with the goal of making 
NLM's services readily available to all who can benefit from 
them, at the least possible cost to the user.
    The Committee is pleased to see that NLM is experimenting 
with the linkage of Medline references and abstracts to medical 
publishers via the worldwide web. This and other innovations 
will expand the library's mandate and provide even more 
comprehensive health information services to medical 
investigators, educators, practitioners, and the general 
public.

                         OFFICE OF THE DIRECTOR

Appropriations, 1996....................................    $260,072,000
Budget estimate, 1997...................................     251,513,000
House allowance.........................................     275,423,000

Committee recommendation

                                                             276,625,000

    The Committee recommends an appropriation of $276,625,000 
for the Office of the Director [OD]. This is $25,112,000 more 
than administration's request, $16,553,000 more than the fiscal 
year 1996 appropriation, and $1,202,000 more than the House 
allowance. The comparable numbers for the budget estimate and 
the Committee recommendation include funds to be transferred 
from the Office of AIDS Research. The fiscal year 1996 
appropriation and 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 Office of 
the Director 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 commends the ORWH 
for cosponsoring the July 1996 scientific workshop on 
fibromyalgia syndrome [FMS]. The Committee encourages the ORWH 
to develop a strategy to address chronic pain syndromes in 
women that tend to overlap, such as fibromyalgia syndrome, 
chronic fatigue syndrome, irritable bowel syndrome, chronic 
headaches, interstitial cystitis, irritable bladder, mitral 
valve prolapse syndrome, and multiple chemical sensitivities.
    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 1997, funds will be 
used to support continued activities in the coordinating center 
and the 40 clinical centers.
    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 poor health outcomes of minority populations, 
particularly those who are low income, is well documented. To 
improve the health outcomes of all minorities, the Committee 
urges the ORMH to work collaboratively with individual NIH 
Institutes and outside organizations to advance research on 
psychosocial care and intervention among lower socioeconomic 
minority groups and to support research training opportunities 
for minority social work researchers.
    The Committee commends the ORMH/NIDDK/NIAID for joining in 
a trans-Institute initiative for further study of H.pylori 
infection and its relationship to peptic ulcer disease and 
gastric cancer. Further research in this area offers exciting 
possibilities for more progress in understanding and treating 
these disorders. Additionally, the Committee commends the 
Office for attracting the American Digestive Health Foundation 
as a partner in this important effort.
    The Committee commends NIH for sponsoring a recent research 
conference on Pacific islander (including native Hawaiian) 
health care research needs. The Committee notes the multitude 
of health care needs facing Pacific islanders, including the 
high prevalence of chronic illnesses among Pacific islanders 
and the extraordinarily high rates of cancer-related mortality 
among native Hawaiians (ranked second highest in the Nation). 
Therefore, the Committee urges the Director to ensure that 
research projects involving native Hawaiians, Asians, 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.
    Office of Behavioral and Social Sciences Research 
[OBSSR].--The Committee is pleased that the OBSSR has 
established a research training task force. The Committee 
encourages the Office to work with NIH Institutes to develop 
small grants programs for young investigators, such as the B/
START program. The Committee believes that funds for such 
programs should not be allocated from within existing 
behavioral science research funds.
    The Committee applauds the Office of Behavioral and Social 
Sciences Research for its leadership in promoting social and 
behavioral science research throughout NIH. In particular, the 
Committee recognizes OBSSR's support for the symposium on 
psychosocial treatments and interventions: social work's 
contribution to a trans-NIH research agenda, and the research 
initiative on violence against women and violence within the 
family. This research initiative is an excellent example of a 
coordinated, trans-NIH initiative that allows for a 
comprehensive interdisciplinary research effort.
    National research service awards.--The Committee notes that 
the National Academy of Sciences recommended in its most recent 
assessment of the Nation's need for biomedical and behavioral 
researchers that NIH increase the number of NRSA awards in 
behavioral science, nursing research, health services research, 
and oral health research, while keeping the number of NRSA 
awards in the basic biomedical sciences at fiscal year 1993 
levels. The Committee requests that the Director report to the 
Committee on NIH's response to the recommendations, progress in 
implementation, and timetable for completion prior to the 
fiscal year 1998 hearings.
    Office of Rare Disease Research.--The recommendation 
includes increased funding over the President's request for the 
Office of Rare Disease Research. Funds above the request are 
provided to facilitate the availability of the clinical 
research data base, to establish the rare and genetic disorders 
information center, to provide support for scientific workshops 
and symposia, to finalize action on the report on plans to 
coordinate rare disease research activities, and for the 
operational activities of the Office.
    The Committee is pleased with the development of the Rare 
Disease Clinical Research Database and anticipates the 
implementation and availability of information from this 
database to match potential research participants with current 
clinical research projects. The Committee also recognizes the 
important collaborative efforts of the Office, the NCI, the 
DRG, and the GCRC program in developing information for this 
data base. Continued cooperation will be required in the future 
to maintain the high quality of information provided in this 
database. The Committee expects the Office to be prepared to 
provide an update on the implementation of the data base during 
the fiscal year 1998 hearings.
    The Committee is supportive of the Office of Rare Diseases 
and the National Center for Human Genome Research planning 
efforts to develop an information center to respond to 
inquiries about rare and genetic disorders. The Committee is 
pleased with the breadth and scope of scientific workshops and 
symposia supported by the Office to stimulate rare disease 
research by identifying research opportunities across a broad 
spectrum of rare diseases and conditions. The Committee 
recommends the Office monitor the impact of these meetings and 
provide a report on the outcomes before the end of fiscal year 
1997.
    Clinical research.--Two key objectives drive the engine of 
biomedical research: the first is to expand fundamental 
knowledge about how living systems exist and function; and the 
second is to apply that fundamental knowledge to the 
prevention, treatment, and cure of disease. The second 
objective is commonly known as clinical, or patient-oriented 
research. Both objectives are essential components of the 
Federal biomedical research effort. The Committee has been 
concerned for some time about a growing crisis in clinical 
research. The Committee was pleased to learn during its hearing 
on April 11, 1996, regarding clinical research that the 
Director's panel on clinical research was constituted to 
develop action items, and not simply conduct another review of 
the clinical research programs of NIH. The Committee 
understands that the panel has come to some preliminary 
recommendations and urges the NIH to act expeditiously to 
implement action items identified by the panel.
    Pediatric research.--In its fiscal year 1996 report, the 
Committee expressed its interest in assuring that optimum 
attention and resources are devoted to pediatric research 
conducted and supported by the NIH. The Committee appreciates 
the work of the NIH in preparing its April 1996 ``Report on NIH 
Pediatric Research.'' The report's description of the current 
pediatric research portfolio and efforts to assess the 
appropriate participation of children in research were 
particularly instructive. The Committee is encouraged by the 
recognition of the importance of a strong commitment to 
pediatric research across Institutes and expects the NIH to 
continue to strengthen its pediatric biomedical research 
portfolio.
    The Committee recognizes that the opportunity for 
scientific progress in combating and preventing illnesses and 
diseases affecting children has never been greater. To assist 
the NIH in strengthening its pediatric research effort, the 
Committee recommendation includes $5,000,000 within the Office 
of the Director for a pediatric biomedical research initiative. 
The purpose of the initiative is to encourage increased funding 
and collaborative efforts across Institutes in high priority 
pediatric research to assure that expanding opportunities for 
advancement in scientific investigations and care for children 
are realized. The Committee intends the Director to have wide 
discretion in the allocation of the pediatric research 
initiative funding, provided that research support is directly 
related to the needs of children. The Committee encourages the 
Director to allocate funds in consultation with the Institutes, 
Centers and Divisions of the NIH currently supporting pediatric 
research and to maximize support for the initiative through 
leveraging additional funding from participating Institutes.
    Bionutrition.--Nutrition research is a trans-NIH activity 
which the Committee continues to highlight. We are encouraged 
by the testimony of the Director as to the success of the 
obesity research initiative. The National Science and 
Technology Council has also recently indicated that we are 
experiencing a major epidemic of obesity. The Committee urges 
NIH to expand the focus on obesity research and particularly on 
its clinical aspects.
    Chronic fatigue and immune dysfunction syndrome.--The 
Committee reiterates its support of the NIAID's advisory 
council's recommendation in 1995 that CFIDS research continue 
in a multidisciplinary manner and encourages the NIH to appoint 
a CFIDS coordinator with crosscutting authority to provide 
leadership on CFIDS research and cultivate the interests of 
other appropriate Institutes not currently engaged in research 
on this disorder. Furthermore, the Committee encourages the 
CFIDS coordinator to make recommendations for the inclusion of 
CFIDS representatives on appropriate NIH advisory councils.
    Office of Dietary Supplements.--The Committee believes that 
the Office of Dietary Supplements [ODS] has made excellent 
progress during its first year. Accordingly, the Committee 
urges the Director to maintain level support for the ODS. 
Furthermore, the Committee encourages the ODS to evaluate the 
potential effects of supplements such as glutamine, 
antioxidants, arginine, and anabolic factors to positively 
affect the immune system of pre- and postsurgical patients and 
thereby reduce infection and inflammation
    Office of Alternative Medicine.--The Committee continues to 
strongly support the work of the Office of Alternative Medicine 
and has included increased funds to support the Office above 
its fiscal year 1996 level so that alternative therapies can be 
rigorously reviewed to determine their effectiveness. The 
Committee continues to believe the central mission of the OAM 
is to provide consumers with sound and reliable information 
about alternative therapies which will expand access to 
effective therapies and to protect consumers from false or 
misleading claims about ineffective therapies. Despite the fact 
that more and more Americans are seeking care from alternative 
providers, the resources and infrastructure needed to conduct 
research on complementary and alternative treatments continue 
to be inadequate.
    The Committee is interested in research on complementary 
methods such as chiropractic care to treat low back pain. A 
report released by the Agency for Health Care Policy and 
Research estimates that the total annual societal costs of back 
pain range from $20,000,000,000 to $50,000,000,000. Recent 
research also indicates that spinal manipulation is an 
effective form of initial treatment for acute low back 
problems. The recommendation includes sufficient funds for the 
Office of Alternative Medicine to establish a center for 
research on chiropractic health care and manipulative methods 
within a major chiropractic training institution.
    Child abuse and neglect research.--The Committee recognizes 
the magnitude and significance of the problem of child abuse 
and neglect. An excellent report done in 1993 by the National 
Research Council [NRC] on understanding child abuse and neglect 
examines the current state of research in this area and 
recommends a research agenda designed to address the problems 
and gaps that currently exist. In order to facilitate 
collaborative and cooperative efforts in this important area, 
the Committee urges NIH to convene a working group made up of 
representatives of its component organizations currently 
supporting research on child abuse and neglect. The Committee 
further encourages the working group to hold a conference on 
child abuse and neglect to assess the state-of-the-art science 
and make recommendations for a research agenda in this field, 
and include in this conference relevant outside organizations 
and experts in the field. The Committee requests that this 
working group be prepared to report on current NIH efforts in 
this area, the accomplishments of that research, and on plans 
for future coordinated efforts at the NIH at the fiscal year 
1998 hearings.
    Neurodegenerative and brain disorders initiative.--This 
area of research extends to studies which seek to understand 
the development of the normal brain and the changes in 
development which may underlie brain disorders. Over 50 million 
Americans have a permanent, neurological disability that limits 
their daily activities. One in three Americans will experience 
some form of mental disorder at some point in their lives, and 
more people are hospitalized with neuropsychiatric disorders 
than any other disease. Many other brain-related disorders and 
ailments, such as pain, addiction, neurodegenerative disease, 
diseases of the aging brain, such as Alzheimer's and 
Parkinson's, inflict untold misery on millions of Americans.
    The Committee has received compelling testimony on the 
promise of intensified research on Parkinson's disease and 
related disorders. Recent scientific findings on the cause, 
pathogenesis, and treatment of Parkinson's, as evidenced in the 
1995 NIH-sponsored workshop, support a strategy of expanded 
focus in basic and clinical research in this area. The 
Committee acknowledges substantial bipartisan support for such 
an expanded Parkinson's Disease Research Program, as evidenced 
by the majority cosponsorship in both Houses of Congress of the 
Morris K. Udall bill.
    The Committee is pleased the NIH has identified the biology 
of brain disorders as an area of scientific emphasis and was 
supportive of the implementation of the neurodegenerative 
disorders initiative begun by the Committee in fiscal year 
1996. Due to the significance of this area of research, both in 
human and fiscal terms, the Committee has again reserved 
$8,000,000 within the Director's Office to build upon this 
initiative. The Committee expects that the initiative will 
involve both basic and patient-oriented research involving 
brain disorders, and that particular emphasis will again be 
given to expanding support for innovative research related to 
neurodegenerative disorders.
    Clinical Research Center.--The Committee supports the NIH 
request for authority to allow the Clinical Research Center to 
bill third-party insurers for nonresearch-related patient 
services. In a report issued last October, the HHS inspector 
general also encouraged NIH to modify its accounting system to 
collect the full costs of treating patients at NIH; separate 
research costs from nonresearch costs; collect insurance and 
financial information from patients; and develop a plan for 
implementing the new billing policies in consultation with 
insurance companies. The Committee requests a status report on 
how NIH is responding to the above recommendations and the 
expected savings expected from implementing direct billing in 
fiscal year 1997 and in future years.
    Sleep disorders.--The Committee is supportive of the work 
of the NIH, particularly the NHLBI, to establish the National 
Center on Sleep Disorders Research. However, no mechanism has 
been formally established to encourage grant collaboration 
between the National Center and other NIH Institutes that have 
an interest in and a portfolio of sleep research activity, as 
statutorily authorized. The Committee is hopeful that the 
recently approved national sleep disorders research plan will 
serve as the focal point for this important activity, and that 
the Director's Office will help facilitate implementation of 
this plan and the necessary cross Institute collaboration.
    The Committee also views the continued implementation of 
the National Sleep Disorders education campaign as a very high 
priority and urges the NIH Director to help facilitate this 
initiative through the NHLBI and other relevant Institutes.
    Paget's disease.--The Committee has been pleased with the 
collaborative efforts demonstrated by various Institutes to 
address aspects of Paget's disease. The Committee encourages 
the NIH to continue and expand these initiatives in fiscal year 
1997, particularly within ongoing NIH center and laboratory 
programs.
    Cancer and minorities.--The Committee understands that 
cancer will soon be the leading cause of death in the United 
States. Cancer crosses all groups in America, but often takes 
the deadliest toll among minorities and the medically 
underserved. For instance, Hispanic women are nearly twice as 
likely as the general population to develop cervical cancer and 
native Americans are only one-half as likely as the general 
population to survive lung cancer. Furthermore, African-
American men are 36 percent more likely to develop prostate 
cancer, giving them the highest prostate cancer incidence in 
the world.
    It has been 5 years since the establishment of the Office 
of Research on Minority Health and the minority health 
initiative at the NIH. While there is evidence of improvement 
in NIH support for research, training, recruitment, and 
information dissemination regarding minority health issues, 
disproportionately higher risks of cancer continue for African-
Americans, other minorities, and the medically underserved. The 
Committee believes that the gravity of this issue demands that 
every appropriate effort be taken to ensure that the programs 
and activities of the Nation's chief medical research 
institution produce long-term gains against cancer that will 
benefit all Americans. Toward that end, the Committee has 
included sufficient funds for the Institute of Medicine to 
conduct a one-time review of the status of research into cancer 
among minorities and the medically underserved at the National 
Institutes of Health.
    The Committee expects the study will evaluate the status of 
cancer research relative to minorities at the various 
Institutes, centers, and divisions of the NIH to include, but 
not limited to, factors such as: the relative share of NIH 
resources allocated to cancers disproportionately afflicting 
minorities and the medically underserved; breast, cervical, and 
other cancers that have a higher mortality among many minority 
women; minority scientists' involvement in decisionmaking on 
research priorities; whether NIH has a sufficient overview of 
cancer among minorities to prioritize a research agenda dealing 
with multiple, contributing factors such as genetics, 
environment, behavioral factors, including diet and smoking, 
socioeconomic factors, and access to health care; how well NIH 
research findings are being externally communicated and applied 
to cancer prevention and treatment in communities with the 
highest cancer incidence; whether there is an adequate 
understanding of survivorship issues that uniquely impact 
minorities and the medically underserved; whether NIH 
procedures offer equitable opportunities for minority 
scientists and researchers to propose research; the success of 
minority recruitment and retention in clinical trials; and the 
creation of an annual reporting mechanism on the status of 
cancer research among minorities and the medically underserved 
at the NIH.
    Genetic research.--Genetics has become a critical component 
of all biomedical research, and as such, is central to the 
contemporary mission of the NIH. Human genetic research and its 
applications have raised, and will continue to raise, 
significant ethical, social and legal issues. If left 
unaddressed, these issues could jeopardize progress in 
understanding human genetics and/or the use of newly developed 
diagnostic and therapeutic tools. The Committee urges the 
Director to bring a coordinated effort at the NIH to these 
critical legal, ethical, and social issues, which pertain to 
many diseases and disorders, affecting millions of Americans.
    One issue in particular is the concern among the general 
public about the privacy of information, and especially, of 
genetic information, that may be obtained during the course of 
medical care, and recorded in the medical record. Some of these 
concerns are now focused on archival collections of human 
tissue samples that have been collected for clinical purposes 
and accrued for generations in academic medical centers, where 
they have provided a rich and irreplaceable resource for 
research on human diseases. The status, accessibility, and use 
of stored tissue samples raise important issues that require 
the careful balancing of considerations of patient autonomy and 
privacy with society's compelling interest in encouraging 
opportunities for biomedical discoveries, and the improvement 
of human health. The Committee urges the Director to study 
these issues and recommend appropriate policies and procedures 
that will protect the rights of research subjects and assure 
the continuing availability and accessibility of the human 
tissue archive.
    Perrine primate facility.--The Committee commends the NIH 
for its recent action in approving the excessing of the Miami-
based Perrine primate facility. The Committee continues to 
believe the best use of the facility is for the continuation of 
important primate and animal model research. The current 
licensee/management operator structure is the optimal way to 
achieve the continuation of this important research. The 
Committee urges the NIH to conclude the actions necessary to 
deem this facility as excess, so it can be transferred to the 
best use operator, consistent with prior Federal investment 
strategies.
    Chimpanzee research retirement.--The Committee recognizes 
that the issue of long-term care for chimpanzees used in 
research has received increasing attention during the last 
several years. The Committee understands that the NIH has 
funded a study by the National Academy of Sciences [NAS] to 
develop specific recommendations on the biomedical research 
community's chimpanzee requirements and the national long-term 
care and support of the chimpanzee population. Specifically, 
the NAS has been asked to look at the specific options for 
achieving cost-effective long-term care of chimpanzees. The 
Committee looks forward to the results of the NAS study, 
particularly with regard to an evaluation of the establishment 
of a program that provides for annual resources to a national 
research retirement sanctuary system and the potential savings 
realized from such an approach. The Committee expects the NIH 
to be prepared to discuss the results of the study, a 
comparison of costs associated with the current system for 
covering long-term care costs of the chimpanzee population, and 
the costs associated with options identified by the NAS study 
committee, during the fiscal year 1998 hearings.
    Bioengineering research.--The Committee is aware of the 
report entitled, ``Support for Bioengineering Research'' 
submitted to the Congress last August. The Committee requests 
that the Director prepare and submit a report to the Committee, 
and to the appropriate authorizing committee, regarding the 
plans and timeframes for implementation of the recommendations 
of the report. The report should be submitted prior to the 
fiscal year 1998 hearings.
    National Bioethics Advisory Commission.--The Committee was 
pleased to learn of the recent appointment of members for the 
National Bioethics Advisory Commission. Given the current 
debate regarding genetic privacy and discrimination; the need 
to examine the ethics involved with research involving human 
subjects; and the pace of biomedical breakthroughs, a standing 
commission at the national level to discuss the ethical 
ramifications of these issues is critical. The Committee urges 
the Commission to move expeditiously on the development of an 
agenda and the date, places, and times of its public hearings. 
The Committee applauds the Secretary for providing the core 
administrative support for the Commission. The Committee urges 
the Secretary to work with other agencies with an investment in 
issues of relevance to the Commission, to obtain the complete 
support necessary for the successful implementation and 
operation of NBA in fiscal year 1997.
    Pain research.--The Committee is pleased that pain research 
is becoming an increasing part of the NIH research agenda, and 
remains interested in the level of its overall growth and the 
need for better coordination. Pain is a major public health 
problem afflicting or disabling nearly 50 million Americans. 
The Committee encourages the NIH to quickly advance 
interdisciplinary coordination and support of the complex 
issues involved in pain research, including collaboration with 
chiropractic colleges and schools of nursing. The Committee is 
aware of the December 1995 NIH-sponsored workshop on pain 
research, and requests the Director be prepared to report on 
the implementation of the workshop's recommendations during the 
fiscal year 1998 budget hearing.
    Spinal cord injury research.--The Committee was pleased to 
learn that the Director has scheduled an NIH-sponsored workshop 
later this month. The Committee views the workshop as providing 
an important opportunity to discuss the current state of 
research and to chart the future course for an invigorated 
Spinal Cord Injury Research Program. The Committee requests 
that the Director be prepared to report on the recommendations 
of the scientific workshop, the status of their implementation, 
and the level of support of spinal cord injury research during 
the fiscal year 1998 budget hearing.

                        BUILDINGS AND FACILITIES

Appropriations, 1996....................................    $146,151,000
Budget estimate, 1997...................................     390,261,000
House allowance.........................................     200,000,000

Committee recommendation

                                                             180,000,000

    The Committee recommends an appropriation of $180,000,000 
for buildings and facilities [B&F;]. This is $210,261,000 less 
than the administration's request, $33,849,000 more than the 
fiscal year 1996 appropriation, and $20,000,000 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, North Carolina; Hamilton, MT; Perrine, FL; New 
Iberia, LA; and Sabana Seca, PR.
    Clinical research center.--The Committee concurs with the 
judgment of the House and the President's request that the NIH 
should move ahead with the construction of a new clinical 
research center to replace the existing 43-year-old structure. 
Maintaining a facility to focus intramural investigators on the 
clinical applications of basic research supported by the NIH is 
essential to ensuring a balanced research program, both 
intramurally and extramurally. The new clinical research center 
will have 250 beds, as recommended by the Marks-Cassel 
intramural research review panel. The new center will enable 
the NIH to address the serious structural impediments and 
environmental safety problems that currently confront the 
existing facility.
    The President's budget had requested $310,000,000 for the 
clinical research center, a level represented as the full 
amount necessary for design and construction of the facility. 
The Committee recommendation includes $70,000,000, $20,000,000 
less than the House amount and $240,000,000 below the request. 
The Committee concurs with the House in intending to provide 
the full cost of the project over the next several years in a 
manner that does not disrupt its construction timetable or 
unnecessarily add to its total costs. Additionally, the 
recommendation maintains language in the bill permitting NIH to 
contract for the entire scope of the project in the first year, 
subject to the availability of appropriations. This should 
allow NIH to avoid the delays and added costs associated with 
letting separate contacts for each annual appropriation of 
funds.
    While the Committee fully supports the clinical research 
center, it believes that the cost and size of a project of this 
magnitude requires careful oversight. The Committee, therefore, 
directs NIH to establish an independent committee to review the 
program, timetable, and cost estimates at the design 
development stage of the project (approximately 50 percent 
stage of design). This independent committee and NIH should 
report to the Committee at the completion of the design 
development stage, and at important subsequent milestones, the 
project costs, their reasonableness, and the projected project 
timetable. The Committee does not intend that this additional 
oversight delay the construction timetable, but believes it is 
important to continue to have outside oversight as construction 
commitments are being undertaken.

                        OFFICE OF AIDS RESEARCH

Appropriations, 1996....................................................
Budget estimate, 1997...................................  $1,431,908,000
House allowance.........................................................

Committee recommendation

                                                           1,460,312,000

    The Committee recommends an appropriation of $1,460,312,000 
for Office of AIDS Research [OAR]. This is $28,404,000 more 
than the administration's request. The fiscal year 1996 
appropriation and the House allowance did not provide a direct 
appropriation 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.
    The AIDS research program evaluation working group, chaired 
by Dr. Arthur Levine, recently conducted a rigorous review of 
the NIH AIDS program. The report from the working group 
emphasized the importance of the OAR as an institute without 
walls, and the need for a strong OAR to provide the overall 
scientific leadership and coordination of the NIH AIDS research 
program. The Committee concurs with the working group's 
conclusion that authority to develop and implement the annual 
AIDS research plan and budget is essential.

       Substance Abuse and Mental Health Services Administration

Appropriations, 1996....................................  $1,883,100,000
Budget estimate, 1997...................................   2,089,011,000
House allowance.........................................   1,849,235,000

Committee recommendation

                                                           1,873,943,000

    The Committee recommends $1,873,943,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 1997. In addition, $50,000,000 was provided for 
substance abuse treatment in Public Law 104-121, which brings 
the total for SAMHSA to $1,923,943,000. This is $40,843,000 
more than the fiscal year 1996 level. 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 Committee believes that SAMHSA's three centers should 
remain separate authorities. The Committee has provided funding 
for the Knowledge, Development, and Application Program to each 
of the three authorities: mental health, substance abuse 
treatment, and substance abuse prevention. Separate funding is 
provided for the Children's Mental Health Program, the PATH 
formula grant, the Protection and Advocacy Formula Grant 
Program, and for the two block grant programs.
    The Committee notes in SAMHSA's strategic plan that 
populations in remote, medically underserved areas; ethnic/
racial communities; women, children, and elderly individuals; 
homeless individuals; and people affected by HIV/AIDS have not 
been well served by the mainstream systems of care. These 
populations are best served through special modalities that 
take into account unique sets of circumstances such as culture 
and language preference, socioeconomic factors, and geographic 
environment. However, the Committee is concerned by the 
disproportionate cuts to programs in rural and native 
communities in fiscal year 1996. Substance abuse is a major 
problem in many rural areas, particularly for American Indian 
and Alaska Native communities. The Committee believes that 
funds for prevention and treatment programs must be equitably 
distributed and should be targeted to those persons and 
communities most in need of service. Therefore, the Committee 
has provided sufficient funds over fiscal year 1996 to fund 
projects to increase knowledge about effective ways to deliver 
services to rural and native communities. Within the funds 
reserved for rural programs, the Committee intends that 
$3,000,000 be reserved for CSAT grants, and $2,000,000 be 
reserved for CSAP grants.

                   CENTER FOR MENTAL HEALTH SERVICES

Mental health, knowledge, development, and application

    The Committee recommends $38,032,000 for the mental health, 
knowledge, development, and application program [KDA] the same 
as the comparable fiscal year 1996 amount and the House 
allowance and $24,101,000 less than the President's request. 
The following programs are included in the mental health center 
KDA: Community Support Program [CSP]; homeless and AIDS 
demonstrations; and training and AIDS training programs.
    The Committee believes mental health and substance abuse 
services are essential elements of primary care, is concerned 
about the impact of managed care on access to mental health 
services, and supports training of behavioral and mental health 
professionals for work in managed care settings, particularly 
in rural and underserved communities. The Committee commends 
CMHS for its support of the managed care and work force 
training project to identify training needs in managed care. 
The Committee concurs with the House and urges the Secretary to 
develop standards and guidelines for the delivery of mental 
health services in managed care entities, including guidelines 
for cultural competencies, work force diversity, and 
collaboration among primary care disciplines. The Committee 
urges SAMHSA to collaborate with HRSA on this effort. The 
Committee also supports special projects to design curricula 
and training models that prepare behavioral and mental health 
professionals to work in managed care systems and other 
interdisciplinary primary health care settings.
    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 understands that SAMHSA has supported 
projects which provide outreach and counseling services in 
rural areas to displaced coal miners, farmworkers, their 
families, and encourages SAMHSA to consider funding such 
projects in the future.

Clinical and AIDS training

    The Committee is aware of the need for more trained health 
providers to work with people suffering from HIV/AIDS. To the 
extent that funds are available, the Committee encourages 
SAMHSA to continue funding existing grants and contracts 
approved by SAMHSA under the current AIDS Training Program.
    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.

AIDS demonstrations

    This program provides 4 year grants to public and nonprofit 
private organizations to provide innovative mental health 
services to individuals who are experiencing severe 
psychological distress and other psychological sequelae as a 
result of infection with HIV. One coordinating center is 
supported to independently evaluate the quality and 
effectiveness of these services. The Committee commends CMS for 
its leadership in working cooperatively in demonstrating the 
efficacy of delivering mental health services to individuals 
affected by and living with HIV/AIDS. The Committee encourages 
the Secretary to maintain these agencies' support for this 
program.

Mental health block grant

    The Committee recommends $275,420,000 for the mental health 
block grant, the same as the fiscal year 1996 amount, the 
President's request, and the House allowance. 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.

Children's mental health

    The Committee recommends $59,927,000 for the Children's 
Mental Health Program, the same as the fiscal year 1996 level, 
$31,000 less than the President's request, and the same as 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 1997.

Projects for assistance in transition from homelessness [PATH]

    The Committee recommends $20,000,000 for the PATH Program, 
the same as the fiscal year 1996 amount and the House 
allowance.
    PATH is a critical program which provides outreach, mental 
health and case management services and other assistance to 
persons who are homeless and have serious mental illnesses. 
Congress has continued to show strong support for PATH, 
providing $29,000,000 in fiscal year 1995 and $20,000,000 in 
the most recent fiscal year 1996 appropriation. The PATH 
program makes a significant difference in the lives of homeless 
persons with mental illnesses. PATH services eliminate the 
revolving door of episodic inpatient and outpatient hospital 
care. Multidisciplinary teams address client needs within a 
continuum of services, providing needed stabilization so that 
mental illnesses and co-occurring substance abuse and medical 
issues can be addressed. Assistance is provided to enhance 
access to housing, rehabilitation and training, and other 
needed supports, assisting homeless people in returning to 
secure and stable lives.

Protection and advocacy

    The Committee recommends $21,957,000, for protection and 
advocacy, $2,107,000 more than the fiscal year 1996 amount and 
the same as both the President's request and 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.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Substance abuse treatment knowledge, development, and application

    The Committee recommends $110,000,000 for the substance 
abuse treatment knowledge, development, and application program 
[KDA]. This amount is $20,223,000 more than the comparable 
fiscal year 1996 amount, $66,043,000 less than the President's 
request, and $8,667,000 more than the House allowance.
    The Committee has provided sufficient funding and expects 
that the final year of the target cities projects will be fully 
funded through completion. 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 has provided sufficient funds to continue all 
13 residential women and children grants that were discontinued 
in 1996, and expects these projects will be fully funded 
through completion.
    The Committee is concerned about the disproportionate cuts 
to programs in rural and native communities, and has included 
$3,000,000 for rural CSAT programs. The Committee acknowledges 
that there is a severe shortage of services in the State of 
Alaska and that there is a pressing need to continue support of 
Alaska programs and to develop knowledge about effective 
techniques for treating and preventing substance abuse in 
native populations, and, therefore, expects that the programs 
in Alaska will be continued.

Substance abuse block grant

    The Committee recommends $1,184,107,000 for the substance 
abuse block grant. In combination with the $50,000,000 provided 
for the block grant in Public Law 104-121, $1,234,107,000 is 
provided for the block grant, the same as the comparable fiscal 
year 1996 level.
    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.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Substance abuse prevention, knowledge, development, and application

    The Committee has provided $110,000,000 for the substance 
abuse prevention, knowledge, development, and application 
program, $20,201,000 more than the comparable fiscal year 1996 
amount, $66,043,000 less than the President's request, and 
$16,041,000 more than the House allowance.
    Within the total recommended, the Committee has included 
$7,000,000 for community partnership grants and $4,000,000 for 
high-risk youth school-based grants, or one-half of the amount 
needed to fully fund the continuation of all grants. The 
Committee expects that these programs will continue in fiscal 
year 1997 at reduced rates, so that these programs can provide 
prevention services and can transition to other sources of 
funding. The Committee expects that these projects will be 
funded at reduced rates through their current grant cycle.
    The Committee is concerned about the disproportionate cuts 
to programs in rural and native communities, and has included 
$2,000,000 for CSAP programs which serve rural communities.
    The Committee expects that funding for those PPWI programs 
which provide services to low-income women and their children 
throughout urban, suburban, and rural regions of a State will 
be fully restored. These programs must provide the following 
services: a residential living setting, an educational center, 
and must operate a free medical clinic.
    The Committee believes that prevention programs need to 
start when children are young, and need to continue to help 
children make successful transitions. The Committee has 
included sufficient funds for evaluations of established 
school-based early prevention and transition programs. The 
evaluations should focus on the experiences of students 
involved in established year-round elementary education and 
prevention service programs which teach decisionmaking, 
problem-solving, and communication skills necessary to decrease 
substance abuse or the precursors of substance abuse. The 
Corporate Alliance for Drug Education [CADE] has been operating 
a program providing education and prevention services to 
120,000 elementary school-aged children in Philadelphia serving 
in 22 elementary schools and community recreation, religious, 
and civic organizations. CADE would be especially suited to an 
evaluation such as the one described above.
    Within the funds available, the Committee urges CSAP to 
continue the national effort to provide alcohol and substance 
abuse prevention and education to children of native Americans 
with alcoholism.
    The Committee encourages CSAP to give consideration to 
proposals for computer-assisted self-help therapy programs for 
adolescents at risk for alcohol or drug abuse.
    The Committee commends SAMHSA for taking initiatives for 
developing oversight and new working groups such as the 
knowledge development application [KDA] workgroup on emerging 
trends in HIV/AIDS. The Committee recognizes the need for 
ongoing development of small scale demonstration projects, 
particularly those targeted to newly emerging problems such as 
methamphetamines.
    The Committee remains concerned that CSAP may have adopted 
an informal policy of funding only grantees which have not 
received funding from sources within the alcohol and tobacco 
industries, and directs that SAMHSA discontinue any such 
policy.

                           PROGRAM MANAGEMENT

    The Committee recommends $54,500,000 for program management 
activities of the agency, $1,688,000 less than the 1996 level 
and the same as both the President's request and the House 
allowance.
    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.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 1996....................................    $166,925,000
Budget estimate, 1997...................................     176,392,000
House allowance.........................................     176,392,000

Committee recommendation

                                                             176,392,000

    The Committee provides an estimated $176,392,000 for 
retirement pay and medical benefits for commissioned officers 
of the U.S. Public Health Service. This is the same as the 
administration request and the House allowance and is 
$9,467,000 over the estimated payments for fiscal year 1996.
    This account provides for: retirement payments to U.S. 
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, 1996....................................    $125,169,000
Budget estimate, 1997...................................     143,780,000
House allowance.........................................     125,169,000

Committee recommendation

                                                             143,587,000

    The Committee recommends $83,463,000 in Federal funds for 
the Agency for Health Care Policy and Research [AHCPR]. In 
addition, the Committee provides transfers of $60,124,000 from 
funds available under section 241 of the Public Health Service 
Act. Total funding provided for the Agency is $143,587,000, 
which is $18,418,000 more than both fiscal year 1996 funding 
and the House allowance and $193,000 less than the 
administration'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 cost effectiveness and 
appropriateness of health care and to reduce the costs of 
health care.
    The Committee is supportive of AHCPR's efforts to establish 
a children's health services research agenda. To the extent 
that resources permit, the Committee encourages AHCPR to 
consider sponsoring a national conference on developing a 
national research agenda on quality, effectiveness, and 
outcomes measures in children's health care. The Committee 
further encourages the Agency to work with the Emergency 
Medical Services for Children Program at HRSA to evaluate the 
potential impact of managed care on children's access to 
emergency services.

                  Health Care Systems Cost and Access

    The Committee provides $48,416,000 for research on health 
care systems cost and access, which is the same as the 
administration request and $3,727,000 below the 1996 level. Of 
the $48,416,000 provided, $25,424,000 is derived from the 
section 241, 1-percent evaluation set-aside, which is 
$6,140,000 above the administration request. The House did not 
provide set-aside funding for this activity.
    Research on health care systems cost and access programs, 
develop analyses on ways to enhance efficiencies in the health 
care system by: identifying the most effective means in health 
care service delivery; determining how the structural and 
financial aspects of the health care system affects 
utilization, quality, and costs; and helps translate relevant 
research findings for the use of the major participants in the 
health care system.

Rural health services research

    The Committee reiterates its support of the Agency's work 
in the area of rural health services research, and expects that 
AHCPR continue 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.

                Health Insurance and Expenditure Surveys

    The Committee provides $44,700,000 for health insurance and 
expenditure surveys, which is the same as the administration 
request and the House allowance and $29,700,000 above the 1996 
level. Of the $44,700,000 provided, $34,700,000 is derived from 
the section 241, 1-percent evaluation set-aside, which is the 
same as the administration request and the House allowance.
    The health insurance and expenditure surveys obtain 
information necessary to develop timely national estimates of 
health care use and expenditures, private and public health 
insurance coverage, and the extent and costs of private health 
insurance benefits. The surveys also analyze changes in health 
care use, expenditures, and insurance coverage resulting from 
changes in market forces or government policy. To accomplish 
these functions, AHCPR employs medical expenditure panel 
surveys [MEPS], an interrelated series of surveys that replace 
the national medical expenditure survey. The Committee provides 
the full administration request for MEPS and urges continued 
efforts by the Agency to identify appropriate savings within 
MEPS that could be used for other agency research priorities, 
including health services research.

                    Health Care Outcomes and Quality

    The Committee provides $48,241,000 for research on health 
care outcomes and quality, which is the same as the 
administration request, $9,241,000 above the House allowance, 
and $7,555,000 below the 1996 level. The Committee has not 
included transfers from Medicare trust funds for this activity, 
which is $5,796,000 below the administration request. The House 
did not include Medicare trust funds for this activity.
    The health care outcomes and quality programs fund 
activities to ascertain what works best in medical care by 
enhancing cost effectiveness and appropriateness of clinical 
practice; developing tools to measure and evaluate health 
outcomes, quality of care, and consumer satisfaction; and 
facilitating translation of information into practical uses 
through data bases, information technology and provider-to-
patient education.

Minority and underserved populations

    The Committee continues to be supportive of the agency 
working with Hawaii, its unique health insurance plan, and its 
culturally diverse population.
    Social workers are important care providers within the 
health and mental health care delivery system, especially in 
minority and underserved communities. Social workers are well-
positioned to provide cost-effective prevention, primary care, 
and recovery and rehabilitation services. The Committee is 
aware of the lack of data on types, effectiveness, and cost-
efficiency studies of social work services delivered among 
different populations and encourages the agency to develop 
initiatives to train social work researchers to conduct such 
studies, consistent with the Agency's overall mission and 
priorities.

Advance directives

    In fiscal year 1995, the agency initiated a 2-year study to 
test methods to improve completion rates for advance directives 
among the general public, in accordance with the Patient Self-
Determination Act of 1990. The Committee believes that advance 
directives are important tools in protecting personal rights by 
allowing patients to make treatment preferences known in case 
of serious illness or injury. The Committee recommends 
expansion of the study's activities at existing sites to the 
extent practicable and has provided sufficient funds within the 
Agency's appropriation for continuation of the project for an 
additional year at the current rate.
    The Committee is aware of a proposal by a coalition of 
researchers and provider groups entitled ``Supportive Care of 
the Dying: A Coalition for Compassionate Care.'' This proposal 
would conduct research on the needs of persons, families, and 
communities confronted with life-threatening illness and to 
assess the current abilities of our health care system to meet 
those needs, to be followed by the development and 
dissemination of appropriate health care delivery models and 
protocols. The Committee encourages AHCPR to give full and fair 
consideration to the coalition's proposal.

Program support

    The Committee recommends $2,230,000 for program support. 
This amount is the same as the 1996 level and the House 
allowance, and $193,000 below the administration request. This 
activity supports the overall management of the Agency for 
Health Care Policy and Research.

                  Health Care Financing Administration

                     GRANTS TO STATES FOR MEDICAID

Appropriations, 1996.................................... $55,094,355,000
Budget estimate, 1997...................................  75,056,618,000
House allowance.........................................  75,056,618,000

Committee recommendation

                                                          75,056,618,000

    The Committee recommends $75,056,618,000 for grants to 
States for Medicaid. This amount is $19,962,263,000 more than 
the fiscal year 1996 appropriation and the same as both the 
administration request and the House allowance. This amount 
excludes $26,155,350,000 in fiscal year 1996 advance 
appropriations for fiscal year 1997. In addition, 
$27,988,993,000 is provided for the first quarter of fiscal 
year 1998, 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 90 percent, is 
based upon the State's average per capita income relative to 
the national average.

                  PAYMENTS TO HEALTH CARE TRUST FUNDS

Appropriations, 1996.................................... $63,313,000,000
Budget estimate, 1997...................................  60,079,000,000
House allowance.........................................  60,079,000,000

Committee recommendation

                                                          60,079,000,000

    The Committee recommends $60,079,000,000 for Federal 
payments to the Medicare trust funds. This amount is the same 
as both the administration request and the House allowance and 
is a decrease of $3,234,000,000 from the fiscal year 1996 
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 Committee has provided $59,456,000,000 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 
$4,071,000 more than the fiscal year 1996 amount.
    The recommendation also includes $405,000,000 for hospital 
insurance for the uninsured. This amount is the same as both 
the administration request and the House allowance, and is 
$47,000 more than the 1996 amount.
    The Committee also recommends $76,000,000 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 $13,000 more than the fiscal year 1996 
appropriation.
    The Committee recommendation includes $142,000,000 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 $3,000,000 less than 
the fiscal year 1996 level.

                           PROGRAM MANAGEMENT

Appropriations, 1996....................................  $2,124,281,000
Budget estimate, 1997...................................   2,193,152,000
House allowance.........................................   1,733,125,000

Committee recommendation

                                                           1,729,584,000

    The Committee recommends $1,729,584,000 for HCFA program 
management. This is $3,541,000 less than the House allowance, 
$463,568,000 less than the budget request, and $394,697,000 
less than the fiscal year 1996 enacted level.

Research, demonstrations, and evaluation

    The Committee recommends $45,000,000 for research, 
demonstration, and evaluation activities. This amount is 
$3,000,000 more than the House allowance, $5,810,000 more than 
the budget request, and $5,000,000 more than the amount 
provided in fiscal year 1996.
    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 $45,000,000 for the 
regular research and demonstration program 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 General Accounting Office [GAO] estimates that as much 
as 10 percent of Medicare costs are lost every year to waste 
and abuse. Senior citizens are also our best front line defense 
against these losses. Yet often they don't have the information 
and expertise needed to appropriately assess their Medicare 
bills and statements. As a result, abuses go unreported and 
some cases which are not abusive are reported incorrectly. 
There are thousands of retired accountants, health 
professionals, investigators, teachers, and others who, with 
appropriate training, could serve as volunteer expert resources 
and educators for seniors in their communities. This would 
substantially increase our efforts to curb losses to Medicare. 
Accordingly, the Committee has included $2,000,000 to fund the 
testing of different models designed to train retirees in local 
communities to both serve as volunteer resources and educators 
for other area Medicare beneficiaries to assist in the 
detection and reporting of Medicare waste and abuse. These 
funds are to be transferred to the Administration on Aging to 
facilitate the involvement of the aging network (area agencies 
on aging) in the project. The demonstration should include at 
least 10 sites throughout the Nation, including rural and urban 
areas. Since many seniors get information through the aging 
network, at least one-half of the tests should be run through 
local senior centers. Others could be done through insurance 
counseling programs and other senior advocacy efforts. The 
Administration on Aging should consult with the Office of 
Inspector General and the GAO to assure appropriate expertise 
in designing and implementing the pilots. The project should 
also include the development of outcome measures to demonstrate 
the effectiveness of different models tested. And, in order to 
assure that the project is timely, the Committee strongly urges 
that grants be awarded no later than February 1, 1997.
    Within available funds, the Committee has provided 
sufficient funds for the first year of a 3-year project to 
develop a comprehensive health care information managed system 
that will link patient care across the full range of health 
care, with special priority for projects involving a private 
sector partner.
    The Committee recommendation includes sufficient funds for 
a project that explores new approaches to meet the needs of 
vulnerable populations in an urban, low-income setting. The 
Committee encourages HCFA to give full and fair consideration 
for such a demonstration grant at Misericordia Hospital in 
Philadelphia. The Committee is aware of Misericordia Hospital's 
efforts to date in serving vulnerable populations in an urban 
low-income setting.
    The Committee urges the Secretary to conduct a 
demonstration program designed to integrate acute and long-term 
care under the Medicare and Medicaid programs. The 
demonstrations would operate for 5 years and in up to 10 
States. The demonstrations would explore integration of 
preventive, acute, and long-term care services by integrated 
systems of care [ISC]. ISC's would employ case management and 
interventions intended to avoid functional deterioration and 
unnecessary institutionalization. The Secretary and a State (or 
organization of States) would enter into an agreement to 
conduct a demonstration project within the State. Beneficiary 
participation in the demonstration would be voluntary. 
Individuals eligible for both Medicare and Medicaid and within 
the service area of an ISC would have the option to enroll in 
the ISC for services otherwise covered by these programs. The 
ISC's would be responsible for contracting with providers 
directly for all covered services. The ISC's would be paid on a 
fully or partially capitated basis and would bear risk in 
accord with applicable Federal and State laws and regulations. 
The Secretary would make the Medicare payment directly to the 
ISC's.
    The Committee has noted that HCFA has issued a notice to 
cease reimbursement for the only antibiotic currently covered 
in the home care setting. The Committee recommends that HCFA 
conduct a demonstration project to evaluate the cost 
effectiveness of reimbursing alternative antibiotics, including 
injectable and infused antibiotics, to vancomycin (which is 
currently covered until September 1, 1996) in the home care 
setting. HCFA should evaluate the savings associated with 
patients being treated in home care setting versus in the 
hospital or inpatient setting. The Committee recommends that 
the Secretary select two DMERC's to conduct the demonstration. 
The DMERC's should convene an expert panel of clinicians to 
select several alternatives to vancomycin for the 
demonstration. The Committee requests that the study be 
completed by September 30, 1997, and the results communicated 
by report to the Committee by November 1, 1997.
    Within the funds provided, the Committee also urges the 
Administrator to give full and fair consideration of a proposal 
from the Rhode Island Department of Elderly Affairs to 
establish an integrated health assessment system. The Committee 
understands that this system would serve as a single assessment 
for case management services under State home- and community-
based care programs and demonstrate an innovative means of 
improving the coordination of health care services for low-
income elderly patients.
    The Committee recognizes that congestive heart failure 
[CHF] is the leading cause of morbidity and mortality among 
Medicare beneficiaries and is also the most costly diagnosis 
for Medicare. The Committee, therefore, recommends that HCFA 
undertake a project to develop and implement improvements in 
the quality and cost effectiveness of the diagnosis and 
treatment of CHF which would benefit patient outcomes while 
optimizing Medicare and other health expenditures. In this 
regard, the Committee is aware of a proposal from the 
University Cardiovascular Care Consortium, an association of 10 
academic medical centers, to collaborate to develop strategies. 
The Committee urges HCFA to give full and fair consideration to 
this group's proposal.
    The Committee has serious concerns about the Medicare 
choices and the Medicare managed care competitive pricing 
demonstration projects being considered by HCFA and urges HCFA 
to carefully examine its implementation of these projects. HCFA 
is strongly urged to consult and collaborate with the 
beneficiaries, health plans, and providers in any areas under 
consideration for these projects. The Committee is concerned 
that implementing these demonstrations prematurely could 
adversely affect beneficiaries and may cause damage to the 
Medicare risk contract program in the demonstration areas.
    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 the Committee's interest in 
containing health care expenditures while providing the highest 
quality service, the Committee expects HCFA to review the 
training requirements for administrators of health care 
facilities, systems, and networks and report to the Committee 
at next year's appropriations hearings what steps should be 
taken to improve that training.

Medicare contractors

    The Committee recommends a program level of $1,642,200,000 
for Medicare contractors, of which $1,157,813,000 is for 
contractor operations. This overall amount is $28,000,000 more 
than the administration request, the same as the House 
allowance, and $44,558,000 more than comparable fiscal year 
1996 appropriation. The amount for contractor operations is 
$25,613,000 more than the House allowance. This includes 
funding of payment safeguards at $435,000,000 as part of 
recently enacted health insurance reform legislation, which 
converts funding to a mandatory basis.
    The Committee notes that the budget request and House 
allowance provide an increase from $20,000,000 in fiscal year 
1996 to $75,000,000 in fiscal year 1997 for the Medicare 
transaction system [MTS], while reducing funding for claims 
processing activities by $49,242,000. The Committee recommends 
shifting a portion of the increase budgeted for MTS, in order 
to restore claims processing funding to 98 percent of last 
year's level, consistent with action taken throughout this bill 
on administrative activities. This will provide $1,157,813,000 
for contractor operations, compared to the House allowance of 
$1,132,200,000.
    The Committee agrees that contracts with States for health 
advisory services programs for Medicare beneficiaries is an 
allowable activity under the Medicare contractor beneficiary 
services budget. These contracts would provide assistance, 
counseling, and information activities relating to Medicare 
matters as well as Medicare supplemental policies, long-term 
care insurance, and other health insurance benefit information.
    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.

State survey and certification

    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.
    The Committee recommends $158,000,000 for Medicare State 
survey and certification activities. This is the same as the 
House allowance, $5,800,000 less than the request, and 
$10,375,000 more than the 1996 enacted level.
    The fiscal year 1996 appropriations bill included language 
which extended the intervals for surveying Medicare-certified 
home health agencies. According to the Congressional Budget 
Office, this amendment increased the funds available for 
Medicare survey and certification by $8,000,000 in fiscal year 
1997. Therefore, the total amount of funds available for these 
activities is $164,000,000.
    The Congress acted to extend the survey intervals on 
assurances from the Health Care Financing Agency that quality 
of critical Medicare home care services would not decline as 
HCFA took steps to focus survey activities on problem agencies. 
The Committee would like a report on the status of efforts to 
focus survey activities within the first 6 months of fiscal 
year 1997. The Committee notes that recent General Accounting 
Office reports have indicated that management controls on 
payment for Medicare home care services and quality assurance 
are very poor. In light of the rapid growth in payment for 
Medicare home health services, the Committee is very concerned 
about these reports and directs HCFA to make recommendations on 
actions to address these problems.

Federal administration

    The Committee recommends a total of $319,384,000 for 
Federal administrative costs. This is $6,541,000 less than the 
House allowance, $40,458,000 less than the administration 
request, and $6,541,000 less than the fiscal year 1996 
appropriation. This amount represents 98 percent of the 1996 
enacted level, consistent with action taken throughout this 
bill on administrative activities.
    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 and 
taken other corrective actions over an 8-year period to expose 
and reduce these losses. The Committee is pleased that HCFA, at 
the Committee's urging, has begun the process of utilizing its 
inherent reasonableness authority to assure that Medicare is 
not paying unreasonably high prices for numerous types of 
supplies and equipment. The Committee expects to be updated by 
HCFA on this effort in the coming months.
    The Committee has for 6 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 have been taken 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 remains concerned that the Department is not 
utilizing the most sophisticated computer technology to reduce 
wasteful and abusive billings to Medicare. A recent report by 
the GAO found that billions of dollars could be saved if 
Medicare carriers utilized commercially available software to 
detect and stop billing abuse. HCFA has not complied with the 
Committee's directive last year to implement such cost saving 
technology. The Committee again directs HCFA to take this step 
to modernize technology.
    The Committee wishes to express its concern over the manner 
of implementation by the Health Care Financing Administration 
[HCFA] of the Medicaid Voluntary Contribution and Provider-
Specific Tax Amendments of 1991. That legislation was intended 
to establish a framework for continued use by States of 
provider taxes if a State chooses to use the means of revenue 
generation. It adopted standards that would prevent recurrence 
of certain abusive situations that had arisen in the past. It 
provided for waivers so that provider tax programs not strictly 
meeting the standards could be implemented without penalty as 
long as the programs were consistent with the overall statutory 
policies. The Committee is concerned about the strictness of 
HCFA's waiver rules and their application, about the cramped 
interpretation of HCFA's interpretations of the statute, and 
about HCFA's delay in acting on waiver applications. These 
positions place in jeopardy substantial amounts of Federal 
Medicaid payments to States even though the States proceeded in 
good faith to develop provider tax programs that satisfied the 
intention of the 1991. The Committee expects HCFA to apply the 
law, its regulations, and the waiver standards in a manner 
consistent with the congressional purpose of permitting use of 
provider taxes that do not present the abusive situations 
involved in some of the prior programs, and to act 
expeditiously and favorably on state waiver applications 
relating to such taxes.
    The Committee concurs with the House report language on 
lung volume reduction surgery, and has, in addition, included 
bill language requiring the Department of Health and Human 
Services to submit a report on this matter no later than 
January 1, 1997.
    The Committee expects the Health Care Financing 
Administration to review Medicare reimbursement regulations 
with respect to physical therapist in independent practice 
[PTIP] or occupational therapist in independent practice 
[OTIP]. Concerns have been expressed to the Committee that it 
should not be necessary for the PTIP or OTIP to be on the 
premises in order for those services to be reimbursed as 
Medicare services. The Committee expects the Secretary of HHS 
to be prepared to address this issue at next year's 
appropriations hearings, including recommended regulatory or 
instructional changes.
    The Committee expects that no funds be used for the 
implementation of or planning for future implementation of the 
Medicare/Medicaid data bank.
    It has come to the Committee's attention that the Medicaid 
rebate statutory formula has resulted in an unintended and 
inequitable consequence due to an anomaly in the calculation of 
the rebate.
    The purpose of the Medicaid rebate statute was to guarantee 
that Medicaid receive the benefit of the best price for which a 
manufacturer sells a prescription drug to any purchaser. 
However, in some cases the rebate claimed by Medicaid has far 
exceeded the price Medicaid paid for the drug and significantly 
exceeded the manufacturer's sales revenue for the drug. This 
has eliminated any incentive and amounted to an egregious 
penalty for participating in the Medicaid program in these 
cases.
    The Committee is concerned that this result, which runs 
counter to reason and fundamental fairness, was not 
contemplated by the statute. The Committee urges both HCFA and 
the authorizing committees to reexamine the problem to find a 
fair and equitable resolution of this situation.
    It is the Committee's understanding that HCFA has indicated 
that it will move forward with a new coverage rule which 
codifies many of the advisory criteria it now uses to make 
coverage decisions. The Committee strongly urges HCFA to 
carefully follow the requirements of the Administrative 
Procedures Act [APA] as it proceeds with this regulation. 
Specifically, the Committee feels that HCFA should publish this 
rule as a notice of proposed rulemaking [NPR] in order to 
obtain appropriate, timely public comment prior to issuing a 
final regulation. The health care environment has changed 
dramatically since HCFA published its last NPR on this subject 
in 1989.
    The Committee feels that it would not be appropriate to 
move to a final regulation status based on comments that are 
now more than 7 years old. Any new rule on coverage will 
certainly be significantly different in enough ways that this 
action warrants a new period of notice and comment. While the 
Committee is supportive of issuance of a final coverage 
regulation, it believes that the interim action of an NPR will 
keep HCFA within the requirements of the APA and will, 
therefore, result in a final regulation that appropriately 
addresses the concerns of all impacted parties.

                Administration for Children and Families

                   FAMILY SUPPORT PAYMENTS TO STATES

Appropriations, 1996.................................... $18,014,307,000
Budget estimate, 1997...................................  18,101,000,000
House allowance.........................................  18,101,000,000

Committee recommendation

                                                          18,101,000,000

    The Committee recommends an appropriation of 
$18,101,000,000 for family support payments to States, which is 
in addition to $4,800,000,000 appropriated in fiscal year 1996 
as an advance for the first quarter of 1997. This appropriation 
is the same as the administration's request and the House 
allowance, and $86,693,000 more than the fiscal year 1996 
comparable appropriation level.
    The recent enactment of Public Law 104-193 (the Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996) 
eliminates the AFDC and related programs, creating in their 
place the new temporary assistance for needy families [TANF] 
block grant. However, Public Law 104-193 provides States with a 
period to transition from the AFDC programs into the new TANF 
program. In accordance with this transition, the Committee 
recommendation continued to appropriate funds in fiscal year 
1997 for AFDC and related programs. The amount needed for AFDC 
programs during this transition is unclear because it is not 
known when, within the year (before July 1997), States will 
begin implementing their new program. States will also have 
prior-year claims from the AFDC programs. Therefore, the 
Committee recommendation retains the existing appropriations 
accounts for fiscal year 1997, for both family support payments 
to States and payments to States for jobs.
    Under the old 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 $11,713,000,000 for benefit payments under the Aid 
to Families With Dependent Children Program and $25,000,000 for 
payments to the territories. For emergency assistance, the 
Committee has provided the amount recommended by the President, 
$1,867,000,000. The Committee recommendation also includes 
$1,000,000 for repatriation and $1,875,000,000 for State and 
local welfare administrative costs. Finally, the Committee 
recommendation includes $879,405,000 for the costs of AFDC/JOBS 
child care, $267,595,000 for transitional child care, and 
$300,000,000 for the At-risk Child Care Program.
    For child support enforcement, $2,132,000,000 is included 
for State and local administration. These costs are offset by 
the Federal share of collections, estimated at $1,366,000,000. 
In addition, Federal incentive payments of $459,000,000, an 
increase of $20,000,000 over fiscal year 1996, are provided.
    The Committee recommendation deletes the requested first 
quarter advance for fiscal year 1998; this advance is no longer 
necessary, due to enactment of welfare reform legislation.

                      PAYMENTS TO STATES FOR JOBS

Appropriations, 1996....................................    $990,000,000
Budget estimate, 1997...................................   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 as 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. As stated under the previous account, 
this program will undergo a period of transition in fiscal year 
1997 due to enactment of welfare reform legislation. Since it 
is unclear how much will be needed for prior-year claims, the 
recommendation retains the current request level.

               low-income home energy assistance program

Appropriations, 1996....................................    $900,000,000
Budget estimate,1996....................................   1,000,000,000
House allowance.........................................     900,000,000

Committee recommendation

                                                           1,000,000,000

    The Committee recommends that $1,000,000,000 be made 
available in fiscal year 1997 for the Low-Income Home Energy 
Assistance Program [LIHEAP], $100,000,000 more than the regular 
appropriation for fiscal year 1996; this is the same as the 
budget request and $100,000,000 more than the House allowance.
    The Committee recommendation also includes a $1,000,000,000 
advance appropriation for fiscal year 1998, the same as the 
budget request, but which was not included by the House. The 
advance appropriation, as authorized by law, gives States 
greater opportunity for effective program planning, including 
sound allocation of resources among the various components of 
the program.
    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 $300,000,000 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. In addition to the $120,000,000 remaining available from 
previous appropriations actions, this would make available up 
to a total of $420,000,000 in emergency funds. Together with 
regular appropriations of $1,000,000,000, the Committee 
recommendation makes available a total of $1,420,000,000 for 
LIHEAP in fiscal year 1997.
    The Committee intends that up to $25,000,000 of the amounts 
appropriated for LIHEAP for fiscal year 1997 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 
1998 advance appropriation, up to $25,000,000 is also for the 
leveraging fund.

                     refugee and entrant assistance

Appropriations, 1996....................................    $402,166,000
Budget estimate, 1997...................................     381,536,000
House allowance.........................................     412,076,000

Committee recommendation

                                                             385,609,000

    The Committee recommends $385,609,000 for refugee and 
entrant assistance, a decrease of $16,557,000 below the level 
appropriated for fiscal year 1996 and $4,073,000 more than the 
budget request.
    Based on an estimated refugee admission ceiling of 90,000, 
compared to 110,000 in fiscal year 1996, this appropriation, 
together with bill language allowing prior-year funds of an 
estimated $9,300,000 to be available for 1997 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 
$237,202,000 for transitional and medical assistance, including 
State administration and the voluntary agency program; 
$99,802,000 for social services; $2,448,000 for preventive 
health; and $46,157,000 for targeted assistance. The total 
available for transitional and medical assistance, with the 
inclusion of bill language making available $9,300,000 in 
carryover funds, is $246,502,000.
    The Committee agrees that $19,000,000 is available for 
assistance to serve communities affected by the Cuban and 
Haitian entrants and refugees whose arrivals in recent years 
have increased; these funds are included in the social services 
line item. The $46,157,000 included in the targeted assistance 
line item represents an increase of $9,760,000 over the 
comparable fiscal year 1996 amount, adjusting for the fiscal 
year 1997 shift in funds identified for Cuban and Haitian 
activities.
    The Committee notes the recent request for proposals to 
provide mental health services to victims of torture, and 
recommends that the Office of Refugee Resettlement, to the 
extent possible, devote increased resources to that program in 
fiscal year 1997.
    The Committee is aware of the valuable work the Voluntary 
Agency Assistance Program is doing to resettle immigrants, 
especially Russian Jews, in the United States. The Committee 
expects $39,000,000 will be used to support grants for the 
Voluntary Agency Grant Program.

                 child care and development block grant

Appropriations, 1996....................................    $934,642,000
Budget estimate, 1997...................................   1,048,825,000
House allowance.........................................     950,000,000

Committee recommendation

                                                             956,120,000

    The Committee recommends $956,120,000 for the child care 
and development block grant, the same as the House allowance 
and $19,120,000 over the fiscal year 1996 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 1996 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.
    The bill provides that $19,120,000 of the amount 
appropriated shall become available for obligation on October 
1, 1996. Of this amount, $6,120,000 shall be derived from 
amounts appropriated in welfare reform legislation. The 
Department is instructed to obligate the $19,120,000 
immediately for the purposes of supporting resource and 
referral programs and before- and afterschool services. This 
represents the Federal commitment to the activities previously 
funded under the dependent care block grant. The Committee 
further expects that these funds will not supplant current 
funding dedicated to resource and referral and school age 
activities provided by the child care and development block 
grant. The Committee strongly encourages States to address the 
matters of before- and afterschool care and the establishment 
of resource and referral programs with the funds provided in 
this program. Bill language provides that the remaining funds, 
$937,000,000 for child care activities, become available on 
October 1, 1997; historically, these funds have not been 
obligated until late September of each fiscal year, for use in 
the next fiscal year.

                      social services block grant

Appropriations, 1996....................................  $2,381,000,000
Budget estimate, 1997...................................   2,800,000,000
House allowance.........................................   2,480,000,000

Committee recommendation

                                                           2,240,000,000

    The Committee recommends an appropriation of $2,240,000,000 
for the social services block grant. The recommendation is 
$240,000,000 below the House allowance, $560,000,000 below the 
budget request, and $141,000,000 below the 1996 enacted level. 
Bill language has been included to reduce the amount of this 
capped entitlement program. The Committee notes that recently 
enacted welfare reform legislation reduced the entitlement cap 
to $2,380,000,000; this further reduction of $140,000,000 is 
necessitated by severe budgetary constraints, without which 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 
fund 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. Many of these 
activities are funded by separate appropriations elsewhere in 
the bill.
    The Committee urges the Administration for Children and 
Families to encourage States to utilize title XX funds to 
adequately provide services to Indian children residing within 
their boundaries. The Committee further expects the 
Administration for Children and Families to implement the 
recommendations made by the Department of Health and Human 
Services inspector general to improve child welfare services 
and protection for native American children, including entering 
into a memorandum of agreement with the Bureau of Indian 
Affairs, and working more closely with tribal and State 
governments.

                children and families services programs

Appropriations, 1996....................................  $4,765,970,000
Budget estimate, 1997...................................   5,251,298,000
House allowance.........................................   4,856,435,000

Committee recommendation

                                                           4,779,434,000

    The Committee recommends an appropriation of $4,779,434,000 
for the ``Children and families services programs'' account, 
which is $471,864,000 less than the administration request and 
$13,464,000 more than the fiscal year 1996 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 $3,600,000,000 for the Head Start 
Program, the same as the House allowance, an increase of 
$30,671,000 above the 1996 level, and $381,000,000 below the 
budget request.
    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 Committee applauds the Head Start Bureau for 
recognizing the needs of homeless children and their families 
by continuing to fund slots for homeless preschoolers in the 
fiscal year 1996 budget. The Committee supports the Bureau's 
continued investment in programs which meet the needs of 
homeless children and their families in fiscal year 1997, and 
the agency's decision to move forward with conversion of these 
homeless families projects into ongoing Head Start programs for 
future years.
    Over the past 15 years, research has greatly improved the 
understanding of how children learn to read. Research also 
shows that exposing very young children to print, books, and 
reading aloud will provide children with important concepts 
about print that prepares them to learn how to read. The 
Committee encourages the Department to place a greater emphasis 
on the emergent literacy concept to prepare children to learn 
to read, and thereby help ensure their school readiness. 
Therefore, within the increase provided, the Committee has 
included funds to establish a training program and book 
distribution for Head Start grantees. The Children's Literacy 
Initiative Organization in Philadelphia, PA, received a grant 
for this purpose in 1995 and would be well suited to continue 
this activity.
    The Department recently awarded $4,200,000 in Head Start 
funds to expand services to disadvantaged children. The 
Committee notes that over 86 applications were submitted and 
only 11 were funded. Therefore, the Committee strongly urges 
the Department to hold another competition in the same service 
area at an amount equal to the funds awarded in fiscal year 
1996 with priority given to applicants who have not received 
Federal child care funds. Priority should also be given to 
agencies which are providing other federally funded social 
services to unserved and underserved populations.

Runaway and homeless youth

    The Committee recommends $43,653,000 for this program, the 
same as the House allowance and the fiscal year 1996 level. 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 $2,000,000 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 $14,949,000 
for transitional living, which is the same as the House 
allowance and the 1996 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.

Teen pregnancy prevention

    The Committee agrees with the House in not approving the 
$30,000,000 request from the administration to fund a new teen 
pregnancy prevention program. Several existing programs are 
pursuing the goal of preventing teen pregnancy; a new program, 
duplicative of these efforts, is not needed.

Child abuse prevention programs

    The Committee has included $35,180,000 for child abuse and 
neglect prevention and treatment activities, including 
$21,026,000 for State grants and $14,154,000 for discretionary 
activities, the same as the House allowance and the fiscal year 
1996 level. No funding is provided for the Advisory Board on 
Child Abuse and Neglect. These programs seek to 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 no separate categorical funding 
for temporary child care and crisis nurseries. The House also 
provided no separate allowance. The Committee concurs with the 
President's budget request to consolidate funding of this 
program with the Community-Based Resource Program and strongly 
urges the Department to provide funding to continue all 
existing awards for temporary child care and crisis nurseries.
    Under this program, 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.

Abandoned infants assistance

    The Committee concurs with the House in recommending an 
appropriation of $12,251,000 for abandoned infants assistance, 
the same as the 1996 level and $2,155,000 less than 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 care givers; and assisting abandoned infants and children 
to reside with their natural families or in foster care.

Child welfare

    The Committee recommends an appropriation of $277,389,000 
for child welfare services, the same as the fiscal year 1996 
appropriation and the House allowance and $14,600,000 less than 
the administration request. 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, the Committee recommends 
$4,000,000, the same amount recommended by the House. 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.
    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 
caseworkers have social work training, and 50 percent have no 
previous experience working with children and families. 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 urges 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 reiterates its interest in the work of the 
University of Hawaii Center on the Family and supports the 
continued use of Hawaii's ethnically diverse population to 
devise policies and programs to strengthen the family. In 
addition to activities relating to the closure of century-old 
sugar plantations, the Committee also endorses work directed to 
family resiliency and the building of family strengths. The 
Committee is especially interested in the development of self-
help programs 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. 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 again strongly 
urges the Department to implement this recommendation.

Adoption opportunities

    The Committee recommends $15,000,000 for adoption 
opportunities, an increase of $4,000,000 over the fiscal year 
1996 level, the administration request, and 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.

Social services research

    The Committee recommends $17,000,000 for social services 
and income maintenance research, for which no funds were 
provided in fiscal year 1996. The administration requested 
$10,000,000. The Committee recommendation includes a sufficient 
amount to fund existing awards for family support centers, 
through their completion. Remaining funds are for grants and 
contracts for a national random sample study of child welfare, 
and for research, evaluations, and national studies in fiscal 
year 1997.
    The Committee recommendation includes funding to carry out 
activities authorized by section 413(h)(3) of Public Law 104-
193, ``demonstrations of innovative strategies which would 
include funding for successful programs that move people from 
welfare to work.'' The Committee approves of efforts to reduce 
dependency and increase self-sufficiency among welfare 
recipients, and strongly urges the Secretary to fund these 
initiatives.

Family violence prevention programs

    For programs authorized by the Family Violence Prevention 
and Treatment Act, the Committee recommends $60,000,000, which 
is $2,399,000 more than the House allowance and $12,357,000 
more than the fiscal year 1996 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 entire amount recommended is included in crime prevention 
trust funds activities, for which the administration requested 
$27,381,000. The House allowance includes $24,958,000 from the 
crime prevention trust fund. The amount recommended is the full 
amount authorized in 1997. Due to the increase in the funds 
provided, the Committee has included a provision amending the 
Family Violence Prevention and Services Act [FVPSA] to raise 
the minimum amount each State would be allocated under the act 
from $200,000 to $400,000 or 1 percent, whichever is less.

Community-based resource centers

    The Committee recommends $32,835,000 for community-based 
resource centers. This represents level funding at the fiscal 
year 1996 level for a consolidation of the community-based 
family resource program and the temporary child care and crisis 
nurseries program. The administration requested $50,569,000 for 
this consolidation. The House recommended no funding for this 
purpose.
    This program is intended to assist States in implementing 
and enhancing a statewide system of community-based, family-
centered, family resource programs and child abuse and neglect 
prevention through innovative funding mechanisms and broad 
collaboration with educational, vocational, rehabilitation, 
health, mental health, employment and training, child welfare, 
and other social services within the State.
    The temporary child care and crisis nurseries serve 
thousands of families with children who have a disability or 
serious illness, and families that are under stress, including 
families affected by HIV/AIDS, homelessness, violence, family 
crisis, and drugs and alcohol. Over 20,000 families were served 
in the last 2 years alone. Respite care services are in 
critically short supply, providing, on average, only one out of 
every four eligible families with the critical services they 
need. Some programs report waiting lists of 400 to 500 
families.

Developmental disabilities

    The Committee recommends $114,697,000 for developmental 
disabilities programs, which is $5,715,000 more than the House 
allowance, $7,153,000 less than the request, and $465,000 more 
than the fiscal year 1996 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.

Basic State grants

    For State grants, the Committee recommends $64,803,000, the 
same as the House allowance and the fiscal year 1996 level and 
$5,635,000 less than the administration request. 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 $26,718,000, which is the same as the House 
allowance, the administration request, and the fiscal year 1996 
level. This formula grant program provides funds to States to 
establish protection and advocacy systems to protect the legal 
and human rights of persons with developmental disabilities who 
are receiving treatment, services, or rehabilitation within the 
State.

Projects of national significance

    The Committee recommends $5,715,000, which is the same as 
the request, $465,000 more than the fiscal year 1996 
appropriation, and $5,715,000 more than the House allowance. 
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, the same as the House allowance and the 
1996 level and $1,518,000 below the administration request. 
This program provides operational and administrative support 
for a national network of 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 
$34,933,000 for native American programs, the same as the 1996 
level and $3,449,000 below the administration request. The 
Administration for Native Americans [ANA] assists Indian tribes 
and native American organizations in planning and implementing 
long-term strategies for social and economic development 
through the funding of direct grants for individual projects, 
training and technical assistance, and research and 
demonstration programs. It is an effective program with 
outstanding accomplishments.
    The Committee notes the sharp increase in efforts to 
preserve native American languages through the native American 
languages program, which provides funds to tribes and native 
organizations. In fiscal year 1994, ANA received 158 
applications, representing a request of over $12,600,000 in 
funding. Of these, only 18, or 11.4 percent, were funded. In 
fiscal year 1995, 104 applications totaling $8,800,000 in 
requested funds were submitted, however, only 13 applications, 
or 12.5 percent were awarded. Despite the growth of interest in 
native languages, the lack of sufficient resources for language 
preservation led to the loss of three native languages in the 
last year alone. Accordingly, the Committee urges increased 
funding for the native American languages program. The 
Committee further recommends continued funding of the native 
Hawaiian revolving loan program.
    The Committee notes that the May 1994 final report of the 
Joint Federal-State Commission on Policies and Programs 
Affecting Alaska Natives found that many Alaska Native 
individuals, families, and communities were experiencing a 
social, cultural, and economic crisis marked by rampant 
unemployment, the lack of economic opportunity, alcohol abuse, 
depression, and morbidity and mortality rates that were 
described by health care professionals as approaching those of 
Third World countries. To address these problems the Alaska 
Natives Commission adopted recommendations that raise important 
policy questions which are unresolved in Alaska and which 
require further study and review before Congress considers 
legislation to implement these recommendations. The Committee 
encourages the Department to use $350,000 for the Alaska 
Federation of Natives to conduct a study and provide 
recommendations to Congress on further approaches to implement 
recommendations of the Alaska Natives Commission.

Community services block grant

    The Committee recommends an appropriation of $460,941,000 
for the community services programs.
    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 Committee recommends a funding level of 
$414,600,000 for the community services block grant. This is 
$25,002,000 above the fiscal year 1996 level and $75,000,000 
below the House allowance. The Committee recommendation 
recognizes the increased demand by the low-income population 
for services provided by CSBG-funded community action agencies.
    The Committee bill also contains a provision requiring that 
carryover CSBG funds remain with the local grantee. This is the 
same language that was contained in the fiscal year 1996 
appropriations bill.
    The Committee is concerned that the Office of Community 
Services has in the past been delinquent in informing States of 
the fiscal year 1996 CSBG carryover provision and in dispensing 
CSBG quarterly grants to the States. This delay has the 
potential of disrupting vital services in the low-income 
communities. The Committee expects fiscal year 1997 CSBG 
funding to be allocated to the States in a timely manner. In 
addition, the Committee expects the Office of Community 
Services to inform the State CSBG grantees of any policy 
changes affecting carryover CSBG funds within a reasonable time 
after the beginning of the Federal fiscal year.
    Several discretionary programs are funded from this 
account. Funding for these discretionary programs is 
recommended at the following levels for fiscal year 1997: 
community economic development, $27,332,000; rural community 
facilities, $3,500,000; national youth sports, $12,000,000; and 
community food and nutrition, $4,000,000. The Committee expects 
national youth sports funds to be awarded competitively. 
Because welfare reform must emphasize moving people into 
private sector jobs, the Committee has again included 
$5,500,000 from within this account for the job creation 
demonstration authorized under section 505 of the Family 
Support Act of 1988. This program has been very successful in 
moving people off welfare and into work. As in past years, the 
Committee expects that this program will be administered by the 
Office of Community Services and that a priority be given to 
community development corporations.
    The Committee is aware of recent adjustments made by the 
Department to correct errors in their application of the 
community services block grant formula for fiscal years 1995 
and 1996. These adjustments have severely impacted 13 small 
States, and the Committee has included bill language so that 
funding for these States is held harmless for both fiscal years 
1995 and 1996. The language instructs the Secretary to set 
aside up to 1 percent of the amount available to the States 
under fiscal year 1997 community services block grant funding 
to correct the recent formula allocation errors and adjustments 
affecting fiscal years 1995 and 1996. The Committee further 
limits amounts available to the Secretary for purposes of 
training, technical assistance, planning, evaluation, and data 
collection activities to provide an adequate level of funding 
to restore cuts made by the Department as a result of 
misapplication of the community services block grant formula.

Program administration

    The Committee recommends $143,115,000 for program 
administration, a decrease of $7,002,000 below the fiscal year 
1996 appropriation, $4,000,000 less than the House allowance, 
and $17,164,000 below the administration 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.
    The Committee understands that recently enacted welfare 
reform legislation provides authority for certain 
administrative expenses of the Administration for Children and 
Families to be provided from mandatory appropriations. In 
anticipation that an estimated $4,000,000 could be shifted to 
mandatory appropriations, a discretionary offset of this amount 
is included in this account. Without further approval of this 
Committee, the Secretary of Health and Human Services should 
not take action to move discretionary administrative costs 
associated with welfare reform legislation in excess of 
$4,000,000 to a mandatory account.

Rescissions

    The Committee has included bill language rescinding a total 
of $27,000,000 made available in recently enacted welfare 
reform legislation for surveys and research activities. These 
are activities that have been historically funded in 
appropriations bills, not through authorizing legislation. 
Funds for social services research activities are included 
elsewhere in this account.

Crime reduction programs

    The Committee recommends $82,000,000 for violent crime 
reduction programs, $60,642,000 above the fiscal year 1996 
appropriation, $54,642,000 above the House allowance, and 
$32,619,000 above the administration request.
    For the community schools youth services and supervision 
program, the Committee recommends $12,800,000, $800,000 less 
than the administration request. No funds were provided for 
this program in fiscal year 1996 and the House recommended none 
for fiscal year 1997. This program provides discretionary 
grants to nonprofit community-based organizations that form 
local consortia of service providers in areas with significant 
poverty and juvenile delinquency. The Committee expects that 
new grants be awarded to projects placing a strong emphasis on 
drug abuse prevention initiatives. The Committee has included 
sufficient funds for evaluations of established school-based 
early prevention and transition programs. The evaluations 
should focus on the experiences of students involved in 
established year-round elementary education and prevention 
service programs which teach decisionmaking, problem-solving, 
and communication skills necessary to succeed in what are 
commonly hostile environments. The Corporate Alliance for Drug 
Education [CADE] has been operating a program providing 
education and prevention services to 120,000 elementary school-
aged children in Philadelphia serving in 22 elementary schools 
and community recreation, religious, and civic organizations. 
CADE would be especially suited to an evaluation such as the 
one described above.
    The Committee notes that the Youth Alternative Program in 
Davenport, IA, and the Academy Day Program in Des Moines, IA, 
have developed model community schools programs and strongly 
encourages the Department to give proposals from them full 
consideration.
    For the runaway youth prevention program, the Committee 
recommends $8,000,000; $2,442,000 above the fiscal year 1996 
appropriation, $6,000,000 above the House allowance, and the 
same as the administration request. This is a discretionary 
grant program open to private nonprofit agencies for the 
provision of services to runaway, homeless, and street youth. 
Funds may be used for street-based outreach and education, 
including treatment, counseling, provision of information, and 
referrals for runaway, homeless, and street youth who have been 
subjected to or are at risk of being subjected to sexual abuse.
    The Committee recommends $60,000,000 for the grants for 
battered women's shelters program, $45,000,000 above the fiscal 
year 1996 appropriation, $35,042,000 above the House allowance, 
and $32,619,000 above the administration request. This is a 
formula grant program to support community-based projects which 
operate shelters for victims of domestic violence. Emphasis is 
given to projects which provide counseling, advocacy, and self-
help services to victims and their children.
    For the national domestic violence hotline, the Committee 
recommends $1,200,000, which is $800,000 above the fiscal year 
1996 appropriation, the House allowance, and the administration 
request. This is a cooperative agreement which funds the 
operation of a national, toll-free, 24-hours-a-day telephone 
hotline to provide information and assistance to victims of 
domestic violence.

                    family support and preservation

Appropriations, 1996....................................    $225,000,000
Budget estimate, 1997...................................     240,000,000
House allowance.........................................     240,000,000

Committee recommendation

                                                             240,000,000

    The Committee recommends $240,000,000 for fiscal year 1997, 
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, 1996....................................  $4,322,328,000
Budget estimate, 1997...................................   4,445,031,000
House allowance.........................................   4,445,031,000

Committee recommendation

                                                           4,445,031,000

    The Committee recommends $4,445,031,000 for this account, 
which is the same as the budget request and the House allowance 
and $122,793,000 more than the 1996 comparable level. Also 
included is the administration's request of $1,111,000,000 for 
a new advance appropriation for the first quarter of fiscal 
year 1998, the same as the House allowance. The Foster Care 
Program provides Federal reimbursement to States for: 
maintenance payments to families and institutions caring for 
eligible foster children, 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.

                        Administration on Aging

Appropriations, 1996....................................    $829,320,000
Budget estimate, 1997...................................     828,137,000
House allowance.........................................     810,545,000

Committee recommendation

                                                             830,168,000

    The Committee recommends an appropriation of $830,168,000 
for aging programs, $19,623,000 more than recommended by the 
House, $848,000 more than the 1996 appropriation, and 
$2,031,000 above the amount requested by the administration.
    As noted elsewhere in this report, the Committee is pleased 
that the Alzheimer's demonstration grant program, administered 
by the Health Resources and Services Administration is proving 
to be an effective catalyst by encouraging an estimated 225 
State and local agencies to coordinate and strengthen services 
for Alzheimer families. Under the circumstances, the Committee 
is concerned that efforts to transfer program responsibility to 
AOA could prove disruptive and counterproductive. The 
Committee, therefore, directs that the Alzheimer's 
demonstration grant program remain in HRSA and its mission 
remain unchanged.
    The Committee recommends a legislative provision which 
would prevent any State from having its administrative costs 
under title III of the Older Americans Act reduced by more than 
5 percent below the fiscal year 1995 level. This provision was 
included in the fiscal year 1996 omnibus appropriations bill. 
The House bill contained no similar provision.

Supportive services and senior centers

    The Committee recommends an appropriation of $300,556,000 
for supportive services and senior centers, an increase of 
$5,769,000 above the amount requested by the administration and 
the same amount appropriated in fiscal year 1996 and 
recommended by the House. 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 award funds to designated area agencies 
on aging who in turn make awards to local services providers. 
All individuals age 60 and over are eligible for services, 
although, by law, priority is given to serving those who are in 
the greatest economic and social need, with particular 
attention to low-income minority older individuals. The basic 
law States have the option to transfer up to 20 percent of 
funds appropriated between the senior centers program and the 
nutrition programs which allows the State to determine where 
the resources are most needed.

Ombudsman/elder abuse

    The Committee has earmarked $4,449,000 for the ombudsman 
services program and $4,732,000 for the prevention of elder 
abuse program within the funds for ``Supportive services and 
senior centers'' account. The amounts recommended are the same 
amount provided for these programs in fiscal year 1996. The 
administration request included separate line items for these 
programs. The House recommended no 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

    Again this year, the Committee agrees with the House and 
provides no funding for the public benefit and insurance 
counseling program. 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.

Preventive health services

    The Committee recommends $15,623,000 for preventive health 
services, the same amount appropriated in fiscal year 1996 and 
a decrease of $1,359,000 below the amount requested by 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

    For congregate nutrition services, the Committee recommends 
an appropriation of $364,535,000, the same amount appropriated 
in 1996 and recommended by the House, and an increase of 
$7,516,000 over the budget request. For home-delivered meals, 
the Committee recommends $105,339,000, the same amount 
appropriated in fiscal year 1996 and recommended by the House, 
and an increase of $11,148,000 above the amount recommended by 
the administration. These programs address the nutritional need 
of older individuals. 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 has included a provision which directs the 
Assistant Secretary to provide the maximum flexibility to 
applicants who seek to take into account subsistence, local 
customs, and other characteristics that are appropriate to the 
unique cultural, regional, and geographic needs. The provision 
clarifies that applicants who serve American Indian, native 
Hawaiian, and Alaska Native recipients in highly rural and 
geographically isolated areas are permitted to continue to 
tailor nutrition services that are appropriate to the 
circumstances associated with the served population. In 
addition, in an effort to meet the needs of the native Hawaiian 
elderly population sufficiently, the Committee urges the native 
Hawaiian grantee to coordinate with the Lunalilo Home, the only 
care facility for aged native Hawaiians.

In-home services for frail older individuals

    The Committee recommends $9,263,000 for in-home services 
for the frail elderly, the same level as the fiscal year 1996 
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 $16,057,000 for grants to Indian 
tribes, the same amount recommended by the House and the 
administration. 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 percent 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 $4,000,000 for aging research, 
training, and discretionary programs, $1,150,000 more than the 
fiscal year 1996 enacted level, and $7,666,000 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 
$2,000,000 to fund a national program of statewide senior legal 
services hotlines and related elder rights projects and 
$600,000 to continue the Family Friends Program. The Committee 
directs the Secretary to provide level funding for the elder 
care locator program.
    Within the funds provided, the Committee has included 
$130,000 for the National Asian Pacific Center on Aging to 
continue an existing grant directed to developing, 
strengthening, and expanding linkages of a rapidly growing 
Asian Pacific aging community with local, State, and national 
community service providers and organizations.
    Within the amount provided for the National Indian Council 
on Aging, the Committee has included sufficient funds to 
continue an existing grant to increase Indian elder awareness 
and participation in the public policy issues that directly 
impact all of Indian country.

Federal Council on Aging

    The Committee agrees with the House and has provided no 
funding for the Federal Council on Aging. No funds were 
provided for this purpose in fiscal year 1996. The 
administration requested $226,000 for this program.

Program administration

    The Committee recommends $14,795,000 to support Federal 
staff that administer the programs in the Administration on 
Aging, the same amount recommended by the House, $1,994,000 
below the budget request, and $302,000 below the 1996 
appropriation. These activity funds provide administrative and 
management for programs administered by the Department.

Native Americans

    The Committee is aware that the Administration on Aging has 
only provided support for the first 2 years of the 4-year 
cooperative agreements. Therefore, the Committee strongly urges 
the Assistant Secretary on Aging to provide $350,000 from 
existing funds for each of the national resource centers 
serving native American elders in fiscal year 1997.

                        Office of the Secretary

                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 1996....................................    $145,554,000
Budget estimate, 1997...................................     145,350,000
House allowance.........................................     154,850,000

Committee recommendation

                                                             159,688,000

    The Committee recommends $159,688,000 for general 
departmental management [GDM]. This is $14,338,000 more than 
the administration request, $4,838,000 more than the House 
allowance, and $14,134,000 more than the fiscal year 1996 
level. Within this amount, the Committee includes the transfer 
of $5,851,000 from Medicare trust funds, which is $3,336,000 
less than the administration request, the same as the House 
allowance, and $777,000 less than the fiscal year 1996 level.
    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 certain 
health activities that were previously performed in the former 
Office of the Assistant Secretary of Health, including the 
Office of the Surgeon General. GDM funds support the 
Department's centralized services carried out by several Office 
of the Secretary staff divisions, including personnel 
management, administrative and management services, information 
resources management, intergovernmental relations, legal 
services, planning and evaluation, finance and accounting, and 
external affairs.
    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.
    As was done last year, the Committee provides funds to the 
Office of the Secretary to administer the Office of Emergency 
Preparedness, the Office of Disease Prevention and Health 
Promotion, and the Office of Research Integrity. These offices 
were consolidated within the Office of the Secretary in 
conjunction with the elimination of the Office of the Assistant 
Secretary for Health. Sufficient funds are provided so that, if 
the Secretary so chooses, each of the above offices may be 
supported at or near the previous fiscal year's level.
    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, leading 
activities toward attaining the goals enunciated in Healthy 
People 2000, and strengthening interdepartmental coordination 
of school health education and services.
    The Committee understands the role the Office of HIV/AIDS 
Policy [OHAP] plays in developing policy across the Public 
Health Service to address the programmatic and budgetary 
implications of new-combination drug therapies for HIV/AIDS. 
The recent emergence of promising, but more costly, new 
therapies for HIV disease places greater pressures upon 
existing PHS programs addressing treatment needs of these 
populations. The Committee expects OHAP to coordinate a review 
of data regarding new HIV therapies and the implications for 
HIV treatment and prevention, and provide guidance on ways to 
improve access and availability, and to control costs.
    The Committee has again provided $500,000 from this account 
for the continuation 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 is pleased with the selection of the charter 
members of the National Bioethics Advisory Commission [NBAC]. 
NBAC was established by Executive order on October 3, 1995, for 
a 2-year period. Given the current debate regarding genetic 
privacy and discrimination; the ethics of human subjects 
research; and the potential implications of biomedical 
breakthroughs, there is a critical need for NBAC's envisioned 
activities to discuss the ethical ramifications of these and 
other issues. The Committee urges the NBAC to establish and 
implement its working agenda as soon as possible.
    The Committee recognizes the established relationship 
between the Public Health Service and the Uniformed Services 
University of the Health Sciences [USUHS]. The PHS has 
consistently provided students and faculty to USUHS since the 
university's establishment and has benefited from the services 
of these individuals. The Committee urges the Department to 
continue to assign medical students, graduate students, and 
faculty members from PHS to USUHS in numbers consistent with 
previous levels.
    The Committee is aware of the Public Health Service's 
sensitivity to the health needs of Hawaii, including the 
assignment of certain personnel, and is appreciative of these 
efforts.
    The Committee strongly urges the Secretary of Health and 
Human Services, working with the Secretary of Transportation 
through the DOT/DHHS Coordinating Council, to develop 
guidelines for State and local planning to achieve specific 
transportation coordination objectives, including but not 
limited to: joint identification of client transportation needs 
and the appropriate mix of transportation services to meet 
those needs; the expanded use of public transit services to 
deliver human services program transportation; and cost-sharing 
arrangements for program clients transported by paratransit 
systems based on a uniform accounting system.
    For several years, the Committee has supported efforts to 
relocate and revitalize the National Museum of Health and 
Medicine. The Committee is pleased to learn that the museum and 
its foundation are working with representatives of the Centers 
for Disease Control and Prevention and the National Institutes 
of Health to explore the potential for the museum to 
communicate information about activities currently underway at 
CDC and NIH in the areas of health promotion, disease 
prevention, and medical research.
    The Committee is impressed with the plans for an 
educational exhibit on emerging and reemergent diseases which 
the museum and the museum foundation are seeking to develop 
with the involvement of a number of expert partners including 
CDC and NIH. Both agencies are encouraged to consider the 
opportunity presented by this exhibit to reach a broad and 
diverse audience with timely health information. The Committee 
commends the foundation on its efforts to build meaningful 
relationships with public sector partners and to raise the 
private sector support necessary to build the new museum.

Office of Research Integrity [ORI]

    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 and 
extramural programs.
    The Committee is aware of the concern over the procedures 
used in investigating alleged incidents of scientific 
misconduct. ORI is responsible in establishing appropriate and 
timely due process protections for those accused of misconduct; 
however, there have been excessive delays in certain cases, 
that proved disruptive and costly. This is unfair to those 
individuals ultimately cleared of misconduct charges. The 
Committee expects the Secretary to thoroughly review the 
mission and operations of the ORI and to propose necessary 
reforms assuring that rigorous and fair standards are applied 
in all investigations and proceedings. The Secretary is 
requested to submit a plan for ORI's reform by next year's 
appropriations hearings at the latest, and to be prepared to 
answer questions at the hearings regarding the Office's 
operations.

Adolescent family life

    The Committee has provided $12,698,000 for the Adolescent 
Family Life Program [AFL]. This is $6,511,000 more than the 
administration request, and $5,000,000 higher than both the 
fiscal year 1996 appropriation and the House allowance. Of this 
amount, the Committee intends that $9,368,000 be available for 
demonstration grants for prevention services, and for 
abstinence education activities specified in the enacted 
welfare reform legislation, and has included bill language to 
enable this allocation.
    This amount is sufficient for new prevention projects as 
well as for continuing prevention and prevention/care projects.
    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.
    The Committee understands that in January 1996, the 
Department began an evaluation of the adolescent family life 
program. The Committee directs the Department to submit to the 
Committee on Appropriations, a detailed report on the 
evaluation findings, no later than January 1, 1997. Such report 
should include the number of grantees reviewed, program 
effectiveness, and information regarding the policies of the 
grantees on stressing abstinence only education programs.
    The Committee further directs that the administrative 
functions of, and the leadership direction for the Adolescent 
Family Life Program, be transferred from the Office of 
Population Affairs to the Office of the Administrator of the 
Health Resources and Services Administration.

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 $7,000 less than the administration request, 
the same as the House allowance and the fiscal year 1996 
appropriation.
    The President's Council on Physical Fitness and Sports 
serves as a catalyst for 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 $20,500,000 for the Office of 
Minority Health. This is $6,500,000 above the fiscal year 1996 
appropriation, $555,000 above the administration request, and 
$12,500,000 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.
    In light of increasing rates of asthma among minority 
youth, especially in urban areas, and the prospect of averting 
many of these cases through prospective, case-managed 
prevention and education programs, the Committee has provided 
$500,000 to the Office of Minority Health to institute an 
Asthma Attack Avoidance Education Program. With these funds, it 
is expected that such programs would be community-based, 
parent-child focused, and designed to increase identification 
of potential asthma attack-triggering factors, and to ensure 
appropriate referral for medical care.
    The Committee understands that the Children's Hospital of 
Philadelphia serves a primarily urban minority population with 
high incidence of asthma among children and youth that would 
benefit from a well-coordinated, integrated education, and 
referral program. The Committee urges the Office to devote 
strong consideration in supporting its proposal as well as 
other model programs.

Office on Women's Health

    The Committee recommends $12,500,000 for the Office on 
Women's Health. This is $9,930,000 more than the administration 
request, $7,138,000 more than the fiscal year 1996 amount, and 
$3,638,000 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.
    Moreover, in view of the disparities in women's health 
research, health care services, and public and health 
professional education and training, the Committee believes 
that one mechanism through which these inequities can be 
resolved is through providing grants to academic, consumer, 
health care professional, and community groups in this 
important area. To that end, the Committee urges that the PHS 
Office on Women's Health develop and support grant programs to 
support cross-cutting research, services, innovative 
partnerships, and demonstrations that will advance women's 
health.
    The Committee is encouraged by the exciting possibilities 
that imaging technologies developed by the intelligence, 
defense, and space communities may dramatically improve the 
early detection and diagnosis of breast cancer. The Committee 
commends the PHS Office of Women's Health for establishing the 
partnership to foster collaboration between the Department of 
Health and Human Services, CIA, DOD, Department of Commerce, 
NASA, and other Federal agencies to ensure the continued 
progress in this area, and has included $2,000,000 to carry out 
needed clinical trials to make this technology available to 
women.
    Currently, women facing health problems, their families, 
women's health organizations, and health care providers must 
negotiate a maze of Federal agencies and private sector 
organizations to find appropriate information on women's 
health. The Committee has included $2,500,000 for the National 
Women's Health Information Center. This service, available 
through both toll-free telephone and the internet, 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.
    Within the funds provided, the Committee has included funds 
to support leadership training for women's health care 
professionals and develop curriculum to include the unique 
needs of women. The Committee strongly encourages the Office of 
Women's Health to give consideration to developing a series of 
initiatives to encourage leadership of, and by women, in the 
field of women's health, to continue the study of the current 
curricula used by medical schools to train medical students in 
women's health, and to develop a model women's health curricula 
to aid medical schools in improving their educational programs 
regarding the conditions, diseases, and health needs of women.
    The Committee encourages the Office of Women's Health to 
develop a grant program to evaluate model women's health 
centers of excellence that combine health education for 
consumers, model health care service delivery programs, and 
research in women's health.

Office of Emergency Preparedness

    This Office meets the responsibility of the Secretary in 
assuring the continuity of Government 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.

Public health emergencies/antiterrorism measures

    The Committee has provided $8,000,000, which is $3,000,000 
more than the President's request, for activities to counter 
the adverse health and medical consequences from major 
terrorist events. The House did not provide funds for this 
activity. Last year, the Committee provided $7,000,000 for 
similar activities in the public health and social services 
emergency fund.
    Within this amount, sufficient funds are provided for the 
Office of Emergency Preparedness to staff and administer this 
program, as well as the other OEP activities specified in the 
administration's request.
    The Department has lead responsibility for health, medical, 
and health-related support under the Federal response plan to 
catastrophic disasters. On behalf of the Department, the Office 
of Emergency Preparedness has been assigned by the National 
Security Council to assess the potential health and medical 
consequences of a terrorist incident and to formulate necessary 
responses. The funds provided would support activities to build 
local, State, and Federal capacity to respond to terrorist acts 
with public health implications. Such activities would include 
training local emergency managers, coordinating local and 
regional medical responses, and building enhanced capability to 
detect and identify biologic and chemical agents.
    The Committee urges the Office of Emergency Preparedness to 
take full advantage of existing resources across the Federal 
Government, including the military and intelligence agencies, 
to avoid duplication of effort and maximize efficiencies. The 
Committee also expects the broadest feasible participation 
within the Public Health Service to include the National 
Institutes of Health and the Health Resources and Services 
Administration. HRSA's area health education centers, for 
example, might serve as a learning resource for health 
professionals about the medical and psychiatric impact of major 
disasters. NIH's research expertise in infectious disease and 
environmental health would contribute to better diagnostics and 
preventive strategies.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 1996....................................     $78,819,000
Budget estimate, 1997...................................      74,949,000
House allowance.........................................      29,399,000

Committee recommendation

                                                              29,399,000

    The Committee recommends an appropriation of $29,399,000 
for the Office of Inspector General. This is $45,550,000 less 
than the administration request, the same as the House 
allowance, and $49,420,000 less than the fiscal year 1996 
level. The Health Coverage and Availability and Affordability 
Act of 1996 (H.R. 3103) provides appropriations for the Office 
of the Inspector General; the total funds provided to the 
Office by this bill and the authorizing bill would be 
$89,399,000 in fiscal year 1997, the same as the House 
allowance.
    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.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 1996....................................     $19,380,000
Budget estimate, 1997...................................      21,790,000
House allowance.........................................      19,380,000

Committee recommendation

                                                              19,680,000

    The Committee recommends an appropriation of $16,366,000 in 
Federal funds for the Office for Civil Rights. This is 
$1,822,000 less than the administration request and $300,000 
more than the House allowance and the fiscal year 1996 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, the same as the House allowance and the 
fiscal year 1996 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.

                            POLICY RESEARCH

Appropriations, 1996....................................      $8,968,000
Budget estimate, 1997...................................       9,000,000
House allowance.........................................       9,000,000

Committee recommendation

                                                               9,000,000

    The Committee recommends an appropriation of $9,000,000 for 
policy research. This is the same as the administration request 
and the House allowance, and $32,000 more than the fiscal year 
1996 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.

                           General Provisions

    The Committee has concurred with the House in recommending 
a $37,000 ceiling on official representation expenses (sec. 
201), the same as existing law.
    The Committee has concurred with the House in retaining 
language from last year's bill limiting assignment of certain 
public health personnel (sec. 202).
    The Committee concurs with section 203 of the House bill 
which retains language carried last year regarding set-asides 
in the authorizing statute of the National Institutes of 
Health.
    The Committee has concurred 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 more 
than an annual rate of $125,000 (sec. 205); and provide for the 
transfer of funds to the HHS inspector general's office for 
provision of security services to the Secretary of Health and 
Human Services (sec. 207).
    The Committee has concurred with the House in retaining 
language from last year's bill restricting the use of taps 
(sec. 206) for program evaluation activities by the Secretary 
prior to submitting a report on the proposed use of the funds 
to the Appropriations Committee. 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 evaluation activities.
    The Committee has concurred with the House in retaining 
language prohibiting the use of funds for the Federal Council 
on Aging and the Advisory Board on Child Abuse and Neglect 
(sec. 208).
    The Committee has concurred with the House in retaining 
language restricting transfers of appropriated funds among 
accounts and requiring a 15-day notification of both 
Appropriations Committees prior to any transfer (sec. 209).
    The Committee has deleted a House provision enabling the 
transfer of AIDS funds (sec. 210) by the Director of NIH and 
the Director of the Office of AIDS Research of NIH.
    The Committee has deleted a House provision restricting the 
awarding of certain SBIR grants and cooperative agreements at 
NIH (sec. 211).
    The Committee has deleted a House provision extending a 
moratorium regarding the Michigan Medigrant plan (sec. 212).
    The Committee has deleted a House provision authorizing the 
relocation of the Federal Gillis W. Long Hansen's Disease 
Center in Louisiana and the relocation of its patients (sec. 
213).
    The Committee has deleted a House provision requiring 
family planning grantees to prioritize services to individuals 
along certain financial criteria and requiring HHS to submit a 
report on the demographics of family planning service 
recipients (sec. 214).
    The Committee has deleted a House provision reducing funds 
for offices of congressional and legislative affairs, public 
affairs, and intergovernmental affairs (sec. 215).
    The Committee has included a new provision, not included by 
the House, regarding lung reduction surgery (sec. 216).
    The Committee has included a new provision, not included by 
the House, increasing the small State minimum from $200,000 to 
$400,000 for battered women's shelters (sec. 217).
    The Committee has included a new provision, not included by 
the House, to name the new clinical research center at the 
National Institutes of Health the Mark O. Hatfield Clinical 
Research and Patient Care Center (sec. 218).
                   TITLE III--DEPARTMENT OF EDUCATION

                            education reform

Appropriations, 1996....................................    $530,000,000
Budget estimate, 1997...................................     691,000,000
House allowance.........................................     175,000,000

Committee recommendation

                                                             535,000,000

    The Committee has provided $535,000,000 in this account for 
two administration reform initiatives: $355,000,000 for 
education reform activities authorized by the Goals 2000: 
Educate America Act, and $180,000,000 to continue 
implementation of school-to-work transition systems authorized 
by the School-to-Work Opportunities Act.

Goals 2000 State grants

    The Committee bill includes $340,000,000 for State and 
local systemic education improvement grants authorized by title 
III of the Goals 2000: Educate America Act. This amount is the 
same as the fiscal year 1996 appropriation and $136,000,000 
below the administration request. The House bill eliminated 
funding for this program.
    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. By law, 1 percent is reserved for the 
outlying areas, schools supported by the Bureau of Indian 
Affairs and the Alaska Federation of Natives.

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 $15,000,000 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. The increase provided will permit an 
expansion of voluntary parent centers to 14 additional States 
bringing the total number of States participating in the 
program to 42.

School-to-work opportunities

    The Committee supports funds for the School-to-Work 
Opportunities Act, and has recommended $180,000,000 for the 
Department of Education's share of program funding. The amount 
recommended is the same as the 1996 appropriation, $20,000,000 
less than the administration request, and $5,000,000 above the 
amount recommended by the House. Together with $180,000,000 
recommended for the Labor Department, $360,000,000 in direct 
funding is provided to help States implement their plans for 
creating systems to improve the transition from school to work.
    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.

                    Education for the Disadvantaged

Appropriations, 1996....................................  $7,228,077,000
Budget estimate, 1997...................................   7,679,000,000
House allowance.........................................   7,225,130,000

Committee recommendation

                                                           7,225,249,000

    The Committee recommends an appropriation of $7,225,249,000 
for education for the disadvantaged. This is $2,828,000 less 
than the fiscal year 1996 appropriation, $453,751,000 less than 
the administration request, and $119,000 more than the House 
allowance. In fiscal year 1996, $5,929,691,000 was made 
available for this account in the fiscal year 1996 funds and 
$1,298,386,000 was made available in fiscal year 1997. This 
year, the Committee forward funded $670,597,000 into fiscal 
year 1998. The Committee took this action because of the severe 
budget constraints facing the Committee in fiscal year 1997.
    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 Committee recognizes the vital importance of reading 
and writing in an age of technology, particularly for title I 
students. The Committee urges the Department to identify 
effective and cost-effective programs that address reading and 
writing, and to support those that have demonstrated the 
ability to improve children's ability to read and write.

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 program currently provides services to more than 6.6 
million 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. By 
law, 1 percent of the total LEA grant appropriation is set 
aside for the Bureau of Indian Affairs and the outlying areas.
    For title I basic grants, including the amount transferred 
to the Census Bureau for poverty updates, the Committee 
recommends an appropriation of $6,046,266,000. This is the same 
amount appropriated in fiscal year 1996, $1,000,000 less than 
the amount recommended by the House, and $552,201,000 more than 
the budget request.
    The Committee agrees with the House and has provided no 
funding for the targeted grants program. The budget requested 
$1,000,000,000 for this program which distributes funds in a 
manner that provides higher per-children amounts for counties 
with the highest percentage of poor children.
    The Committee recommends $684,082,000 for concentration 
grants, the same amount appropriated in fiscal year 1996, 
$20,000,000 less than the amount recommended by the House, and 
$13,147,000 more than the budget request. Funds under this 
program 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.

Capital expenses for private school students

    The Committee recommends $41,119,000 for the Capital 
Expenses Program, an increase of $3,000,000 above the budget 
request and $21,119,000 more than the amount recommended by the 
House and the administration.
    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 schoolteachers 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 the 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 $101,997,000, the same amount appropriated 
in 1996 and recommended by the House. The administration 
requested $102,000,000 for this program.
    The Even Start Program provides grants for family literacy 
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 partnerships of 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 $305,474,000. The amount 
recommended is the same amount appropriated in 1996 and 
$14,526,000 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 610,000 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 1996, the amount recommended by the House, and $689,000 
below the administration request.
    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 administration 
requested $15,000,000 for this purpose. No funds were 
appropriated in fiscal year 1996 for this program. Funds are 
used to help States stimulate school-based change and hold 
local educational 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 $10,000,000 for this purpose. No funds were 
appropriated in fiscal year 1996 for this program. Funds are 
used for 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 $7,000,000 for title I 
evaluation activities, an increase of $3,641,000 above the 
fiscal year 1996 appropriation and the same amount recommended 
by the House and requested by the administration.
    Evaluation funds are used to support large-scale national 
surveys that examine how the title I program is contributing to 
student performance. The increase will provide sufficient funds 
to design, implement, and produce multiyear evaluations that 
will assess the effects of the changes made in the 
reauthorization of the title I program.

High School Equivalency Program

    The Committee bill agrees with the House and the 
administration and recommends no funds for the High School 
Equivalency Program [HEP]. This program was funded at 
$7,441,000 in fiscal year 1996.
    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 agrees with the House and the administration and 
provides no funds for this activity. The program was funded at 
$2,028,000 in fiscal year 1996.
    Funds provide 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, 1996....................................    $693,000,000
Budget estimate, 1997...................................     617,000,000
House allowance.........................................     728,000,000

Committee recommendation

                                                             703,000,000

    The Committee recommends an appropriation of $703,000,000 
for impact aid for the Department of Education. This amount is 
$10,000,000 above the 1996 amount, $86,000,000 above the 
administration request, and $25,000,000 below 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. During 
the current school year approximately 2,000 school districts 
will receive payments of behalf of 1.2 million eligible 
children.
    The Committee agrees with the House in turning down the 
administration's proposal to override the authorizing statute 
to reduce the number of school districts receiving payments to 
1,000 and to reduce the number of children on behalf of whom 
payments are made to 337,000.
    Basic support payments.--The Committee recommends 
$591,707,000 for basic support payments, an increase of 
$10,000,000 above the 1996 level, and $23,793,000 below the 
amount recommended by the House. The administration requested 
$550,000,000 for this program. 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 1996 
level, the budget request, and the House.
    Payments for heavily impacted districts.--These payments 
provide additional assistance to certain local educational 
agencies that enroll large numbers or proportions of federally 
connected children. The Committee recommends $50,000,000, the 
same amount appropriated in fiscal year 1996 and the House 
amount, and an increase of $30,000,000 over the amount 
requested by the administration.
    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 $3,000,000 for this purpose in fiscal year 1996.
    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 appropriated in fiscal year 1996 and 
recommended by the House, and an increase of $1,000,000 over 
the budget request.
    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 
$16,293,000 for this activity in 1997, the same amount as 
appropriated in fiscal year 1996, and a decrease of $1,207,000 
below the amount recommended by the House. No funds were 
requested by the administration for this activity.

                      school improvement programs

Appropriations, 1996....................................  $1,213,577,000
Budget estimate, 1997...................................   1,404,000,000
House allowance.........................................   1,237,383,000

Committee recommendation

                                                           1,318,631,000

    The Committee recommends an appropriation of $1,318,631,000 
for school improvement programs. This amount is $105,054,000 
more than the 1996 appropriation, $85,369,000 less than the 
administration's request, and $81,248,000 more than the House 
allowance.
    Eisenhower professional development State grants.--The 
Committee recommends $275,000,000 for Eisenhower professional 
development State grants, the same as the fiscal year 1996 
appropriation, and a decrease of $335,000,000 below the amount 
requested by the administration. The House included no funds 
for this purpose. 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.
    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. The Committee expects that the first 
$250,000,000 of the total appropriation be spent solely on 
mathematics and science education as outlined in the 
authorizing statute.
    The Committee is aware of the severe shortage of 
educational personnel with professional training to teach the 
Nation's growing population of limited-English proficient 
students. Accordingly, the Committee strongly urges the States 
to use their Eisenhower funds for professional development 
grants to train teachers serving limited-English proficient 
students.
    Innovative education program strategies State grants.--The 
Committee recommends $275,000,000 for innovative education 
program strategies State grants, the same as the fiscal year 
1996 appropriation. The administration eliminated funding for 
this program, while the House included $606,517,000 for this 
purpose. This program makes 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; and reform activities consistent with Goals 
2000. 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 
$530,978,000 for the safe and drug free schools and communities 
programs State grant program. The amount recommended is 
$90,000,000 more than the fiscal year 1996 amount and the House 
allowance and $15,978,000 more than the budget request.
    National programs.--The Committee has included $25,000,000 
for the national programs portion of the safe and drug free 
schools program, the same as the amount requested by the 
administration. The House eliminated funding for this program. 
Funds are used for to carry out leadership programs for 
prevention of illegal use of drugs and violence and promote 
safety and discipline for students at all educational levels.
    It has been brought to the Committee's attention that the 
Research Triangle Institute is currently finishing an 
evaluation of the Safe and Drug Free Schools Program. This 
study evaluates and compares examples of the types of programs 
delivered by the program. The Committee urges the Department of 
Education to widely disseminate the results of the study so 
that State and local education agencies will have the benefit 
of knowing what drug prevention programs are the most 
effective.
    The Committee strongly urges the Department to work with 
the States to develop an information reporting system. This 
system would be used to collect information from all of the 
States on how the local education agencies use their funds and 
also what specific programs are funded from the Governor's set-
aside. The Department should report to the Committee on these 
findings by January 1998.

Inexpensive book distribution

    For the inexpensive book distribution program, the 
Committee provides $10,265,000, the same as the 1996 
appropriation, $1,265,000 more than requested by the 
administration request, and the same amount recommended by the 
House. 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 7.8 million books will be distributed to 2.5 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, the same as the 1996 appropriation and the 
House allowance, and $1,000,000 below the administration 
request. The amount recommended will support two awards: 
$4,996,000 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 
$4,004,000 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.

Christa McAuliffe fellowships

    The Committee agrees with the House and recommends no 
funding for the Christa McAuliffe fellowship program. The 
administration requested $2,000,000 for this purpose. No funds 
were provided in the fiscal year 1996 appropriation for this 
program which provides 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 to 
improve teacher skills.

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 the administration, and is the same as the 
1996 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 at least 
$3,000,000 of the magnet school appropriation for continuation 
costs 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 part B, 
subtitle B of the Stewart B. McKinney Homeless Assistance Act, 
the Committee recommends $23,000,000, the same as the House 
recommendation and the 1996 appropriation. The budget request 
was $29,000,000 for this program.
    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 
State receives under the title I program.

Women's educational equity

    The Committee recommends $1,000,000 for the women's 
educational equity program, a decrease of $1,000,000 below the 
amount recommended by the House and $3,000,000 below the 
administration request. No funds were provided for this purpose 
in fiscal year 1996. The program supports projects that assist 
in the local implementation of gender equity policies and 
practices.

Training and advisory services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $7,334,000, 
the same as the fiscal year 1996 appropriation and the amount 
recommended by the House, and $6,666,000 below the budget 
request.
    The funds provided will continue the 10 regional 
desegregation assistance centers. Funds are used to provide 
technical assistance, training, and advisory services to 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.

Ellender fellowships

    For Ellender fellowships, the Committee bill includes 
$1,500,000, the same as the 1996 appropriation and an increase 
of $500,000 above the amount recommended by the House. The 
budget requested no funds for this program.
    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 $15,000,000, which is $3,000,000 above 
the 1996 appropriation, $9,000,000 above the budget request, 
and $11,000,000 more than the amount recommended by the House. 
The Committee encourages the Department when allocating these 
funds to provide the following: $2,000,000 for the curricula 
development, teacher training, and recruitment program; 
$1,000,000 for the community-based education learning centers; 
$2,000,000 for the Hawaiian higher education program; 
$1,500,000 for the gifted and talented program, $1,600,000 for 
special education programs; $300,000 for the Native Hawaiian 
Education Council and island councils; and $6,100,000 for 
family-based education centers. The Committee notes the 
disproportionately high numbers of native Hawaiian students who 
have special educational needs, who fail to finish high school, 
who drop out, and who abuse drugs and alcohol. Continued 
funding must be provided to raise the educational status of 
native Hawaiians to the national average. The Committee urges 
the Department to provide $500,000 for workshops in 
aquaculture/education for high school students and teachers at 
the Keahuolu training facilities on the Island of Hawaii.

Alaska Native educational equity

    The Committee recommends $8,000,000 for the Alaska Native 
Educational Equity Assistance Program, authorized under title 
IX, part C, of the Elementary and Secondary Education Act. 
These funds address the severe educational handicaps of Alaska 
Native schoolchildren. Funds are used for development of 
supplemental educational programs to benefit Alaska Natives. Of 
the amount provided, the Committee has included $5,000,000 for 
section 9304, $2,000,000 for section 9305, and $1,000,000 for 
section 9306.
    It has been brought to the Committee's attention that in 
urban areas 60 percent of Alaska Natives entering high school 
do not graduate, and the Alaska Natives test scores are on 
average 40 percent lower than those of other students. In some 
districts, none of the Alaska Native elementary students and 40 
percent of Native high school students are performing at their 
grade levels. The funds provided under the Alaska Native 
Educational Equity Assistance Program will help to address some 
of the barriers faced by Native Alaskan children and develop 
programs tailored to the unique needs of these children to 
improve performance levels.

Charter schools

    The Committee recommends $21,000,000 for support of charter 
schools, which is $3,000,000 more than the 1996 level and the 
House allowance and $19,000,000 below the budget request.
    This program, authorized under title X, part C of the 
Elementary and Secondary Act of 1965, as amended, provides 
funds to the Secretary to make 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 may 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 $21,554,000 for the comprehensive 
regional technical assistance centers. This recommendation is 
the same amount recommended by the House, $47,000 more than the 
fiscal year 1996 level, and $23,446,000 below the 
administration request. This program supports 15 regional 
centers that provide support, training, and technical 
assistance to Department of Education grantees.

                   bilingual and immigrant education

Appropriations, 1996....................................    $188,039,000
Budget estimate, 1997...................................     261,700,000
House allowance.........................................     167,190,000

Committee recommendation

                                                             185,000,000

    The Committee recommends an appropriation of $185,000,000 
for bilingual and immigrant education. This is $3,039,000 less 
than the 1996 appropriation, $76,700,000 below the 
administration request, and $17,810,000 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 $130,000,000 for bilingual 
instructional programs, an increase of $12,800,000 above the 
1996 level and $12,810,000 above the House amount and the 
President's budget request.
    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 agrees with the House and recommends no 
funding for this program. In fiscal year 1996, the Committee 
approved a reprogramming request which provided $9,700,000 for 
support services. The administration has requested $14,330,000 
for this activity in fiscal year 1997. 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. The Committee strongly 
encourages school districts to use their overall funding for 
bilingual education for support services activities. The need 
for support services increases every year. School personnel, 
parents, and other organizations rely on these services to 
understand the needs of students, plan effective instructional 
services, meet State and Federal legal requirements, and train 
staff to work with limited-English proficient students. In 
fiscal year 1996, the Committee approved the administration's 
request to reprogram $10,800,000 into the support services and 
professional development accounts and the Committee would 
entertain a similar reprogramming request in fiscal year 1997.

Professional development

    The Committee agrees with the House and provides no funding 
for professional development activities. The budget requested 
$25,180,000 for this program. In fiscal year 1996, the 
Committee approved a reprogramming request which provided 
$1,100,000 for professional development.
    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.
    The Committee believes that professional development should 
be an integral component of all title VII programs. 
Accordingly, the Committee encourages the Secretary to notify 
all subpart 1 grant recipients that they are permitted to 
devote a portion of their grant resources to provide 
professional development to local education agency personnel 
through career-ladder and other degree-granting programs to 
enhance their professional skills and certification.

Immigrant education

    The Committee recommends $50,000,000 for immigrant 
education, the same amount appropriated in 1996 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.

Foreign language assistance

    The Committee recommends $5,000,000 for competitive foreign 
language assistance grants, $5,039,000 less than the amount 
appropriated in fiscal year 1996, $5,000,000 more than the 
amount recommended by the House, and the same amount requested 
by the administration.
    This activity provides grants to increase the quantity and 
quality of instruction in foreign languages deemed critical to 
the economic and security interests of the United States.

                           Special education

Appropriations, 1996....................................  $3,245,415,000
Budget estimate, 1997...................................   3,552,913,000
House allowance.........................................   3,246,315,000

Committee recommendation

                                                           3,262,315,000

    The Committee recommends an appropriation of $3,262,315,000 
for special education. This is $16,900,000 more than the 1996 
appropriation, $290,598,000 below the administration request, 
and $16,000,000 more than 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 States and 
local educational agencies in educating children with 
disabilities and in 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 $2,333,837,000 for special 
education grants to States, an increase of $10,000,000 more 
than the fiscal year 1996 appropriation and the amount 
recommended by the House and $269,410,000 below the budget 
request. This program supports formula grants to States to 
finance a portion of the cost of providing special education 
and related services for children with disabilities.
    The Committee's recommended funding level represents 
approximately 7 percent of the estimated average per-pupil 
expenditure and 6 percent of excess costs and would provide an 
estimated $403 per child for the 5.8 million children expected 
to receive special education.
    The Committee has included bill language to continue the 
eligibility of the Republic of the Marshall Islands and the 
Federated States of Micronesia for funding under part B of the 
IDEA and distribute the funds in accordance with the 
competition required in Public Law 104-134 with no new 
competition being required in fiscal year 1997.

Preschool grants

    The Committee recommends $360,409,000 for preschool grants, 
the same amount recommended by the House and the fiscal year 
1996 appropriation and $19,591,000 below the budget request. 
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 $619 
per child for the 581,900 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. Five percent may be retained for administration and 20 
percent 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.

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 the fiscal year 1996 appropriation 
and $122,000 more than 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 zero 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, an increase of $8,619,000 over the 1996 
appropriation for the 14 special purpose fund programs which 
expired 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 current law. 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 1996 appropriation and the House 
allowance.
    Deaf-blindness funds are used for technical assistance, 
research, and model demonstration projects for deaf and blind 
infants, toddlers, children, and youth.

Serious emotional disturbance

    The Committee bill provides $4,147,000 for the serious 
emotional disturbance program, the same as the 1996 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 amount 
provided will support 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 1996 
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.

Early childhood education

    The Committee recommends $25,147,000, the same amount as 
appropriated in 1996 and the House allowance.
    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 1996 
and the House allowance.
    About one-half 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.

Postsecondary education

    The Committee recommends $8,839,000 for postsecondary 
education programs, the same as the 1996 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.

Innovation and development

    The Committee recommends an appropriation of $16,000,000, 
an increase of $2,000,000 above the 1996 appropriation and the 
amount recommended by the House. The increase provided will be 
used for improving services and outcomes for children with 
disabilities in the elementary school grades; improved 
alignment and compatibility of general and special education 
reforms; and to initiate a national assessment of the State 
grant programs to provide educators and policymakers with much-
needed information on the performance of the program.
    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.

Media and captioning services

    The Committee recommends $20,030,000 for media and 
captioning services, the same amount recommended by the House 
and $900,000 more than the fiscal year 1996 appropriation.
    The primary focus of this program is the captioning of 
educational and commercial films and the closed captioning of 
television. In addition, funds are awarded to the National 
Theatre of the Deaf and Recording for the Blind, Inc. [RFB]. 
The Committee has included an increase of $900,000 for 
recordings for the blind.

Technology applications

    The Committee bill includes $9,993,000 for special 
education technology, the same amount appropriated in fiscal 
year 1996 and the amount recommended by the House.
    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, the same amount 
appropriated in fiscal year 1996 and the amount recommended by 
the House.
    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 $93,339,000, 
an increase of $2,000,000 over the amount provided in fiscal 
year 1996 and the House amount. The increase provided will be 
used to address the severe personnel shortages in special 
education and to promote best practices in the training of 
teachers and administrators in such areas as behavioral 
management techniques for addressing the conduct of those 
children with disabilities who have behavioral problems.
    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, addressing State identified personnel 
needs, and developing new teaching approaches.
    The Committee also encourages the Secretary, pursuant to 
the authority provided under section 631(c) of IDEA, to 
consider making awards to develop and demonstrate ways to 
better enable the elementary and secondary general education 
faculty at schools and colleges of education to prepare the 
next generation of teachers to serve students with disabilities 
who spend some or all of their schoolday in a regular class.

Parent training

    The Committee provides $15,535,000 for the parent training 
program, an increase of $2,000,000 over the amount appropriated 
in fiscal year 1996 and the amount recommended by the House. 
The increase provided will be used for new or expanded parent 
training and information centers that are needed to help ensure 
that parents of children with disabilities have the skills and 
knowledge they need to help their children succeed. The 
increase would enable the program to serve over 200,000 parents 
in fiscal year 1997.
    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, the same amount as 
recommended by the House and the fiscal year 1996 level.
    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, the same amount appropriated in fiscal year 
1996 and the amount recommended by the House. 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, 1996....................................  $2,456,092,000
Budget estimate, 1997...................................   2,512,587,000
House allowance.........................................   2,509,447,000

Committee recommendation

                                                           2,516,447,000

    The Committee recommends $2,516,447,000 for rehabilitation 
services and disability research, $60,355,000 more than the 
1996 appropriation, $7,000,000 more than the House amount, and 
$3,860,000 more than the administration request.

Basic State grants

    The Committee provides $2,183,038,000 for vocational 
rehabilitation grants to States, which is $7,000,000 more than 
the administration request and the House allowance, and 
$64,204,000 more than the 1996 appropriation. The amount 
included is $68,704,000 more than the amount allocated to State 
grants in 1996; $4,500,000 was used to support the 1996 
Paralympic Games.
    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 the most 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, except the States share is 50 percent 
for the cost of construction of a facility for community 
rehabilitation program purposes. Each State is also required to 
use 1.5 percent of its allotment for innovation and expansion 
activities.

Client assistance

    The Committee bill recommends $10,392,000 for the Client 
Assistance Program, the same amount recommended by the House 
and the administration, and $273,000 more than appropriated in 
1996.
    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 1996 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 all or part of the 
cost of conducting training programs. Long-term, in-service, 
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 $18,942,000 for special 
demonstration programs for persons with disabilities, the same 
as the House allowance and the budget request, and $8,499,000 
less than the 1996 appropriation. The amount included is 
$5,999,000 less than the amount provided for these programs in 
1996, $2,500,000 was used to support the 1996 Paralympic Games.
    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 $1,850,000 for migratory workers, 
an increase of $429,000 above the 1996 appropriation, and the 
same level as the budget request and recommended by the House.
    This program provides a 90-percent Federal match for 
comprehensive rehabilitation services to migrant and seasonal 
farm workers with disabilities and their families. 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 1996 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.

Protection and advocacy of individual rights

    The Committee recommends $7,657,000 for protection and 
advocacy of individual rights, an increase of $201,000 more 
than the 1996 appropriation, and the same as 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, an increase of $6,000 above the 1996 appropriation, 
and the same as 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, the same as the 1996 
appropriation, 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 1997 an estimated 35,500 individuals 
will receive services and it is estimated that of that number 
approximately 10,000 will achieve an employment outcome.

Independent living State grants

    The Committee recommends $21,859,000 for independent living 
State grants, which is the same amount appropriated in 1996, 
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 
$42,876,000, which is $1,127,000 above the 1996 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.

Program improvement

    For program improvement activities, the Committee provides 
$2,400,000, the same as the House allowance and the budget 
request, and $1,400,000 more than the 1996 appropriation. 
Activities under this program were funded under technical 
assistance to States in 1996. In fiscal year 1997, funds for 
these activities would be awarded through contracts to procure 
expertise in identified problem areas of national significance 
and technical support in order to improve the operation of the 
program and the provision of services to individuals with 
disabilities.

Independent living services for older blind individuals

    The Committee provides $9,952,000 for independent living 
services to older blind individuals, an increase of $1,000,000 
above the 1996 appropriation, and the same as 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, an increase of $5,000 above the 1996 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 $7,337,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, an increase of 
$193,000 over the 1996 appropriation, 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 40 agencies. At 
the recommended level, the center would serve approximately 90 
persons with deaf-blindness at its headquarters facility and 
provide field services to approximately 2,125 persons.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $70,000,000 for the National 
Institute on Disability and Rehabilitation Research [NIDRR], an 
increase of $16,000 over the amount appropriated in 1996, and 
the same as the budget request and the House allowance.
    NIDRR develops and implements a comprehensive and 
coordinated approach to the conduct of research, demonstration 
projects, and related activities enabling persons with 
disabilities to better function at work and in the community, 
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 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. 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 Shepherd 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 $3,140,000 below the administration 
request, and the same as the amount recommended by the House 
and the 1996 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 through increased 
access to assistive technology services and devices. It 
provides 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, 1996....................................      $6,680,000
Budget estimate, 1997...................................       6,495,000
House allowance.........................................       6,680,000

Committee recommendation

                                                               6,680,000

    The Committee recommends $6,680,000 for the American 
Printing House for the Blind [APH], an increase of $185,000 
above the budget request, and the same as the 1996 
appropriation and 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, 1996....................................     $42,180,000
Budget estimate, 1997...................................      43,041,000
House allowance.........................................      43,041,000

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 the same as the budget request and the House 
allowance, and $861,000 more than the 1996 appropriation.
    The Committee agrees with the House and recommends a 
consolidated appropriation instead of providing $42,705,000 for 
operations and $336,000 for the endowment grant as proposed by 
the administration.
    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.

                          gallaudet university

Appropriations, 1996....................................     $77,629,000
Budget estimate, 1997...................................      80,030,000
House allowance.........................................      79,182,000

Committee recommendation

                                                              79,182,000

    The Committee recommends $79,182,000 for Gallaudet 
University, an increase of $1,553,000 above the amount 
appropriated in 1996 and the same amount recommended by the 
House, and a decrease of $848,000 below the amount requested by 
the administration. The Committee also agrees with the House 
and recommends funding for this activity under a consolidated 
account. The administration proposed $79,030,000 for operations 
and $1,000,000 for the endowment.
    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.
    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.

                     VOCATIONAL AND ADULT EDUCATION

Appropriations, 1996....................................  $1,340,250,000
Budget estimate, 1997...................................   1,420,000,000
House allowance.........................................   1,329,669,000

Committee recommendation

                                                           1,341,752,000

    The Committee recommendation includes a total of 
$1,341,752,000 for vocational and adult education, consisting 
of $1,080,169,000 for vocational education, and $261,583,000 
for adult education.

                          Vocational education

    The Committee recommendation of $1,080,169,000 for 
vocational education is $39,831,000 less than the 
administration's request, $498,000 less than the fiscal year 
1996 amount, and $4,500,000 above the House allowance.
    The Committee fully expects that if the effort to 
reauthorize several of the vocational and adult education 
programs is not completed in the 104th Congress, these programs 
will continue to be operated under current policy, regulations, 
and law.
    Basic grants.--The Committee has included $972,750,000 for 
basic grants, the same as the 1996 appropriation and the House 
allowance and $127,250,000 less than the administration 
request.
    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 the same as the 1996 
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.
    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, the 1996 appropriation, and the 
administration. 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.
    National programs, research.--The Committee recommends 
$4,500,000 for national research programs, $498,000 less than 
the 1996 appropriation, and $12,581,000 below the amount 
requested by the administration. The House recommended no 
funding for this purpose. Using the funds provided, the 
Committee directs the Department to use $4,500,000 to support 
the National Center for Research in Vocational Education.
    The National Center for Research in Vocational Education 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.

                            Adult Education

    The Committee has included $261,583,000 for adult 
education, $2,000,000 more than the fiscal year 1996 
appropriation, $38,417,000 less than the administration 
request, and $7,583,000 more than recommended by the House.
    Adult education State programs.--For adult education State 
programs the Committee recommends $252,000,000 which is 
$2,000,000 above the 1996 appropriation and the amount 
recommended by the House, and $38,000,000 less than the 
administration's request. These programs are used by States for 
programs to enable economically disadvantaged adults to acquire 
basic literacy skills, to enable those who so desire to 
complete a secondary education, and to make available to adults 
the means to become more employable, productive, and 
responsible citizens. Under section 313(d) the Secretary 
reserves up to $5,000,000 for part D--national programs.
    Due to the tightening fiscal climate several literacy 
programs that have made important contributions were not funded 
in fiscal year 1996 and no funds are recommended in fiscal year 
1997. These programs include literacy for homeless adults, 
workplace literacy partnerships, State literacy resource 
centers, and library literacy. The Committee urges States to 
favorably consider the important activities carried out by 
these programs and encourages that States make funds available 
for these activities.
    The Committee recognizes that literacy is a growing problem 
in the United States and there is a need for the development of 
new practices to deliver literacy education. The Committee 
encourages the Department to use the increase provided for 
research and development activities that will expand the 
potential of technology for delivering literacy services.
    National programs, evaluation and technical assistance.--
The Committee concurs with the House in recommending no funding 
for the national programs of evaluation and technical 
assistance, the same as the 1996 amount. The administration 
requested $5,000,000 for these purposes.
    National Institute for Literacy.--The Committee recommends 
$4,860,000 for the National Institute for Literacy, authorized 
under section 384(c) of the Adult Education Act, the same 
amount appropriated in 1996 for this purpose, $140,000 less 
than the budget request, and $860,000 more than the House 
allowance. 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.
    Literacy programs for prisoners.--The Committee provides 
$4,723,000 for literacy programs for prisoners, the same as the 
1996 appropriation. Neither the House nor the administration 
recommended 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 urges the Department to consult with 
correctional personnel to ensure that activities carried out 
under this authority address the most urgent needs of 
incarcerated individuals.

                      STUDENT FINANCIAL ASSISTANCE

Appropriations, 1996....................................  $6,258,587,000
Budget estimate, 1997...................................   7,359,407,000
House allowance.........................................   6,630,407,000

Committee recommendation

                                                           6,642,830,000

    The Committee recommends an appropriation of $6,642,830,000 
for student financial assistance. In combination with 
$486,000,000 in Pell grants carryover funding which was 
provided in previous appropriations, the Committee makes 
available $7,128,830,000 for student financial assistance.

Federal Pell Grant Program

    For Pell grant awards in the 1997-98 academic year, the 
Committee recommends $5,342,000,000.
    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 is 
sufficient to raise the maximum Pell grant to $2,500, the 
highest level in the program's history and an increase of $30 
over the maximum grant for 1996.

Federal supplemental educational opportunity grants

    The Committee recommends $583,407,000 for Federal 
supplemental educational opportunity grants [SEOG], the same as 
the 1996 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 1996 level, $68,492,000 
below the House allowance, and $62,492,000 less than 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. 
Work-study jobs must pay at least the Federal 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.

Federal Perkins loans

    The Committee bill includes $67,915,000 for Federal Perkins 
loans capital contributions, which is $25,382,000 less than the 
1996 appropriation and $90,085,000 less than the budget 
request. The House proposed no funding for this purpose.
    The Federal Perkins Loan Program supports 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, the same as the 1996 level, 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 $13,000,000, which is $18,375,000 below the 
1996 appropriation and $13,000,000 more than the House 
allowance and the budget request. The SSIG Program is intended 
to encourage and expand need-based State financial assistance 
to postsecondary students. States match SSIG appropriations to 
provide State-based grant and work-study assistance to 
approximately 700,000 financially needy postsecondary students. 
States may use up to 20 percent of their SSIG allotment to 
support campus-based work-learning jobs.
    The Committee recognizes the importance of a student aid 
program that leverages money from the States into need-based 
financial assistance, but at the same time, sees the need to 
reevaluate the current structure of SSIG. The SSIG Program 
leveraged more than $610,000,000 from the States for student 
aid in fiscal year 1995. However, the SSIG Program is now 
criticized as unnecessary to the Federal financial aid 
portfolio because all States now provide need-based financial 
assistance. The Committee believes student assistance should 
include an ongoing source of Federal support which encourages 
and leverages State contributions. Thus, the Committee has 
included another year of funding to delay the phaseout of SSIG 
with the expectation that the program be thoroughly evaluated 
and modified during reauthorization of the Higher Education Act 
next year.

                 FEDERAL FAMILY EDUCATION LOAN PROGRAM

Appropriations, 1996....................................     $29,977,000
Budget estimate, 1997...................................      46,572,000
House allowance.........................................      29,977,000

Committee recommendation

                                                              29,977,000

    The Committee recommends $29,977,000 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 
partially cover the fiscal year 1997 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, for the cost of attendance minus an 
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.

                            HIGHER EDUCATION

Appropriations, 1996....................................    $836,957,000
Budget estimate, 1997...................................     972,771,000
House allowance.........................................     829,497,000

Committee recommendation

                                                             852,269,000

    The Committee recommends an appropriation of $852,269,000 
for higher education programs, $15,312,000 more than the 1996 
amount, $120,502,000 less than the budget request, and 
$22,772,000 above the House. The Committee concurs with the 
House in not adopting the administration request to create a 
new merit-based scholarship program in fiscal year 1997.

Aid for institutional development

    The Committee recommends $194,846,000 for aid for 
institutional development authorized by title III of the Higher 
Education Act, the same as the 1996 appropriation and the House 
allowance, and $12,235,000 more than the budget request.
    Strengthening institutions.--The Committee bill includes 
$55,450,000 for the part A Strengthening Institutions Program, 
the same as the 1996 level and the House allowance, and 
$15,450,000 more than the budget request. 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.
    The Department of Education shall use fiscal year 1997 
title III-A HEA funds for payments for continuing multiyear 
grants, and shall use all additional funds provided in this 
appropriation to make new grants.
    Community colleges provide vital education and training 
programs, serving individuals in rural communities whose access 
to education and training services are limited, and whose 
livelihood is particularly vulnerable to regional economic 
stability. Community colleges such as the Western Iowa Tech 
Community College and Eastern Iowa Community College would be 
especially suited for these grants.
    Hispanic-serving institutions [HSI].--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, the same as the 1996 level and the House 
allowance, and $1,200,000 less than the administration request. 
The Committee has included bill language included in the budget 
request overriding the current law requirement that funds be 
appropriated for the HSI program only when appropriations for 
the regular strengthening institutions program equal or exceed 
$80,000,000. 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 1996 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 1996 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 5 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, the same 
as the 1996 level and 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 of $2,015,000 without funding 
the underlying program.

Fund for the improvement of postsecondary education

    The Committee recommends $18,000,000 for the fund for the 
improvement of postsecondary education [FIPSE], which is 
$3,000,000 more than the 1996 appropriation and the House 
allowance, and the same as the administration request. 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 underrepresented groups, such as women and 
minorities, to enter careers in the fields of science, 
technology, engineering, and mathematics. 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.
    The Committee believes that postsecondary education can be 
improved through faculty development activities that place 
faculty in business settings. The Committee believes that the 
faculty-centered cooperative education program developed by the 
North Dakota Experimental Program to Stimulate Competitive 
Research [EPSCoR] holds great promise in that regard and urges 
full and fair consideration of a proposal from North Dakota 
State University for its implementation.
    The Committee is aware of the effectiveness of reading 
recovery programs in helping elementary school children who are 
behind in their reading skills and the need for educators to be 
trained in this approach. Within the amount provided, the 
Committee urges the Secretary to award a grant to implement a 
program to train educators in reading recovery. The University 
of Nebraska at Kearney would be particularly well suited for 
such a grant.
    The Committee recognizes that there is a shortage of 
minority science and mathematics teachers in the Nation's 
public schools, particularly those schools located in urban 
areas. The Committee, therefore, urges the Department to 
support the development of a model program to prepare teams of 
students from ethnically diverse and multicultural backgrounds 
for careers as mathematics and science teachers. The Committee 
notes the success of the Posse Foundation, located in New York 
City, and encourages the replication of this model.
    The Committee is concerned about the significant shortage 
of Hispanics who are trained in the fields of science and 
technology and participate in the Nation's research and 
development efforts. As the fastest growing population in the 
Nation, persons of Hispanic origin will play a key role in our 
efforts to effectively meet the economic, technological, and 
work force challenges that lie ahead. In order to sustain the 
Nation's current competitiveness in these fields, efforts must 
be encouraged to educate Hispanics in the science and 
technological fields. The Committee supports a demonstration of 
new approaches to enhance the capacity of Hispanic serving 
institutions to improve their research and training capacity in 
the area of science and technology. The Committee is aware that 
such a demonstration has been proposed by a consortium of 
Hispanic serving institutions, known as HiCREST. The Committee 
urges that FIPSE give every consideration to the proposal from 
HiCREST when funding this important initiative.

Minority teacher recruitment

    The Committee recommends $2,212,000 for the Minority 
Teacher Recruitment Program, which is the same as the 1996 
appropriation, $246,000 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], the same as the 1996 level, 
$584,000 less than 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.

International education and foreign language studies

    The bill includes a total of $59,573,000 for international 
education programs, $3,422,000 more than the 1996 level, 
$500,000 above the budget request, and $1,342,000 more than the 
House allowance.
    Domestic programs.--The Committee recommends $52,283,000 
for domestic program activities related to international 
education and foreign language studies, including international 
business education, under title VI of the HEA. This is 
$1,802,000 above the 1996 appropriation, the same as the 
administration request, and $1,198,000 less than 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.
    Overseas programs.--The bill includes $5,790,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This is $1,040,000 above the 1996 level, 
the same as the budget request, and $1,040,000 more than 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 $1,500,000 for the Institute for International 
Public Policy, an increase of $580,000 over the 1996 level and 
$500,000 over 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 undergraduate and graduate level foreign 
language and international studies. An institutional match of 
25 percent is required. The increase provided will allow 
expansion and improvement of the Senior Summer Intensive 
Language Institute.

Law school clinical experience

    The Committee agrees with the House in recommending no 
funding for law school clinical experience, consistent with the 
budget request and the policy adopted in fiscal year 1996 to 
phase out Federal appropriations by providing funding only to 
continue existing multiyear grants. The last new 3-year grants 
were awarded in fiscal year 1994 and are funded to completion 
in fiscal year 1996. The fiscal year 1996 appropriation was 
$5,500,000.

Urban community service

    The Committee recommends $9,200,000 for urban community 
service, the same as the 1996 appropriation, and $920,000 more 
than the House allowance. The administration requested no 
funding for this purpose. 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.

Interest subsidy grants

    The Committee recommends $15,673,000 for interest subsidy 
grants, $1,039,000 less than the 1996 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 300 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.

Bethune Memorial Fine Arts Center

    The Committee recommends $1,400,000 for the Bethune 
Memorial Fine Arts Center. This is $2,280,000 less than the 
1996 level. Neither the administration nor the House 
recommended funding for this program.

Federal TRIO programs

    The Committee bill includes $476,993,000 for Federal TRIO 
programs, $14,000,000 above the 1996 appropriation and 
$23,007,000 below 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 graduate 
programs.

National early intervention scholarships and partnerships

    The Committee bill includes $4,000,000 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 $892,000 above the 1996 
level and $4,000,000 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.

Byrd honors scholarships

    The Committee recommends $29,117,000 for the Byrd Honors 
Scholarship Program, the same as the 1996 appropriation and 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 1994, 1995, and 1996. The 
Committee has included bill language to maintain the same 
number of new scholarships in fiscal year 1997 as in fiscal 
year 1996 within existing resources.

Javits fellowships

    The Committee concurs with the House in not recommending 
separate funding for Javits fellowships but provides $5,931,000 
under the graduate assistance in areas of national need [GAANN] 
to fund the Javits fellowships at the same level as in fiscal 
year 1996. The House provided $3,632,577, consistent with the 
budget request, to continue existing Javits fellowships under 
GAANN.
    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 $30,000,000 for graduate 
assistance in areas of national need, the same as the House 
allowance and the budget request, and $2,748,000 above the 1996 
level. 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.
    The Committee provides $5,931,000 to fund the Javits 
fellowships at the same level as in fiscal year 1996 under the 
GAANN program. The Javits Program is of particular importance 
as a mechanism for supporting America's next generation of 
leaders in the arts, humanities, and social studies and 
although the Committee has consolidated funding within the 
Graduate Assistance Program, this action was taken to 
streamline programs. It is the Committee's intention that the 
merit-based Javits Fellowships Program remain an active and 
identifiable program. The Committee concurs with the House and 
the budget request in funding existing Harris fellowships to 
completion under the GAANN program, and has included bill 
language to accomplish this.
    The Committee has included $3,000,000, if authorized by 
April 1, 1997, for the George H.W. Bush Fellowship Program, 
located at the George Bush School of Government and Public 
Service of the Texas A&M; University. The Bush Fellowship 
Program would help the most qualified individuals from all 
parts of the country to obtain advanced degrees in public 
administration and international affairs.
    The Committee has also included $3,000,000, if authorized 
by April 1, 1997, for the Edmund S. Muskie Foundation. Funds 
will be used to award stewardships and support the Muskie 
Archives and the Edmund S. Muskie Institute of Public Affairs.
    If funds are not authorized for the Muskie Foundation and 
the George Bush Fellowship Program by April 1, 1996, the 
Committee directs the Department to use these moneys to fund 
activities within the fund for the improvement of postsecondary 
education.

                           howard university

Appropriations, 1996....................................    $182,348,000
Budget estimate, 1997...................................     195,963,000
House allowance.........................................     187,348,000

Committee recommendation

                                                             189,000,000

    The Committee recommends an appropriation of $189,000,000 
for Howard University, which is $6,652,000 above the 1996 
appropriation, $6,963,000 less than the budget request, and 
$1,652,000 above 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 50 percent of the university's 
projected educational and general expenditures, excluding the 
hospital.
    Academic program.--The Committee bill provides $159,511,000 
for Howard's academic program, which is $6,652,000 above the 
1996 level and $1,652,000 above the House allowance.
    The Committee concurs with the House in not including a 
separate appropriation for the endowment and does not agree 
with the budget request to provide a minimum of $3,530,000 for 
the endowment. The Committee recommends continuing the policy 
established in fiscal year 1996 which allows the university to 
dedicate a portion of its regular appropriation to the 
endowment at its discretion. The Committee directs that Howard 
notify the Congress of any transfer from the regular 
appropriation to the endowment at least 15 days prior to 
execution of the transfer. The Committee notes that the 
authority under which funds are appropriated for Howard permits 
expenditures for academic services, financial support of 
students, contribution to the university endowment, or 
construction.
    Howard University Hospital.--The Committee recommends 
$29,489,000 for the Howard University Hospital, the same as the 
1996 level, the budget 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.

             college housing and academic facilities loans

Appropriations, 1996....................................        $698,000
Budget estimate, 1997...................................         700,000
House allowance.........................................         698,000

Committee recommendation

                                                                 698,000

    Federal administration.--The Committee bill includes 
$698,000 for Federal administration of the CHAFL program. The 
amount recommended is the same as the 1996 appropriation, 
$2,000 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 1997. 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. The Committee 
agrees with the House and the administration and recommends no 
funding for new loan subsidies in fiscal year 1997. No funds 
were provided for this purpose in 1996.

  historically black college and university capital financing program

Appropriations, 1996....................................        $166,000
Budget estimate, 1997...................................         104,000
House allowance.........................................         104,000

Committee recommendation

                                                                 104,000

    Federal administration.--The Committee recommends $104,000 
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 $62,000 
less than the 1996 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, 1996....................................    $350,646,000
Budget estimate, 1997...................................     634,750,000
House allowance.........................................     317,264,000

Committee recommendation

                                                             350,788,000

    The bill includes $350,788,000 for educational research, 
statistics, assessment, and improvement programs. This amount 
is $142,000 above the 1996 appropriation, $283,962,000 below 
the administration request, and $33,524,000 more than the House 
allowance. This account supports education research, 
statistics, and assessment activities, as well as a variety of 
other discretionary programs for educational improvement.

Research

    The Committee recommends $56,021,000 for educational 
research, the same as the 1996 appropriation, $979,000 below 
the budget request, and $14,620,000 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 $51,000,000 for regional 
educational laboratories, the same amount as appropriated in 
1996 and the amount recommended by the House. The Committee 
reiterates its intent, expressed in the conference report on 
the Omnibus Consolidated Rescission and Appropriations Act of 
1996 (Public Law 104-134) (H. Rept. No. 104-537) that all work 
of the regional education laboratories be based on the 
priorities established by their regional governing boards.
    The Committee encourages the educational laboratories to 
support activities formerly carried out by the National 
Diffusion Network and urges the laboratories to make use of 
existing networks and include technical assistance to promote 
ongoing, effective professional development practices and 
strategies.
    Consistent with the budget request, 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.

Statistics

    The Committee recommends $46,227,000 for data gathering and 
statistical analysis activities of the National Center for 
Education Statistics [NCES], the same amount appropriated in 
fiscal year 1996 and $3,773,000 below the House bill and the 
budget request.
    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 $32,623,000 for assessment, the 
same amount appropriated in fiscal year 1996 and the amount 
recommended by the House and a decrease of $127,000 below the 
budget request.
    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 $40,000,000 for the fund for 
the improvement of education [FIE], which is $2,389,000 more 
than the 1996 appropriation and the same as 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 directs the Department of Education to 
provide $1,000,000 to establish an intensive regional model in 
Washington and Oregon for the purpose of developing a literacy 
program focusing on the distribution of new books to 
disadvantaged children and families, particularly those 
affected by economic downturns in the timber and fishing 
industries. The funding will be a one-time grant which will 
help establish local advisory boards to assist with 
implementing the program in their community. First Book, a 
national organization which emphasizes community-based programs 
would be particularly suited for a project such as the one 
described above and the Committee urges the Department to give 
full and fair consideration to this organization.
    Within the funds provided, the Committee has included 
$300,000 for a demonstration program to further students 
knowledge of space science. The program would provide students 
with hands on knowledge of space missions. Demonstration 
projects which include simulated space stations and mission 
control modules, video displays, computer hardware and 
software, and robotics would provide students with 
opportunities for cooperative learning, problem solving, and 
responsible decisionmaking. The Altoona School District, in 
Altoona, PA, would be especially suited to conduct a 
demonstration such as the one described above.
    The Committee urges the Department to conduct a project 
which expands a large-scale partnership between local community 
services, school districts, and businesses for mentoring at-
risk children involving thousands of volunteers. Inschool 
mentoring has proven particularly effective in encouraging 
attendance, improving academic performance, and lessening peer 
pressure. The Committee is aware of such a proposal by the YMCA 
of Greater Kansas City, MO, and encourages full and fair 
consideration of a proposal from this organization.
    The Committee is aware of educational software that is 
being developed that relies both on modern computer technology 
and on advanced academic research in cognitive science. In 
order to encourage the spread of this technology into our 
elementary and secondary schools, the Committee urges the 
Department to fund projects that implement educational software 
that relies on the latest computer technology, and that is 
based on sophisticated academic research. Northwestern 
University would be especially suited to carry out a 
demonstration such as the one described above.
    Within the funds provided, the Committee has included 
$800,000 to award grants to nonprofit organizations for the 
cost of conducting scholar-athlete games.
    The Committee recognizes the vital importance of reading 
and writing in an age of technology, particularly for title I 
students. The Committee urges the Department to pursue 
demonstrations of successful reading and writing programs in 
schoolwide settings. Further, the Committee urges the 
Department to identify effective and cost-effective staff 
development programs that address reading and writing, and to 
support those that have demonstrated the ability to improve 
classroom practice and research, and children's ability to read 
and write.
    The Committee is aware of projects which promote consumer, 
economic, and personal finance education, such as saving, 
investing, and entrepreneurial education, and urges the 
Department to consider funding a demonstration in this area. 
The Committee understands that the P.R. Harris School in 
southeast Washington, DC, is currently conducting a project and 
would be especially suited for a project such as the one 
described above.
    The Committee urges the Department to fund a program which 
would educate and train staff to teach an employability 
curriculum to students starting in kindergarten and continuing 
through eighth grade. This program would help students 
understand the importance and value of being employed and to 
develop appropriate workplace behavior, motivation, and skills 
needed to survive in the workplace.
    The Committee recognizes the urgency to train K-12 teachers 
in the effective use of instructional technologies and urges 
the Department to provide adequate funding for proven pilot 
programs. The Alliance for Training K-12 Teachers in 
Instructional Technologies would be especially suited for a 
demonstration such as the one described above.
    The Committee reiterates its support for research 
priorities for an integrated delivery system of early childhood 
education, development, and related services. The Jefferson 
County public school system's Project Jump Start is currently 
conducting a project to document changes and achievements in 
children's lives as they enter primary school as a result of 
their participation in such an integrated service program and 
to support a parent component of participation, with emphasis 
on male family members and involvement in school-based 
decisionmaking. The Committee urges the Department to continue 
support of this demonstration project.
    Also included in the amount recommended is $125,000 for the 
national student and parent mock election.

International education exchange

    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 $1,000,000 above the 1996 
level and $3,000,000 more than the administration request and 
the amount recommended by the House bill. 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 student's perceptions of civics, government, and 
economics.

Civic education

    The Committee recommends $5,000,000 for the Center for 
Civic Education, $1,000,000 above the 1996 appropriation, the 
budget request, and 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 $13,342,000 for the Eisenhower 
Professional Development Federal Activities Program, $4,642,000 
below the 1996 appropriation and $1,658,000 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.
    Consistent with the budget request, the Committee has 
included $5,000,000 for the National Board for Professional 
Teaching Standards.
    The Committee directs the Department to provide at least 
$5,472,000 for the National Clearinghouse for Science, 
Mathematics, and Technology Education Materials, the same 
amount appropriated for this purpose in 1996. The budget 
request recommended $2,000,000 for this purpose. The 
clearinghouse 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 $15,000,000 for the Eisenhower 
regional mathematics and science education consortia, the same 
amount appropriated in fiscal year 1996 and the same amount 
recommended by the House and the administration. 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 $1,000,000 for the 21st century 
community learning centers, an increase of $250,000 above the 
amount appropriated in 1996. 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.
    Projects that place schools at the center of the community 
are contributing to rural renewal both culturally and 
economically. They also bring the community into the school in 
the areas of curriculum reform, school organization, planning, 
teacher and administrator education, and fiscal and tax policy. 
The Committee urges the Department to place a high priority on 
schools-at-the-center projects.

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 and the same amount appropriated for 
this activity in fiscal year 1996. The administration proposed 
$10,000,000 for this purpose.
    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.
    The Committee urges the Department of Education to fund the 
National Research Center on the Gifted and Talented at a level 
which would enable the Research Center to continue.

Star schools

    For the Star Schools Program, the Committee recommends 
$23,000,000, the same amount appropriated in 1996 and a 
decrease of $2,000,000 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 initiate an 
innovative project to create a virtual university for rural 
areas. Efforts should focus on making courseware more 
accessible, flexible, and interactive than current distance 
learning systems. The goal should be to eliminate the campus-
centric restrictions on adult and other nontraditional 
education programs. The Committee is aware of such a proposal 
by a group of Kansas universities, and encourages full and fair 
consideration of a proposal from this consortium.
    The Committee encourages the Department to fund a project 
which encourages businesses and organizations to donate surplus 
computer equipment to a nonprofit foundation. Volunteers of the 
foundation repair and renovate the equipment and then 
distribute the equipment to K-12 schools. A project, such as 
the one described above would be especially helpful to both 
urban and rural schools who could not otherwise afford access 
to this technology for distance learning and would be an 
appropriate use of leadership funds.
    Star schools programs, particularly statewide programs, 
have been extremely successful in developing and acquiring 
telecommunications equipment, instructional programming, and 
technical assistance to improve instruction in math, science, 
foreign languages, and other subjects such as vocational 
education in eligible communities. As a result, these statewide 
programs have provided a number of students, particularly those 
located in geographically isolated areas, with opportunities 
that were previously inaccessible. Thus, within the funds 
provided, the Committee urges the Department to solicit 
applications for statewide programs and award a minimum of two 
statewide star school grants in addition to any ongoing 
multiyear statewide grants for which the Department anticipated 
funding in fiscal year 1997.

National writing project

    The Committee bill provides $3,100,000 for the national 
writing project, an increase of $145,000 above the 1996 
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.

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 administration request and the same as the 1996 
appropriation.
    This program supports 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 supports the development, production, and dissemination 
of educational materials designed to help parents, children, 
and care givers obtain the maximum advantage from educational 
programming.

Educational technology

    The Committee recommends $48,000,000 for the technology 
program authorized as part A of title III of the ESEA. The 
amount recommended is the same amount recommended by the House 
and the 1996 appropriation and $277,000,000 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 $38,000,000 for local innovation 
challenge grants, the same amount appropriated in fiscal year 
1996 and a decrease of $22,000,000 below the amount recommended 
by the administration. 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 support 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 urges the Secretary, when awarding 
educational technology grants, to give consideration to school 
districts around the country, such as the Houston Independent 
School District and the Los Angeles Unified School District, 
that exemplify: (1) high concentrations of at-risk youth; (2) 
empowerment zones and enhanced enterprise communities; and (3) 
significant investments to establish infrastructure with 
aggressive plans to utilize educational technology.
    The Committee is aware of an effort to enhance education 
technology as part of a comprehensive school reform initiative 
being implemented by the Los Angeles Education Alliance for 
Restructuring Now [LEARN], and urges the Secretary to give full 
and fair consideration to a proposal from this coalition within 
the Los Angeles Unified School District.
    The Committee has also included $10,000,000 to continue the 
regional consortia, the same amount appropriated in fiscal year 
1996. 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.

Telecommunications demonstration project for mathematics

    The Committee recommends $1,035,000 for the 
telecommunications demonstration project for mathematics, the 
same amount appropriated in fiscal year 1996. No funds were 
provided by the House or recommended by the administration 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, 1996....................................    $132,505,000
Budget estimate, 1997...................................     110,000,000
House allowance.........................................     108,000,000

Committee recommendation

                                                             128,369,000

    The Committee recommends an appropriation of $128,369,000 
for library programs, a decrease of $4,136,000 below the 1996 
appropriation, $18,369,000 above the administration's request, 
and $20,369,000 above the amount recommended by the House. 
Except for programs under the Higher Education Act, funding for 
library programs is unauthorized for fiscal year 1997, and the 
administration had proposed $110,000,000 for later transmittal 
pending the outcome of the authorizing legislation.

Public library services

    The Committee bill includes $92,636,000 for public library 
services under title I of the Library Services and Construction 
Act [LSCA], the same as the 1996 appropriation and the House 
amount.
    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, the same as the 1996 
appropriation. The House and the administration proposed no 
funding for this program. Funds are used by 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 $11,864,000 for interlibrary 
cooperation authorized by title III of LSCA, the same amount 
recommended by the House and a decrease of $6,136,000 below the 
amount appropriated in 1996. 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 education and training

    The Committee provides $2,500,000 for library career 
training programs, the same appropriated in fiscal year 1996 
and the amount recommended by the House. 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 $5,000,000 for library research 
and demonstrations, which is $2,000,000 more than the 1996 
appropriation. The House recommended $1,000,000 for this 
program while the administration proposed to eliminate all 
funding.
    This program provides discretionary grants and contracts to 
support projects to improve libraries and information 
technologies and to disseminate the results of these projects.
    Within the amount recommended the Committee has included 
$1,500,000 for the expansion of the nationally recognized 
demonstration project funding Portals, the Portland area 
library network system [Portals]. This system will make more 
than 1 million historic photos and manuscripts available in 
electronic format for use by the public. High schools, 
community colleges, and universities will also benefit by using 
this technology for instruction and by expanded connection of a 
multistate consortium of public and private colleges and 
universities, a public library system, an articulated high 
school setting, and a State historical library to the internet.
    The Committee recommendation also includes $1,000,000, to 
be competitively awarded, for a nonprofit social tolerance 
resource center to operate a national training program to 
develop educational materials and operate prejudice reduction 
programs for educators, students, health care providers, and 
others involved in community relations. The Simon Wisenthal 
Center, which is currently operating multimedia exhibits on 
social tolerance, 20th century genocide, contemporary human 
rights, tolerance tools, and prejudice reduction programs, is 
uniquely suited to operate this training program such as the 
one described above.
    Within the funds provided, the Committee urges the 
Department to use $500,000 for the establishment of the 
Columbia River history project to provide for the development 
of teaching and library materials focused on the history of the 
Columbia River basin. Students and faculty at Portland State 
University and Washington State University will work with 
community libraries located throughout the basin to create 
local histories that link the community to the attributes of 
the Columbia River. The library at Portland State University 
will work with the Columbia River history project to create a 
collection of interdisciplinary library resources to support 
this effort and to be made available to the public through the 
Portland area library network system [Portals].

                        Departmental Management

                         program administration

Appropriations, 1996....................................    $326,686,000
Budget estimate, 1997...................................     355,476,000
House allowance.........................................     297,229,000

Committee recommendation

                                                             320,152,000

    The Committee recommends $320,152,000 for program 
administration, a decrease of $6,534,000 below the 1996 
appropriation, $35,324,000 below the budget request, and 
$22,923,000 more than 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 some 200 Federal 
education programs. Support for program evaluation and studies 
and advisory councils is also provided under this activity.
    Much of the science, mathematics, engineering, and 
computing research and development in the United States is done 
in Federal and federally funded agencies. The Committee 
recommends that an Executive order be established to assist in 
the science, mathematics, engineering, and computing education 
of our Nation's students by encouraging our Federal agencies to 
provide apprenticeships and internships for precollege 
students.
    An Executive order encouraging recipients of grant or 
contracts from Federal agencies to assist in the science, 
mathematics, engineering, and computing education of our 
students by providing school-to-work transition experiences 
such as apprenticeships and internships is also encouraged.
    This Executive order would further the goals of Executive 
Order No. 12999, ``Educational Technology: Ensuring Opportunity 
for All Children in the Next Century.'' The Committee urges the 
Secretary to continue negotiations with the President to 
institute an appropriate method to advance this cause.

                        office for civil rights

Appropriations, 1996....................................     $55,277,000
Budget estimate, 1997...................................      60,000,000
House allowance.........................................      54,171,000

Committee recommendation

                                                              54,171,000

    The Committee bill includes $54,171,000 for the Office for 
Civil Rights [OCR], $1,106,000 below the 1996 appropriation, 
$5,829,000 below the budget request, and the same 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.

                    office of the inspector general

Appropriations, 1996....................................     $28,563,000
Budget estimate, 1997...................................      30,500,000
House allowance.........................................      27,143,000

Committee recommendation

                                                              27,991,000

    The Committee recommends $27,991,000 for the Office of the 
Inspector General, $572,000 below the 1996 appropriation, 
$2,509,000 less than the 1997 budget request, and $848,000 more 
than the amount recommended by the House.
    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.

                           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 student's 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 modifies language proposed by the House (sec. 
304), which limits the amount of funding and uses of these 
funds under section 458 of the Higher Education Act for 
availability of such funds to $420,000,000 in fiscal year 1997 
while the Committee bill limits funds to $440,000,000. By law, 
$595,000,000 are permitted to be spent under section 458 in 
fiscal year 1997.
    With respect to administrative cost allowances for guaranty 
agencies, the Committee has provided $80,000,000 for payment of 
costs incurred during fiscal year 1996. In addition, the 
Committee provides that an administrative cost allowance of 
0.85 percent shall be paid to guaranty agencies on the first 
$8,200,000,000 of new loans guaranteed during fiscal year 1997, 
and that such amount cannot exceed $70,000,000. The Committee 
estimates that $8,200,000,000 will be approximately the amount 
of new loan volume guaranteed during the first three quarters 
of fiscal year 1997. The Committee expects that the 
administrative costs incurred by guarantors for the remaining 
loan volume guaranteed during fiscal year 1997 will be funded 
in the fiscal year 1998 appropriations bill.
    The Committee has modified a provision included in the 
House bill (sec. 305) prohibiting the use of funds for the 
Historically Black Colleges and Universities Capital Financing 
Advisory Board, the Jacob J. Javits Fellows Program Fellowship 
Board, the National Board of the Fund for the Improvement of 
Postsecondary Education, and the Advisory Board for the Academy 
of Science, Space, and Technology. The Committee has deleted 
the funding prohibition contained in the House bill relating to 
the National Board for the Fund for the Improvement of 
Postsecondary Education.
    The Committee concurs with the provision included in the 
House bill (sec. 306) giving the Secretary of Education 
authority to transfer up to 1 percent of any discretionary 
funds between appropriations.
    The Committee has deleted a provision included in the House 
bill (sec. 307) which would redistribute basic support payments 
for impact aid and instead inserts a provision which clarifies 
the intent of Congress to ensure that student aid application 
data is the only area under which flexibility can occur under 
section 487(A).
                       TITLE IV--RELATED AGENCIES

                      Armed Forces Retirement Home

Appropriations, 1996....................................     $55,783,000
Budget estimate, 1997...................................      56,204,000
House allowance.........................................      53,184,000

Committee recommendation

                                                              56,204,000

    The Committee recommends authority to expend $56,204,000 
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, $421,000 more than the 1996 
appropriation, the same as the budget request, and $3,020,000 
more than the House allowance.
    The Committee has recommended the amount requested by the 
Armed Forces Retirement Home, which is about $2,000,000 below 
OMB guidance. The Committee has provided the requested funding 
level with the intention that the Armed Forces Retirement Home 
will initiate downsizing as outlined in the Armed Forces 
Retirement Home's strategic plan.

Operation and maintenance

    The Committee recommends $55,772,000 for the operation and 
maintenance of the Soldiers' and Airmen's Home and the U.S. 
Naval Home, $1,943,000 more than the fiscal year 1996 
appropriation, the same as the budget request, and $3,020,000 
more than the House allowance.

Capital outlay

    The Committee recommends $432,000 for capital activities at 
the Soldiers' and Airmen's Home and the U.S. Naval Home, 
$1,522,000 less than the 1996 appropriation and the same as 
both the budget request and the House allowance.

             Corporation for National and Community Service

                  domestic volunteer service programs

Appropriations, 1996....................................    $198,117,000
Budget estimate, 1997...................................     226,109,000
House allowance.........................................     203,969,000

Committee recommendation

                                                             202,046,000

    The Committee recommends an appropriation of $202,046,000 
for the domestic volunteer service programs of the Corporation 
for National and Community Service, $3,929,000 more than the 
1996 appropriation, $24,063,000 less than the budget request, 
and $1,923,000 less than the House allowance.

VISTA

    The Committee bill provides $41,235,000 for the Volunteers 
in Service to America [VISTA] Program, the same as the fiscal 
year 1996 level, $10,365,000 less than the budget request, and 
the same as 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.

National Senior Volunteer Corps

    The Committee bill provides $132,841,000 for the National 
Senior Volunteer Corps programs, $4,500,000 more than the 
fiscal year 1996 level, $11,923,000 less than the budget 
request, and $1,923,000 less than the House allowance.
    The Committee-recommended level for fiscal year 1997 is a 
partial restoration of funds to the fiscal year 1995 level. The 
recommended level, therefore, should not be used to fund new 
programs of national significance grants, but is intended to 
restore funding to existing NSVC programs. An increase of at 
least 2 percent for support costs to maintain service levels 
should be provided to existing programs; remaining funds should 
be used to expand the NSVC programs to unserved areas. The 
Committee also recommends that public relations and promotional 
activities in fiscal year 1997 be limited to close to $375,000, 
the minimum stipulated in section 221 of the Domestic Volunteer 
Service Act.

Foster Grandparent Program

    The Committee recommends $67,812,000 for the Foster 
Grandparent Program, $5,575,000 more than the 1996 level, 
$5,000,000 less than the budget request, and the same as the 
House allowance.
    This program provides volunteer opportunities to seniors 
age 60 and over who serve at-risk youth. This program involves 
seniors in their communities, and provides a host of services 
to children.

Senior Companion Program

    For the Senior Companion Program, the Committee bill 
includes $31,244,000, $89,000 more than the 1996 level, 
$3,000,000 less than the budget request, and the same as the 
House allowance.
    This program enables senior citizens to provide personal 
assistance and companionship to adults with physical, mental, 
or emotional difficulties. Senior companions provide vital in-
home services to elderly Americans who would otherwise have to 
enter nursing homes. The volunteers also provide respite care 
to relieve care givers.

Retired and Senior Volunteer Program

    The Committee bill provides $35,708,000 for the Retired and 
Senior Volunteer Program [RSVP], $759,000 more than the 1996 
level, $2,000,000 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.

Program support

    The Committee bill includes $27,970,000 for program 
support, $571,000 less than the 1996 level, $1,775,000 less 
than the budget request, and the same as the House allowance.

                  Corporation for Public Broadcasting

Appropriations, 1997....................................    $275,000,000
Appropriations, 1998....................................     250,000,000
Budget estimate, 1999...................................     275,000,000
House allowance.........................................     250,000,000

Committee recommendation

                                                             250,000,000

    The Committee recommends an appropriation of $250,000,000 
for the Corporation for Public Broadcasting, an advance 
appropriation for fiscal year 1999. This amount is the same as 
the fiscal year 1998 appropriation, $25,000,000 less than the 
budget request, and the same as the House allowance.
    The Committee directs CPB, in allocating funds to consider 
the impact on rural radio and TV stations, especially sole 
service providers, stations with minimal donor bases or service 
areas with limited video programming and cable alternatives. 
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, 1996....................................     $32,815,000
Budget estimate, 1997...................................      32,579,000
House allowance.........................................      32,579,000

Committee recommendation

                                                              32,579,000

    The Committee recommends an appropriation of $32,579,000 
for the Federal Mediation and Conciliation Service [FMCS], 
$236,000 less than the 1996 appropriation and the same as both 
the budget request and the House allowance.
    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, 1996....................................      $6,184,000
Budget estimate, 1997...................................       6,332,000
House allowance.........................................       6,060,000

Committee recommendation

                                                               6,060,000

    The Committee recommends an appropriation of $6,060,000 for 
the Federal Mine Safety and Health Review Commission, $124,000 
less than the fiscal year 1996 appropriation, $272,000 less 
than the budget request, and the same as the 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 judge decisions.

        National Commission on Libraries and Information Science

Appropriations, 1996....................................        $829,000
Budget estimate, 1997...................................         897,000
House allowance.........................................         812,000

Committee recommendation

                                                                 897,000

    The Committee recommends an appropriation of $897,000 for 
the National Commission on Libraries and Information Science, 
$68,000 more than the fiscal year 1996 appropriation, the same 
as the budget request, and $85,000 more than the House 
allowance.
    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 Committee commends the Commission's 
cost-cutting measures noted in the fiscal year 1997 budget 
justification.

                     National Council on Disability

Appropriations, 1996....................................      $1,793,000
Budget estimate, 1997...................................       1,793,000
House allowance.........................................       1,757,000

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 
1996 appropriation and the budget request and $36,000 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 the public issues of concern to 
individuals with disabilities. The Council gathers information 
on the implementation, effectiveness, and impact of the 
Americans With Disabilities Act and looks at emerging policy 
issues as they affect persons with disabilities and their 
ability to enter or reenter the Nation's work force and to live 
independently.

                     National Education Goals Panel

Appropriations, 1996....................................        $994,000
Budget estimate, 1997...................................       2,785,000
House allowance.........................................         974,000

Committee recommendation

                                                               1,500,000

    The Committee recommends $1,500,000 for the national 
education goals panel, $506,000 more than the 1996 
appropriation, $1,285,000 less than the budget request, and 
$526,000 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, 1996....................................    $170,266,000
Budget estimate, 1997...................................     181,134,000
House allowance.........................................     144,692,000

Committee recommendation

                                                             170,266,000

    The Committee recommends an appropriation of $170,266,000 
for the National Labor Relations Board [NLRB], the same as the 
fiscal year 1996 appropriation, $10,868,000 less than the 
budget request, and $25,574,000 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 1996 level due to the 
increasing backlog and constant and uncontrollable number of 
cases which must be investigated, argued, and adjudicated in a 
timely manner by the NLRB.
    The Committee has deleted without prejudice House bill 
language that is legislative in nature and that should be 
addressed by the authorizing committee.
    The Committee remains concerned about the potential impact 
of the NLRB-proposed rule regarding the appropriateness of 
single bargaining units, and includes language which prohibits 
the NLRB from promulgating a final rule on the appropriateness 
of requested single location bargaining units in representation 
cases.

                        National Mediation Board

Appropriations, 1996....................................      $7,812,000
Budget estimate, 1997...................................       8,300,000
House allowance.........................................       7,656,000

Committee recommendation

                                                               8,300,000

    The Committee recommends an appropriation of $8,300,000 for 
the National Mediation Board, $488,000 more than the fiscal 
year 1996 appropriation, the same as the budget request, and 
$644,000 more 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 recommends the amount originally requested by 
the Board and has included language allowing the Board to use 
unspent funds authorized for emergency boards for the Board's 
reorganization and downsizing plan. Following the one-time 
reorganization costs, the Committee expects the Board's budget 
requests to be reduced, as the Board has estimated.

            Occupational Safety and Health Review Commission

Appropriations, 1996....................................      $8,081,000
Budget estimate, 1997...................................       7,753,000
House allowance.........................................       7,753,000

Committee recommendation

                                                               7,753,000

    The Committee recommends an appropriation of $7,753,000 for 
the Occupational Safety and Health Review Commission, $328,000 
less than the fiscal year 1996 appropriation and the same as 
both the budget request and 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.
    The Committee commends the cost-savings initiatives, staff 
reductions, and improvements in efficiency of the Occupational 
Safety and Health Administration.

                  Physician Payment Review Commission

Appropriations, 1996....................................      $2,920,000
Budget estimate, 1997...................................       4,000,000
House allowance.........................................       2,920,000

Committee recommendation

                                                               3,263,000

    The Committee recommends the transfer of $3,263,000 from 
the Medicare trust funds to support operations of the Physician 
Payment Review Commission, $343,000 more than the fiscal year 
1996 level and the House allowance, and $737,000 less than the 
budget request.
    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 fiscal year 
1996 appropriation for the PPRC was a 30-percent reduction in 
anticipation of a merger of the Commission with the Prospective 
Payment Assessment Commission. The Committee has provided a 
restoration of funds as that merger did not take place.

               Prospective Payment Assessment Commission

Appropriations, 1996....................................      $3,263,000
Budget estimate, 1997...................................       3,902,000
House allowance.........................................       3,263,000

Committee recommendation

                                                               3,263,000

    The Committee recommends the transfer of $3,263,000 from 
the Medicare trust funds for the operation of the Prospective 
Payment Assessment Commission [ProPAC], the same as the fiscal 
year 1996 level and the House allowance and $639,000 less than 
ProPAC's request.
    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 concurs with the House report language 
directing ProPAC to prepare a plan on the study of the impact 
of changes in Government reimbursement programs and in the 
private market place on hospitals which are urban, are big and 
busy, and are Government dependent, with at least 60 percent of 
their days reimbursed by a combination of Medicare and 
Medicaid.

                       Railroad Retirement Board

                     dual benefits payments account

Appropriations, 1996....................................    $239,000,000
Budget estimate, 1997...................................     223,000,000
House allowance.........................................     223,000,000

Committee recommendation

                                                             223,000,000

    The Committee has provided a total of $223,000,000 for dual 
benefits, including $9,000,000 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.
    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, 1996....................................        $300,000
Budget estimate, 1997...................................         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 1996 
appropriation, the budget request, and House allowance.

                      limitation on administration

Appropriations, 1996....................................     $89,692,000
Budget estimate, 1997...................................      90,558,000
House allowance.........................................      87,898,000

Committee recommendation

                                                              87,898,000

    The Committee recommends an appropriation of $87,898,000 
for the administration of railroad retirement/survivor benefit 
programs. This amount is $1,794,000 below the fiscal year 1996 
appropriation, $2,660,000 below the budget request, and the 
same as 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

    Fiscal year 1996 was the final year of the Special 
Management Improvement Program. No funds are requested or 
provided for this fund for fiscal year 1997.

           limitation on the office of the inspector general

Appropriations, 1996....................................      $5,656,000
Budget estimate, 1997...................................       5,750,000
House allowance.........................................       5,268,000

Committee recommendation

                                                               5,540,000

    The Committee recommends $5,540,000 for the Office of the 
Inspector General, $116,000 less than the 1996 appropriation, 
$210,000 less than the budget request, and $272,000 more than 
the House allowance. The Committee has provided a sufficient 
appropriation to fund the inspector general's main office and 
field office in Philadelphia, with assumed cost savings from 
the closure of the Houston field office.
    The Committee deletes language included by the House which 
prohibits the Office of the Inspector General from using funds 
to conducts audits, investigations, and reviews of the Medicare 
program. The Committee finds that as long as the RRB has the 
authority to negotiate and administer the separate Medicare 
contract, the RRB inspector general should not be prohibited 
from using funds to review, audit, or investigate the RRB's 
separate Medicare contract.

                     Social Security Administration

                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 1996....................................     $32,641,000
Budget estimate, 1997...................................      30,923,000
House allowance.........................................      30,923,000

Committee recommendation

                                                              30,923,000

    The Committee recommends $30,923,000 for payments to Social 
Security trust funds, the same as the administration request 
and the House allowance. This amount includes $20,923,000 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 1997 request for these mandatory 
payments decreases primarily because special payments for 
certain uninsured persons decline 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, 1996....................................    $485,396,000
Budget estimate, 1997...................................     460,070,000
House allowance.........................................     460,070,000

Committee recommendation

                                                             460,070,000

    The Committee recommends an appropriation of $460,070,000 
for special benefits for disabled coal miners. This is in 
addition to the $170,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1996. 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 holds primary responsibility for claims 
filed before July 1973, with the Department of Labor 
responsible 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 $160,000,000 for the 
first quarter of fiscal year 1998, 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, 1996.................................... $18,560,512,000
Budget estimate, 1997...................................  20,119,000,000
House allowance.........................................  19,447,115,000

Committee recommendation

                                                          19,532,010,000

    The Committee recommends an appropriation of 
$19,532,010,000 for supplemental security income. This is in 
addition to the $9,260,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 1997. The 
recommendation is $586,990,000 less than the administration 
request, $84,895,000 more than the House allowance, and 
$971,498,000 above the fiscal year 1996 level. The Committee 
also recommends an advance of $9,690,000,000 for the first 
quarter of fiscal year 1998 to ensure uninterrupted benefit 
payments.
    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 $100,000,000 for 
beneficiary services, which is $79,000,000 below the 
administration request, the same as the House allowance, and 
$76,400,000 below the 1996 level. Enactment of Public Law 104-
121 will halt SSI payments to drug addicts and alcoholics who 
qualify for assistance primarily on the basis of their 
addictions beginning January 1, 1997. It is anticipated that 
significant numbers deemed ineligible for assistance will 
reapply to the program on the basis of other qualifying 
conditions. The Committee has provided sufficient funds within 
this amount for the continuation of services for potential 
reapplicants removed from the rolls pursuant to Public Law 104-
121. Within this amount, $41,000,000 is available for 
reimbursement of State vocational rehabilitation services 
agencies for successful rehabilitation of SSI recipients.

Research and demonstration projects

    The Committee recommendation includes $7,000,000 for 
research and demonstration projects conducted under sections 
1110 and 1115 of the Social Security Act. This is $1,200,000 
less than fiscal year 1996 and the same as the House allowance 
and the administration request. This amount, along with 
unobligated carryover funds from fiscal year 1996, will support 
research into underlying causes of the recent growth in the SSI 
and OASDI disability programs, including incidence of 
disability in the general population, trends in applications 
for disability benefits, trends in allowance rates, and 
duration of disability.

Administration

    For administration services related to SSI activities, the 
Committee provides $1,931,015,000, which is $30,000,000 less 
than the House allowance, $113,737,000 above the fiscal year 
1996 level, and $87,958,000 lower than the administration 
request. This includes funds for the SSI disability initiative 
that was previously funded as a separate line item.

Investment proposals

    For the SSI portion of the automation investment, the 
Committee recommends $31,218,000 a reduction of $73,709,000 
from the request, and $23,782,000 less than the House allowance 
and the fiscal year 1996 appropriation. Total funding of 
$226,291,000 for this initiative is explained in the limitation 
on administrative expenses portion of this report.

Continuing disability reviews

    The bill provides an additional $175,000,000 to process 
continuing disability reviews [CDR's] related to the SSI 
caseload as authorized by Public Laws 104-121 and 104-193, an 
increase of $160,000,000 above the comparable 1996 
appropriation.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 1996....................................  $5,864,935,000
Budget estimate, 1997...................................   6,582,468,000
House allowance.........................................   6,309,870,000

Committee recommendation

                                                           6,357,198,000

    The Committee recommends a program funding level of 
$6,357,198,000 for the limitation on administrative expenses, 
which is $225,270,000 less than the administration request, 
$47,328,000 more than the House allowance, and $492,293,000 
over the fiscal year 1996 level.
    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. 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 
1997, about 51.2 million beneficiaries will receive a Social 
Security or supplemental security income check each month and 
cash payments are expected to exceed $390,000,000,000 during 
fiscal year 1997.
    The limitation includes $5,820,907,000 for routine 
operating expenses of the agency, which is $78,890,000 less 
than the House allowance, $48,439,000 above the amount 
requested by the President, and $472,294,000 over the 1996 
comparable amount. These funds cover the mandatory costs of 
maintaining equipment and facilities, as well as staffing.

Social Security Advisory Board

    The Committee has included $1,268,000 within the total 
limitation on administration for the Social Security 
Administration Advisory Board for fiscal year 1997, which is 
$232,000 below the House allowance and $1,068,000 above the 
President's request. This is a new activity. Public Law 103-
296, the Social Security Independence and Program Improvements 
Act of 1994, as amended, established a seven-member Advisory 
Board, each of whom would serve without salary, that would make 
recommendations on policies and regulations regarding Social 
Security and supplemental security income programs.
    Following the submission of the budget request, Public Law 
104-121 was enacted into law amending the original act to add 
three professional staff members to the Board to be paid at 
Senior Executive Service rates, in addition to a staff 
director. The Committee believes that four SES-level staff 
members would be disproportionate to the Board's size and 
projected workload. The Committee requests the Board to 
carefully assess its budgetary needs, particularly with respect 
to staff salaries and travel.

Software development

    Last year, the Committee expressed concerns about SSA's 
long-term operational and service delivery system. SSA was 
urged to work with an industry-based consortium dedicated to 
improving software productivity, and to institutionalizing 
software processes and methods. The Committee is pleased to 
note that SSA is focusing upon those concerns and urges that 
work proceed as expeditiously as possible.

Automation initiative

    An additional $226,291,000 has been included within the 
limitation amount to fund the fourth year of the 5-year 
automation initiative requested by the President. This is an 
increase of $59,291,000 over fiscal year 1996, is $73,709,000 
less than the request, and is $23,782,000 below the House 
allowance. In addition to this amount, the Committee expects 
that unspent carryover funds will be made available for these 
activities in fiscal year 1997. The Committee recognizes the 
criticality of automation investments to sustain SSA's efforts 
toward productivity gains and service improvements. The 
reduction from the budget request recommended by the Committee 
is necessitated by severe budgetary constraints.

Chronic fatigue and immune dysfunction syndrome

    The Committee is concerned about reports from people with 
chronic fatigue and immune dysfunction syndrome [CFIDS] who 
encounter at their local SSA offices a lack of knowledge about 
CFIDS, its diagnosis, and impact on the functional ability of 
sufferers. The Committee requests a summary to the CFSICC of 
SSA's CFIDS-related education activities conducted during the 
past fiscal year. The Committee further urges SSA to develop 
effective means to investigate obstacles to benefits for 
persons with CFIDS and to keep relevant medical information 
updated throughout the application process. The Committee 
reiterates its previous recommendation for the establishment of 
a CFIDS advisory committee, and expects SSA's cooperation in 
expediting the committee's formation.

Continuing disability reviews

    The Committee has provided an additional $310,000,000 to 
the ``Limitation on administration expenses'' account for 
continuing disability reviews [CDR's]. This amount, the full 
amount authorized by Public Laws 104-121 and 104-193, is 
$250,000,000 over the 1996 amount.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 1996....................................     $25,815,000
Budget estimate, 1997...................................      27,424,000
House allowance.........................................      27,424,000
Committee recommendation................................      27,424,000

    The Committee recommends $27,424,000 for activities of the 
Office of the Inspector General. This is the same as the amount 
requested by the administration and the House allowance. This 
includes a general fund appropriation of $6,335,000 together 
with an obligation limitation of $21,089,000 from the Federal 
old age and survivors insurance trust fund and the Federal 
disability insurance trust fund.

                        U.S. Institute of Peace

Appropriations, 1996....................................     $11,481,000
Budget estimate, 1997...................................      11,160,000
House allowance.........................................      11,160,000

Committee recommendation

                                                              11,160,000

    The Committee recommends an appropriation of $11,160,000 
for the U.S. Institute of Peace, $321,000 less than the fiscal 
year 1996 appropriation and the same as both the budget request 
and 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, amended to cover State legislatures (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, amended to cover only funds included in this act (sec. 
507); and limit use of funds for abortion (sec. 508).
    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. 509). The Committee recommendation retains the 
prohibition on use of funds for an electronic benefit transfer 
task force (sec. 510).
    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. 511). It also concurs 
with the House language on human embryo research (sec. 512). 
The Committee recommendation deletes House provisions relating 
to: NLRB labor disputes (sec. 513); limitation on any direct 
benefit or assistance to individuals not lawfully within the 
United States (sec. 514); location of Mine Safety and Health 
Administration technology center (sec. 515).
    The Committee concurs with the House bill language 
limitation on use of funds for promotion of legalization of 
controlled substances (sec. 516).
    The Committee recommends deletion of House provisions 
concerning denial of funds for preventing ROTC access to campus 
(sec. 517); and denial of funds for preventing Federal military 
recruiting on campus (sec. 518). The Committee has not deleted 
the House bill language limitation on use of funds to enter 
into or review contracts with entities subject to the 
requirement in section 4212(d) of title 38, United States Code, 
if the report required by that section has not been submitted 
(sec. 519).
    The Committee has further deleted House provisions on: 
limitation on use of funds to enforce section 1926.28(a) of 
title 29, United States Code, relating to a requirement that 
workers wear long pants (sec. 520); limitation on funding to 
order, direct, enforce, or compel any employer to pay backpay 
to any employee not lawfully in the United States (sec. 521); 
limitation on transfers from Medicare and OASDI trust funds 
(sec. 522); and limitation relating to use of funds under title 
X of the Public Health Services Act (sec. 523).
    The Committee has included a general provision limiting 
expenditures on cash performance awards to no more than 1 
percent of amounts appropriated for salaries for each agency 
funded in this bill. In order to assist in complying with this 
requirement, the provision also permits agencies to waive the 
requirement in 5 U.S.C. 5384(b)(2) that those in the Senior 
Executive Service receiving performance awards be awarded not 
less than 5 percent of their basic salary. In addition, the 
provision reduces the amounts otherwise appropriated for 
salaries and expenses in the bill by $30,500,000, to be 
allocated by the Office of Management and Budget (sec. 524).
    The Committee has inserted language authorizing buyouts for 
Railroad Retirement Board and its inspector general employees 
(sec. 525).

                                            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 1997: Subcommittee on Labor, Health and                                                         
 Human Services, Education, and Related Agencies:                                                               
    Defense discretionary...................................  ...........  ...........  ...........  ...........
    Nondefense discretionary................................       65,600       65,775       68,590   \1\ 69,748
    Violent crime reduction fund............................          123          123           52           52
    Mandatory...............................................      222,327      222,327      222,340      222,340
Projections of outlays associated with the recommendation:                                                      
    1997....................................................  ...........  ...........  ...........  \2\ 206,972
    1998....................................................  ...........  ...........  ...........       33,085
    1999....................................................  ...........  ...........  ...........        7,285
    2000....................................................  ...........  ...........  ...........        1,000
    2001 and future year....................................  ...........  ...........  ...........           53
Financial assistance to State and local governments for 1997                                                    
 in bill....................................................           NA      125,349           NA      105,526
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.                                                          
\2\ Excludes outlays from prior-year budget authority.                                                          
                                                                                                                
NA: Not applicable.                                                                                             
                                                                                                                
Note.--Consistent with the funding recommended in the bill for continuing disability reviews and in accordance  
  with Public Laws 104-124--104-193, the Committee anticipates that the Budget Committee will file a revised    
  section 602(a) allocation for the Committee on Appropriations reflecting an upward adjustment of $175,000,000 
  in budget authority and $310,000,000 in outlays.                                                              

  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, 
        $373,000,000;
          Consolidated health centers, $788,000,000;
          Health professions, $265,124,000;
          Organ transplantation, $2,296,000;
          Health teaching facilities interest subsidies, 
        $297,000;
          Bone Marrow Donor Registry Program, $15,272,000;
          Alzheimer's demonstration grants, $6,000,000;
          Family planning, $198,452,000;
          Health education assistance loan [HEAL] loan 
        limitation, $3,165,000;
          Vaccine Injury Compensation Program HRSA 
        Administration (trust fund), $169,721,000;
          Centers for Disease Control and Prevention, 
        $2,168,948,000;
          Childhood immunization, $467,890,000;
          Sexually transmitted diseases, $106,299,000;
          Substance Abuse and Mental Health Services 
        Administration, $1,873,943,000;
          Agency for Health Care Policy and Research, 
        $143,587,000;
          Child care and development block grant, $950,000,000;
          Runaway and Homeless Youth Program, $43,653,000;
          Runaway-Transitional Living Program, $14,949,000;
          Child abuse State grants, $21,026,000;
          Child abuse discretionary activities, $14,154,000;
          Abandoned infants assistance, $12,251,000;
          Adoption opportunities, $15,000,000;
          Native American programs, $34,933,000;
          Adolescent family life, $12,698,000;
          Office of Minority Health, $33,000,000;
          Special education, $3,262,315,000;
          Vocational and adult education, $1,341,752,000;
          Public libraries, $128,369,000;
          Armed Forces Retirement Home, $56,204,000;
          Corporation for National and Community Service, 
        $202,046,000;
          Corporation for Public Broadcasting, $250,000,000.

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 appropriate scorekeeping, by recorded 
vote of 28-0 a quorum being present.
    The vote was as follows:
        Yeas                          Nays
Chairman Hatfield
Mr. Stevens
Mr. Cochran
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. Gorton
Mr. McConnell
Mr. Mack
Mr. Burns
Mr. Shelby
Mr. Jeffords
Mr. Gregg
Mr. Bennett
Mr. Campbell
Mr. Byrd
Mr. Inouye
Mr. Hollings
Mr. Johnston
Mr. Leahy
Mr. Bumpers
Mr. Lautenberg
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.

    Section 107 amends section 213(a) of title 29, United 
States Code as follows:

                            TITLE 29--LABOR

          * * * * * * *

                    CHAPTER 8--FAIR LABOR STANDARDS

          * * * * * * *

Sec. 213. Exemptions

(a) Minimum wage and maximum hour requirements
          * * * * * * *
          (16) a criminal investigator who is paid availability 
        pay under section 5545a of title 5[.] ; or
          (17) any individual who is an inmate of a penal or 
        other correctional institution, and who participates in 
        a correctional work program that is sanctioned by a 
        Federal or State corrections agency or this is 
        administered by a nonprofit organization authorized by 
        State law to conduct a correctional work program on 
        behalf of the State, except that this paragraph shall 
        not apply to a convict or prisoner who participates in 
        a prison work pilot program pursuant to section 1761(c) 
        of title 18, United States Code.

    Section 217 amends section 10403(a)(1) of title 42, United 
States Code, as follows:

                TITLE 42--THE PUBLIC HEALTH AND WELFARE

          * * * * * * *

          CHAPTER 110--FAMILY VIOLENCE PREVENTION AND SERVICES

          * * * * * * *

Sec. 10403. Allotment of funds

(a) Proportionality of allotment; minimum allotment

    From the sums appropriated under section 10409 of this 
title for grants to States for any fiscal year, each State 
shall be allotted for payment in a grant authorized under 
section 10402(a) of this title an amount which bears the same 
ratio to such sums as the population of such State bears to the 
population of all States, except that--
          (1) each State shall be allotted not less than 1 
        percent of the amounts available for grants under 
        section 10402(a) of this title for the fiscal year for 
        which the allotment is made, or [$200,000] $400,000, 
        whichever is the lessor amount; and

    Section 307 amends section 1094a of title 20, United States 
Code, as follows:

                          TITLE 20--EDUCATION

          * * * * * * *

      CHAPTER 28--HIGHER EDUCATION RESOURCES AND STUDENT ASSISTANCE

          * * * * * * *

                   SUBCHAPTER IV--STUDENT ASSISTANCE

          * * * * * * *

   Part F--General Provisions Relating to Student Assistance Programs

          * * * * * * *

Sec. 1094a. Quality assurance program

(a) In general
          * * * * * * *
(d) Experimental sites

    (1) The Secretary is authorized to select institutions for 
voluntary participation as experimental sites [to provide 
recommendations to the Secretary on the impact and 
effectiveness of proposed regulations or new management 
initiatives.] to test alternative data verification.
    (2) The Secretary is authorized to exempt any institution 
participating as an experimental site [from any requirements in 
this subchapter and part C of subchapter I of chapter 34 of 
title 42, or in regulations prescribed under this subchapter 
and part C of subchapter I of chapter 34 of title 42, that 
would bias experimental results.] from regulations prescribed 
under this title related to application data verification that 
would bias experimental results.

    To establish a new commission:
            TITLE VI--COMMISSION ON RETIREMENT INCOME POLICY
        SEC. 601. SHORT TITLE.

          This title may be cited as the ``Commission on 
        Retirement Income Policy Act of 1996''.

        SEC. 602. ESTABLISHMENT.

          There is established a commission to be known as the 
        Commission on Retirement Income Policy (in this title 
        referred to as the ``Commission'').

        SEC. 603. DUTIES.

          (a) In General.--The Commission shall conduct a full 
        and complete review and study of--
                  (1) trends in retirement savings in the United 
                States;
                  (2) existing Federal incentives and programs 
                that are established to encourage and protect 
                such savings; and
                  (3) new Federal incentives and programs that 
                are needed to encourage and protect such 
                savings.
          (b) Specific Issues.--In fulfilling the duty described 
        in subsection (a), the Commission shall address--
                  (1) the amount and sources of Federal and 
                private funds, including tax expenditures (as 
                defined in section 3 of the Congressional Budget 
                Act of 1974 (2 U.S.C. 622)), needed to finance 
                the incentives and programs referred to in 
                subsection (a)(2) and any new Federal incentive 
                or program that the Commission recommends be 
                established;
                  (2) the most efficient and effective manner, 
                considering the needs of retirement plan 
                sponsors for simplicity, reasonable cost, and 
                appropriate incentives, of ensuring that 
                individuals in the United States will have 
                adequate retirement savings;
                  (3) the amounts of retirement income that 
                future retirees will need to replace various 
                levels of preretirement income, including 
                amounts necessary to pay for medical and long-
                term care;
                  (4) the workforce and demographic trends that 
                affect the pensions of future retirees;
                  (5) the role of retirement savings in the 
                economy of the United States;
                  (6) sources of retirement income other than 
                private pensions that are available to 
                individuals in the United States; and
                  (7) the shift away from insured and qualified 
                pension benefits in the United States.
          (c) Recommendations.--
                  (1) In general.--The Commission shall 
                formulate recommendations based on the review 
                and study conducted under subsection (a). The 
                recommendations shall include measures that 
                address the needs of future retirees for--
                          (A) appropriate pension plan coverage 
                        and other mechanisms for saving for 
                        retirement;
                          (B) an adequate retirement income;
                          (C) preservation of benefits they 
                        accumulate by participating in pension 
                        plans;
                          (D) information concerning pension 
                        plan benefits; and
                          (E) procedures to resolve disputes 
                        involving such benefits.
                  (2) Effect on federal budget deficit.--A 
                recommendation of the Commission for a new 
                Federal incentive or program that would result 
                in an increase in the Federal budget deficit 
                shall not appear in the report required under 
                section 607 unless it is accompanied by a 
                recommendation for offsetting the increase.

        SEC. 604. MEMBERSHIP.

          (a) Number and Appointment.--
                  (1) In general.--The Commission shall be 
                composed of 16 voting members appointed not 
                later than 90 days after the date of the 
                enactment of this Act. The Commission shall 
                consist of the following members:
                          (A) Four members appointed by the 
                        President, of which two shall be from 
                        the executive branch of the Government 
                        and two from private life.
                          (B) Three members appointed by the 
                        Majority Leader of the Senate of which 
                        at least one shall be from private life.
                          (C) Three members appointed by the 
                        Minority Leader of the Senate of which 
                        at least one shall be from private life.
                          (D) Three members appointed by the 
                        Majority Leader of the House of 
                        Representatives of which at least one 
                        shall be from private life.
                          (E) Three members appointed by the 
                        Minority Leader of the House of 
                        Representatives of which at least one 
                        shall be from private life.
                  (2) Qualifications.--The individuals referred 
                to in paragraph (1) who are not Members of the 
                Congress shall be leaders of business or labor, 
                distinguished academics, or other individuals 
                with distinctive qualifications and experience 
                in retirement income policy.
          (b) Terms.--Each member shall be appointed for the 
        life of the Commission.
          (c) Vacancies.--A vacancy in the Commission shall be 
        filled not later than 90 days after the date of the 
        creation of the vacancy in the manner in which the 
        original appointment was made.
          (d) Compensation.--
                  (1) Rates of pay.--Except as provided in 
                paragraph (2), members of the Commission shall 
                serve without pay.
                  (2) Travel expenses.--Each member of the 
                Commission shall receive travel expenses, 
                including per diem in lieu of subsistence, in 
                accordance with sections 5702 and 5703 of title 
                5, United States Code.
          (e) Quorum.--10 members of the Commission shall 
        constitute a quorum, but 6 members may hold hearings, 
        take testimony, or receive evidence.
          (f) Chairperson.--The chairperson of the Commission 
        shall be elected by a majority vote of the members of 
        the Commission.
          (g) Meetings.--The Commission shall meet at the call 
        of the chairperson of the Commission.
          (h) Decisions.--Decisions of the Commission shall be 
        made according to the vote of not less than a majority 
        of the members who are present and voting at a meeting 
        called pursuant to subsection (g).

        SEC. 605. STAFF AND SUPPORT SERVICES.

          (a) Executive Director.--The Commission shall have an 
        executive director appointed by the Commission. The 
        Commission shall fix the pay of the executive director.
          (b) Staff.--The Commission may appoint and fix the pay 
        of additional personnel as it considers appropriate.
          (c) Applicability of Certain Civil Service Laws.--The 
        executive director and staff of the Commission may be 
        appointed without regard to the provisions of title 5, 
        United States Code, governing appointments in the 
        competitive service, and may be paid without regard to 
        the provisions of chapter 51 and subchapter III of 
        chapter 53 of that title relating to classification and 
        General Schedule pay rates.
          (d) Experts and Consultants.--The Commission may 
        procure temporary and intermittent services under 
        section 3109(b) of title 5, United States Code, at rates 
        the Commission determines to be appropriate.
          (e) Staff of Federal Agencies.--Upon request of the 
        Commission, the head of any Federal agency may detail, 
        on a reimbursable basis, any of the personnel of the 
        agency to the Commission to assist it in carrying out 
        its duties under this title.
          (f) Administrative Support Services.--Upon the request 
        of the Commission, the Administrator of General Services 
        shall provide to the Commission, on a reimbursable 
        basis, the administrative support services necessary for 
        the Commission to carry out its responsibilities under 
        this title.

        SEC. 606. POWERS.

          (a) Hearings and Sessions.--
                  (1) In general.--The Commission may, for the 
                purpose of carrying out this title, hold 
                hearings, sit and act at times and places, take 
                testimony, and receive evidence as the 
                Commission considers appropriate. The Commission 
                may administer oaths or affirmations to 
                witnesses appearing before it.
                  (2) Public hearings.--The Commission may hold 
                public hearings to receive the views of a broad 
                spectrum of the public on the status of the 
                private retirement system of the United States.
          (b) Delegation of Authority.--Any member, committee, 
        or agent of the Commission may, if authorized by the 
        Commission, take any action which the Commission is 
        authorized to take by this section.
          (c) Information.--
                  (1) Information from federal agencies.--
                          (A) In general.--The Commission may 
                        secure directly from any Federal agency 
                        information necessary to enable it to 
                        carry out this title. Upon request of 
                        the Commission, the head of the Federal 
                        agency shall furnish the information to 
                        the Commission.
                          (B) Exception.--Subparagraph (A) shall 
                        not apply to any information that the 
                        Commission is prohibited to secure or 
                        request by another law.
                  (2) Public surveys.--The Commission may 
                conduct the public surveys necessary to enable 
                it to carry out this title. In conducting such 
                surveys, the Commission shall not be considered 
                an agency for purposes of chapter 35 of title 
                44, United States Code.
          (d) Mails.--The Commission may use the United States 
        mails in the same manner and under the same conditions 
        as other Federal agencies.
          (e) Contract and Procurement Authority.--The 
        Commission may make purchases, and may contract with and 
        compensate government and private agencies or persons 
        for property or services, without regard to--
                  (1) section 3709 of the Revised Statutes (41 
                U.S.C. 5); and
                  (2) title III of the Federal Property and 
                Administrative Services Act of 1949 (41 U.S.C. 
                251 et seq.).
          (f) Gifts.--The Commission may accept, use, and 
        dispose of gifts of services or property, both real and 
        personal, for the purpose of assisting the work of the 
        Commission. Gifts of money and proceeds from sales of 
        property received as gifts shall be deposited in the 
        Treasury and shall be available for disbursement upon 
        order of the Commission. For purposes of Federal income, 
        estate, and gift taxes, property accepted under this 
        subsection shall be considered as a gift to the United 
        States.
          (g) Volunteer Services.--Notwithstanding section 1342 
        of title 31, United States Code, the Commission may 
        accept and use voluntary and uncompensated services as 
        the Commission determines necessary.

        SEC. 607. REPORT.

          Not later than 1 year after the first meeting of the 
        Commission, the Commission shall submit a report to the 
        President, the majority and minority leaders of the 
        Senate, the Committee on Labor and Human Resources and 
        the Committee on Finance of the Senate, the majority and 
        minority leaders of the House of Representatives, and 
        the Committee on Ways and Means and the Committee on 
        Economic and Educational Opportunities of the House of 
        Representatives. The report shall review the matters 
        that the Commission is required to study under section 
        603 and shall set forth the recommendations of the 
        Commission.

        SEC. 608. AUTHORIZATION OF APPROPRIATIONS.

          There are authorized to be appropriated such sums as 
        may be necessary to carry out this title.

        SEC. 609. TERMINATION.

          The Commission shall terminate not later than the 
        expiration of the 90-day period beginning on the date on 
        which the Commission submits its report under section 
        607.

    Public Law 104-134 is amended as follows:

                   low income home energy assistance


                         (including rescission)


    Of the funds made available beginning on October 1, 1995 
under this heading in Public Law 103-333, $100,000,000 are 
hereby rescinded.
    For making payments under title XXVI of the Omnibus Budget 
Reconciliation Act of 1981, $300,000,000 to be available for 
obligation in the period October 1, 1996 through September 30, 
1997[: Provided, That all of the funds available under this 
paragraph are hereby designated by Congress to be emergency 
requirements pursuant to section 251(b)(2)(D) of the Balanced 
Budget and Emergency Deficit Control Act of 1985: Provided 
further, That these funds shall be made available only after 
submission to Congress of a formal budget request by the 
President that includes designation of the entire amount of the 
request as an emergency requirement as defined in the Balanced 
Budget and Emergency Deficit Control Act of 1985].
    Funds made available in the fourth paragraph under this 
heading in Public Law 103-333 that remain unobligated as of 
September 30, 1996 shall remain available until September 30, 
1997.

              DEFINITION OF PROGRAM, PROJECT, AND ACTIVITY

    During fiscal year 1997 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. For the purposes of this bill, or funding under a 
continuing resolution in lieu of a regular bill, 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 1997, the accompanying House and 
Senate Committee reports, the conference report and 
accompanying joint explanatory statement of the managers of the 
committee of conference. In the event of funding under a 
formula-based continuing resolution, agencies should fund each 
project or activity according to the formula, and if this 
process results in a funding level above what the account total 
would be if the formula were applied to it alone, an across-
the-board reduction in each project or activity in the account 
would be required to bring the account total within the 
formula.

                                   - 

                 COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 1996 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL YEAR 1997                
                                                                                    [In thousands of dollars]                                                                                   
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                            Senate Committee recommendation compared with (+ or -
                                                                                                                                                                      )                         
                               Item                                       1996         Budget estimate   House allowance      Committee    -----------------------------------------------------
                                                                      appropriation                                        recommendation         1996                                          
                                                                                                                                              appropriation    Budget estimate   House allowance
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                                                                
                   TITLE I--DEPARTMENT OF LABOR                                                                                                                                                 
                                                                                                                                                                                                
              EMPLOYMENT AND TRAINING ADMINISTRATION                                                                                                                                            
                                                                                                                                                                                                
               TRAINING AND EMPLOYMENT SERVICES \1\                                                                                                                                             
                                                                                                                                                                                                
Grants to States:                                                                                                                                                                               
    Adult training................................................          850,000           947,000           845,000           845,000            -5,000          -102,000   ................
    Youth training................................................          126,672           126,672           126,672           126,672   ................  ................  ................
    Summer youth employment and training program \2\..............          625,000           871,000           625,000           625,000   ................         -246,000   ................
    Dislocated worker assistance:                                                                                                                                                               
        Forward funding...........................................        1,097,500         1,293,000         1,100,000         1,100,000            +2,500          -193,000   ................
        Current funding \2\.......................................            2,500   ................  ................  ................           -2,500   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal................................................        1,100,000         1,293,000         1,100,000         1,100,000   ................         -193,000   ................
Federally administered programs:                                                                                                                                                                
    Native Americans..............................................           52,502            50,000            50,000            52,502   ................           +2,502            +2,502 
    Migrants and seasonal farmworkers.............................           69,285            65,000            65,000            70,285            +1,000            +5,285            +5,285 
    Job Corps:                                                                                                                                                                                  
        Operations................................................          972,475         1,064,824         1,064,824         1,064,824           +92,349   ................  ................
        Construction and renovation \3\...........................          121,467            88,685            73,861            73,861           -47,606           -14,824   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal, Job Corps.....................................        1,093,942         1,153,509         1,138,685         1,138,685           +44,743           -14,824   ................
    Veterans' employment..........................................            7,300             7,300             7,300             7,300   ................  ................  ................
    National activities:                                                                                                                                                                        
        Pilots and demonstrations.................................           27,140            23,717            15,000            33,000            +5,860            +9,283           +18,000 
        Research, demonstration and evaluation....................            6,196            10,196             6,196             6,196   ................           -4,000   ................
        Opportunity areas for youth...............................  ................          250,000   ................  ................  ................         -250,000   ................
        Jobs for residents........................................  ................           50,000   ................  ................  ................          -50,000   ................
        Incumbent worker demonstrations...........................  ................           15,000   ................  ................  ................          -15,000   ................
        Other.....................................................           13,489             8,019             8,019            13,489   ................           +5,470            +5,470 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal, National activities...........................           46,825           356,932            29,215            52,685            +5,860          -304,247           +23,470 
                                                                   =============================================================================================================================
          Subtotal, Federal activities............................        1,269,854         1,632,741         1,290,200         1,321,457           +51,603          -311,284           +31,257 
                                                                   =============================================================================================================================
          Total, Job Training Partnership Act.....................        3,971,526         4,870,413         3,986,872         4,018,129           +46,603          -852,284           +31,257 
                                                                   =============================================================================================================================
Glass Ceiling Commission \2\......................................              142   ................  ................  ................             -142   ................  ................
Women in apprenticeship \2\.......................................              610               647               610               610   ................              -37   ................
Skills Standards..................................................            4,000             9,000             4,000             4,000   ................           -5,000   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, National activities, TES (non-add)...................          (51,577)         (366,579)          (33,825)          (57,295)          (+5,718)        (-309,284)         (+23,470)
School-to-work \4\................................................          170,000           200,000           175,000           180,000           +10,000           -20,000            +5,000 
                                                                   =============================================================================================================================
      Total, Training and Employment Services.....................        4,146,278         5,080,060         4,166,482         4,202,739           +56,461          -877,321           +36,257 
      Subtotal, forward funded....................................       (3,518,026)       (4,208,413)       (3,540,872)       (3,577,129)         (+59,103)        (-631,284)         (+36,257)
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS \5\..............          373,000           350,000           373,000           373,000   ................          +23,000   ................
                                                                                                                                                                                                
           FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES                                                                                                                                         
                                                                                                                                                                                                
Trade adjustment..................................................          279,600           276,100           276,100           276,100            -3,500   ................  ................
NAFTA activities..................................................           66,500            48,400            48,400            48,400           -18,100   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total.......................................................          346,100           324,500           324,500           324,500           -21,600   ................  ................
                                                                                                                                                                                                
  STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS                                                                                                                                
                                                                                                                                                                                                
Unemployment Compensation (Trust Funds):                                                                                                                                                        
    State Operations..............................................       (2,080,520)       (2,224,974)       (2,076,735)       (2,119,475)         (+38,955)        (-105,499)         (+42,740)
    National Activities...........................................          (10,000)          (10,000)           (8,500)          (10,000)  ................  ................          (+1,500)
    Contingency...................................................         (216,333)         (260,573)         (260,573)         (216,333)  ................         (-44,240)         (-44,240)
    Contingency bill language (OMB estimate)......................  ................          (67,800)  ................  ................  ................         (-67,800)  ................
        Portion treated as budget authority.......................  ................          (67,800)  ................  ................  ................         (-67,800)  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal, Unemployment Comp (trust funds)...............       (2,306,853)       (2,563,347)       (2,345,808)       (2,345,808)         (+38,955)        (-217,539)  ................
Employment Service:                                                                                                                                                                             
    Allotments to States:                                                                                                                                                                       
        Federal funds.............................................           23,452            24,085            22,279            22,279            -1,173            -1,806   ................
        Trust funds...............................................         (738,283)         (758,217)         (701,369)         (701,369)         (-36,914)         (-56,848)  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal................................................          761,735           782,302           723,648           723,648           -38,087           -58,654   ................
    National Activities:                                                                                                                                                                        
        Federal funds.............................................            1,876             1,927   ................  ................           -1,876            -1,927   ................
        Trust funds \6\...........................................          (57,058)          (63,949)          (42,735)          (52,559)          (-4,499)         (-11,390)          (+9,824)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
          Subtotal, Emp. Serv., National Activities...............           58,934            65,876            42,735            52,559            -6,375           -13,317            +9,824 
                                                                   =============================================================================================================================
          Subtotal, Employment Service............................          820,669           848,178           766,383           776,207           -44,462           -71,971            +9,824 
              Federal funds.......................................           25,328            26,012            22,279            22,279            -3,049            -3,733   ................
              Trust funds.........................................         (795,341)         (822,166)         (744,104)         (753,928)         (-41,413)         (-68,238)          (+9,824)
One-stop Career Centers...........................................          110,000           150,000           110,000           110,000   ................          -40,000   ................
                                                                   =============================================================================================================================
      Total, State Unemployment...................................        3,237,522         3,561,525         3,222,191         3,232,015            -5,507          -329,510            +9,824 
          Federal Funds...........................................          135,328           176,012           132,279           132,279            -3,049           -43,733   ................
          Trust Funds.............................................       (3,102,194)       (3,385,513)       (3,089,912)       (3,099,736)          (-2,458)        (-285,777)          (+9,824)
ADVANCES TO UNEMPLOYMENT TRUST FUND AND OTHER FUNDS \7\...........          369,000           373,000           373,000           373,000            +4,000   ................  ................
ADVANCES TO THE ESA ACCOUNT OF THE UNEMPLOYMENT TRUST  FUND.......         (-56,300)  ................  ................  ................         (+56,300)  ................  ................
PAYMENTS TO UI TRUST FUND AND OTHER FUNDS.........................        (-266,000)  ................  ................  ................        (+266,000)  ................  ................
                                                                                                                                                                                                
                      PROGRAM ADMINISTRATION                                                                                                                                                    
                                                                                                                                                                                                
Adult employment and training.....................................           25,619            26,091            25,107            25,107              -512              -984   ................
    Trust funds...................................................           (2,283)           (2,354)           (2,237)           (2,237)             (-46)            (-117)  ................
Youth employment and training.....................................           29,441            29,990            28,852            28,852              -589            -1,138   ................
Employment security...............................................            6,057             6,323             5,936             5,936              -121              -387   ................
    Trust funds...................................................          (37,167)          (37,274)          (36,424)          (36,424)            (-743)            (-850)  ................
Apprenticeship services...........................................           16,129            16,689            15,806            15,806              -323              -883   ................
Executive direction...............................................            5,808             5,614             5,692             5,692              -116               +78   ................
    Trust funds...................................................           (1,343)           (1,346)           (1,316)           (1,316)             (-27)             (-30)  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Program Administration...............................          123,847           125,681           121,370           121,370            -2,477            -4,311   ................
          Federal funds...........................................           83,054            84,707            81,393            81,393            -1,661            -3,314   ................
          Trust funds.............................................          (40,793)          (40,974)          (39,977)          (39,977)            (-816)            (-997)  ................
                                                                   =============================================================================================================================
      Total, Employment and Training Administration...............        8,595,747         9,814,766         8,580,543         8,626,624           +30,877        -1,188,142           +46,081 
          Federal funds...........................................        5,452,760         6,388,279         5,450,654         5,486,911           +34,151          -901,368           +36,257 
          Trust funds.............................................       (3,142,987)       (3,426,487)       (3,129,889)       (3,139,713)          (-3,274)        (-286,774)          (+9,824)
                                                                   =============================================================================================================================
            PENSION AND WELFARE BENEFITS ADMINISTRATION                                                                                                                                         
                                                                                                                                                                                                
                     SALARIES AND EXPENSES \8\                                                                                                                                                  
                                                                                                                                                                                                
Enforcement and compliance........................................           51,712            67,430            50,978            56,678            +4,966           -10,752            +5,700 
Policy, regulation and public service.............................           11,831            14,261            11,594            11,594              -237            -2,667   ................
Program oversight.................................................            3,583             3,758             3,511             3,511               -72              -247   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, PWBA.................................................           67,126            85,449            66,083            71,783            +4,657           -13,666            +5,700 
                                                                                                                                                                                                
               PENSION BENEFIT GUARANTY CORPORATION                                                                                                                                             
                                                                                                                                                                                                
Program Administration subject to limitation (Trust Funds)........          (10,557)          (12,043)         (135,720)          (10,345)            (-212)          (-1,698)        (-125,375)
Services related to terminations not subject to limitations (non-                                                                                                                               
 add).............................................................         (127,933)         (128,496)  ................         (125,375)          (-2,558)          (-3,121)        (+125,375)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, PBGC.................................................         (138,490)         (140,539)         (135,720)         (135,720)          (-2,770)          (-4,819)  ................
                                                                                                                                                                                                
                EMPLOYMENT STANDARDS ADMINISTRATION                                                                                                                                             
                                                                                                                                                                                                
                       SALARIES AND EXPENSES                                                                                                                                                    
                                                                                                                                                                                                
Enforcement of wage and hour standards............................           99,751           118,704           102,756           101,506            +1,755           -17,198            -1,250 
Office of Labor-Management Standards..............................           23,992            29,084            23,512            23,512              -480            -5,572   ................
Federal contractor EEO standards enforcement......................           56,171            65,460            55,048            55,048            -1,123           -10,412   ................
Federal programs for workers' compensation........................           73,159            80,222            71,696            71,696            -1,463            -8,526   ................
    Trust funds...................................................           (1,003)           (1,057)             (983)             (983)             (-20)             (-74)  ................
Program direction and support.....................................           10,622            11,386            10,410            10,410              -212              -976   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, salaries and expenses................................          264,698           305,913           264,405           263,155            -1,543           -42,758            -1,250 
          Federal funds...........................................          263,695           304,856           263,422           262,172            -1,523           -42,684            -1,250 
          Trust funds.............................................           (1,003)           (1,057)             (983)             (983)             (-20)             (-74)  ................
                                                                                                                                                                                                
                         SPECIAL BENEFITS                                                                                                                                                       
                                                                                                                                                                                                
Federal employees compensation benefits...........................          214,000           209,000           209,000           209,000            -5,000   ................  ................
Longshore and harbor workers' benefits............................            4,000             4,000             4,000             4,000   ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Special Benefits.....................................          218,000           213,000           213,000           213,000            -5,000   ................  ................
                                                                                                                                                                                                
                 BLACK LUNG DISABILITY TRUST FUND                                                                                                                                               
                                                                                                                                                                                                
Benefit payments and interest on advances.........................          949,494           961,665           961,665           961,665           +12,171   ................  ................
Employment Standards Admin., salaries and expenses................           27,193            26,071            26,071            26,071            -1,122   ................  ................
Departmental Management, salaries and expenses....................           19,621            19,621            19,621            19,621   ................  ................  ................
Departmental Management, inspector general........................              298               287               287               287               -11   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Black Lung Disability Trust Fund, apprn...........          996,606         1,007,644         1,007,644         1,007,644           +11,038   ................  ................
Treasury administrative costs (indefinite)........................              756               356               356               356              -400   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Black Lung Disability Trust Fund.....................          997,362         1,008,000         1,008,000         1,008,000           +10,638   ................  ................
                                                                   =============================================================================================================================
      Total, Employment Standards Administration..................        1,480,060         1,526,913         1,485,405         1,484,155            +4,095           -42,758            -1,250 
          Federal funds...........................................        1,479,057         1,525,856         1,484,422         1,483,172            +4,115           -42,684            -1,250 
          Trust funds.............................................           (1,003)           (1,057)             (983)             (983)             (-20)             (-74)  ................
                                                                                                                                                                                                
           OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION                                                                                                                                        
                                                                                                                                                                                                
                       SALARIES AND EXPENSES                                                                                                                                                    
                                                                                                                                                                                                
Safety and health standards.......................................            8,374            18,066             8,207             8,207              -167            -9,859   ................
Enforcement:                                                                                                                                                                                    
    Federal Enforcement...........................................          120,890           122,386           117,125           118,525            -2,365            -3,861            +1,400 
    State programs................................................           68,295            73,315            66,929            66,929            -1,366            -6,386   ................
Technical Support.................................................           17,815            20,445            17,459            17,459              -356            -2,986   ................
Compliance Assistance:                                                                                                                                                                          
    Federal Assistance............................................           34,822            51,970            34,822            34,822   ................          -17,148   ................
    State Consultation Grants.....................................           32,479            33,064            32,479            32,479   ................             -585   ................
Safety and health statistics......................................           14,465            14,647            14,176            14,176              -289              -471   ................
Executive direction and administration............................            6,670             6,958             6,537             6,537              -133              -421   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, OSHA.................................................          303,810           340,851           297,734           299,134            -4,676           -41,717            +1,400 
                                                                                                                                                                                                
               MINE SAFETY AND HEALTH ADMINISTRATION                                                                                                                                            
                                                                                                                                                                                                
                       SALARIES AND EXPENSES                                                                                                                                                    
Enforcement:                                                                                                                                                                                    
    Coal..........................................................          106,090           108,723           103,968           106,090   ................           -2,633            +2,122 
    Metal/nonmetal................................................           41,412            44,997            40,584            41,412   ................           -3,585              +828 
    Standards development.........................................            1,008             1,303               988             1,008   ................             -295               +20 
Assessments.......................................................            3,497             3,840             3,427             3,497   ................             -343               +70 
Educational policy and development................................           14,782            14,800            14,486            14,782   ................              -18              +296 
Technical support.................................................           21,268            21,950            20,843            21,268   ................             -682              +425 
Program administration............................................            7,667             8,569             7,514             7,667   ................             -902              +153 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Mine Safety and Health Administration................          195,724           204,182           191,810           195,724   ................           -8,458            +3,914 
                                                                                                                                                                                                
                    BUREAU OF LABOR STATISTICS                                                                                                                                                  
                                                                                                                                                                                                
                       SALARIES AND EXPENSES                                                                                                                                                    
                                                                                                                                                                                                
Employment and Unemployment Statistics............................           97,155           111,426            97,624            97,389              +234           -14,037              -235 
Labor Market Information (Trust Funds)............................          (51,278)          (52,053)          (52,053)          (51,665)            (+387)            (-388)            (-388)
Prices and cost of living.........................................           96,322           101,825            98,107            97,214              +892            -4,611              -893 
Compensation and working conditions...............................           53,444            55,617            56,834            55,139            +1,695              -478            -1,695 
Productivity and technology.......................................            6,974             7,263             7,180             7,077              +103              -186              -103 
Economic growth and employment projections........................            4,451             4,640             4,582             4,516               +65              -124               -66 
Executive direction and staff services............................           21,896            23,462            22,175            22,185              +289            -1,277               +10 
Consumer Price Index Revision \7\.................................           11,549            16,145            16,145            16,145            +4,596   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Bureau of Labor Statistics...........................          343,069           372,431           354,700           351,330            +8,261           -21,101            -3,370 
          Federal Funds...........................................          291,791           320,378           302,647           299,665            +7,874           -20,713            -2,982 
          Trust Funds.............................................          (51,278)          (52,053)          (52,053)          (51,665)            (+387)            (-388)            (-388)
                                                                                                                                                                                                
                      DEPARTMENTAL MANAGEMENT                                                                                                                                                   
                                                                                                                                                                                                
                       SALARIES AND EXPENSES                                                                                                                                                    
                                                                                                                                                                                                
Executive direction...............................................           18,641            19,368            20,268            20,268            +1,627              +900   ................
Legal services....................................................           58,072            61,510            56,911            56,911            -1,161            -4,599   ................
    Trust funds...................................................             (303)             (303)             (297)             (297)              (-6)              (-6)  ................
International labor affairs.......................................            9,900             9,465             6,000             9,465              -435   ................           +3,465 
Administration and management.....................................           13,904            13,916            13,626            13,626              -278              -290   ................
Adjudication......................................................           20,500            20,895            20,090            20,090              -410              -805   ................
Promoting employment of people with disabilities..................            4,358             4,389             4,271             4,358   ................              -31               +87 
Women's Bureau....................................................            7,743             7,751             7,588             7,743   ................               -8              +155 
Civil Rights Activities...........................................            4,535             4,541             4,444             4,444               -91               -97   ................
Chief Financial Officer...........................................            4,394             4,399             4,306             4,306               -88               -93   ................
Retirement Income Policy Commission...............................  ................  ................  ................            1,000            +1,000            +1,000            +1,000 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Salaries and expenses................................          142,350           146,537           137,801           142,508              +158            -4,029            +4,707 
          Federal funds...........................................          142,047           146,234           137,504           142,211              +164            -4,023            +4,707 
          Trust funds.............................................             (303)             (303)             (297)             (297)              (-6)              (-6)  ................
                                                                                                                                                                                                
                 VETERANS EMPLOYMENT AND TRAINING                                                                                                                                               
                                                                                                                                                                                                
State Administration:                                                                                                                                                                           
    Disabled Veterans Outreach Program............................          (76,913)          (81,993)          (81,993)          (79,453)          (+2,540)          (-2,540)          (-2,540)
    Local Veterans Employment Program.............................          (71,386)          (75,125)          (75,125)          (73,255)          (+1,869)          (-1,870)          (-1,870)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, State Administration..............................         (148,299)         (157,118)         (157,118)         (152,708)          (+4,409)          (-4,410)          (-4,410)
Federal Administration............................................          (19,419)          (21,752)          (22,831)          (19,517)             (+98)          (-2,235)          (-3,314)
National Veterans Training Institute..............................           (2,672)  ................           (2,000)           (2,000)            (-672)          (+2,000)  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Trust Funds..........................................         (170,390)         (178,870)         (181,949)         (174,225)          (+3,835)          (-4,645)          (-7,724)
REINVENTION INVESTMENT FUND.......................................  ................            3,900   ................  ................  ................           -3,900   ................
                                                                                                                                                                                                
                  OFFICE OF THE INSPECTOR GENERAL                                                                                                                                               
                                                                                                                                                                                                
Program activities................................................           37,622            38,117            36,270            36,270            -1,352            -1,847   ................
    Trust funds...................................................           (3,615)           (3,615)           (3,543)           (3,543)             (-72)             (-72)  ................
Executive Direction and Management................................            6,804             6,355             6,668             6,668              -136              +313   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Office of the Inspector General......................           48,041            48,087            46,481            46,481            -1,560            -1,606   ................
          Federal funds...........................................           44,426            44,472            42,938            42,938            -1,488            -1,534   ................
          Trust funds.............................................           (3,615)           (3,615)           (3,543)           (3,543)             (-72)             (-72)  ................
                                                                   =============================================================================================================================
      Total, Departmental Management..............................          360,781           377,394           366,231           363,214            +2,433           -14,180            -3,017 
          Federal funds...........................................          186,473           194,606           180,442           185,149            -1,324            -9,457            +4,707 
          Trust funds.............................................         (174,308)         (182,788)         (185,789)         (178,065)          (+3,757)          (-4,723)          (-7,724)
                                                                   =============================================================================================================================
      Total, Labor Department \9\.................................       11,356,874        12,734,029        11,478,226        11,402,309           +45,435        -1,331,720           -75,917 
          Federal funds...........................................        7,976,741         9,059,601         7,973,792         8,021,538           +44,797        -1,038,063           +47,746 
          Trust funds.............................................       (3,380,133)       (3,674,428)       (3,504,434)       (3,380,771)            (+638)        (-293,657)        (-123,663)
                                                                                                                                                                                                
      TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES \10\                                                                                                                                    
                                                                                                                                                                                                
           HEALTH RESOURCES AND SERVICES ADMINISTRATION                                                                                                                                         
                                                                                                                                                                                                
                   HEALTH RESOURCES AND SERVICES                                                                                                                                                
                                                                                                                                                                                                
Consolidated health centers.......................................          758,132   ................          802,124           778,000           +19,868          +778,000           -24,124 
Health Centers Cluster (proposed legislation).....................  ................          757,124   ................  ................  ................         -757,124   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Health Centers Activities.........................          758,132           757,124           802,124           778,000           +19,868           +20,876           -24,124 
National Health Service Corps:                                                                                                                                                                  
    Field placements..............................................           37,244   ................           37,244            37,244   ................          +37,244   ................
    Recruitment...................................................           75,189   ................           78,189            78,189            +3,000           +78,189   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, National Health Service Corps.....................          112,433   ................          115,433           115,433            +3,000          +115,433   ................
                                                                                                                                                                                                
                        Health Professions                                                                                                                                                      
                                                                                                                                                                                                
Grants to communities for scholarships............................              474   ................              532               474   ................             +474               -58 
Health professions data system....................................              212   ................              238               212   ................             +212               -26 
Research on certain Health Profession issues......................  ................  ................  ................              450              +450              +450              +450 
Nurse loan repayment for shortage area service....................            1,962   ................            2,197             2,197              +235            +2,197   ................
Workforce Development Cluster (proposed leg)......................  ................          117,205   ................  ................  ................         -117,205   ................
Centers of excellence.............................................           22,072   ................           24,718            22,072   ................          +22,072            -2,646 
Health careers opportunity program................................           23,918   ................           26,785            23,918   ................          +23,918            -2,867 
Exceptional financial need scholarships...........................           10,120   ................           11,333            10,120   ................          +10,120            -1,213 
Faculty loan repayment............................................              947   ................            1,061               947   ................             +947              -114 
Fin assistance for disadvantaged HP students......................            5,999   ................            6,718             5,999   ................           +5,999              -719 
Scholarships for disadvantaged students...........................           16,677   ................           18,676            16,677   ................          +16,677            -1,999 
Minority/Disadvantaged Cluster (proposed leg).....................  ................           64,085   ................  ................  ................          -64,085   ................
Family medicine training/departments..............................           44,002   ................           49,277            44,002   ................          +44,002            -5,275 
General internal medicine and pediatrics..........................           15,741   ................           17,628            15,741   ................          +15,741            -1,887 
Physician assistants..............................................            5,697   ................            6,380             5,697   ................           +5,697              -683 
Public health and preventive medicine.............................            7,148   ................            8,005             7,148   ................           +7,148              -857 
Health administration traineeships/projects.......................              978   ................            1,095               978   ................             +978              -117 
Primary Care Medicine and Public Health Cluster (proposed                                                                                                                                       
 legislation).....................................................  ................           80,000   ................  ................  ................          -80,000   ................
Area health education centers.....................................           23,123   ................           28,495            26,000            +2,877           +26,000            -2,495 
Border health training centers....................................            3,350   ................            3,752             3,350   ................           +3,350              -402 
General dentistry residencies.....................................            3,381   ................            3,786             3,381   ................           +3,381              -405 
Allied health special projects....................................            3,424   ................            3,834             3,424   ................           +3,424              -410 
Geriatric education centers and training..........................            7,933   ................            8,884             7,933   ................           +7,933              -951 
Rural interdisciplinary traineeships..............................            3,709   ................            4,154             4,154              +445            +4,154   ................
Podiatric medicine................................................              605   ................              678               605   ................             +605               -73 
Chiropractic demonstration grants.................................              916   ................            1,026               916   ................             +916              -110 
Enhanced Area Health Education Cluster (proposed legislation).....  ................           35,000   ................  ................  ................          -35,000   ................
Advanced nurse education..........................................           11,134   ................           12,469            11,134   ................          +11,134            -1,335 
Nurse practitioners/nurse midwives................................           15,460   ................           17,588            17,588            +2,128           +17,588   ................
Special projects..................................................            9,436   ................           10,567             9,436   ................           +9,436            -1,131 
Nurse disadvantaged assistance....................................            3,453   ................            3,867             3,867              +414            +3,867   ................
Professional nurse traineeships...................................           14,235   ................           15,942            14,235   ................          +14,235            -1,707 
Nurse anesthetists................................................            2,469   ................            2,765             2,469   ................           +2,469              -296 
Nurse Education/Practice Initiatives Cluster (proposed                                                                                                                                          
 legislation).....................................................  ................           70,000   ................  ................  ................          -70,000   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Health professions................................          258,575           366,290           292,450           265,124            +6,549          -101,166           -27,326 
Other HRSA Programs:                                                                                                                                                                            
    Hansen's disease services.....................................           17,094            16,371            17,094            17,094   ................             +723   ................
    Maternal and child health block grant.........................          678,204           676,061           681,061           678,204   ................           +2,143            -2,857 
    Healthy start.................................................           92,816            74,838   ................           96,000            +3,184           +21,162           +96,000 
    Organ transplantation.........................................            2,069             2,296             2,400             2,296              +227   ................             -104 
    Health teaching facilities interest subsidies.................              411               297               297               297              -114   ................  ................
    Bone marrow program...........................................           15,272            15,332            15,272            15,272   ................              -60   ................
    Rural outreach grants.........................................           27,797            30,254             4,000            27,797   ................           -2,457           +23,797 
    Emergency medical services for children.......................           10,755   ................           12,500            12,500            +1,745           +12,500   ................
    Emergency Medical Services (EMS) Cluster (proposed                                                                                                                                          
     legislation).................................................  ................            9,333   ................  ................  ................           -9,333   ................
    Black lung clinics............................................            3,811   ................            3,900             4,000              +189            +4,000              +100 
    Alzheimers demonstration grants...............................            3,980   ................            6,000             6,000            +2,020            +6,000   ................
    Payment to Hawaii, treatment of Hansen's Disease..............            2,045   ................            2,045             2,045   ................           +2,045   ................
    Pacific Basin initiative......................................            1,200   ................  ................            1,000              -200            +1,000            +1,000 
    Special Populations Cluster (proposed legislation)............  ................            7,485   ................  ................  ................           -7,485   ................
    Brain injury demonstration grants.............................  ................  ................  ................            3,000            +3,000            +3,000            +3,000 
Ryan White AIDS Programs:                                                                                                                                                                       
    Emergency assistance..........................................          391,700           423,943           401,700           401,700           +10,000           -22,243   ................
    Comprehensive care programs...................................          260,847           349,954           290,847           332,847           +72,000           -17,107           +42,000 
    Early intervention program....................................           56,918            64,568            61,918            61,918            +5,000            -2,650   ................
    Pediatric demonstrations......................................           29,000            34,000            34,000            34,000            +5,000   ................  ................
    AIDS dental services..........................................            6,937             6,937             7,500             7,500              +563              +563   ................
    Education and training centers................................           12,000            16,287            16,287            16,287            +4,287   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDS programs..........................          757,402           895,689           812,252           854,252           +96,850           -41,437           +42,000 
Family planning...................................................          192,592           198,452           192,592           198,452            +5,860   ................           +5,860 
Rural health research.............................................            9,353             7,884             7,884             9,553              +200            +1,669            +1,669 
Health care facilities............................................           20,000             2,000   ................           13,000            -7,000           +11,000           +13,000 
Buildings and facilities..........................................              741               828             2,828               828               +87   ................           -2,000 
National practitioner data bank...................................            6,000             6,000             6,000             6,000   ................  ................  ................
    User fees.....................................................           -6,000            -6,000            -6,000            -6,000   ................  ................  ................
Program management................................................          112,058           112,949           112,058           112,949              +891   ................             +891 
Undistributed reduction...........................................  ................          -13,000   ................  ................  ................          +13,000   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Health resources and services........................        3,076,740         3,160,483         3,082,190         3,213,096          +136,356           +52,613          +130,906 
MEDICAL FACILITIES GUARANTEE AND LOAN FUND:                                                                                                                                                     
    Interest subsidy program......................................            8,000             7,000             7,000             7,000            -1,000   ................  ................
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM (HEAL):                                                                                                                                               
    New loan subsidies............................................              126               477               477               477              +351   ................  ................
    Liquidating account (non-add).................................  ................          (14,481)          (14,481)          (14,481)         (+14,481)  ................  ................
    HEAL loan limitation (non-add)................................         (210,000)         (140,000)         (140,000)         (140,000)         (-70,000)  ................  ................
    Program management............................................            2,688             2,695             2,688             2,688   ................               -7   ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, HEAL.................................................            2,814             3,172             3,165             3,165              +351                -7   ................
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:                                                                                                                                                 
    Postfiscal year 1988 claims (trust fund)......................           56,721            56,721            56,721            56,721   ................  ................  ................
    HRSA administration (trust fund)..............................            3,000             3,000             3,000             3,000   ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Vaccine injury compensation trust fund............           59,721            59,721            59,721            59,721   ................  ................  ................
VACCINE INJURY COMPENSATION:                                                                                                                                                                    
    Prefiscal year 1989 claims (appropriation)....................          110,000           110,000           110,000           110,000   ................  ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Vaccine injury.......................................          169,721           169,721           169,721           169,721   ................  ................  ................
                                                                   =============================================================================================================================
      Total, Health Resources and Services Admin..................        3,257,275         3,340,376         3,262,076         3,392,982          +135,707           +52,606          +130,906 
                                                                                                                                                                                                
                    CENTERS FOR DISEASE CONTROL                                                                                                                                                 
                                                                                                                                                                                                
              DISEASE CONTROL, RESEARCH AND TRAINING                                                                                                                                            
                                                                                                                                                                                                
Preventive Health Services Block Grant............................          145,229           145,229           157,000           136,081            -9,148            -9,148           -20,919 
Prevention centers................................................            8,099             7,106             7,106             8,099   ................             +993              +993 
CDC/HCFA vaccine program:                                                                                                                                                                       
    Immunization partnership grant (proposed leg).................  ................          176,656   ................  ................  ................         -176,656   ................
    Childhood immunization........................................          467,890           311,237           467,890           467,890   ................         +156,653   ................
    HCFA vaccine purchase (non-add)...............................         (409,759)         (523,952)         (523,952)         (523,952)        (+114,193)  ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, CDC/HCFA vaccine program level....................         (877,649)       (1,011,845)         (991,842)         (991,842)        (+114,193)         (-20,003)  ................
1995 Vaccine rescission (non-add).................................         (-53,000)  ................  ................  ................         (+53,000)  ................  ................
HIV partnership grant (proposed legislation)......................  ................          297,875   ................  ................  ................         -297,875   ................
Acquired Immune Deficiency Syndrome (AIDS)........................          584,080           319,106           599,080           589,080            +5,000          +269,974           -10,000 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................          584,080           616,981           599,080           589,080            +5,000           -27,901           -10,000 
STD/TB partnership grant (proposed legislation)...................  ................          182,290   ................  ................  ................         -182,290   ................
Tuberculosis......................................................          119,303            16,404           119,303           119,303   ................         +102,899   ................
Sexually transmitted diseases.....................................          105,299            24,578           105,299           106,299            +1,000           +81,721            +1,000 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................          224,602           223,272           224,602           225,602            +1,000            +2,330            +1,000 
Chronic diseases:                                                                                                                                                                               
    Chronic diseases partnership grant (proposed leg).............  ................          117,351   ................  ................  ................         -117,351   ................
    Chronic and environmental disease prevention..................          143,744           106,156           155,000           155,000           +11,256           +48,844   ................
    Breast and cervical cancer screening..........................          124,670            44,677           134,670           139,670           +15,000           +94,993            +5,000 
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Chronic diseases..................................          268,414           268,184           289,670           294,670           +26,256           +26,486            +5,000 
Infectious disease................................................           62,153            87,820            82,153            86,153           +24,000            -1,667            +4,000 
Lead poisoning prevention.........................................           36,188            36,188            38,188            36,188   ................  ................           -2,000 
Injury control....................................................           43,198            43,198            40,598            40,598            -2,600            -2,600   ................
Occupational Safety and Health (NIOSH)............................          128,623           136,584           128,623           136,584            +7,961   ................           +7,961 
Mine safety and health \11\.......................................  ................           32,000   ................           32,000           +32,000   ................          +32,000 
Traumatic Brain Injury............................................  ................  ................  ................            3,000            +3,000            +3,000            +3,000 
Epidemic services.................................................           67,410            67,413            67,413            69,813            +2,403            +2,400            +2,400 
National Center for Health Statistics:                                                                                                                                                          
    Program operations............................................           37,398            35,400            40,063            33,000            -4,398            -2,400            -7,063 
    1 percent evaluation funds (non-add)..........................          (40,063)          (53,063)          (48,400)          (53,063)         (+13,000)  ................          (+4,663)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, health statistics.................................          (77,461)          (88,463)          (88,463)          (86,063)          (+8,602)          (-2,400)          (-2,400)
Buildings and facilities..........................................            4,353             8,353             8,353             7,553            +3,200              -800              -800 
Program management................................................            2,637             2,637             2,637             2,637   ................  ................  ................
Undistributed reduction...........................................  ................          -17,000   ................  ................  ................          +17,000   ................
                                                                   =============================================================================================================================
      Subtotal, Centers for Disease Control.......................        2,080,274         2,181,258         2,153,376         2,168,948           +88,674           -12,310           +15,572 
Crime Bill Activities:                                                                                                                                                                          
    Rape prevention and education.................................           28,542            35,000            28,642            35,000            +6,458   ................           +6,358 
    Domestic violence community demonstrations....................            3,000             6,000             5,000             6,000            +3,000   ................           +1,000 
    Crime victim study............................................              100   ................  ................  ................             -100   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Crime bill activities.............................           31,642            41,000            33,642            41,000            +9,358   ................           +7,358 
                                                                   =============================================================================================================================
      Total, Disease Control......................................        2,111,916         2,222,258         2,187,018         2,209,948           +98,032           -12,310           +22,930 
                                                                                                                                                                                                
                   NATIONAL INSTITUTES OF HEALTH                                                                                                                                                
                                                                                                                                                                                                
National Cancer Institute.........................................        2,248,000         2,060,392         2,385,741         2,102,949          -145,051           +42,557          -282,792 
    Transfer, Office of AIDS Research.............................  ................         (220,539)  ................         (223,147)        (+223,147)          (+2,608)        (+223,147)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................       (2,248,000)       (2,280,931)       (2,385,741)       (2,326,096)         (+78,096)         (+45,165)         (-59,645)
National Heart, Lung, and Blood Institute.........................        1,354,946         1,320,555         1,438,265         1,344,742           -10,204           +24,187           -93,523 
    Transfer, Office of AIDS Research.............................  ................          (58,115)  ................          (58,815)         (+58,815)            (+700)         (+58,815)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................       (1,354,946)       (1,378,670)       (1,438,265)       (1,403,557)         (+48,611)         (+24,887)         (-34,708)
National Institute of Dental Research.............................          182,923           174,463           195,596           177,701            -5,222            +3,238           -17,895 
    Transfer, Office of AIDS Research.............................  ................          (12,318)  ................          (12,483)         (+12,483)            (+165)         (+12,483)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (182,923)         (186,781)         (195,596)         (190,184)          (+7,261)          (+3,403)          (-5,412)
National Institute of Diabetes and Digestive and Kidney Diseases..          770,582           772,975           819,224           787,473           +16,891           +14,498           -31,751 
    Transfer, Office of AIDS Research.............................  ................          (11,948)  ................          (12,109)         (+12,109)            (+161)         (+12,109)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (770,582)         (784,923)         (819,224)         (799,582)         (+29,000)         (+14,659)         (-19,642)
National Institute of Neurological Disorders and Stroke...........          680,902           671,148           725,478           683,721            +2,819           +12,573           -41,757 
    Transfer, Office of AIDS Research.............................  ................          (23,950)  ................          (24,238)         (+24,238)            (+288)         (+24,238)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (680,902)         (695,098)         (725,478)         (707,959)         (+27,057)         (+12,861)         (-17,519)
National Institute of Allergy and Infectious Diseases.............        1,168,483           584,362         1,256,149           595,016          -573,467           +10,654          -661,133 
    Transfer, Office of AIDS Research.............................  ................         (624,368)  ................         (633,993)        (+633,993)          (+9,625)        (+633,993)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................       (1,168,483)       (1,208,730)       (1,256,149)       (1,229,009)         (+60,526)         (+20,279)         (-27,140)
National Institute of General Medical Sciences....................          946,896           936,573         1,003,722           953,214            +6,318           +16,641           -50,508 
    Transfer, Office of AIDS Research.............................  ................          (27,050)  ................          (27,408)         (+27,408)            (+358)         (+27,408)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (946,896)         (963,623)       (1,003,722)         (980,622)         (+33,726)         (+16,999)         (-23,100)
National Institute of Child Health and Human Development..........          594,547           543,441           631,989           554,251           -40,296           +10,810           -77,738 
    Transfer, Office of AIDS Research.............................  ................          (60,209)  ................          (60,993)         (+60,993)            (+784)         (+60,993)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (594,547)         (603,650)         (631,989)         (615,244)         (+20,697)         (+11,594)         (-16,745)
National Eye Institute............................................          313,933           310,072           333,131           315,948            +2,015            +5,876           -17,183 
    Transfer, Office of AIDS Research.............................  ................           (9,135)  ................           (9,204)          (+9,204)             (+69)          (+9,204)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (313,933)         (319,207)         (333,131)         (325,152)         (+11,219)          (+5,945)          (-7,979)
National Institute of Environmental Health Sciences...............          288,378           289,114           308,258           294,745            +6,367            +5,631           -13,513 
    Transfer, Office of AIDS Research.............................  ................           (6,028)  ................           (6,108)          (+6,108)             (+80)          (+6,108)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (288,378)         (295,142)         (308,258)         (300,853)         (+12,475)          (+5,711)          (-7,405)
National Institute on Aging.......................................          453,541           461,541           484,375           470,256           +16,715            +8,715           -14,119 
    Transfer, Office of AIDS Research.............................  ................           (1,824)  ................           (1,818)          (+1,818)              (-6)          (+1,818)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (453,541)         (463,365)         (484,375)         (472,074)         (+18,533)          (+8,709)         (-12,301)
National Institute of Arthritis and Musculoskeletal and Skin                                                                                                                                    
 Diseases.........................................................          242,655           243,169           257,637           247,731            +5,076            +4,562            -9,906 
    Transfer, Office of AIDS Research.............................  ................           (3,972)  ................           (4,029)          (+4,029)             (+57)          (+4,029)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (242,655)         (247,141)         (257,637)         (251,760)          (+9,105)          (+4,619)          (-5,877)
National Institute on Deafness and Other Communication Disorders..          176,383           179,090           189,243           182,693            +6,310            +3,603            -6,550 
    Transfer, Office of AIDS Research.............................  ................           (1,726)  ................           (1,744)          (+1,744)             (+18)          (+1,744)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (176,383)         (180,816)         (189,243)         (184,437)          (+8,054)          (+3,621)          (-4,806)
National Institute of Nursing Research............................           55,814            51,951            59,715            52,936            -2,878              +985            -6,779 
    Transfer, Office of AIDS Research.............................  ................           (5,015)  ................           (5,078)          (+5,078)             (+63)          (+5,078)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................          (55,814)          (56,966)          (59,715)          (58,014)          (+2,200)          (+1,048)          (-1,701)
National Institute on Alcohol Abuse and Alcoholism................          198,401           192,280           212,079           195,891            -2,510            +3,611           -16,188 
    Transfer, Office of AIDS Research.............................  ................          (10,334)  ................          (10,450)         (+10,450)            (+116)         (+10,450)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (198,401)         (202,614)         (212,079)         (206,341)          (+7,940)          (+3,727)          (-5,738)
National Institute on Drug Abuse..................................          458,112           312,014           487,341           317,936          -140,176            +5,922          -169,405 
    Transfer, Office of AIDS Research.............................  ................         (154,311)  ................         (156,200)        (+156,200)          (+1,889)        (+156,200)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (458,112)         (466,325)         (487,341)         (474,136)         (+16,024)          (+7,811)         (-13,205)
National Institute of Mental Health...............................          660,514           578,149           701,247           589,187           -71,327           +11,038          -112,060 
    Transfer, Office of AIDS Research.............................  ................          (93,056)  ................          (94,188)         (+94,188)          (+1,132)         (+94,188)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (660,514)         (671,205)         (701,247)         (683,375)         (+22,861)         (+12,170)         (-17,872)
National Center for Research Resources............................          390,298           309,344           416,523           324,844           -65,454           +15,500           -91,679 
    Transfer, Office of AIDS Research.............................  ................          (68,255)  ................          (71,008)         (+71,008)          (+2,753)         (+71,008)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (390,298)         (377,599)         (416,523)         (395,852)          (+5,554)         (+18,253)         (-20,671)
National Center for Human Genome Research.........................          169,768           177,788           189,267           180,807           +11,039            +3,019            -8,460 
    Transfer, Office of AIDS Research.............................  ................           (2,087)  ................           (1,030)          (+1,030)          (-1,057)          (+1,030)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (169,768)         (179,875)         (189,267)         (181,837)         (+12,069)          (+1,962)          (-7,430)
John E. Fogarty International Center..............................           25,327            15,790            26,707            16,838            -8,489            +1,048            -9,869 
    Transfer, Office of AIDS Research.............................  ................           (9,757)  ................           (9,869)          (+9,869)            (+112)          (+9,869)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................          (25,327)          (25,547)          (26,707)          (26,707)          (+1,380)          (+1,160)  ................
National Library of Medicine......................................          140,936           143,268           150,093           142,070            +1,134            -1,198            -8,023 
    Transfer, Office of AIDS Research.............................  ................           (3,311)  ................           (3,094)          (+3,094)            (-217)          (+3,094)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (140,936)         (146,579)         (150,093)         (145,164)          (+4,228)          (-1,415)          (-4,929)
Office of the Director............................................          260,072           226,913           275,423           243,319           -16,753           +16,406           -32,104 
    Office of AIDS research (non-add).............................          (26,598)          (24,600)          (26,598)          (33,306)          (+6,708)          (+8,706)          (+6,708)
    Transfer, Office of AIDS Research.............................  ................          (24,600)  ................          (33,306)         (+33,306)          (+8,706)         (+33,306)
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal....................................................         (260,072)         (251,513)         (275,423)         (276,625)         (+16,553)         (+25,112)          (+1,202)
Buildings and facilities..........................................          146,151           390,261           200,000           180,000           +33,849          -210,261           -20,000 
Office of AIDS Research...........................................  ................        1,431,908   ................        1,460,312        +1,460,312           +28,404        +1,460,312 
                                                                   =============================================================================================================================
      Total N.I.H.................................................       11,927,562        12,376,561        12,747,203        12,414,580          +487,018           +38,019          -332,623 
                                                                   =============================================================================================================================
     SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION                                                                                                                                  
                                                                                                                                                                                                
Mental Health:                                                                                                                                                                                  
    Knowledge development and application.........................           38,032            62,133            38,032            38,032   ................          -24,101   ................
    Mental health performance partnership.........................          275,420           275,420           275,420           275,420   ................  ................  ................
    Children's mental health......................................           59,927            59,958            59,927            59,927   ................              -31   ................
    Grants to States for the homeless (PATH)......................           20,000   ................           20,000            20,000   ................          +20,000   ................
    Protection and advocacy.......................................           19,850            21,957            21,957            21,957            +2,107   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, mental health.....................................          413,229           419,468           415,336           415,336            +2,107            -4,132   ................
Substance Abuse Treatment:                                                                                                                                                                      
    Knowledge development and application.........................           89,777           176,043           101,333           110,000           +20,223           -66,043            +8,667 
    Substance abuse performance partnership (BA)..................        1,234,107         1,271,957         1,184,107         1,184,107           -50,000           -87,850   ................
    Public Law 104-121 funding (non-add)..........................  ................          (50,000)          (50,000)          (50,000)         (+50,000)  ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Subtotal, Substance Abuse Treatment (BA)....................        1,323,884         1,448,000         1,285,440         1,294,107           -29,777          -153,893            +8,667 
          Program level...........................................       (1,323,884)       (1,498,000)       (1,335,440)       (1,344,107)         (+20,223)        (-153,893)          (+8,667)
Substance Abuse Prevention:                                                                                                                                                                     
    Knowledge development and application.........................           89,799           176,043            93,959           110,000           +20,201           -66,043           +16,041 
Program management................................................           56,188            54,500            54,500            54,500            -1,688   ................  ................
                                                                   =============================================================================================================================
      Total, Substance Abuse and Mental Health (BA)...............        1,883,100         2,098,011         1,849,235         1,873,943            -9,157          -224,068           +24,708 
          Program level...........................................       (1,883,100)       (2,148,011)       (1,899,235)       (1,923,943)         (+40,843)        (-224,068)         (+24,708)
                                                                                                                                                                                                
   RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS                                                                                                                                
                                                                                                                                                                                                
Retirement payments...............................................          129,808           136,421           136,421           136,421            +6,613   ................  ................
Survivors benefits................................................            9,208            11,001            11,001            11,001            +1,793   ................  ................
Dependent's medical care..........................................           25,108            26,414            26,414            26,414            +1,306   ................  ................
Military Services Credits.........................................            2,801             2,556             2,556             2,556              -245   ................  ................
                                                                   -----------------------------------------------------------------------------------------------------------------------------
      Total, Retirement pay and medical benefits..................          166,925           176,392           176,392           176,392            +9,467   ................  ................
                                                                                                                                                                                                
            AGENCY FOR HEALTH CARE POLICY AND RESEARCH                                                                                                                                          
                                                                                                                                                                                                
Research on Health Care Systems Cost and Access: