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109th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                    109-143

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2006

                                _______
                                

 June 21, 2005.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

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

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 3010]

    The Committee on Appropriations submits the following 
report in explanation of the accompanying bill making 
appropriations for the Departments of Labor, Health and Human 
Services (except the Food and Drug Administration, the Agency 
for Toxic Substances and Disease Registry and the Indian Health 
Service), and Education, Committee for Purchase from People Who 
are Blind or Severely Disabled, Corporation for National and 
Community Service, Corporation for Public Broadcasting, Federal 
Mediation and Conciliation Service, Federal Mine Safety and 
Health Review Commission, Institute of Museum and Library 
Services, Medicare Payment Advisory Commission, National 
Commission on Libraries and Information Science, National 
Council on Disability, National Labor Relations Board, National 
Mediation Board, Occupational Safety and Health Review 
Commission, Railroad Retirement Board, and the Social Security 
Administration for the fiscal year ending September 30, 2006, 
and for other purposes.

                        INDEX TO BILL AND REPORT

_______________________________________________________________________


                                                            Page number

                                                            Bill Report
Title I--Department of Labor:
        Employment and Training Administration.............     2
                                                                      5
        Employee Benefits Security Administration..........    10
                                                                     12
        Pension Benefit Guaranty Corporation...............    10
                                                                     13
        Employment Standards Administration................    11
                                                                     13
        Occupational Safety and Health Administration......    16
                                                                     14
        Mine Safety and Health Administration..............    19
                                                                     15
        Bureau of Labor Statistics.........................    20
                                                                     16
        Office of Disability Employment Policy.............    21
                                                                     16
        Departmental Management............................    21
                                                                     16
        Veterans Employment and Training...................    22
                                                                     18
        Office of the Inspector General....................    22
                                                                     18
        General Provisions.................................    23
                                                                     18
Title II--Department of Health and Human Services:
        Health Resources and Services Administration.......    25
                                                                     19
        Centers for Disease Control and Prevention.........    28
                                                                     35
        National Institutes of Health......................    31
                                                                     55
        Substance Abuse and Mental Health Services 
            Administration.................................    39
                                                                    113
        Agency for Healthcare Research and Quality.........    40
                                                                    119
        Centers for Medicare and Medicaid Services.........    40
                                                                    121
        Administration for Children and Families...........    44
                                                                    125
        Administration on Aging............................    52
                                                                    139
        Office of the Secretary............................    52
                                                                    141
        General Provisions.................................    56
                                                                    150
Title III--Department of Education:
        Education for the Disadvantaged....................    65
                                                                    152
        Impact Aid.........................................    66
                                                                    157
        School Improvement Programs........................    67
                                                                    158
        Indian Education...................................    68
                                                                    162
        Innovation and Improvement.........................    68
                                                                    163
        Safe Schools and Citizenship Education.............    69
                                                                    167
        English Language Acquisition.......................    70
                                                                    168
        Special Education..................................    70
                                                                    169
        Rehabilitation Services and Disability Research....    71
                                                                    171
        Special Institutions for Persons with Disabilities.    72
                                                                    174
        Vocational and Adult Education.....................    73
                                                                    175
        Student Financial Assistance.......................    75
                                                                    178
        Student Aid Administration.........................    75
                                                                    179
        Higher Education...................................    75
                                                                    180
        Howard University..................................    77
                                                                    185
        College Housing and Academic Facilities Loans......    77
                                                                    186
        Historically Black College and University Capital 
            Financing......................................    77
                                                                    186
        Institute of Education Sciences....................    78
                                                                    186
        Departmental Management............................    78
                                                                    188
        Office for Civil Rights............................    78
                                                                    190
        Office of the Inspector General....................    78
                                                                    190
        General Provisions.................................    79
                                                                    190
Title IV--Related Agencies:
        Committee for Purchase from People Who Are Blind or 
            Severely Disabled..............................    81
                                                                    191
        Corporation for National and Community Service.....    81
                                                                    191
        Corporation for Public Broadcasting................    88
                                                                    194
        Federal Mediation and Conciliation Service.........    89
                                                                    194
        Federal Mine Safety and Health Review Commission...    90
                                                                    194
        Institute of Museum and Library Services...........    91
                                                                    194
        Medicare Payment Advisory Commission...............    91
                                                                    195
        National Commission on Libraries and Information 
            Science........................................    91
                                                                    195
        National Council on Disability.....................    91
                                                                    195
        National Labor Relations Board.....................    92
                                                                    196
        National Mediation Board...........................    92
                                                                    196
        Occupational Safety and Health Review Commission...    93
                                                                    196
        Railroad Retirement Board..........................    93
                                                                    197
        Social Security Administration.....................    95
                                                                    198
Title V--General Provisions:
House of Representatives Report Requirements


                Summary of Estimates and Appropriations

    The following table compares on a summary basis the 
appropriations including trust funds for fiscal year 2005, the 
budget estimate for fiscal year 2006 and the Committee 
recommendation for fiscal year 2006 in the accompanying bill.

                                 2006 LABOR, HHS, EDUCATION APPROPRIATIONS BILL
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                             Fiscal year--              2006 committee  compared
                                                ---------------------------------------           to--
                                                                                       -------------------------
                                                     2005     2006 budget      2006         2005
                                                  comparable                committee    comparable  2006 budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............................      $15,309      $14,756      $14,808        -$501         +$52
    Advances...................................        2,544        2,512        2,537           -7          +25
Department of Health and Human Services........      373,872      474,273      474,824     +100,952         +551
    Advances...................................       68,101       67,103       67,114         -987          +11
Department of Education........................       59,213       58,939       63,715       +4,502       +4,776
    Advances...................................       15,022       15,022       15,022            0            0
Related Agencies...............................       49,256       49,194       49,066         -190         -128
    Advances...................................       11,330       11,110       11,510         +180         +400
Grand Total, current year......................      497,650      597,162      602,413     +104,763       +5,251
    Advances...................................       96,997       95,747       96,183         -814         +436
Current year total using 302(b) scorekeeping...      496,900      596,798      601,942     +105,042       +5,144
    Mandatory..................................      354,222      455,208      459,428     +105,206       +4,220
    Discretionary..............................      142,678      141,590      142,514         -164         +924
----------------------------------------------------------------------------------------------------------------


                                           PROGRAM LEVEL DISCRETIONARY
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                             Fiscal year--               2006 committee compared
                                                ---------------------------------------           to--
                                                                                       -------------------------
                                                     2005     2006 budget      2006         2005
                                                  comparable                committee    comparable  2006 budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............................      $12,055      $11,586      $11,662        -$393          $76
Department of Health and Human Services........       63,782       62,507       63,149         -633          642
Department of Education........................       56,577       56,219       56,695          118          476
Related Agencies...............................       11,046       11,608       11,479          433         -129
                                                ----------------------------------------------------------------
      Subtotal Program Level...................      143,460      141,920      142,985         -475        1,065
----------------------------------------------------------------------------------------------------------------

                      General Summary of the Bill

    Funding levels in the fiscal year 2006 appropriation bill 
for the Departments of Health and Human Services, and Education 
and Related Agencies reflect the Committee's attempt to 
establish priorities within the very stringent limitations. As 
in past years, the Committee has increased funding for programs 
that work for people and represent a core Federal 
responsibility.
    Bill total.--Total funding, including offsets, for fiscal 
year 2006 in the Departments of Health, and Human Services and 
Education and Related Agencies Appropriations Act, 2006 is 
$601,942,078,000.
    Discretionary Programs.--For Discretionary accounts for 
2006 the bill provides $142,514,000,000, including offsets. 
This is $164,093,000 below the fiscal year 2005 comparable 
level. After adjusting for fluctuations in advance 
appropriations, the comparable program level decrease is 
$474,597,000.
    Mandatory programs.--The bill provides $459,428,078,000 for 
entitlement programs in fiscal year 2006. This is 
$105,206,218,000 above the fiscal year 2005 comparable level, 
or an increase of 29.7 percent. Over three quarters of the 
funding in the bill is for these mandatory costs. Funding 
requirements for entitlement programs are determined by the 
basic authorizing statutes. Mandatory programs include general 
fund support for the Medicare and Medicaid programs, 
Supplemental Security Income, Trade Adjustment Assistance and 
Black Lung payments. The following chart indicates the funding 
levels for the major mandatory programs in fiscal years 2005 
and 2006 and the growth in these programs.

                                                    MANDATORY
                                             [Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year     Fiscal year
                             Program                                   2005            2006           Change
----------------------------------------------------------------------------------------------------------------
Department of Labor:
    Federal Unemployment Benefits and Allowances................      $1,057,300        $966,400        -$90.900
    Advances to the UI and other trust funds....................         517,000         465,000         -52,000
    Special Benefits............................................         233,000         237,000          +4,000
    Special Benefits for Disabled Coal Miners...................         257,997         232,250         -25,747
    Energy Employees Occupational Illness Compensation Fund.....          40,321          96,081         +55,760
    Black Lung Disability Trust Fund............................       1,061,969       1,068,000          +6,031
Department of Health and Human Services:
    Vaccine Injury Compensation Trust Fund......................          66,000          70,884          +4,884
    Medicaid current law benefits...............................     171,407,893     204,166,276     +32,758,383
    Medicaid State and local administration.....................       9,318,602       9,803,100        +484,498
    CMS Vaccines for Children...................................       1,468,799       1,502,333         +33,534
    Medicare Payments to Healthcare Trust Funds.................     114,608,900     177,742,200     +63,133,300
    Welfare Payments............................................          24,000          34,300         +10,300
    Child Support Enforcement...................................       4,066,465       4,185,816        +119,351
    Social Services Block Grant.................................       1,700,000       1,700,000               0
    Promoting Safe and Stable Families..........................         305,000         305,000               0
    Payments to States for Foster Care and Adoption.............       5,037,900       4,852,800        -185,100
    Medical Benefits for Commissioned Officers..................         330,636         328,552          -2,084
Department of Education:
    Vocational Rehabilitation...................................       2,635,845       2,720,192         +84,347
    Pell Grant Shortfall Payoff.................................               0       4,300,000      +4,300,000
Related Agencies:
    Payments to Social Security Trust Funds.....................          20,454          20,470             +16
    Supplemental Security Income................................      38,189,929      37,566,174        -623,755
----------------------------------------------------------------------------------------------------------------

                           Effect Statements

    The Committee directs the Departments of Labor, Health and 
Human Services, Education and the Corporation for National and 
Community Service, and the Social Security Administration to 
provide it with effect statements within 45 days of enactment 
of this Act.

                      TITLE I--DEPARTMENT OF LABOR


                 Employment and Training Administration


                    TRAINING AND EMPLOYMENT SERVICES

                         (INCLUDING RESCISSION)

    The Committee recommends $5,121,792,000 for this account, 
which provides funding authorized primarily by the Workforce 
Investment Act of 1998 (WIA). This is $215,980,000 below the 
fiscal year 2005 level and $66,279,000 below the budget 
request.
    The Training and Employment Services account is comprised 
of programs that enhance the employment and earnings of those 
in need of such services, operated through a decentralized 
system of skill training and related services. The account is 
mostly forward-funded on a July to June cycle, with funds 
provided for fiscal year 2006 supporting the effort from July 
1, 2006 through June 30, 2007.
    The Committee directs that Department take no action in 
fiscal year 2006 to amend, through regulatory or other 
administrative action, the definition established in 20 CFR 
667.220 for functions and activities under title I of the 
Workforce Investment Act until such time as legislation 
reauthorizing the Act is enacted.

Adult employment and training activities

    For adult employment and training activities, the Committee 
recommends $865,736,000. This is $30,882,000 below the fiscal 
year 2005 level and the same as the budget request. Of the 
amount recommended $712,000,000 will become available on 
October 1, 2006. This program is authorized by the Workforce 
Investment Act of 1998. The funds are allocated by formula to 
States and further distributed to local workforce investment 
boards. Services for adults will be provided through the One-
Stop system and most customers receiving training will use 
their individual training accounts to determine which programs 
and providers fit their needs. The Act authorizes core 
services, available to all adults with no eligibility 
requirements, and intensive services, for unemployed 
individuals who are not able to find jobs through core services 
alone.

Dislocated worker employment and training activities

    For dislocated worker employment and training activities, 
the Committee recommends $1,405,264,000. This is $70,800,000 
below the fiscal year 2005 level and $61,680,000 above the 
budget request. Of the amount recommended, $1,060,000,000 will 
become available on October 1, 2006. Of the total, 
$1,193,264,000 is designated for State formula grants that 
support core services, intensive services, training, and 
supportive services. In addition, States use these funds for 
rapid response assistance to help workers affected by mass 
layoffs and plant closures. The bill includes $212,000,000 for 
the National Reserve, which supports National Emergency Grants 
to respond to mass layoffs, plant and/or military base 
closings, and natural disasters across the country, which 
cannot be otherwise anticipated, as well as technical 
assistance and training and demonstration projects.
    The Committee recommendation includes, as it has in past 
years, funding for disclocated worker projects aimed at 
assisting the long-term unemployed.
    The Committee requested that the Department submit its 
report on pilot and demonstration grants as required by the 
Workforce Investment Act by March 31, 2005. The Committee 
expects this report from the Department immediately.

Youth activities

    For youth activities, the Committee recommends 
$950,000,000. This is $36,288,000 below the fiscal year 2005 
level and the same as the budget request.
    The Workforce Investment Act of 1998 consolidated the 
Summer Youth Employment and Training Program and Youth Training 
Grants under the Job Training Partnership Act into a single 
youth training activity. The funds are allocated by formula to 
States and further distributed to local workforce investment 
boards.

Job Corps

    For Job Corps, the Committee recommends $1,542,019,000. 
This is $9,841,000 below the fiscal year 2005 level and 
$25,000,000 above the budget request. Of the amount 
recommended, $691,000,000 will become available on October 1, 
2005. The Committee does not include a rescission of funds as 
requested within construction and rehabilitation account. The 
Committee understands that previously appropriated funds are 
available for the construction of two new centers. The 
Committee further understands that there is a backlog of 
construction and rehabilitation projects at existing centers.
    The Job Corps, authorized by the Workforce Investment Act 
of 1998, is a nationwide network of residential facilities 
chartered by Federal law to provide a comprehensive and 
intensive array of training, job placement and support services 
to at-risk young adults. The mission of Job Corps is to attract 
eligible young adults, teach them the skills they need to 
become employable and independent, and place them in meaningful 
jobs or further education. Participation in the program is open 
to economically disadvantaged young people in the 16 to 24 age 
range who are unemployed and out of school. Most Job Corps 
students come from disruptive or debilitating environments, and 
it is important that they be relocated to residential 
facilities where they can benefit from the highly structured 
and carefully integrated services provided by the Job Corps 
program. A limited number of opportunities are also available 
for non-residential participation. The Committee supports the 
effort of the Workforce Investment Act of 1998 to more fully 
integrate Job Corps centers in their local communities.
    The Committee recognizes the shortage of health care 
professionals and the need to provide access to health care 
vocational opportunities for many disadvantaged young people. 
The Committee is also aware that the Job Corps is uniquely 
qualified to utilize the Department of Health and Human 
Services (HHS) Health Resources and Services Administration 
(HRSA) grant programs to train students to pursue health 
careers while generating more health care professionals to 
serve economically disadvantaged communities.
    The Committee commends the common mission of the Job Corps 
and HRSA in exposing under-represented minorities and 
disadvantaged students to seek strategically important careers. 
Nearly three quarters of the nation's 122 Job Corps Centers 
offer health occupations training as well as training in health 
care related fields. The Committee recognizes and commends the 
Job Corps success in training students with the skills they 
need to fill critical shortages through major national employer 
partners. Through preferred access to HRSA grant funds, Job 
Corps' training can generate even more qualified and prepared 
allied health professionals in the coming decade.
    The Committee commends Job Corps for establishing 
partnerships with national employers, and encourages Job Corps 
to continue to work with both larger employers and small 
businesses to ensure that student training meets current labor 
market needs. The Committee urges Job Corps to also strengthen 
and expand the program in order to help meet our nation's needs 
for trained, entry level workers in three high growth industry 
sectors: health care, homeland security, and national defense. 
In addition, Job Corps should intensify its efforts to upgrade 
its vocational offerings and curricula to reflect industry 
standards and required certifications recognized by employers.
    The Committee is committed to promoting and expanding cost-
effective federal programs: that have proven records of 
success; that provide consistent and positive results for the 
people they serve; and that help address national labor 
shortages. Therefore, the Committee supports the incremental 
expansion of Job Corps. The Committee supports the concept of 
``High Growth Job Corps Centers'' that are focused on 
addressing the country's most vital workforce needs in high 
growth, high demand industries such as automotive, 
construction, financial services, health professions, 
hospitality, information technology, homeland security, and 
transportation.
    The Committee commends the Job Corps program for developing 
mutually beneficial partnerships with community colleges across 
the country. Community college partners including the 
Mississippi Gulf Coast Community College and the Cincinnati 
State and Technical Community College find that it is efficient 
to work with Job Corps because they share the same basic goals 
of providing access and opportunity for disadvantaged Americans 
and they have the ability to partner with employers looking for 
high-skilled workers. The Committee encourages the Department 
of Labor's Community College Initiative to collaborate with the 
Job Corps program to offer advanced co-enrollment programs, 
increase opportunities for disadvantaged youth pursuing a 
career in high growth areas, and maximize access to industry-
recognized certification programs. The Committee also directs a 
minimum of $10 million of the Community College Initiative 
funding dedicated to community colleges partnerships with Job 
Corps centers. The Committee requests this portion be 
designated to: (1) develop strategic partnerships with 
community colleges, business and industry leaders, and Job 
Corps centers to train students in high, growth, high demand 
industries; and (2) design ``dual enrollment'' programs based 
on reciprocal agreements between Job Corps and adjacent 
community colleges.
    The Committee recognizes the significant impact that the 
home building industry continues to have on the health of the 
U.S. economy, and its efforts to expand opportunities for 
homeownership to all of our nation's working families. The 
Committee notes the ongoing shortage of skilled laborers in the 
residential construction industry and the industry's need to 
alleviate that shortage in order to continue to meet the demand 
for affordable housing in the United States. The Committee also 
recognizes the essential role played by the Home Builders 
Institute (HBI), the workforce development arm of the National 
Association of Home Builders, in training Job Corps youth for 
careers in this high growth industry. The Committee commends 
HBI on its 31-year partnership with Job Corps and its proven 
results in developing our nation's workforce by providing at-
risk youth with the skills training and employment 
opportunities they need to have successful careers in 
residential construction. The Committee encourages the 
Department to identify existing and future sites for potential 
expansion of construction trades training by employer-based 
industry groups like HBI, to help alleviate the shortage of 
skilled workers and to further the goal of American 
homeownership.
    The Committee believes that Job Corps' partnerships with 
national non-profit faith founded organizations such as Joint 
Action in Community Services (JACS), Women in Community 
Services, and the YWCA are essential to the success of Job 
Corps. The Committee commends JACS and its national network of 
nearly 3,000 volunteers for their proven record in providing 
at-risk young adults supportive services as they transition 
from Job Corps back to their home communities and into the 
world of work. As such, the Committee encourages the Department 
to expand its Job Corps partnership with such national 
volunteer programs in order to ensure the continued 
availability of youth of transition services that are national 
in scope, yet local in focus.

Native Americans

    For Native Americans, the Committee recommends $54,238,000. 
This is the same as the fiscal year 2005 level and the budget 
request. This program, authorized by the Workforce Investment 
Act of 1998, is designed to improve the economic well being of 
Native Americans (Indians, Eskimos, Aleuts, and Native 
Hawaiians) through the provision of training, work experience, 
and other employment-related services and opportunities that 
are intended to aid the participants to secure permanent, 
unsubsidized jobs. The Department of Labor allocates formula 
grants to Indian tribes and other Native American groups whose 
eligibility for such grants is established in accordance with 
Department regulations.

Migrant and seasonal farmworkers

    For Migrant and Seasonal Farmworkers, the Committee 
recommends $75,759,000. This is the same as the fiscal year 
2005 level. The budget request did not include funds for this 
program. The Committee recommendation includes bill language 
directing that $4,546,000 of this amount be used for migrant 
and seasonal farmworker housing grants. The bill language 
further directs that not less than 70 percent of this amount be 
used for permanent housing grants. The recommendation also 
provides that the remaining amount be used for State service 
area grants, including funding grantees in those States 
impacted by formula reductions at no less than eighty-five 
percent of the comparable 1998 levels for such States. Within 
the National Activities/Other line item, the Committee includes 
$500,000 to be used for Section 167 training, technical 
assistance and related activities, including continuing funding 
for migrant rest center activities at the current level.
    This program, authorized by the Workforce Investment Act of 
1998, is designed to serve members of economically 
disadvantaged families whose principal livelihood is derived 
from migratory and other forms of seasonal farmwork, or 
fishing, or logging activities. Enrollees and their families 
are provided with employment training and related services 
intended to prepare them for stable, year-round employment 
within and outside of the agriculture industry.

National programs

    This activity includes Workforce Investment Act authorized 
programs in support of the workforce system including technical 
assistance and incentive grants, evaluations, pilots, 
demonstrations and research.
    Pilots, Demonstrations and Research: The Committee 
recommends $74,000,000 for grants or contracts to conduct 
research, pilots or demonstrates that improve techniques or 
demonstrate the effectiveness of programs. This is $11,167,000 
below the fiscal year 2005 level and $44,000,000 above the 
budget request.
    Evaluation: The Committee recommends $7,936,000 to provide 
for the continuing evaluation of program conducted under the 
Workforce Investment Act of 1998, as well as of federally 
funded employment-related activities under other provisions of 
law. This is the same as the fiscal year 2005 level and the 
budget request.
    Responsible Reintegration of Youthful Offenders: The 
Committee does not include funding for the Responsible 
Reintegration of Youthful Offenders program. The budget did not 
request funds for this program. The fiscal year 2005 level was 
$49,600,000.
    Prisoner Re-entry: The Committee recommends $19,840,000 for 
the Prisoner Re-entry initiative. The is the same as the fiscal 
year 2005 level and $15,160,000 below the budget request.
    The Committee notes the importance of providing adjudicated 
youth with opportunities to expand and cultivate job skills 
that can provide them with successful careers. The Committee 
recognizes Project CRAFT (Community, Restitution, and 
Apprenticeship-Focused Training), a program of the Home 
Builders Institute (HBI), the workforce development arm of the 
National Association of Home Builders, as a noteworthy effort 
in the rehabilitation and reduced recidivism of adjudicated 
youth. The Committee believes that Project CRAFT serves as an 
example of the success achieved during the Youth Reintegration 
pilot demonstration, and applauds HBI for its ongoing 
dedication to serving the workplace education needs of this 
segment of the youth population. The Committee also recognizes 
the role Project CRAFT plays in preparing young people to join 
the residential construction workforce and the continuing 
importance of the home building industry to our nation's 
economy. The Committee encourages the Department to replicate 
Project CRAFT so that its outcomes-oriented approach will 
assist adjudicated juveniles to become productive members of 
the industry's workforce.
    Community Based Job Training Initiative: The Committee 
recommends $125,000,000 for the Community Based Job Training 
Initiative and rescinds $125,000,000 in funds provided in 
fiscal year 2005 for this program.
    The Committee's recommendations reflect efforts to improve 
the efficiency of the workforce system and support 
opportunities to get people back to work. Therefore the 
Committee has not funded the new Community Based Job Training 
Initiative at the level requested by the Administration, but 
has instead increased funding for Dislocated Worker Assistance.
    The Committee is concerned by the Department's first 
solicitation for grant applications (SGA) under the President's 
Community Based Job Training initiative issued on May 3, 2005 
which restricts eligible applicants to community colleges. The 
Committee has on numerous occasions encouraged the Secretary to 
ensure that funds used for the Community Based Job Training 
Initiative strengthen partnerships between community colleges, 
employers, and local workforce investment boards. During the 
fiscal year 2005 budget hearings and in multiple communications 
with the Department, the Committee conveyed its interest in 
broad eligibility for application to the Community Based Job 
Training Initiative. Specifically, the Committee had made clear 
its interest that One Stop Career Centers be eligible to 
compete for these funds. The Committee is concerned that the 
Department has misunderstood or ignored the Committee's 
interest in including One Stop Career Centers as an eligible 
applicant for funding under the Community Based Job Training 
Initiative. Therefore, the Committee directs that future 
solicitations for grant applications for the Community Based 
Job Training initiative include One Stop Career Centers as an 
eligible applicant.
    Within the funds provided, the Committee encourages the 
Department of Labor to structure the Community Based Job 
Training initiative in a manner that allows community college 
to use federal funding to partner with a high school or career 
and technology center. Such partnerships would provide 
educational services to traditional and non-traditional 
students in a larger geographic area than would otherwise be 
served if the community college was not taking part in such a 
partnership.
    Technical Assistance: The Committee recommends $2,000,000. 
The funds recommended support the development of performance 
management systems, the provision of quality services, and 
promoting accountability and collaboration. This is $1,486,000 
below the fiscal year 2005 level and the same as the budget 
request.
    Rescissions: The Committee has included language rescinding 
$20,000,000 in unobligated Health Care Tax Credit Funds and 
$5,000,000 in unobligated funds provided for emergency response 
activities.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

    The Committee recommends $436,678,000 for community service 
employment for older Americans. This is the same as the fiscal 
year 2005 level and the budget request.
    The community service employment for older Americans 
program provides grants to public and private nonprofit 
organizations that subsidize part-time work in community 
service activities for unemployed persons aged 55 and older, 
whose family's annual income does not exceed 125 percent of the 
poverty level.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

    The Committee recommends $966,400,000. This is $90,900,000 
below the fiscal year 2005 level and the same as the budget 
request.
    The Trade Adjustment Assistance Program provides assistance 
to certified workers adversely affected by imports and trade 
with countries covered by the North America Free Trade 
Agreement. Funding will continue the implementation of the TAA 
program with an emphasis on integrating the program into the 
One-Stop System. The Trade Adjustment Assistance Reform Act of 
2002 increased the possibility of training and income support 
benefits.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

    The Committee recommends $3,470,366,000 for this account. 
This is $166,343,000 below the fiscal year 2005 level and the 
same as the budget request. Included in the total availability 
is $3,339,381,000 authorized to be drawn from the Employment 
Security Administration Account of the Unemployment Trust Fund 
and $130,985,000 to be provided from the general fund of the 
Treasury. The funds in this account are used to provide 
administrative grants and assistance to State agencies that 
administer Federal and State unemployment compensation laws and 
operate the public employment service.
    For Unemployment Insurance Services, the Committee 
recommends $2,632,915,000. This is $40,541,000 below the fiscal 
year 2005 level and the same as the budget request. The total 
includes $2,622,499,000 for State Operations and $10,416,000 
for national activities. Included in the amount provided for 
State Operations is up to $10,000,000 to station staff in One-
Stop Centers to conduct Unemployment Insurance eligibility 
interviews.
    The Committee suggests that the Department encourage states 
to consider supporting Rapid Reemployment Pilot demonstration 
programs that use an already-developed tool for building 
resumes over the phone to assist unemployment insurance 
claimants to quickly move back into the job market.
    For the Employment Service, the Committee recommends 
$696,000,000, which includes $23,300,000 in general funds 
together with an authorization to spend $672,700,000 from the 
Employment Security Administration Account of the Unemployment 
Trust Fund. This is $84,592,000 below the fiscal year 2005 
level and the same as the budget request.
    The Committee recommends $33,766,000 for ES national 
activities. This is $31,210,000 below the fiscal year 2005 
level and the same as the budget request.
    The Committee recommends $87,974,000 for America's Labor 
Market Information System. This is $10,000,000 below the fiscal 
year 2005 level and the same as the budget request. This 
funding supports core employment statistics, universal access 
for customers, improving efficiency in labor market 
transactions, and measuring and displaying WIA performance 
information.
    The Committee recommendation includes $19,711,000 for the 
Work Incentives Grants program, the same as the 2005 level and 
the budget request, to help persons with disabilities find and 
retain jobs through the One-Stop Career Center system mandated 
by the Workforce Investment Act. Funding will support systems 
building grants intended to ensure that One-Stop systems 
integrate and coordinate mainstream employment and training 
programs with essential employment-related services for persons 
with disabilities.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

    The Committee recommends $465,000,000. This is $52,000,000 
below the fiscal year 2005 level and the same as the budget 
request. The appropriation is available to provide advances to 
several accounts for purposes authorized under various Federal 
and State unemployment compensation laws and the Black Lung 
Disability Trust Fund, whenever balances in such accounts prove 
insufficient.

                         PROGRAM ADMINISTRATION

    The Committee recommends $206,111,000. This is $36,010,000 
below the fiscal year 2005 level and the same as the budget 
request. This includes $118,123,000 in general funds and 
authority to expend $87,988,000 from the Employment Security 
Administration Account of the Unemployment Trust Fund. Within 
the amounts provided, the Committee has included $6,993,000 for 
Executive Direction. This is $148,000 below the fiscal year 
2005 comparable level and the same as the request. General 
funds in this account provide the Federal staff to administer 
employment and training programs under the Workforce Investment 
Act of 1998, the Older Americans Act, the Trade Act, 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.

                     WORKERS COMPENSATION PROGRAMS

    The Committee rescinds $120,000,000 in unobligated 
emergency response funds as requested by the Administration.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

    The bill provides $137,000,000 for the Employee Benefits 
Security Administration, $5,787,000 above the fiscal year 2005 
level and the same amount as the budget request.
    The Employee Benefits Security Administration (EBSA) is 
responsible for the enforcement of Title I of the Employee 
Retirement Income Security Act of 1974 (ERISA) in both civil 
and criminal areas. This involves ERISA fiduciary and 
reporting/disclosure requirements. EBSA is also responsible for 
enforcement of sections 8477 and 8478 of the Federal Employees' 
Retirement Security Act of 1986. The agency was also given 
responsibilities under the Health Insurance Portability and 
Accountability Act of 1996.

                  Pension Benefit Guaranty Corporation

    The Corporation's budget for fiscal year 2005 is 
$296,978,000, which is $30,648,000 above the fiscal year 2005 
level and the same as the budget request.
    The Corporation is a wholly owned government corporation 
established by the Employee Retirement Income Security Act of 
1974 (ERISA). The law places it within the Department of Labor 
and makes the Secretary of Labor the chairperson of its board 
of directors. The Corporation receives its income from 
insurance premiums collected from covered pension plans, 
collections of employer liabilities imposed by ERISA, and 
investment earnings. It is also authorized to borrow up to 
$100,000,000 from the United States 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.
    The bill includes language permitting obligations in excess 
of the amount provided in the bill after approval by both the 
Office of Management and Budget as well as the Committee on 
Appropriations. The Committee has an interest in approving 
obligations that may change the total amount available to any 
agency.

                  Employment Standards Administration


                         SALARIES AND EXPENSES

    The bill includes $416,332,000 for this account. This is 
$15,485,000 above the fiscal year 2005 level and the same as 
the budget request. The bill includes $414,284,000 in general 
funds for this account and contains authority to expend 
$2,048,000 from the Special Fund established by the Longshore 
and Harbor Workers' Compensation Act.
    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, the Longshore and Harbor Workers' 
Compensation Act, and the Federal Mine Safety and Health Act 
(black lung). The agency also administers Executive Order 11246 
related to affirmative action by Federal contractors and the 
Labor-Management Reporting and Disclosure Act.

                            SPECIAL BENEFITS

    The bill includes $237,000,000. This is $4,000,000 below 
the fiscal year 2005 appropriation and the same as the budget 
request. This appropriation primarily provides benefits under 
the Federal Employees' Compensation Act (FECA). The payments 
are required by law. In fiscal year 2005, an estimated 155,000 
injured Federal workers or their survivors will file claims; 
55,500 will receive long-term wage replacement benefits for 
job-related injuries, diseases, or deaths.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

    The Committee recommends an appropriation of $232,250,000 
for special benefits for disabled coal miners. This is in 
addition to the $81,000,000 appropriated last year as an 
advance for the first quarter of fiscal year 2005, the same as 
the budget request. 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.
    The Committee recommends an advance appropriation of 
$74,000,000 for the first quarter of fiscal year 2006, the same 
as the budget request. These funds will ensure uninterrupted 
benefit payments to coal miners, their widows, and dependents.
    The Black Lung Consolidation of Administrative 
Responsibility Act of 2002 amends the Black Lung Benefits Act 
to transfer part B black lung benefits responsibility from the 
Commissioner of Social Security to the Secretary of Labor.

    ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 
                           COMPENSATION FUND

    The bill includes $96,081,000 for the Energy Employees 
Occupational Illness Compensation Program authorized by Title 
XXXVI of the National Defense Authorization Act of 2001. This 
is $55,760,000 above the fiscal year 2005 level and the same as 
the budget request. Funds will be used to administer the 
program that provides compensation to employees or survivors of 
employees of the Department of Energy (DOE), its contractors 
and subcontractors, companies that provided beryllium to DOE, 
and atomic weapons employees who suffer from a radiation-
related cancer, beryllium-related disease, or chronic silicosis 
as a result of their work in producing or testing nuclear 
weapons, and uranium workers covered under the Radiation 
Exposure Compensation Act.

                    BLACK LUNG DISABILITY TRUST FUND

    The bill includes $1,068,000,000 for this account. This is 
$6,031,000 above the comparable fiscal year 2005 level and the 
same as the budget request. The bill language provides such 
sums as may be necessary to pay for benefits.
    The Trust Fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operator can 
be assigned liability for such benefits, or when coal mine 
employment ceased prior to 1970, as well as administrative 
costs which are incurred in administering the benefits program 
and operating the Trust Fund.
    The basic financing for the Trust Fund comes from a coal 
excise tax for underground and surface-mines 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. 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

    The bill includes $477,199,000 for the Occupational Safety 
and Health Administration. This is $13,041,000 above the fiscal 
year 2005 level and $10,218,000 above the budget request. This 
agency is responsible for enforcing the Occupational Safety and 
Health Act of 1970 in the Nation's workplaces.
    The Committee directs OSHA to take no further action 
regarding respiratory protection for occupational exposure to 
TB until such time as the CDC has completed the ongoing 
revisions to the TB guidelines. The Committee further directs 
that upon completion of the TB guidelines OSHA should modify 
its rules so that OSHA respiratory regulations with regard to 
TB are not more strenuous than the CDC recommends. The 
Committee is disappointed that OSHA applied its general 
industry respiratory protection standard (GIRPS) to 
occupational exposure to tuberculosis (TB). Occupational 
exposure to TB is unique to healthcare facilities and currently 
is governed by the CDC's TB Guidelines, which, according to the 
CDC, have reduced the number of TB cases in the United States 
by over forty percent in recent years and controlled outbreaks 
in healthcare facilities. In light of this fact, and the CDC's 
Advisory Council for the Elimination of Tuberculosis' (ACET) 
letter urging OSHA not to apply the general industry 
respiratory standard to occupational exposure to TB, the 
Committee feels that this arbitrary regulation is unnecessarily 
burdensome for healthcare facilities, who have already shown 
success in reducing the number of TB cases.
    The Committee is once again disappointed with the lack of 
progress on the agency's regulation concerning Employer Payment 
for Personal Protective Equipment, the public comment period 
for which ended over six years ago. The Committee is especially 
concerned because the rate of worker deaths and injuries, which 
has decreased in the last decade for all American workers, has 
increased among Hispanic workers during that same time because 
they take on a disproportionate number of jobs in the nation's 
most dangerous professions, including the construction 
industry. Despite some recent promising trends in workplace 
injury and death rates for Hispanic workers, the Department 
cannot attribute the trends to better provision of personal 
protective equipment because the Department has not issued the 
regulation. The Committee expects the Secretary to report to 
the Committee, within 30 days of the enactment of the bill, the 
definitive status of this regulation, the agency's reasons for 
not issuing the regulation sooner, and a timetable for its 
issuance.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

    The bill includes $280,490,000 for this agency. This is 
$1,354,000 above the fiscal year 2005 comparable level and the 
same as the budget request. This agency enforces the Federal 
Mine Safety and Health Act in underground and surface coal and 
metal and non-metal mines.
    The Committee includes a provision granting authority for 
continued MSHA participation with the Holmes Safety Association 
to continue to promote miner safety and welfare.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

    The total funding recommended by the Committee for the 
Bureau of Labor Statistics (BLS) is $542,523,000. This is 
$13,520,000 above the fiscal year 2005 comparable level and the 
same as the budget request. The bill includes $464,678,000 in 
general funds for this account and authority to spend 
$77,845,000 from the Employment Security Administration Account 
of the Unemployment Trust Fund. The BLS is the principal fact-
finding agency in the Federal government in the broad field of 
labor economics. Its principal surveys include the Consumer 
Price Index and the monthly unemployment series.
    The Committee is aware of a report by the Government 
Accountability Office titled, ``Current Government Data Provide 
Limited Insight into Offshoring of Services'' that found that 
government data do not adequately capture business transactions 
that offshoring can encompass; and government data provide only 
limited information about the effects of offshoring on the U.S. 
employment and the U.S. economy. The Committee therefore 
encourages the Department of Labor to examine ways to improve 
data collection on the impact of offshore outsourcing on 
employment trends and the U.S. economy.

                 Office of Disability Employment Policy


                         SALARIES AND EXPENSES

    The bill includes $27,934,000 for the Office of Disability 
Employment Policy, which is $19,230,000 below the fiscal year 
2005 comparable level and the same as the budget request. The 
Office provides leadership to eliminate employment barriers to 
people with disabilities.

                        Departmental Management


                         SALARIES AND EXPENSES

    The bill includes $244,423,000 for Departmental Management 
activities. This is $76,265,000 below the fiscal year 2005 
level and the same as the budget request. The bill includes 
$244,112,000 in general funds for this account along with 
authority to transfer $311,000 from the Employment Security 
Administration Account of the Unemployment Trust Fund.
    The Departmental Management appropriation finances staff is 
responsible for formulating and overseeing the implementation 
of Departmental policy and management activities. 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 includes $29,504,000 for 
Executive Direction, $2,784,000 below the fiscal year 2005 
level and the same as the budget request.
    The bill provides $29,760,000 for the Department-wide 
information technology crosscut, the same as the fiscal year 
2005 comparable level and the budget request. The Committee 
commends the Department in streamlining its information 
technology infrastructure into a single, uniform system and 
encourages the Department in this effort.
    The bill provides $1,700,000 for the Departmental 
Management Crosscut. This is $3,260,000 below the fiscal year 
2005 level and the same as the budget request.
    The bill includes $33,197,000 for the Administration and 
Management program that provides leadership and policy guidance 
for a number of Department-wide activities. This is $783,000 
below the fiscal year 2005 level and the same as the budget 
request.
    The Committee is interested in ensuring that qualified job 
training programs of the Department of Labor fully extend 
priority of service for veterans as required by the Jobs for 
Veterans Act. Toward this effort, the Committee urges the 
Secretary to develop a guide for veterans in accessing 
workforce investment services; a guide for assisting veterans 
service organizations and homeless veteran service providers in 
accessing workforce investment funds and workforce investment 
planning processes; and a guide to inform workforce systems on 
the employment services needs of veterans and the 
responsibility of such systems to prioritize veterans for 
services and to collaborate with veterans' organizations and 
providers.
    The Committee urges the Secretary to instruct state 
workforce agencies to increase their outstationing of disabled 
veterans outreach program specialists and local veterans 
employment representatives in locations where homeless veterans 
congregate, including grantees under the homeless provider 
grant and per diem program and the homeless veterans 
reintegration program.
    The Committee is interested in better understanding the 
full impact of federal assistance programs, including the 
number of individuals who access multiple federal programs, 
either concurrently or during the course of their lifetime. As 
such, the Committee directs the U.S. Department of Labor to 
develop the infrastructure necessary to cross-reference 
individuals participating in multiple federal programs. As part 
of this effort, DOL is encouraged to partner with other federal 
agencies to develop common measures across all programs that 
will allow such cross-referencing to occur. The Department 
shall report to Congress, by March 1, 2006, on the status of 
this initiative, including a specific list of barriers that may 
preclude the agency from full compliance with this directive.
    The Committee directs that all financial service or other 
employee benefit products that are covered by the Employee 
Retirement Income Security Act (ERISA) carry the following 
warning, outlined in a box on the cover page, in nothing less 
than 16 point, bold Arial font:
    ``This product is covered by the Employee Retirement Income 
Security Act (ERISA). Under ERISA, recourse is greatly limited 
in disputes of service. It is the responsibility of the 
consumer to read all language pertaining to ERISA and/or 
consult with independent advisors prior to enrolling in this 
benefit plan.''
    The Committee is concerned about the implementation of the 
department's ``policy guidance'' pursuant to Executive Order 
13166, published on August 16, 2000, regarding limited English 
proficiency. The Committee feels it is important to keep track 
of the costs of this policy to make sure that the provision of 
language services is being done as cost effectively as 
possible. Therefore, the U.S. Department of Labor should report 
to the Committee the total funding spent on the provision of 
services in languages other than English, including 
publications costs, web site development and maintenance costs, 
outreach activities, translation activities, and language line 
contracts.

        ASSISTANT SECRETARY FOR VETERANS EMPLOYMENT AND TRAINING

    The Committee recommends $224,334,000 for veteran 
employment and training activities. This is $1,501,000 above 
the fiscal year 2005 level and the same as the budget request. 
Within this amount, the bill includes $194,834,000 to be 
expended from the Employment Security Administration account of 
the Unemployment Trust Fund for the traditional State and 
Federal administration of veterans' employment and training 
activities.
    Individuals leaving the military are at high risk of 
homelessness due to a lack of job skills transferable to the 
civilian sector, disrupted or dissolved family and social 
support networks, and other risk factors that preceded their 
military service. The Transition Assistance Program (TAP) has 
been established to ease the transition of separating service 
members to the civilian sector. The Committee instructs the 
Secretary of Labor to ensure that a module on homelessness 
prevention is added to the TAP curriculum. The module should 
include a presentation on risk factors for homelessness, a 
self-assessment of risk factors, and contact information for 
preventative assistance associated with homelessness.

                    OFFICE OF THE INSPECTOR GENERAL

    The bill includes $70,819,000 for the Office of the 
Inspector General (OIG). This is $1,824,000 above the fiscal 
year 2005 comparable level and the same as the budget request. 
This includes $65,211,000 in general funds for this account 
along with the authority to transfer $5,608,000 from the 
Employment Security Administration Account of the Unemployment 
Trust Fund.
    The 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 program of audits, 
investigations, 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.

                          Working Capital Fund

    The Committee includes $6,230,000 for a new core accounting 
system for the Department of Labor, including hardware and 
software infrastructure. This is $3,690,000 below the 
comparable fiscal year 2005 level and the same as the budget 
request.

                           General Provisions

    Sec. 101. The Committee continues a provision to prohibit 
the use of Job Corps funding for compensation of an individual 
at a rate in excess of Executive Level II.
    Sec. 102. The Committee modifies a provision permitting the 
Secretary of Labor to transfer up to one percent of any 
discretionary appropriation from an account.
    Sec. 103. The Committee includes a provision directing the 
Secretary to provide to the Department of Labor employees in 
the National Capital Region the full transit subsidy that they 
are eligible to receive.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES


              Health Resources and Services Administration


                     HEALTH RESOURCES AND SERVICES

    The bill includes $6,446,357,000 for health resources and 
services programs, which is $356,655,000 below the fiscal year 
2005 comparable level for these activities and $480,213,000 
above the budget request. This includes $500,000,000 that was 
previously provided in the Public Health and Social Services 
Emergency Fund for two bioterrorism programs administered by 
the Health Resources and Services Administration (HRSA)--
$472,479,000 for hospital preparedness grants and $27,521,000 
for education incentives for medical school curricula.
    HRSA supports programs which provide health services to 
disadvantaged, medically underserved, and special populations; 
decrease infant mortality rates; assist in the education of 
health professionals; and provide technical assistance 
regarding the utilization of health resources and facilities.

Community health centers

    The Committee provides $1,834,311,000 for community health 
centers, which is $100,000,000 above the fiscal year 2005 
comparable level and $203,560,000 below the budget request. 
These funds support programs which include community health 
centers, migrant health centers, health care for the homeless 
and public housing health service grants.
    The Committee includes bill language similar to previous 
years limiting the amount of funds available for the payment of 
claims under the Federal Tort Claims Act to $45,000,000, which 
is the same as the budget request and the limitation in the 
fiscal year 2005 bill.
    The Committee does not provide additional funds for loan 
guarantee authority for community health centers under section 
330(d) of the Public Health Service Act. The Committee notes 
that $105 million remains, of the $160 million appropriated in 
fiscal years 1997 and 1998, for loan guarantee authority for 
guarantees of both loan principal and interest.
    The Committee supports the long-standing HRSA policy of 
approving specific qualified applications for future funding. 
This process enables high-quality applicants to take steps to 
develop and implement care delivery systems in their 
communities instead of wasting scarce resources to reapply for 
funding. The Committee intends that HRSA should use $56,000,000 
of the funding provided above the fiscal year 2005 level for 
this purpose.
    The Committee provides $26,000,000 as requested by the 
Administration for a new initiative to fund health centers in 
approximately 40 high poverty counties across the country, as 
well as 25 planning grants. The Committee includes bill 
language requested by the Administration to direct this funding 
to high-poverty counties.
    The Committee encourages community health centers to make 
ultrasound services available to their patients.

Free clinics medical malpractice

    The Committee does not provide fiscal year 2006 funding for 
payments of claims under the Federal Tort Claims Act to be made 
available for volunteer free clinic health care professionals. 
$99,000 was provided for this purpose in fiscal year 2005 and 
claims are not expected against the fund until at least fiscal 
year 2007. The program extends Federal Tort Claims Act coverage 
to health care professional volunteers in free clinics in order 
to expand access to health care services to low-income 
individuals in medically underserved areas. According to Title 
42, Section 233(o), a free clinic must apply, consistent with 
the provisions applicable to community health centers, to have 
each health care professional `deemed' an employee of the 
Public Health Service Act, and therefore eligible for coverage 
under the Federal Tort Claims Act.

Radiation exposure compensation act

    The Committee provides $1,900,000 for the radiation 
exposure compensation act, which is $58,000 below fiscal year 
2005 comparable level and $36,000 below the budget request. 
This program provides grants for the education, prevention and 
early detection of radiogenic cancers and diseases resulting 
from exposure to uranium during its mining and milling at 
nuclear test sites.

Healthy community access program

    The Committee does not provide funding for the healthy 
community access program, which is $82,993,000 below the fiscal 
year 2005 comparable level and the same as the Administration 
request. The program was designed to increase the capacity and 
effectiveness of the variety of community health care 
institutions and providers who serve patients regardless of 
their ability to pay through development of community 
consortia. Congress has appropriated $541 million for this 
program since fiscal year 2000.

Hansen's disease services

    The Committee provides $16,066,000 for the Hansen's disease 
program, which is $1,185,000 below the fiscal year 2005 
comparable level and the same as the budget request. This 
program offers Hansen's disease treatment to 11 long-term 
residents who continue to receive care from the National 
Hansen's Disease Center and to others who receive care from 
grant-supported outpatient regional clinics. Other former long-
term residents have been offered and elected to receive a 
living allowance from the program and now live independently. 
These programs provide treatment to about 3,000 of the 6,000 
Hansen's disease sufferers in the continental United States.

Buildings and facilities

    The Committee provides $222,000 for buildings and 
facilities, which is $25,000 below fiscal year 2005 comparable 
level and the same as the budget request. These funds are used 
to finance the repair and upkeep of buildings at the Gillis W. 
Long Hansen's Disease Center at Carville, Louisiana.

Payment to Hawaii for treatment of Hansen's disease

    The Committee provides $2,016,000 for the treatment of 
persons with Hansen's disease in the State of Hawaii, which is 
$1,000 below the fiscal year 2005 comparable level and the same 
as the Administration request. The program, which provides a 
partial matching payment to the State of Hawaii, dates to the 
period of Father Damien's facility for sufferers of Hansen's 
disease. That facility now has only 40 residents who live there 
by choice, and the grounds have been converted to a historical 
site. Most patients diagnosed with Hansen's disease in Hawaii 
are now treated in the same manner as new patients on the 
mainland; their care is handled on an out-patient basis, with 
the program paying for 247 active ambulatory Hansen's Disease 
cases.

Black lung clinics

    The Committee provides $5,912,000 for black lung clinics, 
which is the $39,000 below the fiscal year 2005 comparable 
level and the same as budget request. The program supports 
fifteen grantees that treat a declining population of coal 
miners with respiratory and pulmonary impairments. The clinics 
presently receive more than one-third of their funding from 
other sources, such as Medicaid and Medicare. Of the fifteen 
grantees, six receive health center funding as well as black 
lung grants.

National Health Service Corps: Field placements

    The Committee provides $40,705,000 for field placements, 
which is $4,363,000 below the fiscal year 2005 comparable level 
and the same as the budget request. These funds are used to 
support the activities of National Health Service Corps (NHSC) 
obligors and volunteers in the field, including travel and 
transportation costs of assignees, training and education, 
recruitment of students, residents and clinicians and retention 
activities. Salary costs of most new assignees are paid by the 
employing entity.

National Health Service Corps: Recruitment

    The Committee provides $86,091,000 for recruitment 
activities, which is $289,000 below the fiscal year 2005 
comparable level and the same as the budget request. The 
program awards scholarships to health professions students and 
assists graduates in repaying their student loans. In return 
for every year of support, these individuals are obligated to 
provide a year of service in health professional shortage areas 
of greatest need. The minimum obligation is two years.
    The Committee believes that the inclusion of optometrists 
in the National Health Service Corps' (NHSC) Student Loan 
Repayment Program would result in the expanded accessibility of 
eye care in communities where it is most needed. Accordingly, 
the Committee encourages HRSA to take immediate steps to fully 
utilize Doctors of Optometry in the NHSC Student Loan Repayment 
Program as part of an effort to make preventive eye care 
services more accessible in community health centers within 
rural and urban primary care health professional shortage 
areas.

Health professions

    The Committee provides $197,119,000 for all health 
professions training programs, which is $253,094,000 below the 
fiscal year 2005 comparable level and $36,585,000 above the 
budget request. The Committee was unable to restore much of the 
$289,679,000 reduction in health professions funding proposed 
by the Administration, but the Committee felt it was especially 
important to support programs for disadvantaged students and 
nurse training programs. The table at the end of the report 
identifies how funding is allocated for programs authorized by 
titles VII and VIII of the Public Health Service Act.
    The Committee commends HRSA for its efforts to address the 
growing gap between the size of the Nation's aging baby boom 
population and the number of pulmonary/critical care 
physicians. The Committee is aware that HRSA has prepared a 
report on the healthcare workforce shortage issue, and that the 
portion of the report that will attempt to identify the causes 
of, and potential responses to, the critical care workforce 
shortage will be informed, in part, by The Critical Care 
Medicine Crisis: A Call for Federal Action prepared by the 
Critical Care Workforce Partnership. The Committee expects HRSA 
to provide a copy of this report to the Committee within 120 
days.

Centers of excellence

    The Committee provides $12,000,000 for centers of 
excellence, which is $21,609,000 below the fiscal year 2005 
comparable level. The Administration did not request funding 
for this program. The program is designed to strengthen the 
national capacity to educate underrepresented minority (URM) 
students in the health professions by offering special support 
to those institutions which train a significant number of URM 
individuals. Funds are used for the recruitment and retention 
of students and faculty, information resources and curricula, 
faculty and student research, and the development of plans to 
achieve institutional improvements.

Scholarships for disadvantaged students

    The Committee provides $35,128,000 for scholarships for 
disadvantaged students, which is $12,000,000 below the fiscal 
year 2005 comparable level and $25,297,000 above the budget 
request. The program provides grants to eligible health 
professions and nursing schools to provide scholarships to 
eligible individuals from disadvantaged backgrounds, including 
students who are members of racial and ethnic minority groups. 
By statute, not less than 16 percent of the funds must go to 
schools of nursing.

Advanced education nursing

    The Committee provides $57,637,000 for advanced education 
nursing, which is $523,000 below the fiscal year 2005 
comparable level and $14,831,000 above the budget request. The 
program provides grants and contracts to eligible entities to 
meet the costs of: (1) projects that support the enhancement of 
advanced nursing education and practice; and (2) traineeships 
for individuals in advanced nursing education programs. The 
program prepares nurse practitioners, clinical nurse 
specialists, nurse midwives, nurse anesthetists, nurse 
educators, nurse administrators, public health nurses or other 
nurse specialists for advanced practice roles. Within the 
allocation, the Committee encourages HRSA to allocate funding 
at least at the fiscal year 2001 level for nurse anesthetist 
education.

Nurse education, practice and retention

    The Committee provides $36,468,000 for nurse education, 
practice and retention, which is the same as fiscal year 2005 
comparable level and 9,857,000 below the budget request. As 
amended by the Nurse Reinvestment Act of 2002, the nurse 
education, practice and retention program is a broad authority 
with targeted purposes under three priority areas--education, 
practice and retention--in response to the growing nursing 
shortage.

Nursing workforce diversity

    The Committee provides $16,270,000 for nursing workforce 
diversity, which is the same as the fiscal year 2005 comparable 
level and $4,974,000 below the budget request. The program 
provides grants and contracts to schools of nursing and other 
eligible entities to meet the costs of special projects to 
increase nursing education opportunities for individuals who 
are from disadvantaged backgrounds, including racial and ethnic 
minorities, by providing student scholarships or stipends, pre-
entry preparation, and retention activities. The program also 
contributes to the basic preparation of disadvantaged and 
minority nurses for leadership positions within the nursing and 
health care community.

Loan repayment and scholarship program

    The Committee provides $31,369,000 for the nurse loan 
repayment and scholarship program, which is $113,000 below the 
fiscal year 2005 comparable level and the same as the budget 
request. This program offers student loan repayment to nurses 
or scholarships to nursing students in exchange for an 
agreement to serve not less than two years at a health care 
facility with a critical shortage of nurses.
    The Committee recognizes the ongoing nursing shortage 
crisis and believes that new strategies are needed to increase 
the numbers of nursing faculty to prepare the future nursing 
workforce. The Committee encourages the Secretary to designate 
schools of nursing as health care facilities for the purposes 
the Nurse Loan Repayment and Scholarship Program as authorized 
by the Public Health Service Act. The Committee further urges 
the Secretary to give increased consideration to eligible 
nurses in the loan repayment program with a commitment to 
working in a faculty setting.

Comprehensive geriatric nurse education

    The Committee provides $3,426,000 for comprehensive 
geriatric nurse education, which is $24,000 below the fiscal 
year 2005 comparable level and the same as the Administration 
request. The comprehensive geriatric education program supports 
grants for (1) providing training to individuals who will 
provide geriatric care for the elderly; (2) develop and 
disseminate curricula relating to the treatment of the health 
care problems of elderly individuals; (3) train faculty members 
in geriatrics; or (4) provide continuing education to 
individuals who provide geriatric care.

Nurse faculty loan program

    The Committee provides $4,821,000 for the nurse faculty 
loan program, which is $10,000 below the fiscal year 2005 
comparable level and the same as the Administration request. 
The nurse faculty loan program supports the development of a 
student loan fund in schools of nursing to increase the number 
of qualified nursing faculty. Students may receive loans up to 
$30,000 per year for a maximum of 5 years. The program has a 
cancellation provision for up to 85 percent of the loan for 
recipients working full-time as nursing faculty for a period of 
4 years.

Children's hospitals graduate medical education program

    The Committee provides $300,000,000 for the children's 
hospitals graduate medical education program, which is $730,000 
below the fiscal year 2005 comparable bill and $100,000,000 
above the budget request. The program provides support for 
health professions training in children's teaching hospitals 
that have a separate Medicare provider number (``free-
standing'' children's hospitals). The funding in this program 
is intended to make the level of Federal Graduate Medical 
Education support more consistent with other teaching 
hospitals, including children's hospitals which share provider 
numbers with other teaching hospitals. Payments are determined 
by formula, based on a national per-resident amount. Payments 
support training of resident physicians as defined by Medicare 
in both ambulatory and inpatient settings. The Committee 
believes this program is vital to restoring the reimbursement 
inequity faced by pediatric hospitals, which provide very high 
quality care to children with difficult and expensive 
conditions.

National practitioner data bank

    The Committee does not provide funding for the national 
practitioner data bank for fiscal year 2006, which is the same 
as both the fiscal year 2005 action on appropriations and the 
budget request. The Committee recommendation and the budget 
request assume that the data bank will be self-supporting, with 
collections of $15,700,000 in user fees. The national data bank 
receives, stores and disseminates information on paid medical 
malpractice judgments and settlements, sanctions taken by 
Boards of Medical Examiners, losses of membership in 
professional societies, and certain professional review actions 
taken by health care entities. Insurance companies, State 
licensure boards and authorities, and other health care 
entities and professional societies are required to report 
information to the data bank within 30 days of each action. The 
coverage of the data bank includes dentists and physicians, 
and, with respect to malpractice settlements and judgments, 
other categories of licensed health professionals. Hospitals 
are required to search the data bank when a health care 
provider applies for employment and once every two years 
thereafter. State licensing boards, other health care entities, 
licensing authorities, and professional societies also have 
access to the data bank. Traditional bill language is included 
to ensure that user fees are collected to cover the full costs 
of the data bank operations.

Health care integrity and protection data bank

    The Committee does not provide funding for the health care 
integrity and protection data bank (HIPDB) for fiscal year 
2006. The Committee recommendation and the budget request 
assume that the data bank will be self-supporting, with 
collections of $4,000,000 in user fees. HIPDB receives, stores, 
and disseminates information on final adverse actions taken 
against health care providers, suppliers, and practitioners, 
health care related civil judgments and criminal convictions. 
This information is collected from and made available to 
Government agencies and health plans.

Maternal and child health block grant

    The Committee provides $700,000,000 for the maternal and 
child health (MCH) block grant, which is $23,928,000 below both 
the fiscal year 2005 comparable level and the budget request.
    The MCH block grant provides funds to States to meet a 
broad range of basic and enabling health services, including 
personal health services; general, population-wide health 
services, such as screening; family support services; and 
integrated systems of care. The authorizing statute provides 
that, up to a funding level of $600,000,000, 85 percent of the 
funds are distributed to the States, with 15 percent of the 
funds set aside for special projects of regional and national 
significance (SPRANS). When the appropriation exceeds 
$600,000,000, 12.75 percent of the amount over $600,000,000 is 
directed to the Community Integrated Service Systems set-aside 
program. The remaining 87.25 percent is distributed by the same 
85/15 percent allocation as in the basic block grant formula.
    The Committee has included bill language identifying 
$116,124,000 for the SPRANS set-aside. Within that total, 
$5,000,000 is provided for the continuation of oral health 
programs in the States. Through grants, cooperative agreements 
or contracts, these funds may be used to increase access to 
dental care for the most vulnerable low-income children, such 
as Medicaid, SCHIP, and Head Start children and to implement 
state-identified objectives for improving oral health. 
Anticipated activities include those targeting the reduction of 
early childhood caries and strengthening school-linked dental 
sealant programs.
    The Committee has also provided $4,000,000 within the 
SPRANS set-aside to support the continuation of the community-
based sickle cell disease outreach and supportive service 
initiative.
    In addition, the Committee provides $3,000,000 within the 
SPRANS set-aside to continue the newborn screening for 
heritable disorders demonstrations begun two years ago. Newborn 
screening is used for early identification of infants affected 
by certain genetic, metabolic, hormonal or functional 
conditions for which there is effective treatment or 
intervention. Screening detects disorders in newborns that, 
left untreated, can cause death, disability, mental retardation 
and other serious illnesses. The Committee is aware that wide 
disparities exist on the number and types of conditions 
screened for in each State. The Committee commends HRSA for 
convening the Secretary's Advisory Committee on Heritable 
Disorders and Genetic Diseases in Newborns and Children to make 
national recommendations to standardize newborn screening 
programs in the U.S. The Committee encourages HRSA to use some 
of the funds provided for the development of parental and 
provider education material and programs to promote the 
importance of newborn screening.
    The Committee has also provided $3,000,000 within the 
SPRANS set-aside to continue epilepsy demonstration programs. 
These programs are designed to improve access to health and 
other services regarding seizures and to encourage early 
detection and treatment in children and others residing in 
medically underserved and rural areas. The Committee is pleased 
that HRSA has partnered with a national voluntary epilepsy 
agency to carry out these activities. Of the amount provided, 
the Committee recommends that up to thirty percent be used to 
continue to fund the development and testing of a national 
public health awareness campaign to increase seizure 
recognition and improve access to care among minorities and 
underserved populations.
    The Committee reiterates its long-standing support for the 
continuation of funding that Maternal and Child Health Block 
Grant has provided to comprehensive thalassemia treatment 
centers under the SPRANS program. The Committee strongly 
encourages HRSA to continue this program and to coordinate with 
the relevant voluntary organizations.
    The Committee is aware that some States have made 
reductions in MCH resources that are allocated for children 
with special health needs. The Committee encourages HRSA to 
continue to work with State MCH programs to assure the 
availability of services for children with special health care 
needs, including medical and support services to maintain their 
physical, mental and emotional health and development.
    The Committee recognizes the critical role of hemophilia 
treatment centers funded through the SPRANS set-aside in 
providing needed comprehensive care for persons with bleeding 
disorders and the expanded role of these centers in addressing 
the needs of women with bleeding disorders and persons with 
clotting disorders such as thrombophilia. The Committee 
encourages HRSA to continue its support of this model disease 
management network.
    The Committee recognizes the contributions of the 
longstanding Provider's Partnership program and encourages HRSA 
to continue its funding. The Partnership includes a series of 
state-level projects initiated to address female psychosocial 
issues through integration of medical care with psychosocial 
services. Such partnerships enhance service integration, 
minimize demands on individual providers, and facilitate 
movement between providers and agencies to create comprehensive 
care.

Sickle cell anemia demonstration program

    The Committee does not provide funding for the sickle cell 
anemia demonstration program, which is the same as the budget 
request and $198,000 less than the fiscal year 2005 comparable 
level. This program was funded for the first time in fiscal 
year 2005. The Committee has provided $4,000,000 within the 
Maternal and Child Health SPRANS funding for sickle cell 
demonstrations.

Traumatic brain injury

    The Committee provides $9,000,000 for the traumatic brain 
injury (TBI) program. This is $297,000 below the fiscal year 
2005 comparable level. The budget request did not fund the 
program. The TBI program funds the development and 
implementation of statewide systems to ensure access to care 
including prehospital care, emergency department care, hospital 
care, rehabilitation, transitional services, and long-term 
community support. Grants also go to State protection and 
advocacy systems.

Healthy Start

    The Committee provides $97,747,000 for Healthy Start, which 
is $4,796,000 below the fiscal year 2005 comparable level and 
the same as the budget request. Healthy Start provides grants 
to select communities with high rates of infant mortality to 
help them identify, plan, and implement a diverse range of 
community-driven strategies that can successfully reduce 
disparities in perinatal health that contribute to the Nation's 
high infant mortality rate.
    Since 1990, the Maternal and Child Health Bureau has worked 
in cooperative agreement to run the National Fetal Infant 
Mortality Review (NFIMR) program. NFIMR provides training and 
assistance to enhance cooperative partnerships among local 
community health professionals, public health officers, 
community advocates and consumers to reduce infant mortality. 
The goal is to improve local services and resources for women, 
infants and families, to remove barriers to care, and to ensure 
culturally appropriate, family friendly services. Such efforts 
are crucial to understanding and addressing infant health 
disparities in communities at highest risk. The Committee 
encourages HRSA to continue to use Healthy Start funds to 
support the NFIMR project.

Universal newborn hearing screening

    The Committee provides $10,000,000 for the universal 
newborn hearing screening program, which is $208,000 above the 
fiscal year 2005 comparable level. The Administration did not 
request funding for this program. The program provides 
competitive grants to States for universal newborn hearing 
screening by means of physiologic testing prior to hospital 
discharge, audiologic evaluation by three months of age, and 
entry into a program of early intervention by six months of 
age.
    Currently, 52 states and territories have received 
competitive grants for the purpose of implementing statewide 
early hearing detection and intervention (EHDI) programs. Since 
these grants have only been operational for a few years, the 
Committee believes that a small amount of continued Federal 
funding is critical at this time to ensure that state EHDI 
programs become fully operational and that screening programs 
are properly linked with diagnosis, early intervention, and the 
child's routine medical care (often referred to as the child's 
medical home). The Committee is concerned that even though 
approximately 90 percent of babies are now screened for hearing 
loss before 1 month of age, about one-third of those who are 
referred from screening do not receive diagnostic evaluations 
by 3 months of age. Moreover, only about half of the infants 
and toddlers diagnosed with permanent hearing loss are enrolled 
in appropriate early intervention programs by 6 months of age.
    The Committee has provided an increase to: (a) enable 
states to institutionalize the State EHDI programs developed 
during the last 3-5 years; (b) increase the availability of 
qualified pediatric audiologists; (c) educate health care 
providers and families about the importance and procedures for 
EHDI; (d) strengthen linkages between EHDI and early 
intervention programs funded by Part C of IDEA; (e) continue 
and expand the National EHDI Technical Assistance System; (f) 
evaluate the impact of statewide EHDI programs; and (g) 
increase the capacity of states to screen children for 
progressive and late-onset hearing losses. To minimize the loss 
to follow-up, the Committee urges HRSA to ensure that all 
infants identified through the screening process are linked to 
an identifiable and ongoing source of routine health care.
    To avoid duplication, the Committee expects HRSA to 
coordinate projects funded with this appropriation with 
projects related to early hearing detection and intervention by 
the National Center on Birth Defects and Developmental 
Disabilities, the National Institute on Deafness and Other 
Communication Disorders, the National Institute on Disability 
and Rehabilitation Research, and the Office of Special 
Education and Rehabilitative Services.

Emergency medical services for children

    The Committee provides $19,000,000 for the Emergency 
Medical Services for Children (EMSC) program, which is $830,000 
below the fiscal year 2005 comparable level. The Administration 
did not request funding for the program. The Committee 
recognizes that this program is the only Federal source of 
funding and expertise for improving EMS systems for children. 
The Committee commends the EMSC program for its twenty years of 
achievement in this arena and applauds its commitment to 
improving the delivery of emergency medical services to ill and 
injured children.

Poison control centers

    The Committee provides $23,301,000 for poison control 
centers, which is $198,000 below the fiscal year 2005 
comparable level and the same as the Administration request. 
These funds support a grant program for poison control centers. 
In addition, funds are used to maintain a national toll-free 
number and to implement a media campaign to advertise that 
number, as well as to support the development of uniform 
patient management guidelines and the improvement of data 
collection.

Ryan White AIDS programs

    The Committee provides $2,058,296,000 for Ryan White AIDS 
programs, which is $10,000,000 above the fiscal year 2005 
comparable level and the same as the budget request. The bill 
also makes available $25,000,000 in program evaluation funding 
under section 241 of the Public Health Service for special 
projects of national significance. Within the total provided, 
the Committee expects that Ryan White AIDS activities that are 
targeted to address the growing HIV/AIDS epidemic and its 
disproportionate impact upon communities of color, including 
African Americans, Latinos, Native Americans, Asian Americans, 
Native Hawaiians, and Pacific Islanders will be supported at no 
less than the fiscal year 2005 level.
    The Committee is aware that over thirty percent of HIV-
infected persons in the United States are also chronically 
infected with the hepatitis C virus (HCV). Chronic hepatitis C 
infection may lead to cirrhosis of the liver and liver cancer, 
and is the leading cause of liver transplantation in the U.S. 
In addition, chronic hepatitis C disease progresses more 
rapidly in HIV-infected persons, and end stage liver disease 
resulting from chronic hepatitis C infection is now a leading 
cause of death for people with HIV/AIDS. The Committee 
encourages HRSA to provide guidance to CARE Act grantees to 
encourage them to proactively address HCV care and treatment 
among their HIV/HCV co-infected patient populations, and 
encourages State AIDS Assistance Programs to provide coverage 
of therapies approved by the FDA for the treatment of HCV in 
HIV/HCV co-infected patients.

Emergency assistance

    The Committee provides $610,094,000 for the Part A, 
emergency assistance program, which is the same as the fiscal 
year 2005 comparable level and the budget request. These funds 
provide grants to metropolitan areas with very high numbers of 
AIDS cases for outpatient and ambulatory health and social 
support services. Half of the amount appropriated is allocated 
by formula and half is allocated to eligible areas 
demonstrating additional need through a competitive grant 
process.

Comprehensive care programs

    The Committee provides $1,131,836,000 for Part B, 
comprehensive care programs, which is $10,000,000 above the 
fiscal year 2005 comparable level and the same as the budget 
request. The funds provided support formula grants to States 
for the operation of HIV service delivery consortia in the 
localities most heavily affected, for the provision of home and 
community-based care, for continuation of health insurance 
coverage for infected persons, and for purchase of therapeutic 
drugs. The Committee has included bill language identifying 
$797,521,000 specifically to support State AIDS Drug Assistance 
Programs (ADAP) as requested by the Administration. In fiscal 
year 2005, $787,521,000 was designated for this purpose.
    The Committee is aware of the success HIV therapies have 
had on prolonging and enhancing the quality of life for those 
infected with HIV/AIDS. As the infected population lives longer 
and becomes increasingly resistant to current treatment 
regimens, there is a growing need to focus on access to newer 
therapies for treatment-experienced or ``later stage'' 
patients. The Committee encourages HRSA and state ADAPs to 
prioritize coverage of treatments for later stage patients so 
that there is parity of access to effective treatments for 
patients across the HIV disease spectrum.

Early intervention program

    The Committee provides $195,578,000 for Part C, the early 
intervention program, which is the same as the fiscal year 2005 
comparable level and the budget request. Funds are used for 
discretionary grants to migrant and community health centers, 
health care for the homeless grantees, family planning 
grantees, hemophilia centers and other private non-profit 
entities that provide comprehensive primary care services to 
populations with or at risk for HIV disease. The grantees 
provide testing, risk reduction counseling, transmission 
prevention, and clinical care; case management, outreach, and 
eligibility assistance are optional services.

Pediatric HIV/AIDS

    The Committee provides $72,519,000 for Part D, pediatric 
AIDS demonstrations, which is the same as the fiscal year 2005 
comparable level and the budget request. The program supports 
demonstration grants to foster collaboration between clinical 
research institutions and primary community-based medical and 
social service providers for the target population of HIV-
infected children, pregnant women and their families. The 
projects are intended to increase access to comprehensive care, 
as well as voluntary participation in NIH and other clinical 
trials.

AIDS dental services

    The Committee provides $13,218,000 for AIDS dental 
services, which is the same as the fiscal year 2005 comparable 
level and the budget request. The program provides 
reimbursements to dental schools and postdoctoral dental 
education programs to assist with the cost of providing 
unreimbursed oral health care to patients with human 
immunodeficiency virus disease. Dental students and residents 
participating in this program receive extensive training in the 
understanding and management of the oral health care needs of 
people living with HIV/AIDS.

Education and training centers

    The Committee provides $35,051,000 for AIDS education and 
training centers (AETCs), which is the same as the fiscal year 
2005 comparable level and the budget request. The centers train 
health care personnel who care for AIDS patients and develop 
model education programs.

Telehealth

    The Committee provides $3,888,000 for telehealth, which is 
$28,000 below the fiscal year 2005 comparable level and the 
same as the budget request. The telehealth program works with 
and supports communities in their efforts to develop cost-
effective uses of telehealth technologies. These technologies 
bring health services to populations that are isolated from 
health care, and health-related education to the practitioners 
who serve them.

Organ transplantation

    The Committee provides $23,282,000 for organ 
transplantation activities, which is $1,131,000 below the 
fiscal year 2005 comparable level and same as the budget 
request. The program supports a scientific registry of organ 
transplant recipients; the National Organ Procurement and 
Transplantation Network, which matches organ donors with 
potential recipients; and grants and contracts with public and 
private non-profit organizations to promote and improve organ 
donation. Several of the new authorities created in the Organ 
Donation Recovery and Improvement Act are funded in the 
Administration request, including demonstration grants for 
reimbursement of travel and subsistence expenses toward living 
organ donation.
    The Committee encourages the Administration to provide 
priority consideration to hospitals serving rural, medically 
underserved communities and those who have a long history of 
transplant surgery but whose accreditation is in jeopardy due 
to their declining number of transplant surgeries.
    The Committee is encouraged by the continuing success of 
the Organ Donation Breakthrough Collaborative and has included 
funds for its continuation, as requested by the Administration. 
This project is focused on increasing organ donation consent 
rates among the nation's hospitals where the greatest number of 
donors exist. As a result, an additional 4,000 organs annually 
are expected to be made available for transplant.
    The Committee commends HRSA for its leadership in promoting 
increased organ and tissue donations across the nation and 
encourages the Division of Transplantation to continue its 
partnership with the pulmonary hypertension (PH) community in 
this important area. Moreover, the Committee encourages the 
Organ Procurement and Transplantation Network/United Network 
for Organ Sharing to continue to work with the PH community to 
address concerns regarding the methodology used to determine 
transplantation eligibility for PH patients.

Cord blood bank

    The Committee does not provide additional funding for the 
cord blood program pending the HRSA response to the Institute 
of Medicine report on the structure and administration of such 
a program. $19,800,000 was provided for this purpose in fiscal 
years 2004 and 2005, to remain available until expended. The 
Administration budget did not request funding for fiscal year 
2006.

Bone marrow program

    The Committee provides $25,416,000 for the bone marrow 
program, which is the same as the fiscal year 2005 comparable 
level and $2,500,000 above the budget request. In addition to 
funding from HRSA in fiscal year 2006, the National Marrow 
Donor Program (NMDP) is expected to receive $17,500,000 from 
the U.S. Navy. Funds are used for donor medical costs, donor 
centers, tissue typing, research, minority recruitment, and 
program administration. The Committee recognizes the important 
life-saving role of the Registry in the lives of thousands of 
Americans. The NMDP, which operates the Registry through a 
contract with HRSA, has facilitated more than 20,000 
transplants since its inception. The Committee understands that 
the Registry lists three sources of blood forming non-embryonic 
stem cells used in transplantation: marrow and peripheral blood 
from adult donors, and umbilical cord blood units. The NMDP now 
lists 5,500,000 potential volunteer, adult donors of marrow and 
peripheral blood stem cells on the Registry. In addition, 17 of 
the 20 public cord blood banks are, or have applied to be, NMDP 
network members. The Committee strongly urges the NMDP to 
continue innovative, technological, and scientific advances in 
non-embryonic cell therapies that have the potential to help 
some of the hundreds of thousands of Americans with leukemia or 
other life threatening blood diseases. The Committee also 
strongly encourages the NMDP to continue the expansion of the 
Registry through its umbilical cord blood program to reduce 
racial and ethnic disparities and improve access for all 
Americans for this lifesaving therapy. The Committee encourages 
the NMDP to implement an education effort on the use of 
umbilical cord blood from all sources to increase donation and 
awareness of this resource. In addition, the Committee supports 
the NMDP's important and expanding role in conducting and 
supporting research to improve the availability, efficiency, 
safety, and cost of transplants and the effectiveness of 
Registry operations; maintaining and expanding its medical 
emergency contingency response capabilities for national 
security; and increasing donor and patient outreach programs, 
especially for minorities and medically underserved population 
groups.

Trauma care

    The Committee does not provide funding for the trauma care 
program, which is the same as the Administration request and 
$3,418,000 below fiscal year 2005 comparable level. The program 
has provided small grants to States to establish State offices 
to coordinate trauma systems within the States. Almost $17 
million has been provided for these State grants in the past 
five years.

State planning grants for health care

    The Committee does not provide funding for state planning 
grants, which is $10,910,000 below the fiscal year 2005 
comparable level. The Administration did not request funding 
for this program. The program has made grants to States to 
gather and analyze information on problems of access to health 
insurance within the State and to develop plans for providing 
access to affordable health insurance coverage to all their 
residents. Almost $71 million has been provided for this 
demonstration program in the last five years.

Rural outreach grants

    The Committee provides $10,767,000 for rural outreach 
grants, which is $28,511,000 below the fiscal year 2005 
comparable level and the same as the budget request. The 
program supports projects that provide health services to rural 
populations not currently receiving them and that enhance 
access to existing services.

Rural health research

    The Committee does not provide funding for rural health 
research, which is $8,825,000 below the fiscal year 2005 
comparable level and $8,528,000 below the budget request. This 
activity supports several rural health research centers and the 
Secretary's rural health advisory committee.

Rural hospital flexibility grants

    The Committee provides $39,180,000 for rural hospital 
flexibility grants, which is the same as the fiscal year 2005 
comparable level and $39,180,000 above the budget request. The 
program is comprised of two components: (1) flexibility grants 
to States to assist small, at risk rural hospitals that wish to 
convert to Critical Access Hospitals and receive cost-based 
payments from Medicare and (2) small hospital improvement 
grants that provide modest amounts to hospitals to assist them 
in automation and compliance with confidentiality requirements. 
Funding is to be allocated between the two programs consistent 
with the fiscal year 2005 distribution.

Rural and community access to emergency devices

    The Committee provides $1,960,000 for the public access 
defibrillation demonstration grant program, which is $6,967,000 
below the fiscal year 2005 comparable level and the same as the 
budget request. The program assists both urban and rural 
communities in increasing survivability from sudden cardiac 
arrest by providing funding for the purchase, placement, and 
training in the use of automated external defibrillators 
(AEDs).

Rural EMS

    The Committee does not provide funding for the new rural 
emergency training and equipment assistance program, which is 
$496,000 lower than the fiscal year 2005 comparable level and 
the same as the budget request. The Committee does not believe 
the program at its current level can provide adequate 
assistance nationwide and believes there are other emergency 
programs funded in the bill that can address some of these 
problems in rural areas.

State offices of rural health

    The Committee provides $8,223,000 for State offices of 
rural health, which is $98,000 below the fiscal year 2005 
comparable level and the same as the budget request. The State 
office of rural health program creates a focal point for rural 
health within each of the fifty States. In each State, the 
office collects and disseminates information on rural health, 
coordinates rural health resources and activities, provides 
technical assistance to rural providers and communities, and 
helps communities recruit and retain health professionals.

Denali Commission

    The Committee has not included funding for the Denali 
Commission, which is $39,680,000 below the fiscal year 2005 
comparable level and the same as the budget request.

Family planning

    The Committee provides $285,963,000 for the family planning 
program, which is the same as the fiscal year 2005 comparable 
level and the budget request. The program provides grants to 
public and private non-profit agencies to support a range of 
family planning and reproductive services, as well as related 
preventive health services such as patient education and 
counseling, breast and cervical cancer examinations, STD and 
HIV prevention education, counseling and testing and referral, 
and pregnancy diagnosis and counseling. The program also 
supports training for providers, an information and education 
program, and a research program which focuses on family 
planning service delivery improvements. The Committee 
encourages HRSA to work with CDC to implement HIV/AIDS testing 
and counseling as a part of the services provided in family 
planning centers.
    The bill repeats language from the 2005 appropriations bill 
making clear that these funds shall not be expended for 
abortions, that all pregnancy counseling shall be nondirective, 
and that these funds shall not be used to promote public 
opposition to or support of any legislative proposal or 
candidate for public office.

Health care facilities and other programs

    The Committee has not provided funding for health care 
facilities. A total of $482,729,000 was provided for this 
purpose in fiscal year 2005; no funding was included in the 
budget request. This program provides funds to public and 
private nonprofit entities for construction or modernization of 
outpatient medical facilities.

Bioterrorism hospital grants to States

    The Committee provides $500,000,000 for bioterrorism 
hospital grants to States. The Administration requested 
$510,000,000 for this program in the Public Health and Social 
Services Emergency Fund. Within this total, $472,479,000 is 
provided for hospital preparedness grants and $27,521,000 is 
provided for education incentives for medical school 
curriculum. The Committee intends that these bioterrorism 
activities continue to be coordinated with those in other parts 
of HHS and directs HRSA to work with the Office of the 
Secretary in the development of the Department-wide operating 
plan requested in the Public Health and Social Services 
Emergency Fund section of this report.
    The Committee includes $8,000,000 as requested by the 
Administration within the hospital grants program to continue 
the credentialing emergency system for advance registration of 
volunteer health professionals. The Committee directs HRSA to 
explore expansion of this program to provide cross-State 
information on volunteer health professionals. The Committee 
believes expansion of this ongoing program is preferable to the 
proposed new credentialing program within the Office of the 
Secretary and does not provide funding for that effort.

Program management

    The Committee provides $145,992,000 for the cost of Federal 
staff and related activities to coordinate, direct and manage 
the programs of the Health Resources and Services 
Administration, which is $1,088,000 below the comparable fiscal 
year 2005 level and the same as the budget request.

               HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

    The Health Education Assistance Loans (HEAL) program 
insured loans provided by non-Federal lenders to students in 
health professions schools. Under the accounting rules 
established in the Budget Enforcement Act of 1990, one account 
is maintained to pay the obligations arising from loans 
guaranteed prior to fiscal year 1992. A second account pays 
obligations and collects income from premiums on loans 
guaranteed in fiscal year 1992 and beyond. Each annual cohort 
of loans is independently tracked in this account. The 
authority for this program expired in fiscal year 1999. Fiscal 
year 1998 was the last year in which loans were obligated to 
previous borrowers under the HEAL authority.
    The Committee provides $4,000,000 to liquidate obligations 
from loans guaranteed prior to 1992, which is the same as 
fiscal year 2005 level and the budget request.
    The Committee provides $2,916,000 for HEAL program 
management, which is $328,000 below the fiscal year 2005 
comparable level and the same as the budget request.

              NATIONAL VACCINE INJURY COMPENSATION PROGRAM

    The Committee makes available the release of $74,384,000 
from the Vaccine Injury Compensation Trust Fund in fiscal year 
2006, which is $5,233,000 above the fiscal year 2005 level and 
$668,000 above the budget request.
    The National Vaccine Injury Compensation Program provides a 
system of compensation for individuals with vaccine-associated 
injuries or deaths. Funds for claims from vaccines administered 
on or after October 1, 1988 are generated by a per-dose excise 
tax on the sale of selected prescribed vaccines. Revenues 
raised by this tax are maintained in a Vaccine Injury 
Compensation Trust Fund.
    Trust funds made available in the bill will support the 
liability costs of vaccines administered after September 30, 
1988. They will also support the $3,500,000 in costs incurred 
by the agency in the operation of the program, which is 
$349,000 above the comparable fiscal year 2005 level and 
$668,000 above the budget request.

                      Centers for Disease Control


                 DISEASE CONTROL, RESEARCH AND TRAINING

    The Committee provides a program level of $6,103,786,000 
for the Centers for Disease Control and Prevention (CDC), which 
is $294,781,000 below the fiscal year 2005 comparable level and 
$181,000,000 above the comparable request. Of the funds 
provided, $157,795,000 shall be derived from evaluation set-
aside funds available under Section 241 of the Public Health 
Service Act, as proposed in the request.
    The Committee notes that it has included the $1,616,723,000 
requested for CDC Terrorism Preparedness and Response within 
this account. These funds were provided in fiscal year 2005, 
and requested by the President for fiscal year 2006, within the 
Public Health and Social Services Emergency Fund.
    The budget request included an information technology 
reduction of $10,000,000, which is realized in project-specific 
areas across CDC's budget. The Committee recommendation assumes 
the realization of these savings, including the reduction of 
$4,903,000 in information technology efficiencies within HIV/
AIDS, STD and TB Prevention activities within Infectious 
Diseases.
    The CDC assists State and local health authorities and 
other non-governmental health-related organizations to 
understand, control, and reduce disease and other health 
problems affecting their people and communities. The activities 
of CDC focus on several major priorities, including providing 
core public health functions, responding to urgent health 
threats, monitoring the Nation's health using scientific 
methods, building the Nation's public health infrastructure to 
insure our national security against bioterrorist threats, 
promoting health throughout each life-stage, and providing 
leadership in the implementation of nationwide prevention 
strategies to encourage responsible behavior and adoption of 
lifestyles that are conducive to good health.
    The Committee considers the table accompanying this report 
and the numbers identified in the paragraphs that follow to be 
determinative of the CDC budget. Funds should be apportioned 
and allocated accordingly, and any changes in funding are 
subject to the normal reprogramming and notification 
procedures.

                          INFECTIOUS DISEASES

    The Committee provides a program level of $1,717,323,000 
for infectious diseases, which is $34,434,000 above the fiscal 
year 2005 comparable level and $7,565,000 above the request. Of 
the funds provided, $12,794,000 shall be derived from 
evaluation set-aside funds available under Section 241 of the 
Public Health Service Act, as proposed in the request.

Infectious diseases control

    The Committee provides $229,471,000 for infectious diseases 
control, which is $3,882,000 above the fiscal year 2005 
comparable level and $4,710,000 above the request.
    The program supports national surveillance of infectious 
diseases, the development of new or improved prevention and 
control methods and techniques, the acceleration of the general 
application of accepted prevention technologies, and 
strengthening of the capability to respond to outbreaks of new 
and re-emerging infectious diseases.
    Botulinum Neurotoxin Research.--The Committee understands 
that botulinum neurotoxin is one of the most toxic substances 
known to mankind and that a recent technological breakthrough, 
using fluorescent sensors, may for the first time enable the 
detection of neurotoxin activity in a person's body and in 
living cells on a near real-time basis. The Committee 
encourages CDC to evaluate, develop, and validate the 
fluorescence resonance energy transfer assay for the detection 
of botulinum toxins to meet its mission requirements, and to 
incorporate it into its bioterrorism preparedness program. The 
Committee also encourages CDC to continue to investigate new 
and advanced methods for measuring botulinum toxins and other 
toxins using mass spectrometry.
    Emerging Infectious Diseases.--The Committee provides 
$102,650,000 to support CDC's emerging infectious disease 
activities, which is $3,498,000 above fiscal year 2005.
    Hepatitis.--The Committee has included $17,912,000 to 
support activities of the Viral Hepatitis Division and to 
implement the National Hepatitis C Prevention Strategy. The 
Committee urges that this funding be focused on supporting the 
capability of state health departments, particularly to 
maintain resources available to the hepatitis C state 
coordinators.
    The Committee is concerned that more than 75% of the 4 
million HCV positive individuals are unaware of their condition 
and therefore urges a public education campaign to urge 
appropriate screening and medical follow up of target 
populations. The Committee also is concerned with increasing 
rates of adult infections of Hepatitis A & B and urges an 
expanded vaccination program be launched in response to this 
critical public health issue. Finally, CDC is encouraged to 
focus on education and awareness programs targeted at specific 
populations where there is a high prevalence of hepatitis B and 
where therapeutic interventions are increasingly effective.
    Meningococcal Disease.--Meningococcal disease is one of the 
few diseases that can be fatal or severely debilitating to a 
victim within a matter of hours of initial onset and yet is 
vaccine-preventable in most cases. The Committee is aware of 
the recent improvements in the meningitis vaccine and of recent 
CDC efforts to increase the availability and focus of 
information on meningococcal disease and ways to prevent it so 
that the general public will be better educated on the symptoms 
and prevention methods. The Committee encourages the CDC to 
improve meningicocccal education and adolescent immunization 
programs, including giving consideration to partnering with 
relevant professional and voluntary health associations to 
ensure that all families, especially those with adolescents and 
young adults, are effectively educated on this disease, vaccine 
availability, and all methods of prevention.
    Prion Disease.--Within the funds provided, not less than 
$5,500,000 is for activities related to Prion diseases, 
including the work of the National Prion Disease Pathology 
Surveillance Center.
    Sepsis.--The Committee is aware that sepsis kills more than 
215,000 Americans every year. Despite new, increasingly 
effective treatments and a new diagnosis protocol, sepsis 
remains a leading cause of death because too few medical 
personnel know how to identify and diagnose it. The Committee 
applauds the CDC's ongoing demonstration program to reduce 
hospital-based transmission of sepsis and other infections, but 
recognizes that significant reductions in morbidity and 
mortality could be achieved through improved, timely diagnosis 
and treatment. Within the funds provided, the Committee 
encourages CDC to consider establishing an education program to 
train critical care nurses, emergency room physicians, and 
infectious disease specialists, especially those in rural and 
traditionally underserved areas, in use of the new protocol to 
identify sepsis and improve patient outcomes. The Committee 
encourages CDC to work towards this end in collaboration with 
the relevant voluntary health organizations, such as the 
American Sepsis Alliance.
    West Nile Virus.--Within the funds provided, not less than 
$37,809,000 is for activities to detect, prevent and control 
the West Nile Virus.

HIV/AIDS, STD and TB prevention

    The Committee provides $956,138,000 for HIV/AIDS, STD and 
TB prevention, which is $4,573,000 below the fiscal year 2005 
comparable level and $145,000 below the request. Of the amount 
provided, $657,694,000 is for HIV/AIDS programs (the same as 
the request); $159,633,000 is for the STD program; and 
$138,811,000 is for the TB program. The Committee 
recommendation assumes the $4,903,000 in information technology 
savings proposed in the budget within HIV/AIDS, STD and TB 
Prevention activities.
    The HIV/AIDS programs support HIV research, surveillance, 
epidemiologic and laboratory studies, and prevention 
activities. CDC provides funds to state and local health 
departments to develop and implement integrated community 
prevention plans. The STD program awards grants to state and 
local health departments and other nonprofit entities to 
support a wide variety of public health activities to prevent 
and treat STDs. CDC directly conducts special investigations, 
surveillance and epidemiologic research. The tuberculosis 
program provides grants to States and large cities for a broad 
range of tuberculosis control activities. In addition, the CDC 
supports state and local laboratories and conducts research, 
epidemiological investigations, and education and training 
seminars.
    Minority HIV/AIDS Initiative.--Within the total provided, 
not less than the fiscal year 2005 amount is provided for 
activities that are targeted to address the growing HIV/AIDS 
epidemic and its disparate impact on communities of color, 
including African Americans, Latinos, Native Americans, Asian 
Americans, Native Hawaiians, and Pacific Islanders.
    Partner Notification.--The Committee supports CDC's efforts 
to require state, territorial, and municipal grantees of HIV/
AIDS prevention programs to conduct partner counseling and 
referral services of newly diagnosed individuals, with strong 
linkages to prevention and care services. The Committee 
understands that all states, territories, and large cities with 
HIV/AIDS prevention cooperative agreements with CDC must 
provide partner notification and counseling services. The 
Committee encourages CDC to ensure that all grantees are in 
compliance with this requirement.
    Tuberculosis.--The Committee understands that the CDC plans 
to undertake a new initiative, the Intensified Support and 
Activities to Accelerate Control (ISAAC). ISAAC targets 
tuberculosis in African Americans, tuberculosis along the U.S./
Mexico border, allows for universal genotyping of all culture 
positive TB cases, and expands clinical trials for new tools 
for the diagnosis and treatment of TB. The Committee encourages 
the CDC to implement ISSAC to enhance and maximize strategies 
to accelerate the control and elimination of TB.
    Tuberculosis is an enormous public health crisis in the 
developing world, killing millions of people in the prime of 
their lives every year. To help stem this growing pandemic, the 
Committee encourages CDC to enhance ongoing efforts involving 
the TB vaccine research cooperative agreement.

Immunization

    The Committee provides a program level of $531,714,000 for 
immunization, which is $38,126,000 over the fiscal year 2005 
comparable level and $3,000,000 above the request. Of the 
amount provided, $12,794,000 is to be derived from section 241 
evaluation set-aside funds, as proposed in the request. In 
addition, the Vaccines for Children (VFC) program is expected 
to provide $1,502,333,000 in vaccine purchases and distribution 
support in fiscal year 2005, for a total of $2,034,047,000 for 
immunization activities in fiscal year 2006.
    Immunization project grants are awarded to States and local 
agencies for planning, developing, and conducting childhood 
immunization programs including enhancement of the vaccine 
delivery infrastructure. CDC directly maintains a stockpile of 
vaccines, supports consolidated purchase of vaccines for state 
and local health agencies, and conducts surveillance, 
investigations, and research into the safety and efficacy of 
new and presently used vaccines. The Committee notes that there 
are other Federal programs that provide immunizations to 
children, including the State Children's Health Insurance 
Program (SCHIP), the Maternal and Child Health Block Grant, and 
community health centers.
    Immunization Safety.--The committee commends the CDC for 
moving the Immunization Safety Branch (ISB) out from under the 
National Immunization Program (NIP) to the office of the 
Director of Science. This is a positive step. The committee 
urges the CDC to carefully review and implement the 
recommendations in the Institute of Medicine report: Vaccine 
Safety Research, Data Access and Public Trust. The Committee is 
particularly interested in the CDC prioritizing IOM 
recommendations that the CDC (1) establish an independent 
oversight board to review CDC's vaccine safety research agenda, 
study protocols, and changes in study protocols, and (2) 
initiate conversations with Managed Care Organizations involved 
in the Vaccine Safety Datalink to ensure that independent 
researchers have access to all VSD data, particularly post-2000 
data through the National Center for Health Statistics.
    Vaccine Safety Research.--The Committee recognizes the 
importance of directing additional funding toward vaccine 
safety research, specifically funding to develop better 
screening methods for children at risk for serious adverse 
reactions. The Committee recommendation includes $3,000,000 
above the request for the CDC to expand funding for vaccine 
safety research, particularly with respect to investigator 
initiated, peer-reviewed, extramural research. Furthermore, the 
Committee urges that this funding be used for non-epidemiology 
research, to better understand risk factors for serious adverse 
reactions, to develop screening tools to eliminate from 
vaccination those children at greater risk for such reactions, 
and to develop effective treatments and interventions for 
children suffering severe adverse reactions.

                            HEALTH PROMOTION

    The Committee provides $983,647,000 for health promotion, 
which is $38,062,000 below the fiscal year 2005 comparable 
level and $19,226,000 above the request.

Chronic disease prevention and health promotion

    The Committee provides $856,468,000 for chronic disease 
prevention and health promotion, which is $40,665,000 below the 
fiscal year 2005 comparable level and $15,610,000 above the 
request.
    Chronic diseases have had a profound human and economic 
toll on our nation. Nearly 125 million Americans today are 
living with some form of chronic condition, including cancer, 
cardiovascular disease, diabetes, arthritis, obesity and 
various neurological conditions such as epilepsy. Complications 
from these conditions include vision loss, kidney disease, limb 
loss, oral disease and paralysis.
    The National Center for Chronic Disease Prevention and 
Health Promotion at CDC supports research and programs to 
prevent the leading causes of death and disability (e.g., heart 
disease and stroke, cancer, diabetes, and arthritis) that are 
among the most prevalent, costly, and preventable of all health 
problems. CDC plays a leadership role in coordinating and 
catalyzing the efforts of numerous public and private partners, 
which allows CDC to substantially extend its effectiveness in 
reaching people at highest risk for chronic disease. The 
Committee recognizes the essential infrastructure that CDC has 
built in state health departments and encourages CDC to expand 
its state-based leadership in surveillance, public health 
education, communications and model programs and research.
    The Committee urges the CDC to examine ways of maximizing 
the federal investments in prevention, such as incorporating 
performance measures into state and local health department 
cooperative agreements where they may not currently exist, 
including incentives or requirements for state and local 
matches of federal funds, and/or streamlining funding 
mechanisms to focus on common risk factors among the leading 
chronic conditions.
    Within the total provided, the Committee includes the 
following amounts for chronic disease prevention and health 
promotion activities: $46,120,000 for heart disease and stroke, 
$1,502,000 above fiscal year 2005; $64,960,000 for diabetes, 
$1,503,000 above fiscal year 2005; $312,600,000 for Cancer 
Prevention and Control, $2,895,000 above fiscal year 2005 
(including not less then $204,425,000 for the National Breast 
and Cervical Cancer Early Detection program); $22,920,000 for 
Arthritis and Other Chronic Diseases, $433,000 above fiscal 
year 2005; $104,370,000 for Tobacco, $25,000 above fiscal year 
2005; $41,930,000 for Nutrition and Physical Activity, the same 
as fiscal year 2005; $25,870,000 for Health Promotion, $276,000 
below fiscal year 2005; $56,760,000 for School Health, $14,000 
above fiscal year 2005; $44,740,000 for Safe Motherhood/Infant 
Health, the same as fiscal year 2005; $12,000,000 for Oral 
Health, $796,000 above fiscal year 2005; $29,700,000 for 
Prevention Centers, the same as fiscal year 2005; $11,200,000 
for Verb, $47,595,000 below fiscal year 2005; $44,300,000 for 
Steps for a Healthier U.S., $24,000 above fiscal year 2005; 
$34,513,000 for REACH, the same as fiscal year 2005; and 
$4,485,000 for Genomics.
    Adolescent Health.--The Committee encourages the CDC to 
maintain a focus on public health issues confronting 
adolescents, including maintaining support of the National 
Network of State Adolescent Health Coordinators (NNSAHC) Annual 
Meeting, which brings together specific expertise on the health 
issues that face adolescents and on the special programmatic 
considerations for this population.
    Alzheimer's disease.--A growing body of evidence suggests 
that many of the same strategies that preserve overall health 
may also help prevent or delay the onset of Alzheimer's disease 
and dementia. In fiscal year 2005, CDC, in cooperation with the 
Alzheimer's Association, launched a new program aimed at 
educating the general public and health professionals on ways 
to reduce the risks of developing Alzheimer's disease by 
maintaining a healthy lifestyle. The Committee supports this 
initiative and urges CDC to consider expanding it within the 
funds made available for fiscal year 2006.
    Breast and Cervical Cancer Screening.--The Committee 
commends the CDC for creating partnerships to address the early 
detection of breast cancer, particularly in historically 
underserved communities, including the Native American, 
Hispanic and African American populations. As part of this 
initiative, the Committee is very interested in the innovative 
approach of the Men Against Breast Cancer Partners In Survival 
Program focusing on the role of the male support-giver as an 
integral component of the early detection, patient care and 
survivorship of breast cancer. The Committee encourages CDC's 
continued support of programs of this type that might also have 
secondary benefits, such as greater participation of the male 
support-giver in their own health management, including early-
detection and health screening activities.
    Colorectal Cancer.--The Committee is pleased with the 
leadership of CDC's National Colorectal Cancer Roundtable in 
promoting the availability and advisability of screening to 
both health care providers and the general public. The 
Committee encourages the CDC to continue to expand its 
partnerships with state health departments, professional and 
patient organizations, and private industry to combat this 
devastating disease.
    Cancer Survivorship.--The Committee supports the ongoing 
partnership between CDC and the Lance Armstrong Foundation 
(LAF) to address the needs of the nearly 10 million cancer 
survivors. The Committee encourages CDC to enhance support for 
the Live Strong, National Cancer Survivorship Resource Center, 
to serve cancer survivors and their families across the 
country.
    Diabetes.--The Committee commends CDC for implementation of 
SEARCH, a pilot study to determine the incidence and prevalence 
of diabetes in youth under the age of 20 years in six locations 
around the United States. The Committee encourages the CDC to 
consider developing a plan to use the information gathered from 
SEARCH to create a national registry of patients afflicted with 
juvenile diabetes. In addition, the Committee urges the CDC to 
examine the feasibility of collecting information about the 
standard of care available to people with diabetes nationwide 
and consider making samples from this study available to the 
research community. CDC should be prepared to report to the 
Committee on these issues during the fiscal year 2007 budget 
hearings.
    Epilepsy.--The Committee provides $8,000,000 for Epilepsy 
activities, which is $440,000 above fiscal year 2005. The 
Committee supports the CDC's epilepsy program and applauds the 
collaboration the Agency developed with the Epilepsy Foundation 
in crafting the recommendations of Living Well With Epilepsy 
II. The Committee encourages CDC to maintain support for 
ongoing epilepsy public health programs as well to begin 
implementation of the new recommendations from Living Well With 
Epilepsy II as funds become available. It is also expected that 
CDC be prepared to report on the current results on 
implementation of those recommendations and future plans, 
including those involving coordination with other agencies, 
during the fiscal year 2007 budget hearings.
    Genomic Medicine.--The Committee understands that steps 
need to be taken now to prepare the public health system for 
the expected widespread future use of genetic technologies in 
healthcare. The Committee encourages CDC to move forward 
aggressively with the creation and implementation of 
partnerships with industry and the nonprofit sector to achieve 
the widest benefits from the coming era of genomic medicine.
    Heart Disease and Stroke.--The Committee understands that 
the CDC is creating a Heart Disease and Stroke Division to 
consolidate and elevate its efforts to prevent and control 
heart disease, stroke and other cardiovascular diseases and is 
supportive of this effort. The Committee supports the goal of 
implementing statewide heart disease and stroke prevention 
programs and urges the CDC to maintain and expand its support 
for these activities within the funds provided for fiscal year 
2006.
    Infertility Prevention.--The Committee understands that 
there are other causes of infertility beyond sexually 
transmitted diseases, such as delayed child bearing, smoking, 
low or excessive body weight, exposure to hazardous 
environmental toxins, drug and alcohol abuse and, particularly 
for men, exposure to high temperatures. The Committee 
encourages CDC to consider expanding the scope of the Agency's 
efforts regarding the prevention of infertility and to 
providing greater support to public education on the broader 
risks to fertility.
    Inflammatory Bowel Disease.--In fiscal year 2005, the 
Committee provided funds to continue a national IBD 
epidemiology program established through a partnership between 
CDC and the Crohn's and Colitis Foundation of America. The 
Committee encourages the CDC to continue this initiative in 
fiscal year 2006.
    Interstitial Cystitis (IC).--The Committee is pleased by 
the establishment of a cooperative agreement between the CDC 
and the Interstitial Cystitis Association and has provided 
sufficient funds to continue the campaign to educate the public 
and professional community about IC.
    Kidney Disease.--The Committee urges the CDC to develop the 
capacity and infrastructure for a kidney disease surveillance, 
epidemiology, and health outcomes program, including awarding 
grants to support several state-based demonstration projects 
for chronic kidney disease prevention and control. Furthermore, 
the Committee urges CDC, in partnership with the relevant 
national voluntary health organization, or organizations, 
convene a consensus conference of experts in the area of kidney 
disease and other stakeholders to lay the groundwork for a 
formal Public Health Kidney Disease Action Plan for prevention 
and control of kidney disease. The Committee provides 
$1,800,000 to undertake this initiative.
    Oral Health.--The Committee is concerned about the rising 
obesity rate among America's youth. Some eating habits can 
adversely affect not only body weight but also oral health. The 
Committee understands that the dental community has developed 
some instructional materials and encourages the CDC to work 
with the American Dental Association in producing an 
instructional video for school-aged children on the harmful 
effects of excessive consumption of high sugar products, such 
as soda.
    Obesity Prevention.--The multiple factors contributing to 
the overweight and obesity epidemic took years to develop. 
Reversing the epidemic will require a long-term, well-
coordinated, concerted approach to reach Americans were they 
live, work, play, and pray. Effective collaboration among the 
public, voluntary, and private sectors is critical to reshape 
the social and physical environment of our nation's communities 
and provide the necessary support, information, tools, and 
realistic strategies needed to reverse the current obesity 
trends nationwide.
    To reduce consumer confusion about the myriad of health 
messages about obesity, diabetes, and cardiovascular disease, 
the Committee strongly urges CDC to design and develop 
mechanisms for fast-tracked translation of research into 
reasoned guidance for the American public.
    In addition, the Committee urges CDC to develop evidenced-
based recommendations on body fat measurement to be used in the 
evaluation of obesity prevention programs.
    The Committee also is very concerned about the adverse 
health toll that the twin epidemics of diabetes and obesity are 
taking on the health of minorities. The Committee encourages 
CDC to collaborate with organizations directed by and serving 
individuals from communities with disproportionate diabetes and 
obesity rates to ensure that the Agency's prevention efforts 
effectively reach all communities.
    To prevent unhealthy weight gain and maintain healthy 
weight among children and adolescents, CDC is urged to work 
with the U.S. Department of Education to issue a report with 
recommendations about reintroducing school physical education 
into the school day.
    Finally, the Committee supports research into the link 
between disadvantaged or physically and sexually abused youth, 
and obesity programs that target the physical health of 
children who have been abused and are in treatment programs. 
The CDC is encouraged to partner with organizations that treat 
or otherwise serve youth who have been abused in efforts to 
identify links between abuse and obesity and programs to 
address childhood obesity among this population.
    Osteoporosis.--The Committee is aware of the report issued 
by the Surgeon General on Bone Health and Osteoporosis 
requested in the fiscal year 2002 Appropriations bill. In the 
report, the Surgeon General calls for a national action plan 
for bone health. The Committee urges the CDC to consider 
supporting the development of an action plan and to ensure that 
all relevant federal agencies and public and private 
stakeholders, including the National Osteoporosis Foundation, 
be involved in the development of any such plan.
    Pulmonary Hypertension.--The Committee continues to be 
interested in pulmonary hypertension (PH), a rare, progressive 
and fatal disease that predominantly affects women, regardless 
of age or race. Because early detection of PH is critical to a 
patient's survival and quality of life, the Committee continues 
to encourage CDC to work in partnership with the pulmonary 
hypertension community to foster greater awareness of the 
disease.
    REACH.--The Committee recognizes the strengths that 
national/multi-geographical minority organizations can provide 
to the REACH Initiative. Such organizations often have the 
capacity to influence communities through coalitions and 
collaborative relationships that have already been established 
and provide essential support to local organizations that may 
lack the infrastructure needed to implement the full scale of 
programmatic activities required for this important program. 
The Committee urges CDC to include such organizations among the 
entities that are eligible to compete for funding without 
preventing other applicants from receiving these grants.
    School Health.--The Committee urges the CDC to prioritize 
obesity prevention in proportion to its burden on childhood and 
adolescent health through the Division of Adolescent School 
Health (DASH). CDC should urge states to use existing program 
funds to address this critical epidemic.
    Sleep Disorders.--The Committee remains concerned about the 
prevalence of sleep disorders and recognizes the need for 
enhanced public and professional awareness on sleep and sleep 
disorders. The Committee encourages CDC to work with other 
agencies, such as the National Center on Sleep Disorders 
Research, and voluntary health organizations, such as the 
National Sleep Foundation, to support the development of a 
sleep education and public awareness initiative.
    VERB.--The Committee provides $11,200,000 for the Verb 
program, a national multi-ethnic media campaign that promotes 
regular physical activity among youth ages 9-13. The campaign 
was launched in June 2002. Evaluation results over the first 
two years show that the Verb campaign has contributed to higher 
levels of physical activity among targeted youth. The funds 
provided for fiscal year 2006 are to be used to augment funding 
available in fiscal year 2005 in order to secure a national 
media program commensurate with the first three years of the 
program.
    Vision Screening and Education.--The Committee commends CDC 
for its partnership with a leading voluntary health association 
dedicated to fighting blindness and saving sight, to improve 
education and early detection of potentially blinding eye 
diseases and encourages CDC to continue and expand this 
partnership. Despite the fact that half of all blindness can be 
prevented through education, early detection and treatment, it 
is estimated that the number of blind and visually impaired 
people will double by 2030 if nothing is done to curb vision 
problems. To address this growing public health problem, the 
Committee provides $2,500,000 to enhance the CDC national 
vision screening and education program and the CDC partnership 
with Prevent Blindness America.

Birth defects, developmental disabilities, disability and health

    The Committee provides $127,179,000 for birth defects, 
developmental disabilities, disability and health, which is 
$2,603,000 above the fiscal year 2005 comparable level and 
$3,616,000 above the request. This program collects, analyzes, 
and makes available data on the incidence and causes of birth 
defects and developmental disabilities.
    Within the total, the Committee provides the following 
amounts for birth defects, developmental disabilities, 
disability, and health activities: $39,130,000 for birth 
defects and developmental disabilities, which is $109,000 below 
fiscal year 2005; $67,868,000 for Human Development and 
Disability, which is $2,757,000 above fiscal year 2005; and 
$20,180,000 for Hereditary Blood Disorders, which is $46,000 
below fiscal year 2005.
    Alpha-1 Antitrypsin Deficiency.--The Committee is aware 
that Alpha-1 Antitrypsin Deficiency (Alpha-1) is the major 
genetic risk factor for Chronic Obstructive Pulmonary Disease 
(COPD) and cryptogenic liver disease. Early detection allows 
individuals to engage in preventative health measures and 
receive appropriate therapies that significantly improve their 
health status. The Committee encourages CDC to consider 
collaborating with appropriate patient and professional 
organizations, such as the Alpha-1 Foundation, to actively 
support Alpha-1 targeted detection efforts that utilize public 
and professional education regarding obstructive lung disease, 
both genetic and tobacco related.
    Attention Deficit/Hyperactivity Disorder (AD/HD).--The 
Committee continues to support the National Resource Center on 
AD/HD and has provided sufficient funds in fiscal year 2006 to 
continue the activities at the Center, such as responding to 
requests for information and support services; reaching out to 
special populations in need; and educating health and education 
professionals on AD/HD.
    Autism.--The Committee is aware of the progress that has 
been made with the autism programs. The Committee acknowledges 
the importance of this work by the CDC in the area of autism 
surveillance and research, and urges this work to continue in a 
timely manner. Within funds provided, $15,500,000 is for autism 
activities, which is $627,000 above fiscal year 2005. Within 
that amount, $14,900,000 is provided for surveillance and 
research programs including the CADDRE and ADDM Network. The 
Committee is pleased to see the work being done in the area of 
the national awareness campaign and provides $600,000 for the 
Center to expand its work on this initiative.
    Birth Defects Surveillance, Research and Prevention.--The 
Committee commends the CDC's work in the area of birth defects 
surveillance, research and prevention and encourages the CDC to 
continue its support for birth defects related programs.
    Cooley's Anemia.--The Committee is pleased with the 
progress that CDC has made with regard to the establishment of 
a blood safety surveillance program for Cooley's anemia 
patients, who are the largest consumers of red blood cells. Six 
treatment centers throughout the nation handle the medical 
monitoring and treatment; the Cooley's Anemia Foundation 
provides education and awareness, patient recruitment, and 
other services; and, CDC has created an archive of tested and 
analyzed blood samples. As the program moves forward and start-
up costs are met, the Committee expects CDC to direct an 
increasing amount of the funds available to education and 
awareness, patient recruitment and other services.
    Down Syndrome.--The Committee understands that CDC has 
undertaken a study to estimate the number of people in the 
United States living with Down syndrome and identify them by 
age and ethnic group and that it is expected to have 
preliminary estimates of prevalence of Down syndrome among 
children and adolescents by the end of fiscal year 2005. The 
Committee further understands that a second study, to document 
the onset and course of secondary and related developmental and 
mental disorders in individuals with Down syndrome, will be 
initiated by the end of this fiscal year. The Committee 
recognizes the importance of this research and has provided 
sufficient funding to further develop the study relating to the 
onset of secondary and related developmental mental disorders 
in fiscal year 2006.
    Duchenne and Becker Muscular Dystrophy.--The Committee 
remains concerned with the pace of the development of the CDC 
Birth Defects Surveillance program covering the muscular 
dystrophies and is aware that the agency has made the 
commitment to enhance the internal staff commitment to the 
program. The Committee is encouraged by that new commitment and 
expects that CDC dedicate its efforts to organize, coordinate 
and implement the agency's Duchenne MD surveillance program. 
The Committee provides $7,000,000 for fiscal year 2006, which 
is $1,073,000 above fiscal year 2005. Within that amount, the 
Committee recommends that $750,000 be used to continue a 
coordinated education and outreach initiative through the 
Parent Project Muscular Dystrophy. Finally, the Committee 
requests that the CDC develop and submit to the Committees on 
Appropriations in the House and Senate by June 1, 2006 a five-
year strategic plan for the Duchenne and Becker Muscular 
Dystrophy programs.
    Early Hearing Detection and Intervention.--Within the total 
provided, $7,000,000, $839,000 over fiscal year 2005, is 
designated for the Early Hearing Detection and Intervention 
(EHDI) program for newborns, infants and young children with 
hearing loss. Currently, 32 states are in the midst of 
completing projects funded through Cooperative Agreements from 
CDC to assist in developing strong surveillance and tracking 
systems to ensure that infants referred from newborn hearing 
screening programs receive appropriate and timely diagnostic 
and early intervention services. The Committee is concerned 
that about one-third of the babies who are referred from 
hearing screening programs do not receive diagnostic 
evaluations by the time they are 3 months of age. Moreover, 
only about half of the infants and toddlers diagnosed with 
hearing loss are enrolled in appropriate early intervention 
programs by 6 months of age. The Committee believes that 
increased funding is required to ensure that states develop 
appropriate surveillance and tracking systems to provide timely 
and appropriate diagnostic and intervention services to infants 
and toddlers.
    Funding may also be used to support applied research 
projects related to increasing the accuracy of newborn hearing 
screening, improving the effectiveness of tracking and 
surveillance programs, determining the etiology and 
epidemiology of childhood hearing loss, and analyzing the costs 
and benefits of such programs. The Committee encourages CDC to 
assist states in clarifying how EHDI surveillance, tracking, 
and data management programs are affected by the Health 
Insurance Portability and Accountability Act and the Family 
Education Rights and Privacy Act
    To avoid duplication and interference, the Committee urges 
CDC to coordinate projects funded with this appropriation with 
EHDI projects conducted by the Health Resources Services 
Administration, the National Institute on Deafness and Other 
Communication Disorders, the National Institute on Disability 
and Rehabilitation Research, and the Office of Special 
Education and Rehabilitative Services.
    Fetal Alcohol.--The Committee is concerned about the 
prevalence of Fetal Alcohol Syndrome (FAS) in the United States 
and notes that drinking during pregnancy is the nation's 
leading known preventable cause of mental retardation and birth 
defects. The Committee commends the U.S. Surgeon General for 
releasing an updated advisory in February, 2005, on alcohol use 
in pregnancy, urging women who are pregnant or who may become 
pregnant to abstain from alcohol. The Committee urges CDC to 
work with partner organizations, such as the National 
Organization on Fetal Alcohol Syndrome, to generate awareness 
of the Surgeon General's new FAS prevention advisory, 
especially among high-risk communities.
    Folic Acid.--The Committee provides $2,400,000 to support 
and expand the folic acid educational campaign, which is 
$212,000 above fiscal year 2005. The Committee is pleased since 
fortification of U.S. grain products with folic acid, the rate 
of neural tube defects has decreased by 26% and encourages CDC 
to enhance the national campaign to increase the number of 
women taking folic acid daily. The Committee also encourages 
CDC to continue to support collaboration among the states on 
issues related to surveillance, research and prevention through 
support of the National Birth Defects Prevention Network.
    Fragile X.--The Committee is encouraged by the CDC's 
progress in establishing a Fragile X public health program to 
expand surveillance and epidemiological research of Fragile X, 
as well as provide patient and provider outreach on Fragile X 
and other developmental disabilities. The Committee has 
provided sufficient funding to support the continuation of 
these activities.
    Hemophilia.--The Committee supports CDC's efforts, in 
collaboration with the National Hemophilia Foundation, to carry 
out needed education, prevention, blood safety surveillance, 
and outreach programs for the millions of people in the United 
States affected by bleeding and clotting disorders, including 
hemophilia, women's bleeding disorders, and thrombophilia. The 
Committee recognizes the strain these additional efforts place 
on the national hemophilia treatment center network. Within the 
resources provided, the Committee urges CDC to enhance its 
support where possible of the network to ensure continued 
access to this comprehensive chronic care model for all persons 
with bleeding and clotting disorders.
    Hereditary Hemorrhagic Telangiectasia (HHT).--The Committee 
is aware of interest in the establishment of an HHT National 
Resource Center through a partnership between the CDC and the 
national voluntary agency representing HHT families. The 
Committee encourages the CDC to examine carefully proposals to 
establish such a center and give every appropriate 
consideration to supporting it within the funds provided.
    Limb Loss Information Center.--The Committee recognizes 
that one of the greatest challenges facing individuals with 
limb loss is access to necessary health and rehabilitative 
services. The Committee applauds CDC for its partnerships with 
governmental, academic and voluntary health organizations, such 
as the Amputee Coalition of America, to advance the quality of 
life through research and support programs for people living 
with limb loss. The Committee continues to strongly support the 
CDC's resource and information center which assist individuals 
living with disabilities, and their families, in need of 
information on medical, physical, and emotional needs, and 
resources and support to reintegrate socially and economically 
into society. The Committee urges CDC to continue its support 
of the Center at no less than the fiscal year 2005 level.
    Spina Bifida.--The Committee provides $5,300,000, which is 
$475,000 above fiscal year 2005 for the National Spina Bifida 
Program in coordination with its external partners, such as the 
Spina Bifida Association of America. The Committee continues to 
support the partnerships CDC has developed and encourages CDC 
to allocate a portion of the increase provided for the 
maintenance and expansion of the National Spina Bifida 
Clearinghouse and Resource Center. In addition, the Committee 
supports the Memorandum of Understanding between CDC and the 
Agency for Healthcare Research and Quality to examine clinical 
treatment of Spina Bifida and improve quality of life.
    The Committee recognizes that the Agent Orange database of 
health and educational services composes the largest repository 
of longitudinal treatment information of people with Spina 
Bifida and can provide much-needed insight and understanding 
into the needs of people with Spina Bifida. The Committee 
commends the CDC and the Department of Veterans Affairs for 
their collaborative efforts to review and analyze the Agent 
Orange database to gain better understanding of the treatment, 
educational, and vocational benefits needs and utilization by 
people with Spina Bifida. The Committee encourages the on-going 
collaboration to analyze this data and requests a report 
summarizing the analysis of the data, including recommendations 
based on the analysis as to how to improve treatment and 
quality-of-life for people with Spina Bifida.
    Tourette Syndrome.--The Committee commends CDC for its work 
regarding Tourette Syndrome and supports the continuation of 
its external partnership with the Tourette Syndrome Association 
to develop and implement a public health education and research 
program. The Committee provides $1,800,000 for fiscal year 2006 
to continue to educate parents, physicians, educators and other 
health care workers about Tourette Syndrome disorder and to 
expand on the scientific knowledge base on prevalence, risk 
factors and co-morbidities of Tourette Syndrome. The Committee 
intends that these resources be used to support the existing 
partnership.
    Tuberous Sclerosis Complex.--Tuberous sclerosis complex 
(TSC) is a genetic disorder that causes uncontrollable tumor 
growth. Because this disorder can affect multiple organs of the 
body, it is difficult to diagnose, track and properly treat. 
The Committee is aware of interest in developing a joint 
initiative between the CDC and a relevant voluntary health 
organization, such as the Tuberous Sclerosis Alliance, to 
collect and analyze data from the nationwide network of TSC 
clinics; support surveillance and epidemiological studies; and 
to educate health care professionals and teachers who come into 
contact with TSC patients. The Committee encourages the CDC to 
examine the feasibility of undertaking this initiative from 
within the funds provided.
    Vision Loss.--The Committee is aware of interest in the 
creation of a National Information Center on Vision Loss to 
address the need for appropriate public health information to 
prevent further impairment and disability among individuals who 
are blind or who have low vision. The Committee encourages CDC 
to consider this proposal, including partnering with a national 
non-profit organization that is recognized for leadership in 
providing information to persons who are blind or visually 
impaired, including published resource guides, directories of 
services for consumers in the field, scholarly journals on 
blindness and vision loss, assistive technology magazines, and 
talking books.

                     HEALTH INFORMATION AND SERVICE

    The Committee provides a program level of $223,799,000 for 
Health Information and Service, which is $4,874,000 below the 
fiscal year 2005 comparable level and the same as the request. 
Within the total, $28,730,000 is to be derived from section 241 
evaluation set aside funds and is included to carry out 
National Center for Health Statistics surveys, Public Health 
Informatics evaluations, and health marketing evaluations.

Health statistics

    The Committee provides a total of $109,021,000 for health 
statistics, which is the same as the fiscal year 2005 
comparable level and the request. Within the amount provided 
$3,516,000 shall be derived from section 241 evaluation set-
aside funds, as proposed in the request.
    The Health Statistics program is responsible for 
collecting, interpreting, and disseminating data on the health 
status of the U.S. population and the use of health services. 
Surveys include the National Vital Statistics System, the 
National Health Interview Survey, the National Survey of Family 
Growth, the National Health and Nutrition Examination Survey, 
and the National Health Care Survey.
    Chronic Obstructive Pulmonary Disease.--Chronic Obstructive 
Pulmonary Disease (COPD) is the fourth leading cause of death 
in the United States and the only one of the top ten causes of 
death that is on the increase. The Committee urges the CDC to 
expand its data collection efforts on COPD. Specifically, the 
Committee encourages the CDC to include questions on COPD in 
the National Health and Nutrition Examination Survey, the 
National Health Interview Study and the Behavioral Risk Factor 
Surveillance Survey that asks about COPD by name.
    Nontuberculous Mycobacteria.--The Committee is concerned 
that Nontuberculous Mycobacteria [NTM] incidence continues to 
rise. Mycobacteria are environmental organisms found in both 
water and soil that cause significant respiratory damage. The 
Committee encourages NCHS to include questions regarding NTM 
testing in ongoing surveys to gain a better understanding of 
the epidemiology of this emergent disease.

Informatics and Health Marketing

    The Committee provides a total of $114,778,000 for 
informatics and health marketing, which is $4,874,000 below the 
fiscal year 2005 comparable level and the same as the request. 
Within the total, $25,214,000 shall be derived from section 241 
evaluation set-aside funds, as proposed in the request.

               ENVIRONMENTAL HEALTH AND INJURY PREVENTION

    The Committee provides $285,721,000 for environmental 
health and injury prevention, which is the same as the fiscal 
year 2005 comparable level and $901,000 above the request.

Environmental health

    The Committee provides $147,483,000 for environmental 
health, which is the same as fiscal year 2005 comparable level 
and $595,000 above the request.
    Asthma.--The Committee is pleased with the work that the 
CDC has done to address the increasing prevalence of asthma. 
However, the increase in asthma among children remains 
alarming. The Committee urges CDC to expand its outreach aimed 
at increasing public awareness of asthma control and prevention 
strategies, particularly among at-risk populations in 
underserved communities. To further facilitate this effort, CDC 
is urged to partner with relevant voluntary health 
organizations, such as the American Lung Association, to 
support program activity consistent with the CDC's efforts to 
fund community-based interventions that apply effective 
approaches demonstrated in research projects within the 
scientific and public health community.
    Biomonitoring.--The CDC's National Report on Human Exposure 
to Environmental Chemicals is a significant new exposure tool 
that provides invaluable information for setting research 
priorities and for tracking trends in human exposures over 
time. Accordingly, the Committee continues to support the CDC 
environmental health laboratory's efforts to provide exposure 
information about environmental chemicals. In addition, the 
Committee encourages CDC to consider devoting a greater 
proportion of program resources to develop the necessary 
methods to interpret human biomonitoring concentrations in the 
context of potential health risks. The Committee applauds the 
CDC's biomonitoring efforts and encourages the agency to 
continue this program and as well as improve its efforts to 
communicate these results in context.
    Childhood Lead Poisoning Prevention.--The Committee 
commends the CDC for its commitment to support the enhanced 
development of a portable, hand-held lead screening device that 
holds great promise for increasing childhood screening rates in 
underserved communities. The Committee understands that further 
development of this device will help ensure its application in 
community health settings.
    Dioxin Emission Reduction.--The Committee encourages the 
CDC to establish a public health awareness effort to inform the 
public of dioxin emissions that may originate from non-point 
sources and methods and/or techniques that the public can use 
to reduce the emissions of non-point source dioxins to the 
environment.
    Landmine Survivor Network.--The Committee commends CDC for 
its partnership with the Landmine Survivor Network that has 
developed peer support networks for landmine survivors in six 
mine-affected countries around the world. The Committee 
recommendation assumes continued support for the Network at no 
less than FY 2005 levels, to expand peer support networks and 
the number of survivors that are reached in network and non-
network countries; strengthen the capacity of medical and 
rehabilitative care facilities to address the needs of 
amputees; enhance economic opportunities for survivors; and 
further CDC programs and research for victims of landmines, 
civil strife and warfare.

Injury prevention and control

    The Committee provides $138,237,000 for the injury control 
program, which is the same as the fiscal year 2005 comparable 
level and $306,000 above the request. The injury prevention and 
control program supports intramural research, injury control 
research centers, extramural research grants, and technical 
assistance to state and local health departments.
    Gun Control Advocacy.--The Committee recommendation 
maintains language carried in the fiscal year 2005 bill and 
prior years prohibiting federal funds from being used to lobby 
for or against the passage of specific federal, state or local 
legislation intended to advocate or promote gun control. The 
Committee understands that the CDC's responsibility in this 
area is primarily data collection and the dissemination of that 
information and expects that research in this area to be 
objective and grants to be awarded through an impartial, 
scientific peer review process.

                     OCCUPATIONAL SAFETY AND HEALTH

    The Committee provides $251,241,000 for occupational safety 
and health, which is $34,800,000 below fiscal year 2005 and 
$34,689,000 below the request. Of the amount provided, 
$87,071,000 is to be derived from section 241 evaluation set-
aside funds, as proposed in the request. The Committee notes 
that after adjusting for the transfer of $34,800,000 for 
central business services and support outlined below, the 
recommendation is the same as fiscal year 2005 and $111,000 
above the request.
    The National Institute for Occupational Safety and Health 
conducts applied research, develops criteria for occupational 
safety and health standards, and provides technical services to 
government, labor and industry, including training for the 
prevention of work-related diseases and injuries. This 
appropriation supports surveillance, health hazard evaluations, 
intramural and extramural research, instrument and methods 
development, dissemination, and training grants.
    The Committee understands that in the reorganization of CDC 
that NIOSH has been recognized as one of the agency's 5 
coordinating centers. Given its unique statutory requirements, 
the Committee concurs that this is the appropriate placement of 
NIOSH within CDC's current structure. It is the expectation of 
the Committee that CDC will afford NIOSH all the rights and 
privileges of this status in the organization including 
participating on CDC's Executive Leadership Board as well as 
the Management Council given that these are the policy and 
decision-making bodies of the Agency.
    The Committee recommendation includes a permanent transfer 
of $34,800,000 from the NIOSH budget activity to CDC's 
centralized business services budget activity. This transfer, 
which is equal to the central business systems assessment for 
fiscal years 2004 and 2005, brings NIOSH in line with the other 
coordinating centers and obviates the need for continued 
central business services assessments, except those required by 
the Department. Finally, the Committee directs CDC to treat any 
additional CDC assessment on the NIOSH budget activity as a 
reprogramming of funds and to comply with the process set forth 
in section 517 of this Act.

                             GLOBAL HEALTH

    The Committee provides $309,076,000 for global health, 
which is $213,000 above the fiscal year 2005 comparable level 
and $2,997,000 above the request.
    Through its Global Health activities, CDC coordinates, 
cooperates, participates with, and provides consultation to 
other nations, U.S. agencies, and international organizations 
to prevent and contain diseases and environmental health 
problems and to develop and apply health promotion activities. 
In cooperation with Ministries of Health and other appropriate 
organizations, CDC tracks and assesses evolving global health 
issues and identifies and develops activities to apply CDC's 
technical expertise to be of maximum public health benefit. 
Program areas include: the Global AIDS Program, the Global 
Immunization Program, the Global Malaria Program, the Global 
Disease Detection Initiative, and Other Global Disease 
Activities.
    Within the total, the following amounts are included for 
global health activities: $123,883,000 for Global AIDS, which 
is $54,000 above fiscal year 2005; $137,194,000 for Global 
Immunization, which is $68,000 above fiscal year 2005; 
$36,500,000 for Global Disease Detection, which is the same as 
fiscal year 2005, after adjusting for the avian flu funding in 
the Emergency Supplemental Appropriations Act for Defense, the 
Global War on Terror, and Tsunami Relief Act, 2005; $9,113,000 
for the Global Malaria Program, which is the same as fiscal 
year 2005; and $2,386,000 for Other Global Disease Activities, 
which is the same as fiscal year 2005.

         TERRORISM AND PUBLIC HEALTH PREPAREDNESS AND RESPONSE

    The Committee provides $1,616,723,000 for CDC terrorism 
preparedness and response activities, which is the same as the 
request and $6,034,000 below the fiscal year 2005 comparable 
level.
    Since fiscal year 2002, CDC terrorism and preparedness 
funds were requested and provided within the Public Health and 
Social Services Emergency Fund (PHSSEF). Now that these 
programs and activities are a part of the CDC's annual 
appropriations, the Committee believes the funding more 
appropriately belongs within the managing Agency's account.
    The Committee seeks to ensure that CDC's bioterrorism 
activities continue to be coordinated with those in other parts 
of HHS and directs CDC to work with the Office of the Secretary 
in the development of the requested Department-wide operating 
plan.
    Within the funds provided, $853,300,000 is for Upgrading 
State and Local Capacity, including $790,000,000 to be provided 
to State and local health departments through grants and 
cooperative agreements (this amount is $67,337,000 below fiscal 
year 2005 and 54,609,000 above the request), and $31,400,000 
for Centers for Public Health Preparedness; $140,200,000 is for 
Upgrading CDC Capacity; $14,000,000 is for Anthrax; $79,223,000 
is for the Biosurveillance Initiative; and $530,000,000 is for 
the Strategic National Stockpile (this amount is $63,300,000 
above fiscal year 2005 and $70,000,000 below the request).
    The Committee also understands that within the above 
amounts for terrorism preparedness and response, up to 
$34,400,000 will be used for CDC business services and support. 
In addition, $8,589,000 of the amounts available for the 
Strategic National Stockpile are to be transferred for the 
administration and management costs within the Office of the 
Secretary related to the BioShield program.
    Pandemic Preparedness and Avian Flu.--The Committee is 
increasingly concerned about the threat posed to public health 
by avian flu and pandemic influenza, which public health 
authorities estimate could kill 90,000 to 300,000 people in the 
United States. Public health preparedness with respect to a 
pandemic influenza cuts across a broad array of federal public 
health activities. As a result, the Committee recommendation 
includes funding to enhance several of CDC's functions to 
assist in improving our nation's capability of detecting, 
controlling, and responding to potential health threats related 
to influenza in general, and novel influenza strains in 
particular. Included is:
          $102,500,000, which is $3,498,000 above fiscal year 
        2005, within Infectious Diseases Control to, among 
        other things, enhance the sentinel physician 
        surveillance system, assist state and local health 
        departments to improve vaccine delivery, and conduct 
        research aimed at developing rapid molecular methods 
        for characterizing influenza viruses;
          $36,500,000 for Global Disease Detection, which is 
        $15,074,000 above the fiscal year 2005 enacted level, 
        to build upon the $15,000,000 provided in the Emergency 
        Supplemental Appropriations Act for Defense, the Global 
        War on Terror, and Tsunami Relief Act, 2005, for 
        combating the spread of the avian influenza virus in 
        Southeast Asia, and to enhance the global surveillance 
        and response network for infectious diseases;
          $265,680,000 for vaccine purchase grants, which is 
        $35,441,000 above the fiscal year 2005 comparable 
        level, to help improve the stability of the influenza 
        vaccine market and ensure a plentiful supply of 
        influenza vaccine for the 2004/2005 flu season; and
          $530,000,000 for the Strategic National Stockpile, 
        which is $63,300,000 above the fiscal year 2005 
        comparable level, to maintain and expand the 
        Stockpile's supplies and countermeasures for assisting 
        State and local governments in responding to both 
        terrorist and naturally occurring public health 
        emergencies, including the purchase of influenza 
        countermeasures.
    In addition, $120,000,000, which is $20,802,000 above 
fiscal year 2005, is provided within the Public Health and 
Social Services Emergency fund for pandemic preparedness. The 
purpose of these funds is to ensure a year-round influenza 
vaccine production capacity in the U.S. and the development and 
implementation of rapidly expandable influenza vaccine 
production technologies.
    The Committee recognizes that although a combination of 
efforts will be needed to address an influenza pandemic, early 
in an outbreak, especially before a vaccine is available, use 
of antiviral drugs may ease some of the symptoms of individuals 
infected and might slow the spread of the pandemic. Given the 
lag time in production and the high demand from other 
countries, the CDC must commit now to purchasing an adequate 
stockpile. The Committee is aware that the World Health 
Organization has recommended that nations stockpile enough 
antiviral treatments to cover 25% of their population. The 
Committee is concerned that the United States currently has 
enough antiviral treatments stockpiled to treat only 1% of the 
population and urges the CDC, in conjunction with HHS and NVPO, 
to determine what percentage of the U.S. population antiviral 
stockpiles should have the capacity to treat and how many doses 
are needed to meet this benchmark and report back to the 
Committee with these findings by no later than January 1, 2006.
    The Committee understands antiviral treatments have 
repeatedly been shown to reduce the duration and severity of 
symptoms when given in the first 48 hours of influenza 
symptoms. Although there are gaps in knowledge about the 
efficacy of antivirals in a pandemic, it appears that these 
gaps should not be used as a reason for inaction. The Committee 
urges the Department to undertake an analysis to define optimal 
antiviral use, potential health impacts and cost-effectiveness 
of antiviral drugs in the setting of a pandemic and directs the 
Secretary to be prepared to report on the findings during the 
Committee hearings on the fiscal year 2007 budget request.
    The Committee urges CDC to review and approve state 
pandemic influenza plans in order to ensure nationwide 
preparedness standards and to facilitate regional coordination. 
Further, CDC should recommend that States make approved plans 
publicly available.
    In addition, the Committee urges CDC to develop and 
implement a public education campaign about pandemic influenza 
and preparedness, including information concerning the 
potential need for general vaccination and personal 
precautionary measures. CDC should also develop a strategy for 
communicating with the business community to provide 
information about the economic disruptions and communiy needs 
that may arise during a pandemic period.
    Modified Vaccinia Ankara.--The Committee is concerned that 
individuals with weak immune systems, an estimated 20% of the 
U.S. population, cannot take the existing animal-derived and 
cell-derived smallpox vaccines currently stored in the 
Strategic National Stockpile for emergency purposes. Funds have 
already been appropriated for the planned stockpiling of the 
Modified Vaccinia Ankara (MVA) Smallpox Vaccine for immuno-
compromised Americans. The Committee supports the Department's 
plans to purchase 60 million doses of the new vaccine.

                         PUBLIC HEALTH RESEARCH

    The Committee provides $31,000,000 for public health 
research, which is the same as the fiscal year 2005 and the 
request. All funds provided shall be derived from section 241 
evaluation set-aside funds, as proposed in the request.
    Through this activity, CDC supports high-quality public 
health research that studies the best methods for making the 
transition from research to practice. Funds support research 
that is proposed by experienced investigators working with 
communities, health practitioners, and policymakers to address 
local priority health concerns.

                PUBLIC HEALTH IMPROVEMENT AND LEADERSHIP

    The Committee provides $258,541,000 for public health 
improvement and leadership, which is $8,301,000 below fiscal 
year 2005 and $52,000,000 above the request.
    This activity supports several cross-cutting areas within 
CDC. Included is the CDC's Leadership and Management function, 
which funds the CDC Office of the Director, coordinating 
centers, and each constituent center and office. The Public 
Health Improvement and Leadership also supports the CDC's 
public health workforce and career development efforts, the 
Director's Discretionary Fund, and Congressional projects.

           PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT

    The Committee provides $100,000,000 for the preventive 
health and health services block grant, which is $18,526,000 
below the fiscal year 2005 comparable level and $100,000,000 
above the request. This block grant provides flexible funds to 
States by formula for a wide range of public and preventive 
health activities. The flexibility afforded to the states, 
allows them to target funds to address chronic diseases, such 
as diabetes, arthritis, heart disease, and stroke, to direct 
funds to meet challenges of outbreaks of infectious diseases, 
such as West Nile Virus and influenza, and/or to implement 
prevention and control programs related to injury and abuse.

                        BUILDINGS AND FACILITIES

    The Committee provides $30,000,000 for buildings and 
facilities, which is $239,708,000 below the fiscal year 2005 
comparable level and the same as the request.
    These funds support construction and ongoing maintenance 
projects, as well as essential safety repairs and equipment 
purchases. Of the funds provided, $22,500,000 is to complete 
the replacement of the CDC's Vector Borne Infectious Diseases 
Laboratory in Ft. Collins, CO.
    Data Security and Storage.--Within the amount provided 
sufficient funds are available for data center storage 
infrastructure hardware and software upgrades. This funding is 
to provide further for the remote mirroring of information 
between CDC data centers and recovery sites, and to provide 
heterogeneous connectivity to existing systems in use at the 
CDC, in order to ensure the protection, recovery, and 
availability of critical resources; as well as to provide for 
enhanced security-specific technologies and services in concert 
with critical infrastructure protection requirements.

                     BUSINESS SERVICES AND SUPPORT

    The Committee provides $298,515,000 for business services 
and support, which is $19,677,000 above the fiscal year 2005 
comparable level and $34,800,000 above the request. The 
Committee notes that the recommendation includes $34,800,000 
within this budget activity that was provided in fiscal year 
2005, and in the request for fiscal year 2006, within the NIOSH 
budget activity. The result is to provide the NIOSH share of 
CDC centralized business systems and support within this 
activity and to obviate the need for additional taps and 
assessments. After making adjustment for this change, the 
recommendation is $15,123,000 below fiscal year 2005 and the 
same as the request.

                     National Institutes of Health

    The Committee provides $28,506,805,000 for the twenty-six 
appropriations which together fund the programs of the National 
Institutes of Health (NIH). The total in the bill is 
$142,290,000 above the fiscal year 2005 comparable level and 
$2,979,000 below the budget request. This amount includes 
$97,021,000 for targeted research activities to develop 
radiological, nuclear and chemical threat countermeasures. The 
Administration had requested this funding in the Public Health 
Social Services Emergency Fund.
    Roadmap.--The Committee endorses the Administration's 
proposal of supporting the NIH Roadmap for Biomedical Research 
at a funding level of $332,800,000 from funding contributed by 
the Institutes and Centers based on less than one percent of 
their budgets and out of the Director's Discretionary Fund. The 
Committee believes the Roadmap is an important step to moving 
biomedical research forward to the next level of discovery at a 
pace that hastens its delivery to patients. The Roadmap 
addresses common needs across all disease areas and should 
produce research advances that will benefit many diseases and 
conditions. The Committee expects to be notified on a quarterly 
basis if the contribution from the Institutes and Centers or 
the allocation of funding by initiative changes from what is 
presented in the congressional justification.
    Biodefense.--The Administration's fiscal year 2006 budget 
for NIH includes $1,791,000,000 for bioterrorism activities, 
including funds proposed in the Public Health and Social 
Services Emergency Fund. The Committee has included the 
$97,021,000 requested for NIH within the Emergency Fund 
directly in the NIH Office of the Director appropriation. The 
Committee has not identified a specific funding level for 
biodefense research, choosing to give the Director of NIH 
flexibility in determining what share of NIH resources should 
be considered biodefense activities.
    Balance in the research portfolio.--The Committee 
reiterates its longstanding view that NIH should distribute 
funding on the basis of scientific opportunity. The Committee 
urges the Director and the Administration to continue to resist 
pressures to earmark, set aside and otherwise politicize these 
resources. To enhance NIH's flexibility to allocate funding 
based on scientific opportunity, the Committee has attempted to 
minimize the amount of direction provided in the report 
accompanying the bill. For example, there are no directives to 
fund particular research mechanisms, such as centers or 
requests for applications, or specific amounts of funding for 
particular diseases.
    In stating that scientific opportunity should be the basis 
for allocating research funding, the Committee understands that 
other factors also are relevant to NIH's decisions, including 
such considerations as the infectious nature of a disease, the 
number of cases and deaths associated with a particular 
disease, the Federal and other costs of treating a disease, the 
years of productive life lost due to a particular disease, and 
the estimated proximity to research breakthroughs. The 
Committee does not presume to judge which criteria should take 
precedence or carry the greatest weight in individual funding 
decisions, but urges NIH to consider the full array of relevant 
criteria as it constructs its research portfolio. The Committee 
applauds the Director's focus on the need to address chronic 
diseases with preemptive interventions before symptoms appear 
and function is lost.
    AIDS funding.--Consistent with the philosophy outlined 
above, the Committee has chosen not to earmark a specific 
dollar amount for AIDS research. The Committee understands that 
it would be NIH's intent to allocate AIDS funding consistent 
with the Director's recommendations. The Committee understands 
that this allocation may change before the beginning of the 
fiscal year.
    The Committee intends that the funds allocated for AIDS 
should be spent in a manner fully consistent with the AIDS 
research plan developed by the Office of AIDS Research (OAR) 
and expects the Director of NIH to use the full authority of 
his office to ensure that this occurs. The Committee has 
provided the Director of OAR, jointly with the Director of NIH, 
transfer authority to reallocate up to three percent of funds 
designated for AIDS research among Institutes, subject to 
normal reprogramming procedures. The Committee encourages NIH 
to use this authority whenever it believes that an adjustment 
in the allocation of AIDS funding between Institutes is 
appropriate to achieve scientific objectives or to facilitate 
promising research efforts.
    The Committee continues to support OAR, its leadership, and 
its coordinated budget planning process and expects the 
individual institutes and centers to fully cooperate with OAR's 
work. The Committee has provided funding for the OAR within the 
Office of the Director and intends that the OAR will maintain 
its current structure and responsibilities, including the 
allocation of an emergency discretionary fund.

                       NATIONAL CANCER INSTITUTE

    The Committee provides $4,841,774,000 for the National 
Cancer Institute (NCI), which is $16,515,000 above the fiscal 
year 2005 comparable level and the same as the budget request. 
The bill includes language requested by the Administration 
permitting up to $8,000,000 for repairs and improvements to the 
NCI intramural facility in Frederick, Maryland.
    Mission.--The NCI conducts and supports basic and applied 
cancer research in early detection, diagnosis, prevention, 
treatment and rehabilitation. NCI provides training support for 
research scientists, clinicians and educators, and maintains a 
national network of cancer centers, clinical cooperative 
groups, and community clinical oncology programs, along with 
cancer prevention and control initiatives and outreach programs 
to rapidly translate basic research findings into clinical 
practice.
    Prostate Cancer.--The Committee recognizes NCI's commitment 
to prostate cancer research as laid forth in its ``Prostate 
Cancer Research Plan, FY 2003--FY 2008''. The Committee 
requests that NCI provide an annual update every January on its 
progress in prostate cancer research as it reflects the goals 
outlined in the plan for years fiscal years 2006-08. In 
developing this update, the Committee urges the NIH to consult 
and work closely with the research community, clinicians, and 
patient advocacy groups and the Congress.
    Breast cancer.--Breast cancer's toll continues to threaten 
the lives and the quality of life of thousands of women. In 
addition to ongoing research activities underway at the 
Institute, the Committee hope that increased attention will 
also be given to areas of research that focus on helping women 
to more fully restore and improve their quality of life after 
treatment, including further research on lymphadema, stress, 
nutrition, exercise, weight, and environment.
    The Committee remains concerned about missed opportunities 
in breast cancer screening, detection, prevention, control, 
early diagnosis, and mammogram detection, reading and analysis. 
The Committee encourages NCI to further accelerate advances in 
breast cancer screening technology and to capitalize on 
existing and create new technologies that improve early 
diagnosis, health outcomes, and survival.
    Ovarian cancer.--The Committee remains concerned that 
survival rates associated with ovarian cancer have improved 
only slightly over the past 20 years. Ovarian cancer is the 
deadliest of all gynecological cancers. For all women diagnosed 
with ovarian cancer, the five-year survival rate is 45 percent. 
More than two-thirds of the women have advanced disease at the 
time of diagnosis, and for this group, the 5-year survival rate 
is 29 percent. The Committee commends NCI for its recognition 
of the importance of studying this deadly women's disease and 
appreciates the NCI's recent investment that is helping to 
increase the understanding of the unique molecular pathways 
associated with ovarian cancer through its SPOREs program. The 
Committee encourages NCI to sustain and strengthen its 
commitment to and investment in ovarian cancer and maintain the 
specialized programs of research excellence (SPORE) initiatives 
directed toward ovarian cancer in fiscal year 2006.
    Liver Cancer.--The Committee remains concerned with the 
increasing incidence of primary liver cancer, which is in sharp 
contrast to many other forms of cancer where the incidence is 
declining and the treatment options are rapidly increasing. The 
Committee is aware that NCI, working with NIDDK, has convened 
an Experts Conference and is moving ahead with plans to 
increase resources dedicated to this disease. The Committee 
urges NCI to make a strong commitment to research on primary 
liver cancer with particular focus on the development of drugs 
that target the cancer without killing healthy cells by 
interfering with the cellular pathways of the disease. The 
Committee further urges NCI to continue to support the NIDDK 
sponsored HALT-C clinical trial which has particular relevance 
to the NCI mission.
    Pancreatic cancer.--Pancreatic cancer is the country's 
fourth leading cause of cancer death. Most patients present 
with advanced disease at diagnosis and the median overall 
survival rate for people diagnosed with metastatic disease is 
only about six months. The Committee is concerned that there 
are too few scientists researching pancreatic cancer and 
compliments the NCI's past efforts for increasing the research 
field through its program of a 50 percent formalized extended 
payline for grants that were 100 percent relevant to pancreatic 
cancer. The Committee considers this an important method for 
attracting both young and experienced investigators to develop 
careers in pancreatic cancer. In 2004, the NCI established a 
new policy for awarding additional grants in pancreatic cancer 
research and extended this initiative to research that is 50 
percent relevant to pancreatic cancer. The Committee requests 
NCI to report in February, 2006 on how the two changes in 
policy have affected the pancreatic cancer portfolio, including 
the percentage relevancy of each grant to pancreatic cancer, 
and urges NCI to continue its commitment to fertilize the 
pancreatic cancer field.
    Lymphoma.--Lymphoma is the fifth most common cancer and the 
most common hematological cancer. Unlike many other cancers, 
lymphoma often strikes individuals in young adulthood and the 
middle years, significantly impacting their professional 
productivity and individual role in the family and society. The 
Committee recommends that NCI take bold action to address 
lymphoma as a public health problem and to capitalize on 
important research advances to date. The Committee encourages 
NCI to strengthen its investment in translational and clinical 
lymphoma research.
    The Committee commends NCI and the National Institute of 
Environmental Health Sciences (NIEHS) for convening a workshop 
on the viral and environmental links to lymphoma and recommends 
that steps be taken to strengthen the NCI investment in this 
area. The Committee recommends that NCI direct resources to: 
(1) studies of adequate scope to assure the identification of 
environmental risk factors for specific subtypes of lymphoma; 
(2) small studies designed to improve detection and 
quantification of historically difficult-to-measure 
environmental factors; (3) studies that are directed toward 
enhancing the understanding of the role of the immune system in 
the initiation and progression of lymphoma; and (4) studies 
that examine the simultaneous presence of a wide profile of 
infectious agents among individuals with lymphoma.
    The Committee recommends that resources be directed to 
research related to long-term survivors of both non-Hodgkin's 
lymphoma and Hodgkin's lymphoma. The report of the Leukemia, 
Lymphoma, and Myeloma Progress Review Group (LLM PRG) 
recommended that resources be invested in identifying the 
populations of patients that are at high risk of adverse 
outcomes from their treatment for lymphoma.
    Cancer centers at minority institutions.--The Committee 
commends NCI on the success of its cancer centers program. 
Given that minority populations suffer disproportionately from 
virtually every form of cancer, the Committee encourages NCI to 
give consideration to supporting the establishment of a 
comprehensive center at a minority institution focused on 
research, treatment, and prevention of cancer in African 
American and other minority communities. The Committee is 
pleased with NCI's attention to this important matter.
    Neurofibromatosis (NF).--The Committee is pleased with 
NCI's clinical trials of NF patients and encourages NCI to 
enhance its NF research portfolio in such areas as further 
development of animal models, natural history studies, 
therapeutic experimentation, and clinical trials. The Committee 
recognizes that basic research has successfully brought NF into 
the clinical era and encourages NCI to create, fund, and 
implement NF clinical trial infrastructures including NF 
centers, patient data bases, and tissue banks. The Committee 
further encourages NCI to apply existing cancer drugs to NF 
patients in clinical trials and to develop new drugs for NF 
which could then apply to the general population because of 
NF's connection to many forms of human cancer. The Committee is 
aware of significant new advances in NF research in the past 
few years in the area of tumor suppression and encourages NCI 
to continue to coordinate its efforts with other NIH institutes 
and government agencies.
    Angiogenesis.--The Committee applauds NCI, working with 
other Institutes, for its leadership in planning and launching 
the Trans-NIH Angiogenesis Research Program (TARP) that 
promotes multidisciplinary research on the control and 
promotion of new blood vessel growth. This research has the 
potential to lead to the development of new therapeutic 
strategies for a variety of diseases, including cancer, 
diabetic eye disease, diabetic kidney disease, and others.
    Hemophilia.--The Committee understands that field work on 
the Multi-Center Hemophilia Cohort Study will be complete in 
September, 2005. This cohort offers a rich database for 
improving the understanding of hepatitis C virus and other 
concerns of major public health interest. The Committee expects 
NCI to take all necessary steps to ensure the samples obtained 
through this cohort are preserved and accessible for future 
research. The Committee also requests a report by March 31, 
2006 on possible future research opportunities using the cohort 
samples.
    Tuberous sclerosis complex (TSC).--TSC is a genetic 
disorder that triggers uncontrollable tumor growth in multiple 
organs of the body, including the brain, heart, kidneys, lungs, 
liver, eyes or skin. In light of its similarities to the 
uncontrolled growth of cancer cells, many scientists believe 
that determining the cause of tumor growth in TSC could open 
the way for cures and treatments for cancer as well. To those 
ends, the Committee strongly encourages NCI to support programs 
examining the molecular and cellular basis of TSC, and the role 
of TSC in tumor development.
    American Russian Cancer Alliance (ARCA).--The Committee 
applauds the progress of ARCA in harnessing the scientific 
strengths of its partners in pursuit of novel research 
activities that ultimately benefit cancer patients worldwide. 
The Committee notes in particular the continued development of 
the unique ARCA projects in molecular imaging and radioisotope-
targeted therapy that have strengthened the scientific 
collaborations with the leading Russian nuclear research 
centers and American cancer centers. Moreover, the Committee 
recognizes and commends NCI for providing support to the ARCA 
infrastructure and facilitating international exchange and 
communication between the American and Russian partners. The 
Committee encourages NCI to continue and enhance its support 
for the research programs of ARCA, recognizing both the 
scientific opportunities within the partnership and the 
national interest in fostering the international effort to 
develop new, productive avenues for the use of nuclear 
stockpiles previously earmarked for weapons development.
    Cancer metastasis.--The NCI is encouraged to develop an 
interdisciplinary and integrated approach to study bone 
metastasis, by combining the expertise of oncologists, bone 
biologists and metastasis experts. Key issues to address 
include the generation of novel organ-like or mouse models 
which closely mimic tumor bone interactions that will pave the 
way for delineating novel mechanisms of how tumor cells go to 
the bone; designing novel targets for better prognosis; and 
effective therapeutic targeting. The Committee encourages NCI 
to continue supporting research that furthers the understanding 
of the causes and consequences of sarcoma. The Committee also 
recommends that NCI support research on osteosarcoma to improve 
survival and quality of life and to prevent metastatic 
osteosarcoma in children and teenagers who develop this cancer.
    Tobacco harm reduction.--The Committee recognizes and 
applauds the significant work of HHS and its agencies in the 
area of tobacco and health, particularly recent efforts aimed 
at facilitating smoking cessation. The Committee believes it is 
important to continue to explore additional methods to reduce 
smoking related mortality and morbidity in the 10 to 15 percent 
of the adult population who cannot or will not quit smoking. In 
a recent study funded by NCI, a panel of leading tobacco 
experts was asked to review scientific literature for the 
comparative mortality risks of low-nitrosamine smokeless 
tobacco products and conventional cigarettes. The panel of 
experts concluded that, based on published scientific 
literature, low-nitrosamine smokeless tobacco products pose a 
substantially lower risk to the user than conventional 
cigarettes. Given this important conclusion, the Committee 
urges NCI to continue its research into harm reduction 
strategies for cigarette smokers, and consider the role low-
nitrosamine smokeless tobacco products may play in the overall 
effort to reduce the incidence of cigarette smoking in the U.S.
    Cancer biobank.--The Committee believes that the cancer 
biobank, because it will centralize and standardize molecular 
annotation of tissues, has the potential to greatly accelerate 
the understanding of cancer and the discovery and development 
of new biomarkers, new diagnostics and new therapeutic 
approaches. As it is established by NCI, the Committee believes 
that it will be most efficient to utilize existing technologies 
such as high-density microarrays, given the long time frame for 
the development of new technologies.
    Advanced technologies.--The Committee commends NCI for its 
goal of eliminating the suffering and death caused by cancer by 
the year 2015. The Committee encourages NCI to pursue the use 
of advanced technologies such as nanotechnology, proteomics, 
and imaging, to rapidly translate basic research discoveries 
into targeted interventions to ultimately achieve the 2015 
goal.
    Informatics grid.--The Committee is pleased with NCI's 
development of the cancer Biomedical Informatics Grid (caBIG) 
as a network to facilitate the integration of diverse data 
types and the sharing of interoperable analytic tools. NCI is 
encouraged to work with the Office of the National Coordinator 
for Health Information Technology to use CaBIG as a prototype 
for an interoperable clinical data network.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

    The Committee provides $2,951,270,000 for the National 
Heart, Lung, and Blood Institute (NHLBI), which is $10,069,000 
above the fiscal year 2005 comparable level and the same as the 
budget request.
    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 basic, 
clinical, and population-based and health education research.
    Cardiovascular diseases.--The Committee continues to urge 
the Institute to place a high priority on research for heart 
disease, stroke and other cardiovascular diseases. The 
Committee encourages NHLBI to strengthen its research portfolio 
through all available mechanisms into the causes, cure, 
prevention and treatment of cardiovascular diseases.
    Heart failure clinical research network.--The Committee is 
concerned that in spite of advances in treatment, the number of 
newly diagnosed cases and the number of Americans suffering 
from heart failure continues to grow. The Committee encourages 
NHLBI to consider initiating a research network to conduct 
clinical studies using new approaches to improve outcomes for 
heart failure patients and to provide an infrastructure to 
enable rapid translation of promising research findings into 
enhanced patient care. The network would have the capability of 
implementing multiple concurrent clinical studies that may show 
promise for new therapies and provide background for larger 
clinical trials.
    Innovative technologies for engineering small blood 
vessels.--The Committee understands that the supply of natural 
blood vessels for multiple grafts does not meet the demand for 
patients undergoing heart artery bypass surgery and that 
prosthetic grafts for children born with complex heart defects 
fail at an unacceptable rate. The Committee encourages NHLBI to 
conduct research to advance the development of substitutes for 
natural blood vessels.
    Specialized centers of clinically oriented research (SCCOR) 
for vascular injury, repair, and remodeling.--Vascular diseases 
result from clogged, weakened or otherwise damaged blood 
vessels. The Committee encourages NHLBI to consider initiating 
a new SCCOR program to conduct interdependent clinical and 
multidisciplinary basic research projects on the molecular and 
cellular mechanisms of vascular injury, repair, and remodeling. 
Such a program would promote patient-oriented research to 
improve prevention, detection, and treatment of vascular 
diseases. The SCCOR would provide an environment for new 
clinical investigators to develop skills and research 
capabilities to conduct relevant research in this area.
    Cooley's anemia.--The Committee remains strongly supportive 
of the focused research effort that is being undertaken by the 
thalassemia clinical research network, which is comprised the 
leading research institutions in the field of thalassemia, or 
Cooley's anemia. The Committee believes that this network is 
just beginning to meet its promise and urges NHLBI to continue 
it and support the research projects undertaken by it.
    Hemophilia.--The Committee commends NHLBI for its 
leadership in advancing research on bleeding and clotting 
disorders and the complications of these disorders. The 
Committee encourages NHBLI to maintain its work in this area 
and applauds the Institute for its efforts, in cooperation with 
voluntary organizations, to support research on improved and 
novel therapies for these disorders.
    Pulmonary hypertension.--Pulmonary hypertension (PH) is a 
rare, progressive and fatal disease that predominantly affects 
women, regardless of age or race. PH causes deadly 
deterioration of the heart and lungs and is a secondary 
condition in many other serious disorders such as scleroderma 
and lupus. The Committee continues to view research in this 
area as a high priority and commends NHLBI's efforts to promote 
PH-related research. The Committee encourages the Institute to 
support funding for basic research, gene therapy and clinical 
trials of promising pharmaceuticals, and to take appropriate 
measures to ensure the submission of high quality proposals in 
this area.
    Cardiovascular advanced screening program.--The Committee 
encourages NHLBI to sponsor a workshop on advanced screening 
methods for cardiovascular disease. This workshop would 
incorporate the Cardiovascular Health Study data, expertise 
from the National Cholesterol Education Project, and input from 
the cardiology community. The proceedings from this workshop 
could be used in the development of a Federal plan to address 
barriers to access to these advanced screening methods.
    Transmissible spongiform encephalopathies.--The Committee 
encourages NHLBI to continue its efforts to develop a 
diagnostic test for TSE that would be suitable for screening 
the blood supply. Currently, there is no suitable method for 
identifying TSE-infected blood. In addition, the Committee 
encourages NHLBI to seek new technologies and procedures for 
inactivating blood-borne causative agents for human TSEs, 
further ensuring a safe blood supply. Human TSEs, for which 
there are no known treatments, include Creutzfeld-Jakob disease 
and new variant Creutzfeldt-Jakob disease.
    National COPD education and prevention program.--The 
Committee is pleased that NHLBI held a preliminary workshop to 
formulate strategies towards implementing a national chronic 
obstructive pulmonary disease (COPD) education and prevention 
program. Since COPD is the fourth leading cause of death in the 
United States, the Committee urges NHLBI to continue its 
education efforts to bring advances in medical care to the 
public. Early identification of those at-risk for or who have 
COPD is essential in the effort to stem the growth of the 
population with COPD. The Committee encourages NHLBI to 
continue its efforts in this area, working with national lung 
organizations, to develop a national education campaign for 
providers and the public about COPD.
    Scleroderma.--The Committee is encouraged by NHLBI's 
growing interest in scleroderma, a chronic and progressive 
disease that predominantly strikes women. Scleroderma is 
disfiguring and can be life-threatening, affecting multiple 
systems including the heart and lungs. The Committee is pleased 
that NHLBI funded the Scleroderma Lung Study, a large multi-
center trial whose focus is to find a therapy that may alter 
the course of the inflammation of the lungs that occurs in 
approximately 40 percent of those diagnosed with the systemic 
scleroderma. The Committee also commends NHLBI for its 
commitment to finding a cause and improved therapies for 
pulmonary arterial hypertension. Pulmonary arterial 
hypertension occurs in approximately 50 percent of those 
diagnosed with systemic scleroderma. More research is needed to 
identify the causes of the complications of scleroderma that 
include pulmonary fibrosis, pulmonary hypertension, myocardial 
fibrosis, cardiac arrhythmias, pericarditis, and Raynaud's 
Phenomenon.
    Neurofibromatosis (NF).--Significant advances continue to 
be made in research on NF's implications with heart disease 
and, in particular, its involvement with hypertension and 
congenital heart disease. The Committee applauds NHLBI for its 
involvement with NF research and with NF patient advocacy 
groups and encourages NHLBI to continue to expand its NF 
research portfolio in light of the enormous implications for 
the general population.
    Sleep disorders.--The Committee continues to recommend that 
the National Center on Sleep Disorders Research partner with 
other federal agencies, such as the Centers for Disease Control 
and Prevention, as well as voluntary health organizations to 
develop a sleep education and public awareness initiative to 
serve as an ongoing, inclusive mechanism for public and 
professional awareness on sleep and sleep disorders.
    Marfan syndrome.--Marfan syndrome is characterized by 
aortic aneurysms, painful orthopedic issues, pulmonary issues 
and ocular manifestations that can result in blindness. The 
Committee commends NHLBI for its support of research 
opportunities to study this life threatening, degenerative 
genetic disorder. Recent advances in basic research are ready 
to be translated into promising clinical trials. The Committee 
suggests that NHLBI collaborate with other institutes to 
support a clinical trial for drug therapies to potentially 
reverse the cardiovascular and pulmonary manifestations of this 
disorder.
    Alpha-1 antitrypsin deficiency.--The Committee is aware 
that Alpha-1 antitrypsin deficiency is often misdiagnosed as 
asthma or Chronic Obstructive Pulmonary Disease (COPD). Alpha-1 
is a major cause of liver transplantation in adults and 
children. The Committee recommends the establishment of an 
inter-institute coordinating committee to facilitate 
cooperation between NHLBI, NIDDK, NHGRI, and other institutes 
to enhance the NIH research portfolio, encourage targeted 
detection, raise public awareness about Alpha-1 and provide 
appropriate information to health professionals.
    Duchenne muscular dystrophy (DMD).--The Committee is 
pleased that NLHBI has enhanced its research and related 
activities surrounding pulmonary complications associated with 
DMD and urges the Institute to continue to enhance its work in 
this area. The Committee hopes that NHLBI will become more 
involved with NIH muscular dystrophy activities by joining the 
Muscular Dystrophy Coordinating Committee.
    Primary immunodeficiency diseases.--The Committee 
understands that NHLBI has begun to work with voluntary 
agencies as part of a national physician education and public 
awareness campaign for primary immunodeficiency diseases. The 
Committee encourages NHLBI to take further action in this 
regard and to continue to be an active participant in the 
development of educational materials, conferences, and related 
initiatives, as appropriate.
    Novel targets and therapy development for clot-based 
stroke.--The Committee recognizes that an urgent need exists to 
develop new therapies to reduce bleeding risk and minimize 
brain damage and loss of function from stroke. The Committee 
encourages NHLBI to consider initiating a collaborative effort 
to identify new molecular targets, explore promising agents, 
and develop innovative therapies to quickly restore blood flow 
to the brain to limit stroke damage.
    Nontuberculous mycobacteria [NTM].--Mycobacteria are 
environmental organisms found in both water and soil that can 
cause significant respiratory damage. The Committee is aware of 
the increasing incidence of nontuberculous mycobacteria [NTM] 
pulmonary infections in women, particularly involving rapidly 
growing mycobacteria, an inherently resistant subspecies. The 
Committee encourages NHLBI to collaborate with NIAID and other 
institutes leading to a better understanding of NTM and 
enhancing diagnostics and treatment and promoting appropriate 
education of health care providers.
    Lymphangioleiomyomatosis (LAM).--The Committee remains very 
interested in efforts to find a cure for LAM, a progressive and 
often fatal lung disease of women with no effective treatment. 
The Committee understands that very recent scientific findings 
have presented new treatment approaches for clinical testing, 
and that experimental trials with the drug sirolimus have 
begun. The Committee encourages NHLBI to explore opportunities 
for funding clinical treatment trials through both intramural 
and extramural means and to use all available mechanisms as 
appropriate, including support of state-of-the-science 
symposia, request for applications, and facilitating access to 
human tissues, to stimulate a broad range of clinical and basic 
LAM research.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

    The Committee provides $393,269,000 for the National 
Institute of Dental and Craniofacial Research (NIDCR), which is 
$1,440,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The NIDCR conducts and supports research and 
research training to improve craniofacial, oral and dental 
health. The Institute's programs reflect the genetic, 
behavioral and environmental factors that result in complex 
human disease and are clustered into the following areas: 
inherited disorders; infection and immunity; oral, pharyngeal 
and laryngeal cancers; chronic and disabling conditions such as 
bone and joint diseases and chronic pain; behavioral science, 
epidemiology and health promotion; and tissue engineering and 
biomimetics research to improve diagnostics and tissue repair 
and regeneration.
    Saliva.--The Committee is aware that research on saliva has 
progressed rapidly and holds the potential to be an inexpensive 
non-invasive diagnostic tool for early detection of breast 
cancer, osteoporosis, hepatitis, HIV, and Sjogren's disease. 
The Committee encourages NIDCR to work cooperatively with NCI 
and other appropriate institutes in pursing research 
initiatives on the development of saliva as a diagnostic tool.
    Dental abnormalities.--The Committee encourages NIDCR to 
continue its support of research aimed at the health of oral 
mineralized tissues. This includes studying the role of genetic 
factors and the potential for cell-based and pharmacological 
therapy and early screening for osteoporosis. Additionally 
NIDCR is urged to continue research on fibrous dysplasia/McCune 
Albright syndrome and to focus on the dental abnormalities 
associated with Paget's disease.
    Scleroderma.--The Committee is encouraged by NIDCR's 
interest in scleroderma, a chronic and progressive disease that 
predominately strikes women. Scleroderma is often associated 
with a number of dental and craniofacial complications, 
including xerostomia and microstomia. Additional concerns are 
increased frequency of caries, periodontal disease, fibrotic 
changes, fungal infections, telangectasia and bone resorption 
of the mandible. Additional research is needed to develop safe 
and effective treatments and to identify the causes of the 
serious complications from the disease.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

    The Committee provides $1,722,146,000 for the National 
Institute of Diabetes and Digestive and Kidney Diseases 
(NIDDK), which is $8,562,000 above the fiscal year 2005 
comparable level and the same as the budget request. In 
addition, $150,000,000 in mandatory funds are available for 
juvenile diabetes research.
    Mission.--The NIDDK supports research in three major 
disease categories: diabetes, endocrinology, and metabolic 
diseases; digestive diseases and nutrition; and kidney, 
urologic, and hematologic diseases. The NIDDK 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.
    Type-2 diabetes.--Type-2 diabetes exacts an enormous human 
and economic toll on Americans. Diabetes costs the healthcare 
system more than $92 billion a year. Medical research has shown 
that achieving and maintaining a blood glucose level below 7 
percent significantly lowers the risk of blindness, amputation, 
and other serious complications of diabetes. The Committee is 
concerned that, despite these advances, only about 2 in 5 
diabetics report having a blood glucose level of less than 7 
percent. The Committee recognizes that treatment guidelines for 
diabetes exist that include recommendations for achieving and 
maintaining appropriate glucose levels, and the Committee 
encourages NIDDK to promote greater use of treatment guidelines 
in clinical practice. The Committee requests that NIDDK examine 
the disparity in available guidelines and actual treatment and 
report to Congress within six months of enactment on actions 
the government can take that will rapidly close the disparity 
between treatment guidelines and the care diabetics receive 
within the first year of being diagnosed.
    Islet transplantation.--The Committee commends NIDDK and 
NIAID for the establishment of the Clinical Islet 
Transplantation Consortium and the islet transplantation 
clinical trial that will include Medicare-eligible individuals 
whose transplant and related costs will be covered by Medicare. 
Cooperation between the NIDDK and NIAID and members of the 
Consortium is urged to ensure the timely launch of these 
clinical trials.
    Drug screening.--The Committee applauds NIDDK for convening 
an exploratory workshop to investigate the potential of 
conducting a screen of FDA-approved pharmaceutical drugs for 
hyperglycemia-induced cellular injury leading to diabetic 
complications. Screens of this type have the potential to lead 
to the identification of new treatment strategies that can be 
rapidly translated into clinical applicability. The Committee 
urges the Institute to continue to promote research in this 
promising area.
    Rapid access to intervention development.--The Committee 
commends NIDDK and NCI for extending the rapid access to 
intervention development (RAID) pre-clinical resources to 
researchers working in the field of type 1 diabetes and its 
complications. The Committee encourages NIDDK to release to the 
public information on compounds to be produced for projects 
supported by RAID, much like the NCI releases for cancer-
related projects on its public website.
    Pediatric kidney disease.--Kidney disease remains a 
persistent and poorly understood problem among infants, 
children and adolescents, impairing normal growth and 
development and often resulting in learning disabilities and 
mental retardation. Of urgent concern today is the explosion in 
the incidence of obesity among chilren and adolescents, a 
morbidity that places more than 15 percent of America's 
children at risk for developing type 2 diabetes, hypertension, 
and chronic kidney disease (CKD). These morbidities not only 
represent a significant financial burden to the health care 
system but also are important risk factors for the development 
of cardiovascular disease. The Committee encourages NIDDK to 
continue to support research focused on the pathogenesis, 
prevention, and treatment of kidney disease in children. The 
Committee recommends that emphasis be placed on exploring the 
contributions of obesity, type 2 diabetes, and hypertension to 
progression of disease, and interventions that may limit 
cardiovascular morbidity in patients with CKD.
    Polycystic kidney disease (PKD).--The Committee recognizes 
that NIH research combined with grants from the private sector 
and the involvement of industry has produced the first clinical 
drug trial for PKD in humans, and has fostered the development 
of additional, innovative PKD therapies. The Committee 
recognizes that the four PKD centers of excellence have 
engendered a broad range of alternative model research systems 
and reagents shared worldwide among PKD investigators and have 
drawn a host of investigators from other disciplines into the 
PKD field. The Committee encourages NIDDK to facilitate PKD 
clinical trials by strengthening studies of pathophysiology and 
cellular pathobiology.
    Incontinence.--Many otherwise healthy, active individuals 
suffer from incontinence. Fecal incontinence, also called bowel 
incontinence, affects people of all ages and is associated with 
a wide variety of causes. The Committee encourages NIDDK to 
develop a standardization of scales to measure incontinence 
severity and quality of life and to develop strategies for 
primary prevention of fecal incontinence associated with 
childbirth.
    Interstitial cystitis (IC).--The Committee believes that 
the 2003 NIDDK-sponsored scientific symposium on IC was very 
successful and encourages NIDDK to convene a similar symposium 
on IC in 2006, collaborating with appropriate voluntary 
organizations. The Committee also encourages NIDDK to hold a 
separate meeting of leading international researchers involved 
in IC research to seek clarity on the definition of IC. The 
absence of a uniform definition which accurately captures the 
condition and the affected population is negatively affecting 
patients in terms of diagnosis and treatment as well as 
researchers in terms of literature review. The Committee was 
encouraged to learn that NIDDK is launching an IC awareness 
campaign and hopes that NIDDK will continue to work closely 
with the IC patient community on both developing the content 
and executing the campaign.
    Liver disease research action plan.--The Committee is 
pleased to note that NIDDK, working with the leading scientific 
experts in the field, has prepared and published a 
comprehensive liver disease research action plan to guide 
future research activities. The plan is organized into 16 
chapters and identifies numerous areas of research important to 
virtually every aspect of liver disease. The Committee 
recommends that steps be taken to begin to implement the plan 
immediately and be ready to report at next year's hearings what 
has been accomplished to date, as well as future plans.
    Hepatitis B.--The Committee is concerned that a consensus 
treatment protocol for hepatitis B does not yet exist, but is 
pleased to learn that NIDDK is actively supporting preliminary 
research in order to convene a research workshop to plan a 
hepatitis B consensus development conference. The Committee is 
pleased that NIDDK is taking all necessary steps to plan a 
successful hepatitis B consensus development conference and 
hopes that this conference is held soon.
    Hepatitis C.--The Committee is pleased to learn that there 
have been 50 patent applications filed for new therapies for 
hepatitis C and there are at least 6 drugs currently in early 
human trials. In addition to developing new drugs, the 
Committee encourages NIDDK to study the improvement of existing 
drugs to reduce their toxicity and negative side effects. The 
Committee applauds NIDDK for formally adopting the goal of a 
90% treatment effectiveness rate for hepatitis C within ten 
years.
    Fatty liver disease.--The Committee notes that there is an 
emerging obesity-related chronic liver disease, which may 
affect as many as one in four adults and a significant number 
of obese children. This diagnosis encompasses a spectrum of 
severity with many cases evolving into non-alcoholic 
steatohepatitis (NASH) and, ultimately, cirrhosis. NASH-related 
liver disease has already become an important indicator for 
liver transplantation, and in the absence of better treatments, 
the need for NASH-related liver transplantation will increase 
significantly over time. The Committee is pleased that NIDDK is 
funding a fatty liver disease clinical trial that includes both 
adult and pediatric populations. The Committee encourages NIDDK 
to focus research on the progression of fatty liver disease to 
cirrhosis and the impact of alcohol on the progression of fatty 
liver disease.
    Pediatric liver disease.--The Committee is pleased that 
NIDDK has taken steps to increase research on biliary atresia, 
the most common cause of liver transplantation in children, by 
creating ten centers within the Biliary Atresia Clinical 
Research Consortium. The Committee is also pleased that centers 
have been added with a special focus on additional neonatal 
liver diseases.
    Alpha-1 antitrypsin deficiency.--The Committee is aware 
that alpha-1 antitrypsin deficiency liver disease is a leading 
cause of pediatric transplantation and can manifest at any age. 
The Committee is encouraged that NIDDK has invested in research 
of this disorder and encourages NIDDK to collaborate with NHLBI 
and other institutes to enhance its research portfolio, 
encourage detection, raise public awareness about alpha-1 and 
provide appropriate information to health professionals.
    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 colorectal 
cancer, inflammatory bowel disease, irritable bowel syndrome, 
hemochromatosis, celiac disease, and hepatitis take a 
tremendous toll in terms of human suffering, mortality, and 
economic burden. The Committee commends NIDDK on the success of 
its Digestive Disease Centers program in addressing a wide 
range of disorders. The Committee continues to encourage NIDDK 
to strengthen this important program with an increased emphasis 
on irritable bowel syndrome.
    Irritable bowel syndrome.--The Committee remains concerned 
about the increasing frequency of irritable bowel syndrome 
(IBS), a chronic complex of disorders that malign the digestive 
system. This common disorder strikes people from all walks of 
life, affecting between 25 and 45 million Americans. The 
Committee encourages NIDDK to provide adequate funding for 
irritable bowel syndrome/functional bowel disorders research 
and to give high priority to funding grants that will continue 
to increase the IBS portfolio. The Committee requests NIDDK to 
report to the Committee by March 15, 2006 its views on the 
appropriateness of developing a strategic plan for IBS 
research.
    Inflammatory bowel disease.--The Committee has been 
encouraged in recent years by discoveries related to Crohn's 
disease and ulcerative colitis, collectively known as 
inflammatory bowel disease (IBD). These extremely complex 
disorders represent the major cause of morbidity from 
intestinal illness. The Committee commends NIDDK for its strong 
leadership in this area and encourages the Institute to give 
priority consideration to the following areas of IBD research: 
the cellular, molecular and genetic structure of IBD, 
identification of the genes that determine susceptibility or 
resistance to IBD in various patient subgroups, and translation 
of basic research findings into patient clinical trials as 
outlined in the research agenda developed by the scientific 
community entitled, ``Challenges in Inflammatory Bowel 
Disease.'' The Committee also encourages NIDDK to continue to 
strengthen its partnership with the IBD community on innovative 
research projects.
    Scleroderma.--The Committee encourages NIDDK to support 
scleroderma-relevant research. Scleroderma is a chronic and 
progressive disease that predominantly strikes women. It is 
estimated that ninety percent of patients with systemic 
sclerosis have gastrointestinal (GI) involvement and that, of 
that number, fifty percent have clinically significant 
manifestations. GI involvement can manifest as gastroesophageal 
reflux disease, dysphagia, Barrett's esophagus, gastroparesis, 
``watermelon stomach'', malabsorption, and fibrosis of the 
small and large intestines. Renal crisis affects twenty percent 
of those with systemic sclerosis often within the first five 
years after diagnosis. More research is needed in order to 
develop safe and effective treatments and to identify the 
causes of the complications of scleroderma.
    Glomerular disease research.--The Committee continues to be 
pleased with the work of NIDDK in the area of glomerular 
disease research, particularly as it relates to focal segmental 
glomerulosclerosis. The Committee commends NIDDK for conducting 
the recent glomerular disease workshop and encourages NIDDK to 
use a program announcement or other appropriate mechanism to 
ensure the initiation of grant proposals, training positions, 
and other activities to expand the NIDDK portfolio in this 
important area of research.
    Tuberous sclerosis complex.--Tuberous sclerosis complex 
(TSC) is a genetic disorder that triggers uncontrollable tumor 
growth in multiple organs of the body including the kidneys, 
where patients are at risk for polycystic kidney disease, 
cancer or, most commonly, benign growths that can result in 
kidney failure. The Committee encourages NIDDK to support 
studies examining the molecular and cellular basis of these 
manifestations of TSC as well as pre-clinical and clinical 
studies.
    Osteoporosis.--The Committee encourages NIDDK to support 
research targeting new technologies and therapies to increase 
bone mass and combat osteoporosis through focus on: (1) 
genetics, environmental and lifestyle factors, and (2) the 
effects of disease, in order to address the research questions 
highlighted in the Surgeon General's Report on Bone Health and 
Osteoporosis.
    Paget's disease.--The Committee encourages NIDDK to study 
the functional consequences of the recently identified gene 
mutations in Paget's disease as a means of identifying new 
therapeutic treatments for the disease.
    Mucopolysaccharidosis (MPS).--The Committee recognizes the 
efforts of NIDDK to enhance research efforts to achieve a 
greater understanding and pursue development of effective 
therapies for MPS disorders. In addition to the general overall 
support of broad based MPS research, the Committee supports 
efforts by NIDDK to reach out to NIAMS to improve collaborative 
bone and joint disease research in MPS disorders. Research 
focused on the underlying pathophysiology of bone and joint 
lesions, the gene mutations and substrates that are stored, and 
potential therapeutic approaches continue to be of significant 
interest of the Committee. The Committee commends NIDDK on its 
collaborations with NINDS, NICHD, NCRR, and ORD in advancing 
broad-based MPS-related research.
    Fragile X.--Fragile X mental retardation is a single-gene 
disorder that results from an unusual kind of mutation. Study 
of the chain of events set in motion by this mutation may lead 
to the identification of points in the process at which 
interventions may ameliorate symptoms. The Committee encourages 
NIDDK to enhance its research activities on fragile X and to 
coordinate these efforts with other Institutes working on 
related activities, including NIMH and NICHD.
    Cooley's anemia.--The Committee continues to support the 
high quality research being conducted by NIDDK on such issues 
as iron chelation, non-invasive iron measurement, fetal 
hemoglobin, and other topics critical to improving the lives of 
Cooley's anemia patients. The development of a less burdensome 
means of iron chelation is urgently needed. In addition, the 
Committee encourages NIDDK to continue to work closely with 
NIBIB to develop and perfect non-invasive means of iron 
measurement.
    Cystic fibrosis (CF).--The Committee commends NIDDK for 
supporting cystic fibrosis research and translational centers. 
When awarded later this year, they will provide resources for 
communication and collaboration between basic and clinical 
researchers to enhance the efficiency of research and foster 
cooperation within and among institutions with strong existing 
bases of cystic fibrosis (CF) research. The Committee also 
commends NIDDK for its support of the EPIC study, a 
longitudinal assessment of risk factors for and impact of 
Pseudomonas aeruginosa acquisition and early anti-pseudomonal 
treatment in children with CF. This study holds the promise of 
yielding critically important information about the optimal 
treatment of initial lung infections in children with CF. The 
Committee encourages NIDDK to continue its support of CF 
research efforts, including proteomics research. CF researchers 
are looking at the many proteins that play a role in CF, in 
hopes of identifying new drug targets to treat CF. The 
Committee commends NIDDK for its support of the program 
announcement for research proposals focusing on discovery and 
development of compounds that will correct protein misfolding. 
The Committee encourages NIDDK to further support this 
especially promising area of research.
    Hepatitis C virus (HCV) and bleeding disorders.--The 
Committee encourages NIDDK to work with appropriate voluntary 
organizations in developing and advancing research initiatives 
for addressing HCV within the bleeding disorders community.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

    The Committee provides $1,550,260,000 for the National 
Institute of Neurological Disorders and Stroke (NINDS), which 
is $10,812,000 above the fiscal year 2005 comparable level and 
the same as the budget request.
    Mission.--The NINDS supports and conducts basic and 
clinical neurological research and research training to 
increase understanding of the brain and improve the prevention 
and treatment of neurological and neuromuscular disorders. The 
NINDS mission encompasses over 600 disorders, including stroke; 
head and spinal cord injury; epilepsy; multiple sclerosis; and 
neurodegenerative disorders such as Parkinson's disease.
    Stroke.--The Committee continues to place a high priority 
on stroke research and encourages NINDS to allocate resources 
to basic, clinical and translational research into stroke, 
which is a major contributor to late-life dementia and a 
leading cause of permanent disability. The Committee encourages 
NINDS to continue implementing the long-range strategic plan 
for stroke research and to continue searching for novel 
approaches to improve stroke diagnosis, treatment, 
rehabilitation and prevention.
    Epilepsy.--Epilepsy remains a major, unsolved public health 
problem affecting the lives of millions of Americans and their 
families. The Committee seeks intensified efforts by the 
Institute to produce breakthroughs in the prevention, 
treatment, and eventual cure of epilepsy. The Committee 
applauds the development of benchmarks for epilepsy research 
resulting from the ``Curing Epilepsy: Focus on the Future'' 
conference held in 2000 and encourages NINDS to address 
important research issues raised at the ``Living Well with 
Epilepsy II'' conference held in 2003. The Committee encourages 
NINDS to continue to allocate resources to the anti-epileptic 
drug development program, and to report to the Committee in 
next year's hearings on its activities to further these 
important areas of research.
    Alzheimer's disease.--NINDS is currently supporting both 
pre-clinical and translational research intended to expand the 
pool of therapeutic agents for treating Alzheimer's disease. 
For example, a recent NINDS-supported study tested a drug that 
interferes at a specific point in the cholesterol pathway that 
contributes to the generation of amyloid protein, a hallmark of 
Alzheimer's. The study resulted in a 99 percent reduction in 
brain amyloid in a mouse model of the disease, suggesting that 
this may provide a novel approach for developing a therapeutic 
intervention for Alzheimer's disease. The Committee encourages 
NINDS to continue to assign a high priority to Alzheimer 
research, and to work closely with NIA, NIMH and other 
institutes.
    Parkinson Disease.--The Committee supports the innovative 
multidisciplinary research and training concerning Parkinson's 
disease provided by the Morris K. Udall Parkinson's Disease 
Research Centers of Excellence. The additional research 
opportunities and discoveries made by Udall Center scientists 
are leading to improved diagnosis and treatment of patients 
with Parkinson's. The Committee commends both the basic and 
clinical objectives of the Centers that, together, enhance 
research effectiveness in a multidisciplinary setting.
    The Committee commends NINDS for participating in a 
community-wide examination of private and pubic Parkinson's 
disease research funding through the Parkinson's Community 
Research Advisory Council. The Committee recommends that NINDS 
continues to participate in this effort.
    The Committee commends the Director for participating in 
the Neuroscience Blueprint, which create new opportunities for 
collaborative research across institutes and through public-
private partnerships. Specifically, the Committee encourages 
collaborations with other institutes in the areas of genetics, 
cell biology, pathology/epidemiology, non-human models, 
biomarkers, neuroimaging, gene therapy, surgical approaches, 
drug development, cell replacement therapy (i.e., stem cells), 
and mental health.
    Transmissible spongiform encephalopathies (TSE).--The 
Committee recognizes the efforts of NINDS, in collaboration 
with NHLBI, to fund contracts for the development of a 
biological assay for TSE. The Committee requests that the 
Director of the Institute be prepared to report on the progress 
made toward the development of a TSE bioassay at the fiscal 
year 2007 appropriations hearing. The Committee is particularly 
interested in the success in detecting disease-causing agents 
in blood, saliva, cerebrospinal fluid, and other bodily fluids, 
as well as lymphoid tissue, especially tonsils.
    Peripheral neuropathy.--As many as 20 million Americans 
suffer from peripheral neuropathy, a neurological disorder that 
causes debilitating pain, weakness in the arms and legs, and 
difficulty walking. Peripheral neuropathy affects approximately 
one-third of diabetics, or about 5.1 million people, while 
other forms of neuropathy are inherited; associated with 
cancer, kidney disease, or infections like hepatitis, HIV/AIDS, 
or Lyme disease; or caused by autoimmunity, traumatic injuries, 
poor nutrition, toxins, and certain medications. While 
significant research is underway on diabetic neuropathy and 
HIV/AIDS-related neuropathy, the Committee encourages NINDS to 
strengthen its research portfolio on other forms of neuropathy. 
The Committee is pleased to learn that NINDS plans to convene a 
workshop with distinguished scientists to identify research 
goals aimed at expanding the research knowledge base and 
identifying potential therapies.
    Juvenile diabetic neuropathy.--The Committee commends NINDS 
for its recognition of diabetic neuropathy as a serious problem 
of juvenile diabetes. The Committee encourages the Institute to 
work with other agencies on the development of new animal 
models of diabetic neuropathies to aid in the development and 
testing of novel clinical treatments for diabetic peripheral 
and autonomic neuropathies.
    Charcot-Marie-Tooth disease (CMT).--The Committee welcomes 
the upcoming NINDS workshop on peripheral neuropathies, and 
encourages NIH to focus on CMT in this workshop, with a goal of 
producing outcomes which will be directly relevant to CMT 
research. The Committee encourages all relevant institutes and 
centers, including NIAMS, NIDDK, and NICHD, to participate in 
the workshop. In addition, the Committee encourages NIH to 
incorporate CMT research into the Blueprint for Neurosciences 
initiative.
    Traumatic brain injury (TBI).--The Committee encourages 
NINDS to build upon basic and translational research in brain 
injury rehabilitation at the National Center on Medical 
Rehabilitation and Research (NCMRR). NCMRR has awarded grants 
to eight bench science research centers and a data center to 
establish the cooperative multi-center traumatic brain injury 
clinical trials network. The Committee encourages NINDS to 
participate in supporting these centers and to support training 
grants for TBI researchers.
    Dystonia.--The Committee continues to support research on 
the neurological movement disorder dystonia, given that 
dystonia is the third most common movement disorder after 
essential tremor and Parkinson's disease. The Committee 
encourages NINDS to support research on both focal and 
generalized dystonia, and to continue its study of the DYT1 
gene. The Committee is pleased with progress made in expanding 
the dystonia research portfolio as a result of the joint 
dystonia research program announcement, and hopes that NINDS 
will consider options for continued progress once the program 
announcement expires in August 2005.
    Spina bifida.--The Committee strongly encourages NINDS to 
enhance research to address issues related to the outcome and 
recommendations of the 2003 Spina Bifida Research Conference. 
NINDS is urged to strengthen and prioritize research efforts in 
the prevention and treatment of spina bifida and associated 
secondary conditions, with a particular focus on improved 
treatment of hydrocephalus. The Director should be prepared to 
testify on its efforts to advance these areas of research at 
the fiscal year 2007 appropriations hearing.
    Tuberous sclerosis complex (TSC).--TSC is a genetic 
disorder that triggers uncontrollable tumor growth in multiple 
organs of the body, including the brain, heart, kidneys, lungs, 
liver, eyes or skin. Its victims--many of whom are infants and 
young children--face a lifetime of suffering with kidney 
failure, seizures, behavioral disorders, autism and mental 
retardation. Because of the effects of TSC on multiple organ 
systems, the Committee last year called upon the NIH Director 
to formulate an NIH-wide research agenda. The Committee 
understands that NINDS is assigned to implement and coordinate 
that effort, and looks forward to a yearly report on that 
effort. In the meantime, NINDS is urged to support research 
examining the molecular and cellular basis of central nervous 
system manifestations in TSC, including studies examining TSC-
associated epilepsy and brain tumor formation, and the effect 
of tubers and seizures on cognition and behavior.
    Neurofibromatosis (NF).--Advances in NF research have 
linked NF to cancer, brain tumors, learning disabilities, 
memory loss and heart disease affecting millions of Americans. 
The Committee encourages NINDS to strengthen its NF clinical 
and basic research portfolios. The Committee commends NINDS for 
its leadership role in NF research and in coordinating efforts 
with other Institutes engaged in NF research. The Committee 
recognizes that basic research has now successfully brought NF 
research into the clinical era. The Committee encourages NINDS 
to continue its exemplary efforts in the creation, 
implementation and funding of NF clinical trials 
infrastructures and clinical trials using existing and new 
drugs on NF patients. The Committee hope that NINDS will 
continue to coordinate its efforts with the other institutes at 
NIH as well as other government agencies.
    Spinal muscular atrophy (SMA).--SMA is the leading genetic 
killer of infants and toddlers. The Committee understands that 
the severity of the disease, its relatively high incidence, and 
the possibility of imminent treatments have led NINDS to 
initiate the SMA Therapeutics Development Program. The 
Committee commends NINDS for this initiative and encourages the 
Institute to continue to commit the resources to ensure a 
timely completion of the project to identify and complete 
preclinical research and development of candidate therapeutics 
for treating SMA by 2007. To maximize program efficiency, it is 
also important that NINDS lead efforts to integrate 
therapeutics development efforts with emerging programs in the 
biotech and pharmaceuticals industry, academic medical centers 
and collaborations with voluntary health organizations to 
ensure that duplication of effort is avoided. The Committee 
understands that the strategy for developing a treatment for 
SMA will guide therapeutics development for other diseases 
including Duchenne muscular dystrophy, ALS, Huntington's and 
Alzheimer's.
    Down syndrome.--The Committee commends NINDS for sponsoring 
a down syndrome workshop to address research priorities 
relating to optimizing synaptic structure and function in 
neuronal circuits important for cognition. The Committee 
encourages NINDS to identify opportunities for investigating 
the genetic and cellular basis for abnormalities in the 
structure and function of these circuits in both the developing 
and mature nervous system. NINDS is also encouraged to work 
with NIA to develop strategies to investigate the biology of 
age-related disorders, such as Alzheimer's disease and 
Parkinson's disease, in people with Down syndrome. NINDS is 
also encouraged to work with the Office of the Director to 
develop a strategic plan for Down syndrome research and to 
coordinate its research with NICHD, NIA, NIMH and other 
institutes.
    Mucopolysaccharidosis (MPS).--The Committee commends NINDS 
efforts in the development and release of a program 
announcement to enhance blood brain barrier research in 
lysosomal storage disorders. The Committee continues to 
encourage NINDS to collaborate with all appropriate institutes 
and centers to support ongoing MPS research, to study the blood 
brain barrier as an impediment to treatment, and to use all 
available mechanisms to further stimulate efforts to better 
understand and treat MPS disorders.
    Fragile X.--Fragile X is a single-gene disorder, but both 
its symptoms and its cellular mechanisms suggest involvement of 
multiple genes and specific brain pathways which are associated 
with other neurological disorders, such as autism and seizures. 
Recent research offers clear evidence of disruption of 
fundamental brain circuitry in Fragile X. Thus, Fragile X 
research has the potential to contribute to the understanding 
of multiple disorders, such as seizure disorders, especially in 
the context of developmental disorders, and autism. The 
Committee encourages NINDS to intensify its research into these 
issues as they relate to Fragile X, and to coordinate this 
research with other institutes working on Fragile X, including 
but not limited to NIMH and NICHD.
    FXTAS.--Fragile X-associated tremor/ataxia syndrome, or 
FXTAS, is a newly discovered, progressive neurological disorder 
that affects older men who are carriers of a premutation in the 
same gene that causes Fragile X syndrome. Nearly 1 in 800 men 
in the general population carries this premutation and as many 
as 30 percent of these carriers--roughly 1 in 3,000 men--may 
develop FXTAS later in life. Identification of older male 
carriers will lead to a better understanding of the true 
incidence of Fragile X syndrome and afford at-risk families of 
child-bearing age the opportunity to pursue genetic counseling. 
NINDS, in collaboration with NIA, is urged to strengthen 
research into FXTAS, including working with the other NIH 
institutes.
    Frontotemporal dementia (FTD).--The Committee encourages 
NINDS to support research into drug discovery efforts that 
focus on specific targets relevant to treating the mechanisms 
underlying brain degeneration due to frontotemporal dementia 
(FTD) such as Pick's disease. The Committee is interested in 
research that will focus on methods for discovering the causes 
of this family of diseases, improving diagnostic accuracy, and 
providing longitudinal characterizations so that the success of 
intervention can be determined.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

    The Committee provides $4,359,395,000 for the National 
Institute of Allergy and Infectious Diseases (NIAID), which is 
$43,445,000 below the fiscal year 2005 comparable level and 
$100,000,000 below the budget request. Bill language requested 
by the Administration is not included to permit the transfer of 
$100,000,000 to the global AIDS, tuberculosis, and malaria 
fund. Bill language requested by the Administration is included 
providing $30,000,000 for the construction of extramural 
facilities for research on infectious agents and 
countermeasures.
    Mission.--The NIAID supports and conducts basic and 
clinical research and research training programs in infectious 
diseases caused by, or associated with, disorders of the immune 
system. NIAID supported research includes research on acquired 
immunodeficiency syndrome (AIDS), asthma and allergies, 
tuberculosis, sexually transmitted diseases, tropical diseases, 
and emerging microbes. The goals of NIAID research are to 
better understand disease pathogenesis, to improve disease 
diagnosis, to develop new and improved drugs to treat diseases, 
and to develop new and improved vaccines to prevent disease, 
many of which significantly affect public health.
    Tuberculosis (TB).--The World Health Organization estimates 
that nearly one billion people will become infected with TB, 
200 million will become sick, and 70 million will die worldwide 
between now and 2020 of this disease. The Committee is pleased 
with NIAID's efforts to develop an effective TB vaccine. The 
Committee encourages the Institute to continue its TB vaccine 
development work and to strengthen efforts to develop new drugs 
to treat TB.
    Hemophilia.--The Committee encourages NIAID to continue its 
efforts with voluntary organizations in developing and 
advancing research initiatives for addressing hepatitis C (HCV) 
within the bleeding disorders community. The Committee 
understands that HCV continues to have a devastating impact on 
this community, with nearly half of all persons with hemophilia 
having contracted HCV from blood clotting factor products.
    Primary immunodeficiency diseases.--NIAID is the lead 
agency for research into this class of diseases that is known 
to afflict about 500,000 Americans and may affect an equal 
amount that have not yet been diagnosed. To address the complex 
research needs of this group of about 140 separate diseases, 
the NIAID has created a research consortium comprised of the 
leading experts in primary immunodeficiency diseases. The 
Committee requests that NIAID report by February 28, 2006 on 
the management of the consortium, as well as its plans for 
future research in this field.
    Psoriasis.--The Committee encourages NIAID to support 
research on psoriasis, a chronic, immune-mediated disease that 
affects between 5.8 and 7.5 million Americans. Safe and 
effective treatments for women of child-bearing age and for 
children are particularly lacking, and new research indicates 
mothers with psoriasis have a 50 percent increased risk of 
bearing a child with autism. The Committee asks NIAID to 
investigate the possible causes of this troubling finding, as 
well as related research on causes of and treatments for 
psoriasis.
    Inflammatory bowel disease (IBD).--The Committee continues 
to note with interest a scientific research agenda for Crohn's 
disease and ulcerative colitis (collectively known as 
inflammatory bowel disease) entitled ``Challenges to 
Inflammatory Bowel Disease''. This report identifies strong 
linkages between the functions of the immune system and IBD. 
The Committee encourages the Institute to enhance its support 
of research focused on the immunology of IBD, as well as the 
interaction of genetics and environmental factors in the 
development of the disease.
    Asthma.--The Committee is pleased with NIAID's leadership 
regarding asthma research and management. The Committee 
encourages NIAID to continue to improve its focus and effort on 
asthma management, especially as it relates to children. The 
Committee also encourages NIAID to collaborate more 
aggressively with voluntary health organizations to support 
asthma prevention, treatment, and research activities. 
Additionally, recent studies suggest that a variety of viral 
and bacterial agents may play a role in the development of 
asthma. The Committee recommends that the Institute consider 
expanding research into the role that infections and vaccines 
may play in the development of asthma.
    Hepatitis C virus (HCV) vaccine development.--The Committee 
is encouraged to learn that a small hepatitis C vaccine human 
trial has been successfully completed. The Committee urges 
NIAID to begin to implement the results of the recent workshop 
that was held to discuss and evaluate efforts toward 
development of HCV vaccines with the goal of spurring their 
development and testing. The Committee also encourages NIAID to 
proceed with phase two of the human clinical trial as soon as 
it is scientifically practicable. Additionally, NIAID is urged 
to foster the development of an in vitro culture system for HCV 
as well as new animal models for basic research. The Committee 
continues to be concerned about the prevalence of hepatitis and 
urges NIAID to work with public health organizations to promote 
liver wellness, education, and prevention of hepatitis.
    Transplantation research.--The Committee is aware that 
while one-year organ transplantation survival has improved 
remarkably over the last fifteen years, there has been little 
success in reversing the decline in long-term graft and patient 
survival. The Committee suggests that NIAID convene an expert 
conference, in collaboration with NIDDK and NHLBI, to develop a 
five-year Transplantation Research Action Plan identifying the 
most urgently needed research to facilitate an increase in the 
success of organ transplantation. The expert conference should 
also focus on promising new technologies in pre-transplant 
organ care and post-transplant patient therapies. The Committee 
also suggests the initiation of a cohort study to assess the 
health outcomes of living donors, not only for the period 
immediately following the donation, but for the quality of life 
implications in the decades post-donation.
    Coinfection research.--The Committee is concerned that 
there is growing evidence of liver toxicity resulting from HIV 
treatment protocols such as highly active antiretroviral 
therapy (HAART) in those with chronic viral hepatitis and those 
with decompensated liver disease awaiting liver 
transplantation. There also appears to be an emerging problem 
of liver cancer in co-infected patients. The Committee 
encourages NIAID to initiate research initiatives in both of 
these areas.
    Scleroderma.--The Committee commends NIAID for their 
growing commitment to understanding the cause and to finding 
improved treatments for scleroderma, a chronic and progressive 
disease that predominantly strikes woman. Scleroderma is 
disfiguring and can be life threatening, affecting multiple 
systems including the heart, lungs, kidneys, and 
gastrointestinal tract. NIAID has provided a grant to fund the 
SCOT Study (Scleroderma Cytoxan or Transplant). This study will 
compare the differences between autologous stem cell transplant 
versus high dose cytoxan for the treatment of progressive 
systemic scleroderma. The Committee encourages NIAID to 
continue this commitment through inclusion of scleroderma in 
the Autoimmune Centers of Excellence and through continued 
collaboration with the institutes that are part of the 
Autoimmune Disease Coordinating Committee.
    Atopic dermatitis (AD).--The Committee was pleased to learn 
about NIAID research efforts related to atopic dermatitis 
undertaken through projects such as the Immune Tolerance 
Network and the Atopic Dermatitis and Vaccinia Immunization 
Network. Last year, the Committee encouraged NIAID to 
complement these efforts by working with NIAMS to spearhead a 
multidisciplinary, multi-institute initiative to encourage 
investigator-initiated research projects on AD as it relates to 
smallpox vaccination as well as the progression to asthma and 
other allergic diseases. The Committee requests a report on 
efforts that have been made to foster investigator-initiated 
research in this area.
    Nasal aerosol and spray vaccine delivery systems.--The 
prevention of infectious diseases through the effective use of 
vaccines has saved mankind untold suffering and death. Recent 
developments exploring new routes of immunization such as 
delivery of measles vaccine via the aerosol route and nasal 
spray give great hope for achieving this goal, generating 
significant savings, and resulting in fewer side effects than 
immunization by injection. The Committee encourages NIAID to 
support research in developing and testing these new approaches 
and translating this research into public benefits. The 
Committee recommends that NIAID build upon the testing already 
completed in older children by investigating this delivery 
method in younger children. The Committee believes that NIAID 
and other institutes should collaborate with physicians and 
researchers working with these newer and possibly superior 
methods of vaccine delivery in the hopes of developing safer, 
more effective, and less expensive vaccine delivery modes.
    Meningococcal disease/Serogroup B immunization research.--
Although meningococcal disease is vaccine-preventable in most 
cases, approximately 30 percent of the deaths and disabilities 
from this bacterial infection are attributed to serogroup B 
which is not vaccine-preventable. The Committee encourages 
NIAID to increase research efforts to develop an effective, 
low-cost vaccine against serogroup B that will help protect 
infants and adolescents in the near term.
    Food allergies.--The Committee is concerned about the high 
prevalence of food allergies, among children in particular, 
with up to eight percent affected. The Committee recognizes 
that 30,000 individuals require emergency room treatment for 
food allergies each year, that 100 to 200 individuals die each 
year from allergic reactions to food, and that there is 
currently no cure for food allergies. The Committee is 
encouraged by the March 2005 release of a report in The Journal 
of Allergy & Clinical Immunology containing guidelines for the 
definition of anaphylaxis, and hopes that these guidelines will 
improve the diagnosis, treatment, and understanding of food 
allergy and anaphylaxis. NIAID is encouraged to invest in 
research into the causes of food allergies and its potential 
treatments.
    Bioterrorism.--Respiratory pathogens that cause life-
threatening pneumonia are commonly proposed agents of 
bioterrorism. The following are associated with acute 
pneumonia/lung injury: anthrax, smallpox, plague, and 
tularemia. The Committee encourages further research on the 
mechanisms of pneumonia by these respiratory pathogens and the 
development of new therapeutic interventions to reduce injury 
and death.
    Nontuberculous mycobacteria [NTM].--Mycobacteria are 
environmental organisms found in both water and soil that can 
cause significant respiratory damage. The Committee is aware of 
the increasing incidence of nontuberculous mycobacteria [NTM] 
pulmonary infections in women, particularly involving rapidly 
growing mycobacteria, an inherently resistant subspecies. The 
Committee encourages NIAID to advance diagnostic and treatment 
protocols for patients suffering from NTM diseases. Further, 
the Committee recommends additional focus on research leading 
to a better understanding of NTM by establishment of an inter-
institute coordinating committee to facilitate cooperation 
between NIAID, NHLBI, and other institutes.
    Genetic tools for infectious disease research.--The 
Committee believes that, with regard to both biodefense and 
public health, the development by NIAID of multi-pathogen 
identification arrays that can be used to identify infectious 
agents through epidemiological outbreak surveillance is 
critically important. The use of whole genome expression, all 
exon transcription analysis and whole genome SNP analysis 
studies to identify and understand host biomarkers that may 
identify the type, severity and likely response to therapeutics 
of infectious agents holds great promise. The Committee 
encourages NIAID to pursue these lines of inquiry.
    Islet transplantation.--The Committee commends NIDDK and 
NIAID for the establishment of the Clinical Islet 
Transplantation Consortium and the islet transplantation 
clinical trial that will include Medicare-eligible individuals 
whose transplant and related costs will be covered by Medicare. 
The Committee urges cooperation between NIDDK and NIAID and 
members of the Consortium to ensure the timely launch of these 
clinical trials.
    Detection of disease and bioterror agents.--The Committee 
recognizes the potential threat to national security posed by 
terror attacks involving biological, chemical, nuclear, and 
radiological weapons. One of the challenges facing public 
health officials responding to such an attack is the limited 
ability to diagnose exposure to these agents in the non-sick-
appearing and early illness individals. The Committee 
recognizes that disease outbreaks--such as SARS in Asia and 
Canada, avian influenza in East Asia, and Ebola and Marburg 
virus in Africa--demonstrate that the speed of diagnosis and 
implementation of public health measures can mean the 
difference between an isolated outbreak and a global pandemic. 
The Committee commends NIAID for its initiatives that provide 
comprehensive genomic, bioinformatics, functional genomics, and 
immune cell proteomic research resources to the scientific 
community conducting basic and applied research on infectious 
agents and the immune system. The Committee encourages NIAID to 
maintain its support of these programs, which provide a 
critical resource for the scientific community that could lead 
to the discovery and identification of novel targets for the 
next generation of drugs, vaccines, diagnostics and 
immunotherapeutics.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

    The Committee provides $1,955,170,000 for the National 
Institute of General Medical Sciences (NIGMS), which is 
$11,103,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The 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 supports 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 find applications in the biotechnology 
and pharmaceutical industries. The Institute's training 
programs help provides the scientists needed by industry and 
academia.
    Training programs.--The Committee continues to be pleased 
with the quality of NIGMS's training programs, particularly 
those that have a special focus on increasing the number of 
minority scientists, such as the Minority Access to Research 
Careers (MARC) and Minority Biomedical Research Support (MBRS) 
programs. The Committee encourages NIGMS to continue to support 
these important initiatives, and is particularly pleased that 
NIGMS has supported biomedical research career opportunity 
programs for high school and undergraduate college students in 
conjunction with historically black health professions schools. 
The Committee encourages continued, long-term support of this 
program.
    Anesthesiology research.--The Committee urges NIGMS to 
continue to support and enhance research opportunities focused 
on discovering the mechanisms of anesthesia, perfecting agents 
for regional and general anesthesia, improving the safety of 
anesthesia, monitoring and protection of specific organs of 
patients under anesthesia and optimizing post-surgery 
prognosis. The Committee encourages NIGMS to continue to work 
with other appropriate Institutes to promote improvements in 
pain research. The Committee believes that NIGMS should 
strongly support training, innovation and scientific inquiry in 
these crucial areas of medical research.
    Cystic fibrosis (CF).--The Committee commends NIGMS for the 
renewal and expansion of its large-scale collaborative project 
awards. These cross-disciplinary, multi-institutional 
collaborative projects are important for moving burgeoning 
fields faster than through traditional investigator-initiated 
grants. The Committee encourages NIGMS to consider support for 
research on the barriers to productive protein folding and the 
creation of tools, reagents and advances in techniques for 
precision monitoring of folding. These tools will support 
ongoing research efforts to understand the underlying 
mechanisms of disease caused by improper protein folding, as 
well as efforts to develop therapies to correct this defect for 
CF and other diseases.

        NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

    The Committee provides $1,277,544,000 for the National 
Institute of Child Health and Human Development (NICHD), which 
is $7,223,000 above the fiscal year 2005 comparable level and 
the same as the budget request.
    Mission.--The NICHD conducts and supports laboratory and 
clinical research on the reproductive, developmental, and 
behavioral processes that determine and maintain the health and 
well-being of children, adults, families and populations. In 
addition, research in medical rehabilitation is supported.
    Preterm birth.--Last year, the National Center for Health 
Statistics reported the first increase in the U.S. infant 
mortality rate since 1958, and 61% of this increase was due to 
an increase in the birth of premature and low birth weight 
babies. The Committee is pleased that NICHD is one of the 
sponsors of an Institute of Medicine study now underway to 
define and address the health related and economic consequences 
of premature birth and encourages NICHD to develop a plan to 
implement the study's recommendations once they are available.
    Genomic and proteomic research.--The Committee is pleased 
that NICHD has launched a major new research initiative to 
address the public health problem of premature birth, which 
affects one in eight babies born in this country and is the 
leading cause of newborn death. NICHD is encouraged to move 
forward with this initiative, which focuses on genomic and 
proteomics, in an effort to accelerate knowledge in the 
mechanisms responsible for premature birth. The Committee 
intends to closely monitor this effort because it assigns a 
high priority to promoting the birth of healthy infants.
    Stillbirth.--The Committee applauds NICHD efforts in 
addressing stillbirth, a major public health issue with 
morbidity equal to that of all infant deaths. The Committee 
understands that NICHD has established a cooperative network of 
clinical centers and a data center to address this issue with a 
standard protocol. The Committee encourages NICHD to strongly 
support this effort.
    Maternal-fetal medicine units network.--The Committee 
recognizes the efforts of NICHD, through its maternal fetal 
medicine units network (MFMU), to achieve a greater 
understanding of and pursue development of effective treatments 
for the prevention of pre-term births, low birth weight 
infants, and medical complications during pregnancy such as 
pregnancy related hypertension and diabetes. The Committee is 
pleased to learn that NICHD is proceeding with a competitive 
renewal of the MFMU network in 2006 and encourages a sustained 
research investment in this program to facilitate resolution of 
these problems and promote the birth of healthy infants.
    Spina bifida.--The Committee is pleased that the Institute 
cosponsored the 2003 spina bifida research conference. However, 
the Committee has heard concerns that NICHD has not engaged in 
adequate follow-up on the conference recommendations. The 
Committee encourages NICHD to enhance research to address 
issues related to the outcome of the conference and urges NICHD 
to jumpstart its research efforts in the prevention, and 
treatment of spina bifida and associated secondary conditions, 
with a particular focus on improved understanding of urological 
disorders among children and adults. The Director should be 
prepared to testify on its efforts to advance these areas of 
research at the fiscal year 2007 appropriations hearing.
    Drug safety for children.--The Committee recognizes the 
importance of ensuring that drugs are safe and effective for 
use by children. The Committee strongly supports continued 
implementation of the Best Pharmaceuticals for Children Act, 
which supports the pediatric testing of off-patent drugs, as 
well as on-patent drugs not being studied through existing 
mechanisms. The Committee is pleased to note that in 2004 six 
studies were initiated and five additional studies are planned 
for 2005. In implementing this provision, NICHD should act as 
coordinator for all other Institutes within NIH for which 
pediatric pharmacological drug research may have therapeutic 
relevance and should consult with the Food and Drug 
Administration to ensure that the studies conducted are 
designed to yield improved pediatric labeling. The Committee 
notes that NICHD has made numerous outreach efforts to other 
Institutes and Federal agencies to further refine the priority 
listing process. The Committee requests NICHD to provide an 
update during its annual appropriations testimony which shall 
include the role of other Federal agencies in implementing the 
Best Pharmaceuticals for Children Act; information on the 
number of studies supported through the Research Fund; the 
estimated cost of each study undertaken; the nature and type of 
studies undertaken; the number of label changes resulting from 
completed studies; the patent status of the drugs studied; the 
number of drugs remaining on the priority list; and a summary 
of NICHD's findings on the frequency of pediatric use for 
medications that may be considered for the priority list.
    The National Children's Study.--The Committee remains 
interested in NICHD efforts to launch the National Children's 
Study, which is intended to follow 100,000 children to age 21, 
examining the impacts and influences of many environmental and 
genetic factors on children's health and development.
    Neurofibromatosis (NF).--Learning disabilities occur with 
high frequency in children with NF. Enormous advances have been 
made in the past few years in the successful treatment and 
curing of learning disabilities in pre-clinical NF animal 
models. The Committee encourages NICHD to issue requests for 
applications for NF research and to pursue funding of clinical 
trials for NF patients in the area of learning disabilities.
    Down syndrome.--The Committee commends NICHD for increasing 
support in fiscal year 2005 for increased production of an 
experimental mouse model of Down syndrome, the Ts65Dn mouse. 
NICHD is encouraged to partner with NINDS and other agencies to 
define additional mouse models needed to link important 
structural and functional abnormalities that underlie cognitive 
difficulties to the actions of specific genes and gene 
pathways. The Committee also encourages NICHD to work with the 
Office of Director to develop a strategic plan for Down 
syndrome research and to coordinate its research with NICHD, 
NIA, NIMH and other institutes.
    Fragile X.--The Committee is pleased that NICHD has funded 
three Fragile X centers and encourages NICHD to enhance the 
centers and recruit new researchers to the Fragile X field. The 
Committee also encourages NICHD to coordinate its Fragile X 
research efforts and to relate Fragile X research with that in 
other developmental disorders, such as autism research.
    Autism.--The Committee is aware of the important research 
supported by NICHD into the genetic basis of autism spectrum 
disorders and of its support for the Baby Sibling study on the 
incidence of autism among children in the same families. The 
Committee encourages the Institute to strengthen its support 
for the Baby SIBS study, and encourages the Institute to expand 
its work with similar public-private partnerships.
    Childhood diseases and the growing skeleton.--The Committee 
encourages NICHD to support studies investigating the effects 
of pharmaceuticals, lifestyle, and chronic childhood diseases 
on the growing skeleton and fracture risk and bone-formation 
interventions for children. NICHD is encouraged to support 
osteogenesis imperfecta research, especially in genetic 
therapies, animal models, drug treatment and rehabilitation. 
The Committee encourages NICHD to work with NIAMS to study the 
rare disorders osteopetrosis and juvenile Paget's disease.
    Infertility and contraceptive research.--The Committee 
notes that infertility is a disease which affects over six 
million people in the United States and is concerned that the 
number appears to be growing as age, lifestyle, and 
environmental factors increasingly impact reproductive health 
outcomes. The Committee suggests that NICHD conduct additional 
research to improve reproductive health intervention outcomes.
    Demographic research.--The Committee commends NICHD for its 
strong support of demographic research. Given the tremendous 
changes occurring in the U.S. population, demographic research 
is necessary to analyze trends and determine consequences for 
the health and well-being of our nation. The Committee 
encourages the institute to ensure adequate support for 
demographic training and for critical demographic databases.
    Primary immunodeficiency diseases (PI).--The Committee 
continues to be impressed with NICHD's contributions to the 
physician education and public awareness program conducted by a 
voluntary organization to reach earliest diagnosis of this 
class of about 140 diseases. With regard to research on PI, the 
Committee is encouraged by the Institute's commitment to 
develop newborn screening procedures for PI, particularly X-
linked SCID, utilizing microarray technologies.
    Physical therapy.--The Committee recognizes the burgeoning 
growth in rehabilitation services provided to patients, 
especially the elderly, with musculoskeletal problems and the 
urgent need to establish a solid scientific basis for clinical 
practice in this area. The Committee encourages the 
establishment of a research program in the National Center for 
Medical Rehabilitation Research (NCMRR) to: (1) evaluate the 
efficacy and establish optimal schedules and settings for 
movement-based rehabilitation interventions, such as 
therapeutic exercise, to improve physical function in 
individuals with musculoskeletal conditions, including 
arthritis, back pain, hip fracture and major joint 
replacements, and (2) further knowledge of the underlying 
mechanisms of repair, regeneration and recovery of these 
interventions. The Committee encourages NIA, NIAMS, and NIBIB 
to collaborate on these initiatives.
    Glucose monitoring.--The Committee recognizes the 
importance of independent evaluation of blood glucose 
monitoring technologies. The Committee commends NICHD for its 
support of the Diabetes Research in Children Network 
(DirecNet), which aims to improve the management of diabetes in 
children by understanding how to best apply monitoring 
technology in this patient population. The Committee notes the 
unique infrastructure that DirecNet has developed to assess 
such technologies in children and encourages continued support 
for this important clinical research program.
    Pediatric kidney disease.--The Committee encourages NICHD 
to study pre- and post-natal exposures that increase the risk 
of kidney disease, hypertension, and the progression of chronic 
kidney disease from birth to early adulthood. The Committee 
encourages NICHD to support research toward understanding the 
physiologic mechanisms responsible for these risks to further 
prevent the development of kidney disease and the antecedents 
of cardiovascular disease.
    Spinal muscular atrophy (SMA).--The Committee recognizes 
the efforts at NINDS as the leading institute against SMA in 
recent years, and strongly encourages other institutes, notably 
NICHD, to expeditiously work collaboratively to support and 
strengthen the SMA Project. The Committee fully expects that 
NICHD will explore new potential avenues to collaborate with 
NINDS, given the fact that SMA is the leading genetic killer of 
infants and toddlers.

                         NATIONAL EYE INSTITUTE

    The Committee provides $673,491,000 for the National Eye 
Institute (NEI), which is $4,421,000 above the fiscal year 2005 
comparable level and the same as the budget request.
    Mission.--The NEI conducts and supports 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.
    Juvenile diabetes.--The Committee encourages NEI to 
continue its efforts to collaborate with other institutes on 
identification of genes that contribute to diabetic retinopathy 
by collecting and analyzing human samples through existing 
clinical studies and working to develop new animal models that 
mimic this condition.
    Diabetic retinopathy.--The Committee commends NEI for its 
continued support of the diabetic retinopathy clinical research 
network. The Committee encourages NEI to expand this network 
through collaboration with other institutes, such as NIBIB, and 
private and public partners and through the introduction of new 
treatments to prevent, treat, or cure diabetic retinopathy.
    Ocular albinism.--Ocular albinism is a hereditary, blinding 
disease that causes terribly distorted vision in children. 
Victims, who are usually boys and receive the defective gene 
from their mother, experience nystagmus, photophobia, lack of 
stereoscopic vision, strabismus, and other symptoms which deny 
these children normal vision. In recent years, research has 
made great strides in the search for improved diagnostic tools, 
and treatments. Recently, the OA1 gene, responsible for most 
cases of the disease, was identified, and a diagnostic 
screening test created to help women determine if they are at 
risk of passing the disease on to their children. As 
researchers move closer to understanding how this disease 
works, and developing potential treatments that could improve 
the vision of children with the condition, the Committee 
requests NEI to be prepared to report in next year's hearing on 
advances in research on ocular albinism.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

    The Committee provides $647,608,000 for the National 
Institute of Environmental Health Science (NIEHS), which is 
$3,103,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The NIEHS mission is to reduce the burden of 
environmentally related illness and dysfunction by 
understanding how environmental exposures affect health, how 
individuals differ in their susceptibility to these effects, 
and how these susceptibilities change over time. This mission 
is achieved through multidisciplinary biomedical research 
programs, prevention and intervention efforts, and 
communication strategies that encompass training, education, 
technology transfer, and community outreach.
    Parkinson's disease.--The Committee encourages NIEHS to 
continue funding research into environmental influences of 
Parkinson's disease. The causes of Parkinson's and other 
neurodegenerative disorders are increasingly shown to be a 
result of the inter-relation of environment and genes. Possible 
environmental triggers of Parkinson's are pesticides and/or 
heavy metals. If these environmental toxins can be identified 
and the mechanisms elucidated, appropriate prevention or 
treatment may prevent many cases of Parkinson's, especially in 
the concerning increasingly younger persons at risk.
    Mercury.--In order to properly research gaps in the area of 
mercury exposure and brain chemistry, and given recent hearings 
on mercury exposure and relationships between autism and 
Alzheimer's disease and mercury exposure, NIEHS is encouraged 
to pursue studies of how inorganic mercury and organic mercury 
compounds (including ethyl, methyl, and other forms of mercury 
from all sources) are processed in the bodies of children and 
adults. NIEHS is also encouraged to support studies of the 
toxic effects of inorganic mercury and organic mercury 
compounds on the nervous systems of young children, adults, and 
the elderly and methods of properly removing mercury and 
mercury-containing compounds from the brains of affected 
humans.
    Toxic exposure and brain development.--Notwithstanding the 
Institute of Medicine May 2004 report on autism, the Committee 
believes it is important to develop a more complete 
understanding of the impact that toxic exposures may have on 
brain development. There is a convergence of findings from 
tissue culture studies, animal models, and clinical studies of 
immune dysfunction in children with autism and other 
neurodevelopmental disorders (NDDs) that suggests a biological 
link between genetic sensitivity and damage to developing 
brains from certain toxins. It is important that NIH continue 
this research to better understand the impact that exposures to 
mercury (including thimerosal) and other toxins have on brain 
development. A more complete understanding of the impact of 
these exposures through research, including animal models, will 
help to develop more effective interventions.
    Toxicology validation reviews.--In order for the 
Interagency Coordinating Committee for the Validation of 
Alternative Methods (ICCVAM) to carry out its responsibilities 
under the ICCVAM Authorization Act of 2000, the Committee 
encourages NIEHS to strengthen the resources for methods 
validation reviews in fiscal year 2006. The Committee is 
encouraged by the National Toxicology Program's Road Map and 
Vision for NTP's toxicology program in the twenty-first century 
and encourages NIEHS to move rapidly to implement the programs, 
especially those directly aimed at strengthening the scientific 
basis for many alternative methods (such as Quantitive 
Structure-Activity Relationships), mechanistic screens, high 
throughput assays, and toxicogenomics).
    Risk analysis.--The Committee encourages NIEHS to establish 
a competitive, peer-reviewed extramural program of centers for 
risk sciences to conduct research in risk sciences, including 
assessment, management, analysis, and communication of risks 
from exposure to environmental chemicals. NIEHS is encouraged 
to work with these centers to develop scientifically-based 
methodologies used to determine, quantify, and communicate risk 
to the public's health.
    Asthma.--Given the link between environmental factors and 
the onset of asthma, COPD, and pulmonary fibrosis, the 
Committee encourages NIEHS to further develop research 
initiatives, such as a large multi-site, long-term 
longitudinal, and maternal/birth cohort to understand the 
environmental and genetic risk factors for predisposing some 
individuals to and in controlling the severity of these lung 
diseases.

                      NATIONAL INSTITUTE ON AGING

    The Committee provides $1,057,203,000 for the National 
Institute on Aging (NIA), which is $5,213,000 above the fiscal 
year 2005 comparable level and the same as the budget request.
    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.
    Alzheimer's disease.--The most common cause of dementia, 
Alzheimer's disease has become a very serious threat to the 
nation's health and economic well-being. Today, an estimated 
4.5 million Americans--one in ten persons over age 65 and 
nearly half of those over 85--suffer from Alzheimer's disease. 
Over the next decade, Medicare spending on beneficiaries with 
Alzheimer's will more than triple, to $189 billion, while 
Medicaid spending over the same period will rise to $27 
billion. In light of these social and economic imperatives, the 
Committee was troubled to learn that NIA's investment in 
Alzheimer research declined in fiscal year 2004 from the 
previous year. The Committee believes that NIA should continue 
to assign the highest priority to this effort.
    Down syndrome.--The Committee commends NIA for its support 
of studies to examine the cellular, molecular and genetic bases 
for age-related neuropathological and cognitive abnormalities 
in people with Down syndrome. It encourages NIA to further 
examine these abnormalities and to devise new methods for 
diagnosing and treating them. Given that all people with Down 
syndrome develop the neuropathological changes of Alzheimer's 
disease, and that many or most go on to suffer dementia, NIA is 
encouraged to consider how studies of the Down syndrome 
population might enhance the ability to understand, diagnose 
and treat Alzheimer's disease. The Committee encourages NIA to 
coordinate its research with NICHD, NINDS, NIMH and other 
institutes.
    Parkinson's disease.--The Committee commends NIA on its 
collaboration with Parkinson's researchers at NINDS Udall 
Centers in helping to discover new Parkinson's susceptibility 
genes, including dardarin, the most recently discovered 
Parkinson's gene by a NIA scientist. This research will prove 
to be invaluable in the development of improved methods of 
diagnosis, as well as neuroprotective and neurorestorative 
treatment of Parkinson's disease. The Committee encourages 
continued collaborations, including additional intramural 
activities, between NINDS, NIMH, and NIA to enhance 
understanding of neurodegenerative diseases, particularly 
Parkinson's.
    Age-related bone health.--The Committee is aware that age-
related bone loss costs $17 billion annually. NIA is urged to 
address cell senescence and altered cell phenotype in age-
related bone diseases, aging's impact on bone response to 
loading, bone matrix and quality, and bone marrow; and the role 
of exercise, new anabolics, and stem cells in elderly bone.
    Quality of life.--The Committee encourages studies on 
quality of life in patients with osteoporosis before and after 
treatment, and strategies for optimizing treatment of frail 
nursing home patients at high risk for osteoporotic fracture. 
The Committee also encourages NIA to expand research on the 
role of environmental and lifestyle factors associated with 
osteoporosis and Paget's disease and to work in conjunction 
with NIAMS on models for Paget's disease.
    Roybal centers.--The Committee is very satisfied with the 
progress made by the Roybal Centers for Applied Gerontology 
Research in the application of research to direct service 
interventions resulting in the improvement in the quality of 
life for older adults. The Committee also views the 
collaboration between the Roybal Centers and the Demographic 
Centers as being very positive and encourages NIA to continue 
to promote such collaboration.
    Demographic and economic research.--The Committee commends 
NIA for supporting its Centers on the Demography of Aging 
program and expanding its program to include four new centers 
in 2004. In particular, the Committee encourages NIA to support 
the Health and Retirement Survey and the National Long-Term 
Care Survey. Data from these surveys are particularly important 
for understanding the budgetary impact of population aging and 
for Congress as it deliberates potential changes to the Social 
Security, Medicare, and Medicaid programs.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

    The Committee provides $513,063,000 for the National 
Institute of Arthritis and Musculoskeletal and Skin Diseases 
(NIAMS), which is $1,906,000 above the fiscal year 2005 
comparable level and the same as the budget request.
    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.
    Scleroderma.--The Committee is encouraged by NIAMS's 
continued interest in scleroderma, a chronic and progressive 
disease that predominantly strikes women. Scleroderma is 
disfiguring and can be life-threatening, and effective 
treatments are lacking. The Committee encourages NIAMS to 
continue to collaborate with other institutes, including NHLBI, 
NIAID, NIDDK, and NIDCR, and through the NIH Autoimmune 
Coordinating Committee to generate additional research 
opportunities for scleroderma that may assist to identify 
genetic risk factors and the development of safe and effective 
treatments.
    Burden of skin diseases.--The Committee notes the release 
of the recent report, Burden of Skin Diseases, which supports 
evidence gathered at the September 2002 workshop on the burden 
of skin diseases sponsored by NIAMS. Based on these findings, 
the Committee encourages NIAMS to continue to strengthen the 
research portfolio on skin disease. The Committee also 
recommends that NIAMS consider potential partnerships with the 
skin disease research community to address the challenges 
outlined by the Burden of Skin Diseases findings.
    Psoriasis.--Psoriasis is a chronic, immune-mediated disease 
that affects between 5.8 and 7.5 million Americans. The 
Committee recommends that NIAMS support additional research 
into this serious disease, both to identify the several genes 
believed to play a role in psoriasis pathogenesis, as well as 
to support additional clinical research on current and 
potential therapies for psoriasis and psoriatic arthritis.
    Vitiligo treatments for children.--Vitiligo is an 
environmental and genetic auto-immune disease of unknown origin 
which affects about three to six million Americans. Almost 
fifty percent develop the disease in childhood, with the median 
age of onset at four years of age. In its most severe forms, 
patients have milky white patches covering widespread areas of 
the body due to the loss of pigment in these areas. Especially 
for young children, the physical pain caused by severe burns 
from the harmful effects of sunlight and the emotional pain 
caused by people confusing vitiligo with an infectious disease 
diminish the quality of a patient's life. There are no FDA-
approved treatments for children. The Committee encourages 
NIAMS to enhance research efforts through all appropriate 
mechanisms to identify the causes of this disease and develop 
pediatric treatment options for vitiligo.
    Marfan syndrome.--The Committee commends NIAMS and its 
collaborative efforts with other institutes to provide support 
of research on Marfan syndrome, a life-threatening, progressive 
and degenerative genetic disorder which is characterized by 
aortic aneurysms, orthopedic disabilities and ocular 
manifestations which can result in blindness. Years of 
investment in basic research are ready to be translated to 
clinical studies of drug therapies with the potential of 
reversing many of the life-threatening and disabling symptoms 
of Marfan syndrome. These drug therapies may also prove to 
benefit people with other connective tissue disorders. The 
Committee encourages NIAMS to support clinical trials of new 
drug therapies through all available mechanisms, as 
appropriate.
    Tuberous sclerosis complex (TSC).--TSC is a genetic 
disorder that triggers uncontrollable tumor growth in multiple 
organs of the body, including the skin. The Committee 
encourages NIAMS to support programs examining the molecular 
and cellular basis of dermatological lesions in TSC as well as 
the development of non-surgical treatments for skin 
manifestations.
    Mucopolysaccharidosis (MPS).--The Committee encourages 
NIAMS to work collaboratively with NIDDK in an effort to 
achieve a greater understanding of the bone and joint lesions 
in MPS disorders. The committee supports NIAMS research 
addressing the underlying pathophysiology of bone and joint 
lesions, the gene mutations and substrates that are stored, and 
potential therapeutic approaches to treating these debilitating 
aspects of MPS and related disorders.
    Osteogenesis imperfecta.--The Committee commends NIAMS for 
its support of promising gene-targeting stem cell research that 
could represent a potential cure for osteogenesis imperfecta 
and encourages continued support of this research.
    Osteopetrosis.--The Committee encourages NIAMS to increase 
support of research on models, methods and modalities to 
increase bone formation and alter bone remodeling, and address 
the impact of aging, genetics, obesity, inactivity and exercise 
on bone at molecular, cellular, and tissue levels. NIAMS is 
encouraged to work with NICHD and NIDDK to strengthen research 
on the genetics and new treatments for the rare disorder 
osteopetrosis.
    Lupus.--The Committee is aware that the discovery of lupus 
susceptibility genes may be a prerequisite to developing 
exciting new therapies for lupus and ultimately a way to 
prevent and cure the disease. Advanced new technologies make 
finding these genes less expensive and more feasible than ever 
before. The Committee is also aware that new consortia within 
the lupus community have been formed to facilitate genetic 
research. The Committee urges the Institute to strengthen its 
work in support of the collection of DNA, serum, genotyping and 
subject information from lupus patients, their family members 
and healthy unrelated controls so that the identification of 
the relevant genes can be explained.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

    The Committee provides $397,432,000 for the National 
Institute on Deafness and Other Communication Disorders 
(NIDCD), which is $3,173,000 above the fiscal year 2005 
comparable level and the same as the budget request.
    Mission.--The NIDCD funds and conducts research in human 
communication. Included in its program areas are research and 
research training in the normal and disordered mechanisms of 
hearing, balance, smell, taste, voice, speech and language. The 
Institute addresses special biomedical and behavioral problems 
associated with people who have communication impairments or 
disorders. In addition, the NIDCD is actively involved in 
health promotion and disease prevention, dissemination of 
research results, and supports efforts to create devices that 
substitute for lost and impaired sensory and communication 
functions.
    Hearing loss.--The Committee encourages the NIDCD to 
further research in the area of early identification of hearing 
loss and interventions strategies. The Committee urges NIDCD to 
continue to support research in the areas of inner ear 
protection, rescue, and regeneration, such as noise-induced 
hearing loss, ototoxicity and hair cell regeneration, as well 
as research on the central auditory system. In addition, the 
Committee encourages NIDCD to continue research on 
rehabilitative technologies and strategies, leading to improved 
prevention, treatment and management of hearing loss, tinnitus 
and dizziness. The Committee recommends that NICHD maintain 
support for the translation of basic research discoveries into 
better clinical diagnostic techniques and treatments.
    Early hearing detection and intervention (EHDI).--The 
Committee encourages NIDCD to enhance its EHDI research, 
especially as it pertains to the genetics of hearing loss, the 
causes of late-onset and progressive hearing loss, the benefits 
of early identification, and the identification of and 
effective intervention for children with monaural and milder 
degrees of hearing loss. To avoid duplication, NIDCD should 
coordinate its efforts with other institutes and agencies 
conducting EHDI activities.
    Neurofibromatosis (NF).--NF accounts for approximately five 
percent of genetic forms of deafness. Unlike other genetic 
forms of deafness, NF-associated deafness is potentially 
preventable or curable if tumor growth is halted before damage 
has been done to the adjacent nerve. Research is now being 
conducted to cure deafness in NF mice through gene therapy, 
with important implications for patients suffering from 
meningiomas and other tumors. The Committee encourages NIDCD to 
strengthen its NF research portfolio through all suitable 
mechanisms including RFAs and clinical trials.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

    The Committee provides $138,729,000 for the National 
Institute of Nursing Research (NINR), which is $657,000 above 
the fiscal year 2005 comparable level and the same as the 
budget request.
    Mission.--The NINR supports and conducts scientific 
research and research training to reduce the burden of illness 
and disability; improve health-related quality of life; and 
establish better approaches to promote health and prevent 
disease.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

    The Committee provides $440,333,000 for the National 
Institute on Alcohol Abuse and Alcoholism (NIAAA), which is 
$2,056,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The NIAAA supports research to generate new 
knowledge to answer crucial questions about why people drink; 
why some individuals are vulnerable to alcohol dependence or 
alcohol-related diseases and others are not; the relationship 
of genetic and environmental factors involved in alcoholism; 
the mechanisms whereby alcohol produces its disabling effects, 
including organ damage; how to prevent alcohol misuse and 
associated damage and how alcoholism treatment can be improved. 
NIAAA addresses these questions through a program of 
biomedical, behavioral, and epidemiologic research on 
alcoholism, alcohol abuse, and related problems. This program 
includes various areas of special emphasis such as medications 
development, fetal alcohol syndrome, genetics, and moderate 
drinking.
    Alcohol, obesity, and liver disease.--The relationship 
among the use of alcohol, the occurrence of obesity, and the 
presence of liver disease has become increasingly worrisome for 
clinicians. While alcohol's negative impact on weight and liver 
wellness is long established, the current epidemic of obesity 
and its consequent increase in liver disease creates a new 
focus for research. The Committee encourages NIAAA to focus 
greater attention to this relationship with special emphasis on 
the differentiation of impact of alcohol consumption on the 
liver for specific populations, such as women, minorities, the 
elderly, and others.
    Translation.--The Committee is interested in ensuring that 
current research on the health effects of alcohol and 
alcoholism is more effectively communicated and disseminated 
within the alcohol abuse treatment community. The Committee 
recommends that NIAAA jointly work with related alcohol 
research organizations on a plan to broaden the reach and 
timely communication of funded alcohol and alcoholism research 
to the treatment community.

                    NATIONAL INSTITUTE ON DRUG ABUSE

    The Committee provides $1,010,130,000 for the National 
Institute on Drug Abuse (NIDA), which is $3,711,000 above the 
fiscal year 2005 comparable level and the same as the budget 
request.
    Mission.--NIDA-supported science addresses questions about 
drug abuse and addiction, which range from its causes and 
consequences to its prevention and treatment. NIDA research 
explores how drugs of abuse affect the brain and behavior and 
develops effective prevention and treatment strategies; the 
Institute works to ensure the transfer of scientific data to 
policy makers, practitioners, and the public.
    Drug abuse and HIV/AIDS.--The Committee understands that 
one of the most significant causes of HIV virus acquisition and 
transmission is drug taking practices and related risk factors 
in different populations. Drug abuse prevention and treatment 
interventions have been shown to be effective in reducing HIV 
risk. Therefore, the Committee encourages NIDA to continue its 
support of research focused on the development and testing of 
drug abuse-related interventions designed to reduce the spread 
of HIV/AIDS in these populations.
    Translation of research findings.--The Committee commends 
NIDA for its outreach and work with State substance abuse 
directors, also known as Single State Authorities (SSAs), to 
reduce the current 15- to 20-year lag between the discovery of 
an effective treatment intervention and its availability at the 
community level. In particular, the Committee applauds NIDA for 
working with SAMHSA on a recent RFA designed to strengthen 
State Substance Abuse agencies' capacity to support and engage 
in research that will foster statewide adoption of meritorious 
science-based policies and practices. The Committee also 
encourages NIDA to continue collaborative work with SSAs to 
ensure that research findings are relevant and adaptable by 
State Substance Abuse systems.
    Prevention research.--The Committee remains interested in 
research on preventive medicine and encourages NIDA to conduct 
research on prevention of drug abuse by focusing on the role 
environment plays on neurobiological factors such as gene 
expression.
    Drug-induced liver injury.--The Committee notes that the 
mechanisms and causes of drug-induced liver injury related to 
over-the-counter and prescription medications are not well 
understood and merit further research. The Committee encourages 
NIDA to work collaboratively with NIDDK, FDA, industry, and the 
liver research community to address these priorities.
    Impact of prescription drugs.--The Committee encourages 
NIDA to conduct research on the use of prescription 
psychoactive medication in children and adolescents and their 
impact on the development of mental health and substance abuse 
problems across the life span of individuals.
    Hepatitis and drug abuse.--The Committee is concerned about 
the prevalence of hepatitis and substance abuse and urges NIDA 
to work with voluntary health organizations to promote liver 
wellness, education, and prevention of both hepatitis and 
substance abuse.
    Drug treatment in criminal justice settings.--The Committee 
is very concerned about the well-known connections between drug 
use and crime. Research continues to demonstrate that providing 
treatment to individuals involved in the criminal justice 
system decreases future drug use and criminal behavior, while 
improving social functioning. Blending the functions of 
criminal justice supervision and drug abuse treatment and 
support services create an opportunity to have an optimal 
impact on behavior by addressing public health concerns while 
maintaining public safety. The Committee supports NIDA's 
efforts in this area, particularly the Criminal Justice Drug 
Abuse Treatment Studies (CJ-DATS), a multi-site set of research 
studies designed to improve outcomes for offenders with 
substance use disorders by improving the integration of drug 
abuse treatment with other public health and public safety 
systems.
    Reducing health disparities.--The Committee notes that the 
consequences of drug abuse disproportionately impact 
minorities, especially African American populations. The 
Committee is pleased to learn that NIDA formed a subgroup of 
its Advisory Council to address this important topic. The 
Committee applauds NIDA for working to strategically reduce the 
disproportionate burden of HIV/AIDS among the African American 
population. Researchers should be encouraged to conduct more 
studies in this population and to target their studies in 
geographic areas where HIV/AIDS is high and/or growing among 
African Americans, including in criminal justice settings.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

    The Committee provides $1,417,692,000 for the National 
Institute of Mental Health (NIMH), which is $5,759,000 above 
the fiscal year 2005 comparable level and the same as the 
budget request.
    Mission.--The NIMH is responsible for research activities 
that seek to improve diagnosis, treatments, and overall quality 
of care for persons with mental illnesses. Disorders of high 
priority to NIMH include schizophrenia, depression and manic 
depressive illness, obsessive-compulsive disorder, anxiety 
disorders and other mental and behavioral disorders that occur 
across the lifespan; these include childhood mental disorders 
such as autism and attention-deficit/hyperactivity disorder; 
eating disorders; Alzheimer's disease; and other illnesses. 
NIMH supports and conducts fundamental research in 
neuroscience, genetics, and behavioral science. In addition to 
laboratory and controlled clinical studies, the NIMH supports 
research on the mental health needs of special populations and 
health services research.
    Down syndrome.--The Committee encourages NIMH to develop 
new strategies for cataloging, understanding, diagnosing and 
treating behavioral disorders that are common in people with 
Down syndrome. They include autism, pervasive developmental 
disorder, obsessive compulsive disorder, depression and 
psychosis. The Committee urges NIMH to coordinate its research 
on Down syndrome with NICHD, NINDS, NIA and other institutes.
    Alzheimer's disease.--Combining imaging with genetics, a 
team of NIMH-funded scientists recently identified a possible 
genetic marker for Alzheimer's disease, a variant of the gene 
that codes for APOE, a protein involved in metabolizing 
cholesterol. PET scans of normal individuals in their fifties 
and sixties who carry this variant showed decreased activity in 
regions of the brain known to be affected by Alzheimer's. PET 
scans of younger individuals who carry this variant found 
lowered metabolism in the same brain areas, suggesting that the 
process at work in Alzheimer's starts decades before memory 
deficits become apparent. The Committee strongly encourages 
NIMH to continue to advance understanding of Alzheimer's 
disease.
    Fragile X.--Fragile X is the most common single-gene 
neuropsychiatric disease known. It causes cognitive impairment, 
mental disorders such as obsessive-compulsive disorder, and 
extreme anxiety. The Committee commends NIMH for spearheading 
three focused research meetings in the past four years devoted 
to identifying critical research needs. The Committee 
encourages NIMH to pursue the highest priority needs identified 
by the meeting panels. These include controlled studies of 
existing and new pharmacological treatments for Fragile X and 
identification of the key molecular targets which are likely 
candidates for designing drug treatments for Fragile X and 
related disorders such as autism. The Committee also recommends 
that NIMH include Fragile X in its studies of related 
neuropsychiatric disorders and to work with other Institutes 
such as NICHD and NINDS to develop cooperative research support 
mechanisms in this area. In addition, the Committee suggests 
that NIMH work with industry and academia to test available 
medications and bring new treatments to market.
    Adolescent depression and suicide.--Major depressive 
disorder in adolescence, one of the major risk factors for 
suicide, has become increasingly common. Suicide now accounts 
for 13 percent of all adolescent deaths and ranks third as a 
cause of death among teenagers. The Committee encourages NIMH 
to strengthen its investment in understanding the clinical 
epidemiology of suicidal behavior and thinking in children and 
adolescents; improving the criteria for identifying those at 
risk; and examining the outcomes of actions taken to assist 
those found to be at risk.
    Mental health for older Americans.--The Committee is aware 
that demographics will demand an increased focus on mental 
disorders in older persons. The Committee encourages NIMH to 
strengthen research in this area through all available 
mechanisms to advance the geriatric mental health research 
agenda.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

    The Committee provides $490,959,000 for the National Human 
Genome Research Institute (NHGRI), which is $2,351,000 above 
the fiscal year 2005 comparable level and the same as the 
budget request.
    Mission.--NHGRI coordinates extramural and intramural 
research, as well as research training, in the areas of 
genomics and genetics. The Division of Extramural Research 
supports research on sequence and function of both human and 
non-human genomes, human genetic variation, technology 
development for genome research, database management and 
analysis, and research on the ethical, legal, and social 
implications of human genome research. The Division of 
Intramural Research focuses on applying the tools and 
technologies of the successful Human Genome Project to 
understanding the genetic and environmental basis of disease, 
and developing DNA-based diagnostics and gene-based therapies.
    Targeting disease prevention.--The Committee commends NHGRI 
for its leadership of the international haplotype mapping 
(HapMap) project. The HapMap will provide a powerful new public 
resource to gain a deeper understanding of human biology, and 
discover the genetic and environmental factors that contribute 
to disease, predict potential disease risk, optimize drug 
prescribing for individuals, and identify and validate critical 
new targets for therapeutic development.
    Molecular libraries.--The Committee commends NHGRI for 
leadership in the NIH Roadmap Initiative on molecular 
libraries. This includes the founding of the NIH Chemical 
Genomics center, which will provide public sector researchers 
with access to high-throughput screens for small organic 
molecules, enabling development of new tools for exploration of 
health and disease. The Committee recognizes that advances in 
the use of these molecular libraries will enhance NIH's global 
leadership in the future.
    Genome strategic plan.--The Committee commends the 
Institute's efforts to contribute to the future possibility 
that comprehensive genome sequence information could become a 
part of each American's individual health care plan. NIH has 
assembled significant resources of well-characterized 
populations to enable the testing and validation of genotyping 
and genome sequencing in diseases that are known to have a 
strong genetic basis, such as diabetes, hypertension, and 
several others. The Committee urges NHGRI to work together with 
other appropriate Institutes in this regard to develop models 
for the new era of molecular medicine.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

    The Committee provides $299,808,000 for the National 
Institute of Biomedical Imaging and Bioengineering (NIBIB), 
which is $1,599,000 above the fiscal year 2005 comparable level 
and the same as the budget request.
    Mission.--The mission of the Institute is to improve health 
by promoting fundamental discoveries, design and development, 
and translation and assessment of technological capabilities in 
biomedical imaging and bioengineering, enabled by relevant 
areas of information science, physics, chemistry, mathematics, 
materials science, and computer sciences.
    Imaging for autoimmune disease.--The Committee is 
encouraged by the recent development of imaging technology 
being evaluated in clinical trials for detection of metastatic 
cancer in human patients. The Committee encourages the 
Institute to support the translation of imaging technologies to 
the detection and diagnosis of autoimmune diseases, in 
particular juvenile diabetes and organ transplantation. Non-
invasive imaging approaches are critical to the detection of 
progression of disease or early rejection of transplanted 
organs or cells.
    Bone imaging.--The Committee urges NIBIB to focus on 
improving musculoskeletal disease detection, monitoring and 
treatment through focused imaging and engineering advances. The 
Institute is encouraged to develop noninvasive techniques to 
measure bone quality and bone strength in humans.
    Liver imaging techniques.--Consistent with NIBIB's mission 
to improve all diagnostic imaging technologies, the Committee 
encourages NIBIB to make liver imaging techniques a primary 
focus, speeding the development of new modalities that better 
capture the early stages of various liver diseases, including 
cancer, as well as offering the potential for combinations of 
diagnosis and treatment. This is also necessary to develop less 
invasive diagnostics for liver disease patients. The Committee 
recommends that NIBIB participate actively in trans-NIH 
initiatives that address these priorities.
    Long term budgets.--The Committee acknowledges receipt of 
the Five-Year Professional Judgment Budget for the National 
Institute of Biomedical Imaging and Bioengineering (NIBIB) 
requested in House Report 108-636. The Committee notes the 
budget's central conclusion that biomedical imaging and 
bioengineering ``are dynamic and ripe with opportunities for 
major scientific advances'' that could be translated into 
dramatic improvements in health care. The Committee notes that 
the Five-Year Professional Judgment Budget recommends a 
measured, reasonable rate of growth for the NIBIB to achieve 
the goals of the important research areas enumerated in the 
report. As with all professional judgment budgets, the 
Committee considers them within the constraints of the annual 
budget, acknowledging that they represent the judgment of 
scientific opportunity but not competing demands.
    Interdisciplinary research.--The Committee also notes that 
the Five-Year Professional Judgment Budget recognizes the role 
of the NIBIB with respect to interdisciplinary research, the 
physical sciences, and technology development. NIBIB has taken 
a leadership role in efforts to examine the scientific 
questions that can be addressed by collaboration between life 
and physical scientists, the barriers to such collaboration, 
and the steps that need to be taken to bridge these 
disciplines. The Committee recommends that NIBIB serve as the 
primary home of any new NIH or interagency programs or 
initiatives at the crossroads of physical sciences and 
biomedicine.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

    The Committee provides $1,100,203,000 for the National 
Center for Research Resources (NCRR), which is $14,887,000 
below the fiscal year 2005 comparable level and the same as the 
budget request. The Committee does not include bill language 
identifying funding for extramural facility construction, which 
is the same as the Administration request. $29,760,000 was 
provided in fiscal year 2005 for extramural construction.
    Mission.--The NCRR develops and supports critical research 
technologies and shared resources that underpin biomedical 
research. The NCRR programs develop a variety of research 
resources; provide resources for complex biotechnologies, 
clinical research and specialized primate research; develop 
research capacity in minority institutions; and enhance the 
science education of pre-college students and the general 
public.
    Institutional development awards (IDeA).--The Committee has 
identified $222,208,000 for this program, which is the same as 
the Administration request and the fiscal year 2005 level. The 
program is comprised of the Centers of Biomedical Research 
Excellence (COBRE) program and the IDeA Networks of Biomedical 
Research (INBRE) program. The Committee commends NCRR in its 
efforts to support the IDeA program to foster innovation and 
infrastructure in the IDeA-eligible states that have 
traditionally not been able to take advantage of biomedical 
research funding opportunities.
    Advancing clinical and translational sciences.--To 
capitalize on the revolutionary discoveries emerging from basic 
science, there is a pressing need to strengthen and accelerate 
the clinical research process, and to more efficiently transmit 
research findings to practitioners on the front lines of 
patient care. The Committee commends NIH for developing a 
proposal to overcome the challenges facing the translation of 
clinical research, which include: difficulty recruiting and 
retaining clinical researchers; increasing regulatory burden; 
fragmented training programs; and limitations/barriers due to 
NIH funding mechanisms, review and program structure. The 
Committee is supportive of NIH's efforts to help grantee 
institutions create the academic home and integrated resources 
needed to advance the new intellectual discipline of clinical 
and translational sciences, create a cadre of well-trained 
investigators, and transform basic discovery research into 
clinical practice. The Committee looks forward to hearing more 
about how this effort will integrate NIH's existing grants into 
more efficient awards, and how this will transform clinical and 
translational sciences.
    Clinical research curriculum award.--The clinical research 
curriculum award has been extremely effective in training 
successful clinical researchers. Funded programs report that 
over 60 percent of their graduates are active researchers who 
have already secured funding for their research. The Committee 
supports the NIH decision to increase the size of these awards 
from $200,000 to $300,000 and would support a decision by the 
NIH Director to increase funding from the various institutes 
and centers that support the program in order to expand the 
number of institutions receiving this important award.
    Research centers at minority institutions.--The Committee 
continues to recognize the critical role played by minority 
institutions at both the graduate and undergraduate level in 
addressing the health research and training needs of minority 
populations. These programs help facilitate the preparation of 
a new generation of scientists at these institutions. The 
Research Centers in Minority Institutions (RCMI) Program 
continues to impact significantly on these problems. The 
Committee encourages NIH to strengthen participation from 
minority institutions and the resources available in this area. 
The Committee also encourages NIH to work with minority 
institutions with a track record of producing minority scholars 
in science and technology.
    Cystic fibrosis (CF).--The Committee commends NCRR for its 
efforts to improve systems for efficient conduct of clinical 
trials. NCRR support for the CF clinical trials system 
continues to contribute to the development of data collection 
and analysis systems and data safety monitoring efforts that 
are critical elements of the CF system. The Committee 
encourages NCRR to strengthen its support for clinical trials 
systems, including CF work.
    Clinical trials technology.--The Committee encourages NCRR 
to work with grantees in the Research Centers at Minority 
Institutions (RCMI) program and the General Clinical Research 
Centers (GCRC) program to upgrade their clinical trials data 
management capabilities.
    Islet cell resource (ICRs) centers.--The Committee applauds 
the goal of the ICRs to provide human islets for 
transplantation and basic scientific research. The Committee 
encourages the NCRR to ensure that the ICRs continue to improve 
the quality and consistency of islet isolation. The NCRR is 
also urged to maximize the data collection and analysis 
potential of the Administrative and Bioinformatics Coordinating 
Center, the coordinating center for the ICR consortium.

       NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

    The Committee provides $122,692,000 for the National Center 
for Complementary and Alternative Medicine (NCCAM), which is 
$587,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The Center was established to stimulate, develop, 
and support rigorous and relevant research of high quality and 
open, objective inquiry into the safety and effectiveness of 
complementary and alternative medicine practices in order to 
provide the American public with reliable information about 
these practices.
    Ameliorating liver disease.--The Committee is pleased with 
NCCAM's efforts to conduct clinical trials in collaboration 
with NIDDK regarding the use of milk thistle as a possible 
treatment in slowing the progression of nonalcoholic 
steatohepatitis and to reduce the side effects of hepatitis C 
interferon treatments. The Committee looks forward to the 
development and dissemination of the research results 
associated with the use of milk thistle as a treatment to 
ameliorate liver disease.
    Parkinson's disease.--The Committee encourages NCCAM to 
continue exploration of aerobic exercise and Chinese exercises 
such as T'ai Chi Chuan in the treatment of Parkinson's. Recent 
studies show exercise may increase neuroprotective chemicals in 
the brain and decrease falls in the elderly. The Committee also 
encourages continued research into magnetic stimulation for 
depression and the phytomedicine Valerian for sleep 
dysfunction, as both symptoms are significant non-motor co-
morbidities in Parkinson's. Finally, NCCAM is encouraged to 
work the Office of Dietary Supplements in investigating 
supplements which may be neuroprotective, such as berries, 
alpha lipoic acid, N-acetyl-L-cysteine, acetyl-L-carnitine, 
vitamin E, ginko biloba, vitamin D, vitamin B12, 
phosphatidylcholine, and glyconutrients.

       NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

    The Committee provides $197,379,000 for the National Center 
on Minority Health and Health Disparities (NCMHD), which is 
$1,220,000 above the fiscal year 2005 comparable level and the 
same as the budget request.
    Mission.--The Center conducts and supports research, 
training, information dissemination and other programs aimed at 
reducing the disproportionately high incidence and prevalence 
of disease, burden of illness and mortality experienced by 
certain American populations, including racial and ethnic 
minorities and other groups, such as the urban and rural poor, 
with disparate health status.
    Glomerular injury.--The Committee understands that 
glomerular injury, a group of diseases affecting the filtering 
mechanisms of the kidneys, is more prevalent among African-
Americans than the general population. The Committee encourages 
NCMHD to explore collaboration with NIDDK to support research 
activities related to glomerular injury and requests a report 
on progress made in this area.
    Scleroderma.--The Committee encourages NCMHD to support 
research that furthers the understanding of causes and 
consequences of scleroderma, a chronic, degenerative disease of 
collagen production, present among African-Americans, Hispanic 
and Native American men and women. NCMHD is encouraged to 
establish epidemiological studies to address the prevalence of 
scleroderma among these populations, as statistics indicate 
that African-Americans have a slightly higher incidence of 
scleroderma. This population is also likely to be diagnosed at 
a younger age and tends to be diagnosed more often with the 
diffuse form of scleroderma.
    Lung disease.--The Committee is concerned with the 
disproportionate impact of lung diseases affecting minorities. 
The Committee encourages the Center to partner with other 
agencies within the NIH, including NHLBI, to develop an 
epidemiological approach to determine the disproportionate 
impact of airway disease on minority populations.
    Psoriasis.--The Committee encourages NCMHD to support 
research that furthers the understanding of causes and 
consequences of psoriasis, a chronic, immune-mediated disease 
that affects between 5.8 and 7.5 million Americans. New 
research indicates that psoriasis is twice as common among 
African-Americans as previously believed, and the research 
found suggestions that psoriasis among African-Americans may be 
more severe than among Caucasians. NCMHD is encouraged to 
establish epidemiological studies to address the prevalence of 
psoriasis among African-Americans, Hispanics, and other 
minority populations, as well as research into the apparent 
differences in psoriasis severity among different populations.
    Liver disease.--The Committee notes that many liver 
diseases, such as hepatitis C, hepatitis B and nonalcoholic 
steatohepatitis, are more common in the African-American, 
Hispanic, Asian Pacific Islander and Native American 
populations, than in European Americans. In addition, access to 
and acceptance of care is particularly problematic in these 
populations. The Committee encourages the Center to initiate 
and participate with NIDDK, NIDA and NCI in research focused on 
addressing and reducing these disparities.
    Cancer center at minority institutions.--The Committee 
commends NCMHD for its leadership in addressing the 
disproportionate impact of cancer in minority communities. The 
Committee encourages NCMHD to consider collaborating with NCRR 
and NCI in supporting the establishment of a cancer center at a 
historically minority institution focused on research, 
treatment, and prevention of cancer in African-American and 
other minority communities.
    Research endowments.--The Committee commends NCMHD for its 
leadership in addressing the longstanding problem of health 
status disparities in minority and medically underserved 
populations. The Committee continues to encourage NCMHD to 
implement its successful Research Endowment program as an 
ongoing initiative.
    Project EXPORT.--The Committee commends NCMHD for its 
successful ``Project EXPORT'' initiative and recommends 
continued support for this important program.
    Minority community based organizations.--The Committee 
believes that implementation of recommendations stemming from 
the IOM study, ``Unequal Treatment: Confronting Racial and 
Ethnic Disparities in Health Care'' offer significant 
opportunities for improving health across communities of color. 
NCMHD is urged to support minority organizations and minority 
community-based efforts to disseminate research-based health 
information that highlights health disparities experienced by 
different racial and ethnic groups. NCMHD is encouraged to 
engage minority national organizations and minority community-
based organizations in educating diverse communities about the 
findings and recommendations of the Institute of Medicine 
report.

                  JOHN E. FOGARTY INTERNATIONAL CENTER

    The Committee provides $67,048,000 for the Fogarty 
International Center (FIC), which is $416,000 above the fiscal 
year 2005 comparable level and the same as the budget request.
    Mission.--The FIC was established 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.
    Chronic obstructive pulmonary disease (COPD).--The 
Committee notes that COPD is the fourth leading cause of death 
in the U.S. and encourages the Fogarty International Center to 
strengthen its COPD research and training activities.
    Tuberculosis training.--The Committee is pleased with the 
Fogarty International Center's efforts to supplement grants in 
the AIDS International Training and Research Program (AITRP) or 
International Training and Research Program in Emerging 
Infectious Diseases (ERID), which train tuberculosis experts in 
the developing world. Given the magnitude of global 
tuberculosis, the Committee encourages FIC to develop a 
specific free standing TB training program.
    Fragile X.--The Fogarty International Center addresses 
global health challenges through innovative and collaborative 
research and training programs and supports and advances the 
NIH mission through international partnerships. International 
collaboration among scientists is an essential element in 
Fragile X research. The Committee encourages the Fogarty 
International Center to consider Fragile X syndrome through all 
appropriate programs, such as the Fogarty International 
Research Collaboration Award and the FIC Brain Disorders in the 
Developing World Program.

                      NATIONAL LIBRARY OF MEDICINE

    The Committee provides $318,091,000 for the National 
Library of Medicine (NLM), which is $2,945,000 above the fiscal 
year 2005 comparable level and the same as the budget request. 
In addition, $8,200,000 is made available from program 
evaluation funds as requested by the Administration to support 
the National Center on Health Services Research. The same 
amount was provided last year.
    Mission.--The National Library of Medicine collects, 
organizes, disseminates, and preserves biomedical literature in 
all forms, regardless of country of origin, language, or 
historical period. The Library's collection is widely 
available; it may be consulted at the NLM facility on the NIH 
campus; items may be requested on interlibrary loan; and the 
extensive NLM bibliographic databases may be searched online by 
health professionals around the world. NLM has a program of 
outreach to acquaint health professions with available NLM 
services. The Library also is mandated to conduct research into 
biomedical communications and biotechnology; to award grants in 
support of health science libraries and medical informatics 
research and training; and to create specialized information 
services in such areas as health services research, 
environmental health, AIDS, hazardous substances, and 
toxicology.

                         OFFICE OF THE DIRECTOR

                          (INCLUDING TRANSFER)

    The Committee provides $482,216,000 for the Office of the 
Director (OD), which is $124,169,000 above the fiscal year 2005 
comparable level and $97,021,000 above the budget request. 
Included within funding for the Office of the Director is 
$97,021,000 for radiological, nuclear and chemical 
countermeasures. The Administration had requested these funds 
as part of the Public Health and Social Services Emergency 
Fund. It is intended that the Director allocate these funds to 
those Institutes that support these areas of countermeasure 
research.
    The bill repeats language included in prior years 
authorizing the collection of third party payments for the cost 
of clinical services, providing the Director of NIH with one 
percent transfer authority, and allocating up to $500,000 of 
funds within the Office of the Director appropriation for the 
Foundation for the National Institutes of Health. The Committee 
provides $93,000,000 within the Office of the Director for the 
Director's Discretionary Fund (DDF), which is the same as the 
Administration request and $23,560,000 above the fiscal year 
2005 comparable level. $83,000,000 of this funding is intended 
to be used for Roadmap initiatives. The Committee has repeated 
last year's bill language making up to $10,000,000 of this 
total available through the flexible research authority 
provided in section 217 of the Act. The Committee also includes 
bill language providing $10,000 for representation allowances 
when specifically approved by the Director of NIH.
    The Committee includes $2,000,000 as requested by the 
Administration for a new Office of Portfolio Analysis and 
Strategic Initiatives. The Committee strongly supports this 
effort as a needed mechanism to review the NIH research 
portfolio as a whole and to address the issues raised by 
external groups about the coding of diseases for funding 
reporting.
    The Committee includes bill language from last year's bill 
identifying the maximum funding that may be used for Roadmap 
activities and the method of calculating each Institute or 
Center's contribution. The language also permits the transfer 
of Roadmap funds to a single location for the purpose of using 
a standardized accounting structure for supporting Roadmap 
activities.
    Mission.--The Office of the Director provides leadership to 
the NIH research enterprise and coordinates and directs 
initiatives which cross-cut the NIH. The OD is responsible for 
the development and management of intramural and extramural 
research and research training policy, the review of program 
quality and effectiveness, the coordination of selected NIH-
wide program activities, and the administration of centralized 
support activities essential to operations of the NIH.

Office of Research on Women's Health

    The Office of Research on Women's Health (ORWH) works in 
collaboration with the Institutes and Centers of NIH to promote 
and foster efforts to address gaps in knowledge related to 
women's health through the enhancement and expansion of funded 
research and/or the initiation of new investigative studies. 
The ORWH is responsible for ensuring the inclusion of women in 
clinical research funded by NIH, including the development of a 
computerized tracking system and the implementation of 
guidelines on such inclusion. This Office is also involved in 
promoting programs to increase the number of women in 
biomedical science careers, and in the development of women's 
health and sex and gender factors in biology as a focus of 
medical/scientific research.
    The Committee is pleased with the increased focus on 
irritable bowel syndrome (IBS) at the ORWH. It is estimated 
that between 25 and 45 million Americans, disproportionately 
women, suffer from IBS.

Office of AIDS Research

    The Office of AIDS Research (OAR) is responsible for 
coordination of the scientific, budgetary, legislative, and 
policy elements of the NIH AIDS research program. The OAR 
develops a comprehensive plan for NIH AIDS-related research 
activities which is updated annually. The plan is the basis for 
the President's budget distribution of AIDS-related funds to 
the Institutes, and centers within NIH. The Committee expects 
the Director of NIH to use this plan and the budget developed 
by OAR to guide his decisions on the allocation of AIDS funding 
among the Institutes. The Director of NIH also should use the 
full authority of his office to ensure that the Institutes and 
Centers spend their AIDS research dollars in a manner 
consistent with the plan. In addition, the OAR allocates an 
emergency AIDS discretionary fund to support research that was 
not anticipated when budget allocations were made.
    The Committee has included the same general provisions in 
bill language that were contained in the 2005 appropriations 
bill. This language permits the Director of OAR, jointly with 
the Director of NIH, to transfer between Institutes and Centers 
up to three percent of the funding determined by NIH to be 
related to AIDS research. This authority could be exercised 
throughout the fiscal year subject to normal reprogramming 
procedures, and is intended to give NIH flexibility to adjust 
the AIDS allocations among Institutes if research opportunities 
and needs should change. The Committee also repeats language 
from last year's bill making the research funds identified by 
NIH as being AIDS related available to the OAR account for 
transfer to the Institutes. This provision permits the flow of 
funds through the OAR in the spirit of the authorization 
legislation without requiring the Congress to earmark a 
specific dollar amount for AIDS research.
    Pediatric HIV research.--The Committee recognizes the 
importance of research into the long-term health implications 
of preventive HIV drug regimens in children, the psychological 
and social needs of HIV-infected children and appropriately 
targeted prevention services. The Committee requests the 
Director to identify the resources necessary for domestic and 
international research on the long-term effects of preventive 
drug regimens on HIV-exposed pediatric populations; the long-
term health, psychosocial, and prevention needs for pediatric 
populations perinatally HIV-infected; the transition to 
adulthood for HIV-infected pediatric populations; and safer and 
more effective treatment options for pediatric populations with 
HIV disease.
    Pediatric HIV vaccine testing.--The Committee requests the 
Director of the National Institutes of Health to submit a 
report within 90 days of enactment of this bill on the status 
of activities related to the testing of potential HIV vaccine 
candidates in relevant pediatric populations, including 
infants, preadolescents, and adolescents. The report should 
include an analysis of regulatory or other barriers to 
developing an HIV vaccine and a comprehensive review of current 
and planned clinical trials in relevant pediatric populations. 
In addition, the Committee requests that the NIH Fiscal Year 
2007 Plan for HIV-Related Research and future plans include: 
plans for expanding existing capacity for HIV vaccine candidate 
testing in relevant pediatric populations; plans for increasing 
coordination in advancing pediatric HIV vaccine testing across 
Federally funded HIV vaccine research programs, including, but 
not limited to the HIV Vaccine Trials Network, the Pediatric 
AIDS Clinical Trials Group, the Food and Drug Administration, 
the Centers for Disease Control and Prevention, and the 
Partnership for AIDS Vaccine Evaluation; opportunities for 
collaboration with the Office of the Global HIV/AIDS 
Coordinator; appropriate principles for initiating HIV vaccine 
testing in relevant pediatric populations, including 
recommendations for sequencing the enrollment of adults and 
relevant pediatric populations and for addressing issues 
related to human subjects protections for children involved in 
clinical research; and proposed community education efforts in 
support of the inclusion of relevant pediatric populations in 
HIV vaccine clinical trials.

Office of Dietary Supplements

    The Office of Dietary Supplements (ODS) was established in 
recognition that dietary supplements can have an important 
impact on the prevention and management of disease and on the 
maintenance of health. ODS is charged with promoting, 
conducting, and coordinating scientific research within NIH 
relating to dietary supplements.

Office of Behavioral and Social Sciences Research

    The Office of Behavioral and Social Sciences Research 
(OBSSR) provides leadership and direction for the development 
of a trans-NIH plan to increase the scope of and support for 
behavioral and social science research and in defining an 
overall strategy for the integration of these disciplines 
across NIH institutes and centers; develops initiatives to 
stimulate research in the behavioral and social sciences arena 
and integrate a biobehavioral perspective across the research 
areas of NIH; and promotes studies to evaluate the 
contributions of behavioral, social and lifestyle determinants 
in the development, course, treatment, and prevention of 
illness and related public health problems.

Office of Rare Disease Research

    The Office of Rare Disease Research (ORD) was established 
in recognition of the need to provide a focal point of 
attention and coordination at NIH for research on rare 
diseases. ORD works with Federal and non-Federal national and 
international organizations concerned with rare disease 
research and orphan products development; develops a 
centralized database on rare diseases research; and stimulates 
rare diseases research by supporting scientific workshops and 
symposia to identify research opportunities.
    Pediatric liver diseases.--The Committee is pleased that 
the ORD has continued to provide significant funding to support 
10 centers within the Biliary Atresia Clinical Research 
Consortium. The Committee urges ORD to continue to address rare 
liver diseases including primary biliary cirrhosis, primary 
sclerosing cholangitis, and auto-immune hepatitis.

Multi-Institute Research Issues

    Clinical Trials Technology.--The Committee recommends that 
the NIH Director and the Director of the NIH Clinical Center 
explore options for utilization of technology to improve 
efficiency, cost savings, and sharing of information in 
clinical trials being supported intramurally and extramurally. 
The Director is encouraged to investigate software systems that 
could reduce the administrative costs of clinical trials, 
improve the availability and transfer of clinical data for 
review or use by other researchers, and bring uniformity to the 
administration of NIH research.
    Clinical investigators.--The Committee has heard testimony 
that there is currently a shortage of adequately trained 
clinical investigators within every medical specialty who can 
translate basic science advances into the diagnosis, treatment 
and prevention of disease. This shortage inhibits clinical 
research productivity and slows the rate at which results from 
basic biomedical research efforts can be applied to the 
problems of patients. Improved clinical research will have a 
positive effect on the quality of health care and patient 
safety, and advance the application of the principles of 
evidenced-based medicine to routine patient care. The Committee 
has as a priority the training of physician-scientists through 
all NIH institutes, to support studies of patient outcomes, 
medical effectiveness, and disease- and treatment-specific 
quality of life.
    Public access.--The Committee is pleased that NIH is moving 
forward to implement its public access policy and is hopeful 
that the policy will be a first step toward providing free and 
timely access to the published results of all NIH-funded 
biomedical research. The Committee endorses NIH's expressed 
goals for the policy, namely to create an archive of NIH-funded 
research, to provide an opportunity to better manage the NIH 
research portfolio, and to provide enhanced public access to 
NIH research results. The Committee is concerned, however, that 
the final policy may not achieve these goals. For this reason, 
the Committee directs the Office of the Director to submit to 
the Committee by March 1, 2006 a comprehensive report on the 
progress achieved during the first eight months following the 
implementation of the new policy. Specifically, the Committee 
requests that the report provide: 1) the total number of 
applicable peer-reviewed articles deposited in PubMed Central 
since the May 2, 2005 implementation date; 2) the embargo 
period requested by the author for each deposited work; and 3) 
NIH's best estimate of the total number of applicable peer-
reviewed articles available for deposit during this time frame, 
together with an explanation of the mechanisms relied upon to 
determine this estimate. Additionally, the Committee is 
concerned that grant recipients may not fully understand the 
NIH policy and the steps required to post an article in PubMed 
Central. The Committee, therefore, directs NIH to develop an 
aggressive education and outreach initiative aimed at informing 
grant recipients about the policy in an effort to maximize full 
and prompt participation.
    Duchenne muscular dystrophy.--The Committee is disappointed 
with the time the Department took to implement the provisions 
of the MD Care Act. It is pleased that the Muscular Dystrophy 
Coordinating Committee (MDCC) eventually produced an MD 
Research and Education Plan, which is to be updated every two 
years and submitted to Congress. The Committee understands that 
NIH also submits an annual report to Congress on implementation 
of the MD Care Act. The Committee requests that it be included 
in the Congressional distribution of both of these periodic 
reports. The Committee asks that the annual report state NIH's 
current research goals related to duchenne muscular dystrophy, 
the progress made toward each goal, the total amount of money 
invested toward each goal as well as projected spending for the 
present and future fiscal year, and all opportunities for 
translation research and external partnerships.
    The Committee is pleased that NIH has funded one additional 
Senator Paul Wellstone Muscular Dystrophy Cooperative Research 
Center and is working to fund two more, for a total of six. The 
Committee urges NIH to provide adequate funding and resources 
for each center. The NIH is also urged to devote separate 
resources to DMD translational research beyond the funding that 
is provided in Centers of Excellence programs.
    Duchenne muscular dystrophy translational research.--The 
Committee recognizes that several promising translational 
treatments and therapies for Duchenne and Becker muscular 
dystrophy are in development. The Committee requests NIH to 
develop a translational research initiative specific to 
muscular dystrophy to ensure the effective coordination of 
these efforts and their acceleration. The Spinal Muscular 
Atrophy [SMA] Project may be an appropriate model for the 
initiative. The Committee believes the SMA model enhances the 
dialogue between program directors and investigators, 
facilitating and accelerating review and modifications of grant 
proposals that are in the best interest of the patients and 
that show the greatest promise for success. To achieve maximum 
effectiveness, the Committee urges NIH to assess the 
background, experience, and capabilities of staff needed to 
launch, perform, and sustain such a translational research 
initiative. The Committee requests a report by March 1, 2006 on 
the timeline to establish a DMD Translational Research 
Initiative.
    As a component of the Initiative, the Committee encourages 
NIH to conduct a workshop to explore the most promising 
potential approaches to Duchenne and Becker muscular dystrophy 
no later than February 2006 and to provide a full report to the 
Committee within 3 months of the workshop.
    Autism spectrum disorders.--The Committee is pleased with 
NIH's autism research matrix and encourages NIH to devote 
sufficient resources to this research agenda. When implementing 
the autism research matrix, the Committee encourages NIH to 
coordinate with autism organizations already funding research 
initiatives to ensure the most efficient use of resources. The 
Committee also notes the promise of particular areas cited in 
the matrix, including genetic and behavioral characterization 
of the disorder, screening and early diagnosis.
    Autism and vaccines.--The Committee continues to be aware 
of concerns about reports of a possible association between the 
measles component of the measles-mumps-rubella (MMR) vaccine 
and a subset of autism termed autistic entercolitis. The 
Committee continues its interest in this issue and encourages 
the Interagency Coordinating Committee to continue to give 
serious attention to these reports. The Committee is aware that 
research is underway, supported by NIH, and encourages NIH to 
avoid further delays in this research.
    The Committee is also concerned that there is some evidence 
that infant exposures to thimerosal in the 1990s may be related 
to the epidemic of neurodevelopmental disorders in children. 
CDC's most extensive review of Vaccine Safety Datalink data 
concluded that more research needs to be conducted in this 
arena to answer these questions with certainty and the 
Committee concurs with the need for this continued research.
    The Committee encourages NIH to dedicate significant 
resources to pursue the recommended research initiatives 
outlined in the Institute of Medicine's (IOM) Immunization 
Review. These reports have identified the research needed to 
better understand why a number of children suffer severe 
adverse reactions to childhood vaccines. Continuation of this 
research to develop a better understanding of biological 
mechanisms is critical for knowing with certainty whether or 
not thimerosal and other vaccines exposures might cause 
increased risks for some children.
    Stem cell research.--Since the late 1960s bone marrow 
transplants and bone marrow stem cells have been used to treat 
cancer and blood diseases. In recent years, basic and clinical 
research has demonstrated the ability of adult stem cells to 
treat a broader range of diseases through regenerative medicine 
including autoimmune diseases and tissue repair. The Committee 
urges NIH to place a high priority on investigating the 
plasticity and expansion of adult stem cells using more 
recently discovered multipotent adult stem cells from fat, 
dental pulp, heart, umbilical cord blood, and olfactory 
neurons. Clinical research, including FDA-approved clinical 
trials applying these novel sources of stem cells to the 
treatment of Parkinson's disease, ALS, diabetes, heart disease, 
and other diseases should be pursued vigorously as well.
    The Committee requests the Director, through the new Office 
of Portfolio Analysis and Strategic Initiatives, to consider 
the distinctions between the various types of adult stem cell 
research as it develops tools to more accurately categorize and 
assess expenditures on stem cell research as a whole. By April 
2006 the Committee requests a detailed report compiling the 
complete range of diseases being treated with all adult stem 
cells (including umbilical cord blood cells). This report 
should include a breakdown of spending among the various types 
of basic and clinical human adult stem cell research in a way 
that distinguishes traditional applications of bone marrow stem 
cells in the treatment of cancer and blood diseases from 
pioneering research into the novel use of multi-potent adult 
stem cells in regenerative medicine. Within six months of the 
release of this report, the Committee also requests that NIH 
develop an initiative to strengthen its portfolio of basic and 
clinical research into novel therapeutic uses of adult stem 
cells.
    Microbicides for the prevention of HIV/AIDS.--The Committee 
urges strengthened funding for microbicide research and 
development at NIH. In addition, the Committee has long 
advocated that NIAID establish a dedicated microbicide unit 
with clearly identified leadership to accelerate microbicide 
research. The Committee understands that NIAID has established 
the Microbicide Team in the Division of AIDS (DAIDS), which 
also coordinates a broader NIAID group with representatives 
from DAIDS and the Division of Microbiology and Infectious 
Diseases (DMD). The Office of AIDS Research, within the Office 
of the NIH Director, is continuing to coordinate microbicide 
research across NIH. Greater leadership and coordination on 
this issue is especially critical given that consideration is 
being given to the possibility of a microbicide-specific 
clinical trial network.
    Public-private partnerships in support of microbicides to 
prevent HIV/AIDS.--There is an urgent need to expand the 
development pipeline with more microbicide candidate products, 
particularly those that target HIV in new ways. In addition to 
candidates that may arise from NIH-funded basic research 
efforts, possibilities may be found within pharmaceutical 
companies where there are potential compounds already developed 
as therapeutics that could be tested as potential microbicides. 
NIH has mechanisms in place to encourage partnerships among 
researchers in academia, government and the private sector. The 
Committee strongly urges the leadership at NIH to support the 
microbicide field by encouraging partnering with the 
pharmaceutical industry and non-governmental organizations. In 
the past year, the International Partnership for Microbicides 
has entered into agreements with leading pharmaceutical 
companies to jointly test and develop leading AIDS drugs as 
microbicides. More partnerships like these between the 
pharmaceutical industry and the non-profit community in 
collaboration with NIH will be critical, and should receive the 
active support of NIH leadership.
    Parkinson's disease.--The Committee understands that the 
Director has scheduled a Parkinson's disease research 
conference in June, 2005. The Committee requests the Director 
to report back to the Committee within six months of the 
conference on the conclusions from the summit, an examination 
of the existing Parkinson's research portfolio, and 
recommendations of research goals for the next three years for 
diagnosis, better treatments and a cure for Parkinson's 
disease.
    Autoimmune diseases.--Congress recognizes the cross-cutting 
nature of the NIH Autoimmune Diseases Coordinating Committee 
(ADCC) and its comprehensive Autoimmune Diseases Research Plan. 
The ADCC has been effective in fostering collaborative, 
integrated multi-Institute research on issues affecting the 
genetically related family of autoimmune diseases. The ADCC 
should focus on the role of environmental and infectious agents 
in the initiation and/or exacerbation of autoimmune diseases. 
Additionally, the Committee encourages the ADCC to be proactive 
in identifying promising areas of autoimmune research where 
collaboration among the NIH institutes enhances the potential 
for major advances.
    Heart disease research and prevention action plan.--
Concerned that heart disease remains a major cause of permanent 
disability, the Committee encourages NIH to consider convening 
an inter-agency conference on heart disease to develop a 
comprehensive, long range research and prevention action plan. 
Participants should include representatives from all Federal 
agencies involved in heart disease research and prevention, 
including the NIH, CDC, AHRQ, DOD, and pertinent voluntary 
nonprofit organizations and experts in the field. The 
conference would be the basis for a long-range, strategic heart 
disease research and prevention action plan which would include 
quantifiable goals and benchmarks to measure progress in the 
battle against heart disease.
    Spina bifida.--The Committee recognizes that spina bifida 
is the leading permanently disabling birth defect in the U.S. 
and has heard concerns that NIH has not prioritized research 
into primary and secondary treatment of this condition. While 
spina bifida is highly preventable through proper nutrition, 
including appropriate folic acid consumption, too many 
pregnancies still are affected each year by this devastating 
birth defect. Since more than 70,000 individuals are living 
with spina bifida, the Committee urges NIH to allocate adequate 
resources to research into primary and secondary treatment of 
spina bifida. The Committee is pleased with the outcome of the 
2003 Spina Bifida Research Conference and encourages NIH to 
consider organizing a follow-up national conference involving 
NICHD, NINDS, NIDDK, and the Office of Rare Diseases along with 
the National Center on Birth Defects and Developmental 
Disabilities, the Agency for Healthcare Research and Quality, 
and the National Institute on Disability and Rehabilitation 
Research to identify and explore improved treatment and 
outcomes for adults and children with spina bifida.
    Rett syndrome.--Rett syndrome is a neurological disorder 
resulting from a mutated gene that seen worldwide in most 
racial and ethnic groups, almost exclusively in females. It is 
estimated to occur approximately one in fifteen thousand female 
births, although recent discoveries may reveal significantly 
more affected people than previously diagnosed. The Committee 
applauds NIH's continued commitment to Rett syndrome research 
and encourages support for new animal models and genotype/
phenotype investigations of Rett syndrome. Since Rett syndrome 
is a multi-faceted disorder, the Committee encourages NIH to 
redouble its effort to integrate the appropriate Institutes 
into this program area, including NIA, NIMH, NIDCD, NHLBI, 
NIAMS, NIDDK, and NIGMS, whose mandates include areas involved 
with understanding, treating and curing Rett syndrome.
    Cystic fibrosis (CF).--One of the priorities of the NIH 
Roadmap is the re-engineering of the clinical research system. 
There are a number of clinical trials systems that might serve 
as models for the re-engineering effort. One such model is the 
clinical trials system for testing therapies for CF, which 
includes centralized data management and analysis capability, 
centralized data safety monitoring, and the participation of 18 
leading CF research centers. The Committee encourages the 
Director to evaluate and support the CF system as a model for 
the clinical trials reform effort. The structure and systems 
that achieve cost and research efficiencies in the CF network 
might be applicable to trial networks for other diseases.
    Charcot-Marie-Tooth disorder.--Charcot-Marie-Tooth disorder 
(CMT) is one of the most common inherited neurological 
disorders, affecting approximately one in 3,500 people in the 
United States. The Committee is concerned about the prevalence 
of this disease and its effect on people across the age 
spectrum and recognizes the value of CMT research for advancing 
understanding into other neuromuscular disorders. The Committee 
encourages NIH to identify new research opportunities on CMT 
that could lead to a relevant program announcement or request 
for applications. The Committee requests a report on NIH 
efforts on CMT and CMT-related disorders by March, 2006.
    Polycystic kidney disease (PKD).--The Committee is pleased 
that NIH-supported PKD research, combined with grants from the 
private sector and the involvement of industry, has not only 
produced the first clinical drug trial for PKD in humans, but 
has fostered the development of additional, innovative PKD 
therapies. Given the unprecedented momentum and therapeutic 
opportunities in PKD science, the Committee urges NIH to 
further implement its PKD Strategic Plan by facilitating PKD 
clinical trials and expanding knowledge-based studies of 
pathophysiology and cellular pathobiology.
    Lymphatic system research.--The lymphatic system is central 
to the progression of disease and the maintenance of health, 
yet scientific and medical knowledge of this important system 
has gaps. The Committee is pleased that a Trans-NIH 
Coordinating Committee on the Lymphatic System exists to ensure 
that scientific knowledge and understanding about this body 
system will be advanced and coordinated. The Committee is 
encouraged to learn that the Coordinating Committee is working 
with patient advocates to address the needs of the lymphatic 
disease and lymphedema patient communities. The Committee 
encourages NIH to consider initiatives such as a national 
lymphatic disease patient registry and tissue bank; an NIH 
partnership funding program; intramural longitudinal studies; 
and multidisciplinary centers.
    Asian American and Pacific Islander (AAPI) populations.--
The Committee encourages NIH, particularly NIDA, NIAAA, and 
NIMH, to strengthen its support of behavioral health research 
for AAPI populations. Additional research is needed to develop 
a body of knowledge addressing the bio-psycho-social aspects of 
substance abuse as well as co-occurring disorders among AAPI 
populations. Studies are also needed to address the biological 
differences that may exist within the diverse AAPI populations 
in terms of their reaction to the range of substances used and 
abused, and nature of substance abuse; effective prevention and 
treatment strategies; and culturally appropriate ways to 
evaluate these AAPI substance abuse services.
    Dystonia.--The Committee is very pleased with progress 
demonstrated by the NIH intramural research program in the 
treatment and understanding of dystonia. NIH intramural 
researchers have successfully utilized injections of botox to 
treat many patients who otherwise would be severely debilitated 
by dystonia. The Committee urges continued work in this 
important area of study and treatment.
    Fragile X.--The Committee notes the progress made by 
Fragile X researchers in understanding the basic neural defects 
that cause this developmental disorder. However, further 
efforts are required to translate these basic science findings 
into viable treatments. Specifically, collaborative efforts 
between industry, academia and NIH Institutes are likely to be 
necessary to develop promising therapeutic options for this 
orphan indication. The Committee further notes that while 
Fragile X is a relatively common genetic disease, the 
treatments being developed for Fragile X may also be effective 
for a much larger number of people with related autism spectrum 
disorders. Research has shown many possible treatment 
strategies which merit human Fragile X clinical trials. The 
Committee encourages the Director to facilitate and support 
public/private partnerships which will enable these important 
studies to proceed. NIH is urged to convene a yearly workshop 
with the research community to develop priorities for basic, 
clinical and translational research as they relate to Fragile 
X.
    Spinal muscular atrophy (SMA).--The Committee encourages 
the Office of the Director to ensure support of the SMA Project 
by providing active and ongoing support from the OD as well as 
from other related Institute Directors, particularly NICHD, 
since SMA is the leading genetic killer of infants and 
toddlers.
    Psoriasis.--The Committee encourages NIH to strengthen its 
work on psoriasis, a chronic, immune-mediated disease that 
affects between 5.8 and 7.5 million Americans. Safe and 
effective treatments for women of child-bearing age and for 
children are particularly lacking, and new research indicates 
mothers with psoriasis have a 50% increased risk of bearing a 
child with autism. New research also indicates psoriasis is 
twice as common among African-Americans as previously believed. 
Psoriasis research involves many disciplines, and the Committee 
encourages NIH to intensify coordination of psoriasis research 
across its institutes and centers.
    Gene therapy research.--While the promise of gene therapy 
has not yet been realized, the Committee is encouraged by some 
promising research done in the area of thalassemia, or Cooley's 
anemia. It is concerned, however, that the most innovative gene 
therapy research is currently being done in Europe rather than 
in the United States. The Committee urges the Director to 
assess the prospects for the most promising areas for 
breakthroughs in this field and to develop a program to focus 
resources on it. The assessment should also include the 
prospects for successes in additional hemoglobinopathies and in 
an even broader range of diseases.
    Hereditary hemorrhagic telangiectasia.--Hereditary 
hemorrhagic telangiectasia (HHT), also known as Osler-Weber-
Rendu Syndrome, is a multi-system vascular genetic disorder 
producing blood vessel malformations in the brain and lung 
which may result in stroke, hemorrhage, aneurysm and death. 
Sudden death or disability may occur in twenty percent of 
children and adults, but is largely preventable with proper 
intervention. Because this is a multi-system disorder, the 
Committee encourages the Director to formulate an NIH-wide 
research agenda with the participation of the NHLBI, NINDS and 
NIDDK Institutes.
    Osteoporosis.--The Committee is pleased that the Surgeon 
General has submitted the report on bone health requested in 
the FY 2002 appropriations bill. The Surgeon General's report 
on bone health and osteoporosis comes at a critical time when 
the aging population of the United States faces an increasing 
burden of musculoskeletal disease and disability. Osteoporosis, 
which the report recognizes will affect one in two Americans 
over the age of 50 by 2020, will lead to disability, loss of 
independence and early mortality. The Surgeon General calls for 
a national action plan to achieve improved bone health. To this 
end, the Committee encourages NIH to establish a ``Bone Health 
Research Blueprint'' to achieve the Surgeon General's 
objectives through enhanced cooperation between NIH institutes. 
The Blueprint should place particular emphasis on osteoporosis, 
osteogenesis imperfecta, Paget's disease, other metabolic bone 
diseases and rare bone disorders such as osteopetrosis. The 
Committee requests a report on the status of the Bone Health 
Blueprint by March 1, 2006.
    Human tissue supply.--The Committee remains interested in 
matching the increased needs of NIH grantees and intramural 
researchers who rely upon human tissues and organs to study 
disease and search for cures. The Committee is aware that NIH 
has established a multi-institute initiative on human tissue 
supply. While this is promising, there is still an unmet demand 
for the use of human tissue in research. The Committee 
encourages the Director to strengthen the core support for this 
initiative and to broaden its scope to other Institutes such as 
NCI, NHLBI, and NINDS that have not previously participated in 
the initiative's core support.
    Minority health professions schools.--The Committee 
continues to be pleased with the NIH Director's implementation 
of various programs focused on developing research 
infrastructure at minority health professions institutions, 
including Research Centers at Minority Institutions and the 
National Center on Minority Health and Health Disparities. The 
Committee encourages the NIH Director to work closely with the 
Director of the NCMHD to establish a program of coordination 
among these mechanisms to partner with minority health 
professions schools to address their infrastructure needs.
    Down syndrome.--The Committee urges the Director of NIH to 
establish an NIH Down syndrome research task force on cognition 
to develop a strategic plan for genetic and neurobiological 
research relating to the cognitive dysfunction and the 
progressive late-life dementia associated with Down syndrome. 
The purpose of the strategic plan is to provide a guide for 
coordinating Down syndrome research on cognition across NIH and 
for enhancing the development of new research efforts based on 
identification of areas of greatest scientific opportunity, 
especially as they relate to the development of future 
treatments. The plan should include short, intermediate and 
long-term goals for basic and clinical research with strategies 
for achieving goals and with specified timeframes for 
implementation. The Committee expects the NIH to report to the 
Committee by April, 2006 on the steps it is taking to develop a 
down syndrome research task force on cognition.
    Child abuse and neglect research.--The Committee recognizes 
the magnitude and significance of child abuse and neglect as a 
serious public health problem claiming an estimated 896,000 
victims in 2002, according to data reported by the Department 
of Health and Human Services. The Committee applauds NIH for 
developing a coordinated research agenda for child abuse and 
neglect involving relevant NIH institutes, including NIMH, 
NICHD, NIDA, NINR, and NIAAA, the Office of Behavioral Social 
Science and Research and other appropriate agencies, and the 
continued collaborative and cooperative efforts in child abuse 
and neglect research. In response to recommendations in the 
1993 National Research Council report which examined the 
current state of research in this area, the NIH child abuse and 
neglect initiative first addressed the knowledge gaps in child 
neglect. The Committee encourages NIH to examine current gaps 
that exist in research on the abuse of children, including 
research on treatment interventions with substantiated cases of 
child maltreatment. The Committee requests that the Director be 
prepared to report on current and proposed NIH efforts in this 
area at the fiscal year 2007 hearings.
    Science education.--The Committee recognizes the success of 
grid computing as used by the Kentucky data research 
initiative, a partnership between elementary and secondary 
schools and postsecondary education research institutions to 
maximize research capabilities through computer resources. With 
the cooperation of the state of Kentucky and its local 
education agencies, the Kentucky data research initiative uses 
computers in local schools to provide additional computing 
capacity to cancer researchers at the Brown Cancer Center at 
the University of Louisville. During the hours the computers 
are not used, the excess computing capacity is harnessed so 
that cancer researchers in Louisville have a greater capacity 
to do more complex research. In exchange for the expanded 
research capabilities, scientists visit the schools to discuss 
their research to provide support for students interested in 
math and science. The Committee recognizes the success that 
this program has had in exposing students in elementary and 
high schools to careers in science and increasing the state's 
capacity for cancer research. The Committee encourages the 
Office of Science Education within the Office of the Director 
to review the Kentucky program as a possible model to be 
transferred to other states and utilized to enhance research 
capabilities in the sciences and health-related fields or other 
appropriate fields of research.
    PubChem.--The Committee understands that the stated mission 
of the PubChem database, which is part of the NIH Roadmap 
Initiative, is to create a new and comprehensive database of 
chemical structures and their biological activities, and will 
house both compound information from the scientific literature 
as well as screening and probe data from the new NIH molecular 
libraries screening center network. The Committee is concerned 
that NIH is replicating scientific information services that 
already exist in the private sector. In order to properly focus 
PubChem, the Committee urges NIH to work with private sector 
providers to avoid unnecessary duplication and competition with 
private sector chemical databases.
    Neuroscience and the genome.--The Committee understands 
there are exciting developments in the field of neuroscience 
where integrating genomic-based methodologies with computer 
science and traditional neuroanatomy is being supported by 
private philanthropic (or voluntary could be used here) 
support. These developments could result in advancing our 
knowledge along a broad front of neurologic, psychiatric and 
neurodegenerative diseases, their causes and cures. NIH is 
encouraged to collaborate with these efforts in a public-
private partnership as espoused in the Roadmap initiative or 
other appropriate mechanisms.
    Amyloidosis.--The Committee encourages NIH to intensify its 
research efforts into the amyloidoses, a group of rare diseases 
characterized by abnormally folded protein deposits in tissues. 
These diseases are often fatal and there is no known cure. 
Treatment involving large-dose intravenous chemotherapy 
followed by stem cell replacement or rescue is effective for 
many patients, but this procedure is risky, unsuitable for many 
patients, and not a cure. The Committee understands that NIH 
will be holding one or more conferences on amyloidosis and 
related diseases during 2005, and looks forward to receiving 
the results and recommendations (as requested in the FY 2005 
Committee report) identifying the next steps that need to be 
taken to increase the understanding, prevention and treatment 
of this devastating group of diseases.

                        BUILDINGS AND FACILITIES

    The Committee provides $81,900,000 for buildings and 
facilities, which is $28,388,000 below the fiscal year 2005 
comparable level and the same as the Administration request.
    Mission.--The Buildings and Facilities appropriation 
provides for the design, construction, improvement, and major 
repair of clinical, laboratory, and office buildings and 
supporting facilities essential to the mission of the National 
Institutes of Health. The funds in this appropriation support 
the 77 buildings on the main NIH campus in Bethesda, Maryland; 
the Animal Center in Poolesville, Maryland; the National 
Institute of Environmental Health Sciences facility in Research 
Triangle Park, North Carolina; and other smaller facilities 
throughout the United States.

       Substance Abuse and Mental Health Services Administration


               SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

    The Committee provides a program level of $3,352,047,000 
for the Substance Abuse and Mental Health Services 
Administration (SAMHSA), which is $39,722,000 below the fiscal 
year 2005 comparable level and $16,024,000 above the budget 
request. Within the total, $121,303,000 is provided through the 
evaluation set-aside as requested.
    SAMHSA is responsible for supporting mental health and 
alcohol and drug abuse prevention and treatment services 
nationwide through discretionary targeted capacity expansion 
and knowledge application grants, formula block grants to the 
States and associated technical assistance efforts. The agency 
consists of three principal centers: the Center for Mental 
Health Services, the Center for Substance Abuse Treatment, and 
the Center for Substance Abuse Prevention. The Office of the 
Administrator is responsible for overall agency management.
    The Committee expects that no less than the amounts 
allocated in fiscal year 2005 will be spent in fiscal year 2006 
for activities throughout SAMHSA that are targeted to address 
the growing HIV/AIDS epidemic and its disparate impact on 
communities of color, including African Americans, Latinos, 
Native Americans, Asian Americans, Native Hawaiians, and 
Pacific Islanders. These activities include treatment of mental 
health disorders related to HIV disease and expansion of 
service capacity of substance abuse treatment and prevention 
programs that provide services to high-risk communities of 
color.
    Greater availability of a rapid HIV test can increase 
overall HIV testing and reduce the number of people, an 
estimated 225,000 Americans, who are unaware of their HIV 
infection. The Committee acknowledges that treatment services 
provided by mental and behavioral health care providers for 
individuals testing positive are a necessary component of rapid 
HIV testing. The Committee commends SAMHSA for developing the 
Rapid HIV Testing Initiative (RHTI) to train substance abuse 
and mental health service providers on rapid HIV testing and 
prevention counseling. The Committee strongly supports the 
program and provides SAMHSA an additional $1 million towards 
the RHTI.
    The Committee is concerned about the intersection of 
methamphetamine abuse and the transmission of infectious 
diseases. Methamphetamine is a very dangerous, highly 
addictive, and toxic drug and is strongly linked to risky 
behaviors, increasing the risk of transmissions of infectious 
diseases such as HIV and Hepatitis C. SAMHSA and the Centers 
for Disease Control and Prevention (CDC) have funded crucial 
programs in methamphetamine prevention and treatment and 
infectious disease prevention and treatment programs, but there 
exists a gap on collaboration between the two agencies. 
Recognizing that CDC and SAMHSA have different responsibilities 
in responding to this epidemic, the Committee directs CDC and 
SAMHSA to draft a list of priorities to address the 
intersections of these two epidemics and to jointly provide a 
written report by April 1, 2006 designating a coordinating plan 
between SAMSHA and CDC. The plan should include a proposed 
infrastructure, needed resources, mechanisms of communication, 
and community involvement representing populations at high-risk 
to coordinate prevention, community outreach, professional 
training, treatment and new and existing grant programs to 
effectively address the intersection of the crystal 
methamphetamine epidemic and rising HIV rates. The Committee 
then requests that the CDC and SAMHSA report on the 
effectiveness of the new plan by February 2007.
    The Asian American and Pacific Islander (AAPI) population 
on the continental U.S., Hawaii, and the six Pacific Island 
jurisdictions are one of the fastest growing groups in the U.S. 
However, there are less than 10 culturally competent 
comprehensive substance abuse prevention and treatment programs 
designed to serve the AAPI population in the entire United 
States, and these few programs are located in just four states 
and one Pacific Island jurisdiction. The number and capacity of 
these comprehensive programs has remained essentially the same 
for over 15 years. The need for substance abuse services for 
this population continues to increase while the gap in the 
availability and access to culturally competent services is 
ever-widening. For many in this population services do not even 
exist. The Office of National Drug Control Policy found that 
AAPI parents are the least informed of any group regarding the 
nature and hazards of substance abuse among their teenagers. 
Treatment episodes in some cases have increased by over 50% for 
AAPI clients. SAMHSA should work with appropriate National AAPI 
organizations that provide substance abuse services to create a 
comprehensive system of outreach, training, information and 
resources, and prevention and treatment services that will be 
culturally competent and accessible to all AAPI populations 
across the United States.
    The Committee is concerned about the prevalence of 
hepatitis and substance abuse and urges SAMHSA to work with 
health organizations to promote education and prevention of 
both hepatitis and substance abuse.

Center for Mental Health Services

    The Committee provides a program level total of 
$880,294,000 for the Center for Mental Health Services (CMHS), 
which is $21,023,000 below the fiscal year 2005 comparable 
level and $43,044,000 above the budget request. Within the 
total, $21,803,000 is provided through the evaluation set-aside 
as requested.
            Programs of regional and national significance
    The Committee provides $253,257,000 for mental health 
programs of regional and national significance, which is 
$21,040,000 below the fiscal year 2005 comparable level and 
$43,044,000 above the budget request. The program includes 
studies that identify the most effective service delivery 
practices, knowledge synthesis activities that translate 
program findings into useful products for the field, and 
knowledge application projects that support adoption of 
exemplary service approaches throughout the country.
    The Committee provides $26,000,000 for the State incentive 
grants for transformation, the same level as the budget 
request. At this level, eight grants will be continued and 
three new grants will be awarded to States to plan and 
implement the transformation of their State mental health 
programs across multiple service systems. These comprehensive 
State mental health plans will enhance the use of existing 
resources at the State and local levels and expand the options 
and array of available supports. These grants are not intended 
to provide direct services, but rather are to aid States in 
developing broad systems changes to better serve persons with 
mental illness.
    The Committee provides $84,000,000 for School Violence 
programs. This is $17,187,000 more than the budget request. At 
this funding level it is the Committee's intention that 
additional grants will be awarded to school districts with the 
goals of promoting the healthy development of children and 
youth, fostering their resilience in the face of adversity, and 
preventing violence.
    Within funds provided, the Committee recommends that no 
less than the funding allocated in fiscal year 2005 be provided 
in fiscal year 2006 for the National Child Traumatic Stress 
Initiative. This program has established 54 treatment 
development and community service centers to treat children who 
have experienced trauma. It is estimated that up to 40,000 
traumatized children and their families will directly benefit 
from services delivered as a result of this initiative.
    The mental health needs of our Nation's seniors are largely 
ignored within our mental health system. While many older 
Americans experience depression, dementia, anxiety and 
substance abuse disorders, far too often these conditions are 
not recognized or treated. Outreach to elderly persons 
conducted in places frequented by seniors, such as senior 
centers, meal sites, primary care settings and other locations, 
is needed. The Elderly Treatment and Outreach Program is the 
only federally funded services program dedicated specifically 
to the mental health care of older adults. It is for this 
reason that within the funds provided, the Committee recommends 
that no less than the level allocated in fiscal year 2005 be 
allocated for the older adults program.
    Within funds provided, the Committee recommends that no 
less than level allocated in fiscal year 2005 be provided for 
grants for jail diversion programs. This program provides 
grants to States or localities, Indian tribes, and tribal 
organizations, acting directly or through agreements with other 
public or nonprofit entities, to develop and implement programs 
to divert individuals with a mental illness from the criminal 
justice system to community-based services.
    Preliminary data collected by the Centers for Disease 
Control and Prevention's National Violent Death Reporting 
System reports a 5% increase in suicides for 2003. 
Comprehensive data from the 2002 survey indicate that the rate 
of suicides among youth is growing faster than any other age 
cohort. In order to address this, the Committee recommends that 
within the funding provided, programs that address youth 
suicide prevention strategies be funded in fiscal year 2006 at 
no less than the amounts allocated in fiscal year 2005.
    The estimated number of AIDS cases from 1999 to 2003 has 
increased for racial and ethnic minorities, including African 
Americans, Latino/as, Asian Pacific/Islanders and American 
Indians/Alaska Natives. The Committee recognizes that many 
persons with HIV have a psychological and/or substance abuse 
disorder and that mental health and substance abuse services 
can help stabilize the health and well-being of persons with 
HIV/AIDS. The Committee acknowledges that racial and ethnic 
minorities have less access and lower utilization of mental 
health and substance abuse services. The Committee recommends 
that no less than the level provided in fiscal year 2005 be 
allocated for the Minority AIDS Initiative to provide competent 
and accessible mental health and substance abuse services to 
persons of color living with HIV/AIDS.
    Over the last three years, collaboration between the 
Departments of Housing and Urban Development (HUD) and Health 
and Human Services (HHS) on homeless policy has improved 
through joint efforts such as the Policy Academies, which 
provide training for State officials on accessing mainstream 
resources for homeless people and the 2003 Collaborative 
Initiative to Help End Chronic Homelessness, a $55 million HUD, 
HHS, and Veterans Administration effort that has housed over 
550 chronically homeless persons in 11 communities across the 
country. Although the fiscal year 2006 budget request did not 
include a direct funding request within HHS for the Samaritan 
Initiative, the Committee encourages SAMHSA to continue to 
collaborate with HUD in sharing best practices information and 
in discussing ways in which resources can be maximized toward 
the goal of ending chronic homelessness.
            Mental health block grant
    The Committee provides a program level total of 
$432,756,000 for the mental health block grant, which is the 
same as the fiscal year 2005 comparable level and the budget 
request. The block grant provides funds to States to support 
mental health prevention, treatment, and rehabilitation 
services. Funds are allocated according to statutory formula 
among the States that have submitted approved annual plans. The 
Committee notes that the mental health block grant funding 
represents less than 2 percent of total State mental health 
funding and less than 3 percent of State community-based mental 
health services. Within the total, $21,803,000 is provided 
through the evaluation set-aside as requested.
    The Community Mental Health Services Block Grant Program 
distributes funds to 59 eligible States and Territories through 
a formula based upon specified economic and demographic 
factors. Applications must include an annual plan for providing 
comprehensive community mental health services to adults with a 
serious mental illness and children with a serious emotional 
disturbance. Because the mental health needs of our Nation's 
elderly population are often not met by existing programs and 
because the need for such services is dramatically and rapidly 
increasing, the Committee recommends that SAMHSA require that 
States' plans include specific provisions for mental health 
services for older adults.
            Children's mental health
    The Committee provides $105,129,000 for the grant program 
for comprehensive community mental health services for children 
with serious emotional disturbance, which is $17,000 above the 
fiscal year 2005 comparable level and the same as the budget 
request. Funding for this program supports grants and technical 
assistance for community-based services for children and 
adolescents up to age 22 with serious emotional, behavioral, or 
mental disorders. The program assists States and local 
jurisdictions in developing integrated systems of community 
care. Each individual served receives an individual service 
plan developed with the participation of the family and the 
child. Grantees are required to provide increasing levels of 
matching funds over the six-year grant period.
            Grants to states for the homeless (PATH)
    The Committee provides $54,809,000 for the grants to States 
for the homeless (PATH) program, which is the same as the 
fiscal year 2005 comparable level and the budget request. PATH 
grants to States provide assistance to individuals suffering 
from severe mental illness and/or substance abuse disorders and 
who are homeless or at imminent risk of becoming homeless. 
Grants may be used for outreach, screening and diagnostic 
treatment services, rehabilitation services, community mental 
health services, alcohol or drug treatment services, training, 
case management services, supportive and supervisory services 
in residential settings, and a limited set of housing services.
            Protection and advocacy
    The Committee provides $34,343,000 for the protection and 
advocacy program, which is the same as the budget request and 
the fiscal year 2005 comparable level. This funding is 
distributed to States according to a formula based on 
population and income to assist State-designated independent 
advocates to provide legal assistance to mentally ill 
individuals during their residence in State-operated facilities 
and for 90 days following their discharge.

Center for Substance Abuse Treatment

    The Committee provides a program level total of 
$2,184,986,000 for the Center for Substance Abuse Treatment 
(CSAT), which is $12,935,000 below the fiscal year 2005 
comparable level and $37,621,000 below the budget request. 
Within the total, $83,500,000 is provided through the 
evaluation set-aside as requested.
    The Committee has concerns that people who are seeking 
substance abuse treatment are unable to access services due to 
the lack of an adequate clinical treatment workforce. People 
seeking treatment often have to wait for weeks or months before 
they are accepted into a treatment facility. The Committee 
requests that SAMHSA issue a report, after consultation with 
stakeholders and other Federal partners, on workforce 
development for substance abuse treatment professionals. The 
report should focus on both the recruitment and retention of 
counselors and on improving the skills of those already 
providing services as well as ways in which States can play a 
role. The Committee requests that this report be transmitted to 
the House and Senate Committees on Appropriations by March 1, 
2006.
    The Committee is concerned about the incidence of drug 
addiction among pregnant and parenting women. The National 
treatment infrastructure has not kept pace with the demand or 
complexity of needs experienced by women and their children. 
Family-based substance abuse treatment, which addresses the 
needs of a parent, typically a mother, and her children, 
represents less than 6 percent of the overall treatment options 
available. The Committee believes that increased capacity for 
family-based treatment programs is imperative. Increased family 
treatment capacity ensures child well-being, family 
stabilization, and healthy communities.
            Programs of regional and national significance
    The Committee provides a program level total of 
$409,431,000 for substance abuse treatment programs of regional 
and national significance, which is $12,935,000 below the 
fiscal year 2005 comparable level and $37,621,000 below the 
budget request. Within the total, $4,300,000 is provided 
through the evaluation set-aside as requested. The program 
supports activities to improve the accountability, capacity and 
effectiveness of substance abuse treatment services and 
services delivery. These activities include targeted capacity 
expansion initiatives to help communities respond to serious, 
emerging and unmet treatment needs and best practices 
initiatives to translate science into services through 
monitoring and accreditation of treatment programs, training, 
dissemination and knowledge application activities. The program 
promotes the adoption of science- and evidence-based treatment 
practices by developing and field-testing new treatment models 
in order to facilitate the provision of quality treatment 
services and service delivery. These activities are undertaken 
in actual service settings rather than laboratories and results 
are disseminated to State agencies and community treatment 
providers. The goal is to promote continuous, positive 
treatment service delivery change for those people who use and 
abuse alcohol and drugs.
    The Committee provides $99,200,000 for the Access to 
Recovery (ATR) substance abuse treatment voucher initiative; 
this is the same as the fiscal year 2005 level and $50,800,000 
below the budget request. To the extent possible the Committee 
encourages SAMHSA to provide training and technical assistance 
to both current State grantees to enhance their programs and 
share best practices with States that are interested in 
establishing substance abuse treatment voucher programs in the 
future. In addition, the Committee expects that addictive 
disorder clinical treatment providers participating in the 
Access to Recovery program shall meet the certification, 
accreditation, and/or licensing standards recognized in their 
respective States.
    Within the funds provided, the Committee recommends 
$30,797,000 for the Screening, Brief Intervention, Referral, 
and Treatment (SBIRT) program as requested. This competitive 
grant program assists States, territories, and Tribes in 
targeting non-dependent drug users and is designed to avert the 
progression of patients from chronic substance abuse problems. 
The SBIRT program works in primary and general care settings to 
identify patients in need of treatment and to provide them with 
appropriate intervention and treatment options.
    Within the funds provided, the Committee has included 
$8,166,000 to maintain the funding at last year's level for the 
Addiction Technology Transfer Centers. The Addiction Technology 
Transfer Centers (ATTC) program is a Nation-wide, multi-
disciplinary resource that provides the latest science-based 
addiction information to treatment providers in community and 
faith-based agencies. The ATTCs develop an addiction workforce 
of competent healthcare and related professionals reflective of 
the treatment population.
            Substance abuse prevention and treatment block grant
    The Committee provides a program level total of 
$1,775,555,000 for the substance abuse prevention and treatment 
(SAPT) block grant, which is the same as the fiscal year 2005 
comparable level and the budget request. Within the total, 
$79,200,000 is provided through the evaluation set-aside as 
requested. The substance abuse block grant provides funds to 
States to support alcohol and drug abuse prevention, treatment, 
and rehabilitation services. Funds are allocated among the 
States according to a statutory formula. State applications 
including comprehensive State Plans must be approved annually 
by SAMHSA as a condition of receiving funds.
    The Committee expresses its strong support for the SAPT 
block grant as the foundation of our publicly funded substance 
abuse system. The SAPT block grant, which provided support to 
over 10,500 community-based organizations in 2001, distributes 
formula-based funding to every State and territory. The 
authorizing statute includes certain funding set-asides, 
including a 20 percent set-aside for prevention, an HIV/AIDS 
early intervention set-aside, and others. The overall goal of 
the block grant is to support and expand substance abuse 
prevention and treatment services, while providing maximum 
flexibility to the States. The SAPT block grant is vital given 
that SAMHSA found that in 2003, approximately 22 million 
Americans abuse or are dependent upon alcohol, drugs or both 
and need some level of treatment service.

Center for substance abuse prevention

            Programs of regional and national significance
    The Committee provides $194,950,000 for the substance abuse 
prevention programs of regional and national significance, 
which is $10,601,000 above the budget request and $3,775,000 
below the fiscal year 2005 comparable level. The program 
identifies and disseminates evidence-based substance abuse 
prevention approaches.

Program management

    The Committee provides a program level total of $91,817,000 
for program management, of which $16,000,000 is provided 
through the evaluation set-aside as requested. The fiscal year 
2006 program level is $1,989,000 below the fiscal year 2005 
comparable level and the same as the budget request. The 
appropriation provides funding to coordinate, direct, and 
manage the agency's programs. Funds are used for salaries, 
benefits, space, supplies, equipment, travel and overhead.

               Agency for Healthcare Research and Quality

    The Committee provides a total of $318,695,000 for the 
Agency for Healthcare Research and Quality (AHRQ), which is the 
same as the comparable fiscal year 2005 level and the budget 
request. Fiscal year 2006 support is provided by the Committee 
in budget authority, while the fiscal year 2005 level and the 
fiscal year 2006 budget request are provided in program 
evaluation tap funding.
    The mission of the agency is to generate and disseminate 
information that improves the delivery of health care. Its 
research goals are to determine what works best in clinical 
practice; improve the cost-effective use of health care 
resources; help consumers make more informed choices; and 
measure and improve the quality of care.
    The Committee provides $260,695,000 for research on health 
costs, quality, and outcomes, which is the same as the fiscal 
year 2005 comparable level and the budget request. This program 
identifies the most effective and efficient approaches to 
organize, deliver, finance, and reimburse health care services; 
determines how the structure of the delivery system, financial 
incentives, market forces, and better information affects the 
use, quality, and cost of health services; and facilitates the 
translation of research findings for providers, patients, 
plans, purchasers, and policymakers. It also funds research 
that determines what works best in increasing the cost 
effectiveness and appropriateness of clinical practice; 
supports the development of tools to measure and evaluate 
health outcomes, quality of care, and consumer satisfaction 
with health care system performance; and facilitates the 
translation of information into practical uses through the 
development and dissemination of research databases.
    Within the total for research on health costs, quality, and 
outcomes, the Committee provides $84,000,000 for reducing 
medical errors, which is the same as the fiscal year 2005 
comparable level and the budget request. This amount includes 
$50,000,000 for grants to support the health information 
technology initiative. The Committee urges AHRQ to play a key 
role in the initiative being developed in the Office of the 
National Coordinator for Health Information Technology. The 
Committee encourages AHRQ to conduct pilot projects to 
demonstrate the feasibility and value of standards-based 
electronic health care data interchange.
    Within the total for research on health costs, quality and 
outcomes, the Committee provides $15,000,000 for comparative 
clinical effectiveness research. This is the same as the fiscal 
year 2005 comparable level and the budget request.
    The Committee is aware that a number of medical schools and 
medical centers in the U.S. are using high-tech patient 
simulators or medical simulators to improve doctor training, 
especially surgical and emergency room training. The Committee 
is also aware that AHRQ has a series of projects underway to 
evaluate the use of such simulators. The Committee strongly 
encourages AHRQ to continue these efforts and to expand them if 
necessary in order to evaluate effectively the utility of 
simulators in improving patient care and medical training, and 
decreasing medical mistakes.
    The Committee is pleased that AHRQ is studying care issues 
associated with patients who suffer from Duchenne muscular 
dystrophy. The Committee suggests that AHRQ build on this work 
by partnering with CDC to convene a consensus conference to 
develop these standards.
    The Committee supports the inter-agency agreement between 
AHRQ and the National Center on Birth Defects and Developmental 
Disabilities at CDC to examine clinical treatment and improve 
quality of care of patients with spina bifida.
    The Committee is concerned about the prevalence of 
undiagnosed and untreated mental illness among older Americans. 
Affective disorders, including depression, anxiety, dementia, 
and substance abuse and dependence, are often misdiagnosed or 
not recognized at all by primary and specialty care physicians 
in their elderly patients. Research has shown that the 
treatment of mental illness can improve health outcomes for 
those with other chronic diseases. While effective treatments 
for these conditions are available, there is an urgent need to 
translate advancements from biomedical and behavioral research 
to clinical practice. The Committee encourages AHRQ to support 
evidence-based research projects focused on the diagnosis and 
treatment of mental illnesses in the geriatric population, and 
to disseminate evidence-based reports to physicians and other 
health care professionals.
    Despite the Healthy People 2010 recommendations to decrease 
primary cesarean section rates to 15 percent and repeat 
cesarean section rates to 63 percent, the Committee is aware 
that rates of primary elective cesarean section are 
progressively increasing and that vaginal birth after cesarean 
rates are steadily decreasing. The Committee encourages AHRQ to 
conduct a comprehensive meta-analysis of the best available 
research studies comparing short and long term risks for 
mothers and babies of cesarean versus vaginal birth and 
requests that AHRQ report back to the Committee with this 
information by next year.
    The Committee provides $55,300,000 for the Medical 
Expenditures Panel Surveys (MEPS), which is the same as the 
fiscal year 2005 comparable level and the budget request. The 
MEPS provide data for timely national estimates of health care 
use and expenditures, private and public health insurance 
coverage, and the availability, costs, and scope of private 
health insurance benefits. This activity also provides data for 
analysis of changes in behavior as a result of market forces or 
policy changes on health care use, expenditures, and insurance 
coverage; develops cost/savings estimates of proposed changes 
in policy; and identifies the impact of changes in policy for 
subgroups of the population.
    For program support, the Committee provides $2,700,000 
which is the same as fiscal year 2005 level and the budget 
request. This activity supports the overall direction and 
management of the agency.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

    The Committee provides $156,954,419,000 for the Federal 
share of current law State Medicaid costs, which is 
$33,175,400,000 above the fiscal year 2005 comparable level and 
the same as the budget request. This amount does not include 
$58,517,290,000 which was advance funded in the fiscal year 
2005 appropriation. In addition, the Committee provides an 
advance appropriation of $62,783,825,000 for program costs in 
the first quarter of fiscal year 2007. The Committee has also 
included indefinite budget authority for unanticipated costs in 
fiscal year 2006. Fiscal year 2006 funding increases by 
$22,910,000,000 to shift the program to accrual accounting by 
making a one-time adjustment for incurred but not reported 
obligations.
    Federal Medicaid grants reimburse States for 50 to 83 
percent (depending on per capita income) of their expenditures 
in providing health care for individuals whose income and 
resources fall below specified levels. Subject to certain 
minimum requirements, States have broad authority within the 
law to set eligibility, coverage, and payment levels. Over 46 
million low-income individuals will receive health care 
services in 2006 under the Medicaid program. State costs of 
administering the program are matched at rates that generally 
range from 50 to 90 percent, depending upon the type of cost. 
Total funding for Medicaid includes $1,502,333,000 for the 
entitlement Vaccines for Children program. These funds, which 
are transferred to the Centers for Disease Control and 
Prevention for administration, support the costs of 
immunization for children who are on Medicaid, uninsured or 
underinsured and receiving immunizations at Federally qualified 
health centers or rural health clinics.
    The Committee is concerned that by permitting manufacturers 
to exclude ``authorized generics'' for purposes of best price 
calculations under the Medicaid Rebate Program, CMS and States 
may be losing millions of dollars in rebates. Therefore, the 
Committee encourages CMS to review its practices with respect 
to Medicaid rebate calculations. Specifically, CMS should 
evaluate best price calculations to ensure the Medicaid Rebate 
Program is properly reimbursed by manufacturers that produce 
brand name pharmaceuticals and their authorized generics.
    The Committee is aware that Oklahoma hospitals are in an 
overpayment dispute with CMS regarding disproportionate share 
settlement payments. The Committee strongly urges the parties 
involved in this dispute to come to a timely resolution.
    The Committee is aware of an issue regarding the definition 
of ``hospital costs'' incurred by the Commonwealth of Virginia 
for purposes of Medicaid reimbursement to the Commonwealth, and 
urges CMS to work with the Commonwealth to resolve the pending 
issue.

                  PAYMENTS TO HEALTH CARE TRUST FUNDS

    The Committee provides $177,742,200,000 for the Payments to 
the Health Care Trust Funds account, which is $63,133,300,000 
above the fiscal year 2005 comparable level and $80,000,000 
lower than the budget request. The significant funding increase 
is due to the costs of the new prescription drug benefit. This 
entitlement account includes the general fund subsidy to the 
Federal Supplementary Medical Insurance Trust Fund for Medicare 
Part B benefits and for Medicare drug benefits and 
administration as well as other reimbursements to the Federal 
Hospital Insurance Trust Fund for benefits and related 
administrative costs, which have not been financed by payroll 
taxes or premium contributions. Funds were not provided for the 
reimbursement for Health Care Fraud and Abuse Control, since 
the Committee did not fund this new account. The Committee 
includes bill language requested by the Administration 
providing indefinite authority for paying the general revenue 
portion of the Part B premium match and provides resources for 
the Part D drug benefit program in the event that the annual 
appropriation is insufficient.

                           PROGRAM MANAGEMENT

    The Committee makes available $3,180,284,000 in trust funds 
for Federal administration of the Medicare and Medicaid 
programs, which is $515,373,000 above the fiscal year 2005 
comparable level and $2,806,000 above the budget request. 
Fiscal year 2006 is the first year that the administrative 
costs for the Medicare Modernization Act are scored to this 
account, rather than being directly funded through the 
authorization. The Administration request includes $560 million 
for these activities.
            Research, demonstration, and evaluation
    The Committee provides $65,000,000 for research, 
demonstration and evaluation, which is $12,494,000 below the 
fiscal year 2005 comparable level and $19,806,000 above the 
budget request. These funds support a variety of studies and 
demonstrations in such areas as monitoring and evaluating 
health system performance; improving health care financing and 
delivery mechanisms; modernization of the Medicare program; the 
needs of vulnerable populations in the areas of health care 
access, delivery systems, and financing; and information to 
improve consumer choice and health status.
            Medicare operations
    The Committee provides $2,172,987,000 to support Medicare 
claims processing contracts, which is $450,003,000 above the 
fiscal year 2005 comparable level and $17,000,000 below the 
budget request.
    Medicare contractors partner with the Federal government to 
administer the Medicare fee-for-service program. Contractors 
pay over one billion Medicare fee-for-service claims annually, 
are the first line of defense against Medicare fraud, and are 
the primary contact for Medicare providers and beneficiaries. 
Without adequate funding, contractors are not able to pay 
claims, respond to beneficiary and provider inquiries timely, 
and effectively combat fraud and abuse. The Committee is 
pleased CMS eliminated the five percent cap on transferring 
funds among Medicare functions so that contractors have greater 
flexibility to manage their budgets in a manner that best 
matches program requirements. Budget flexibility is important 
to Medicare contractors, particularly in a tight funding 
environment. The Committee strongly recommends CMS give 
Medicare Contractors and Program Safeguard Contractors greater 
flexibility to manage their Medicare Integrity Program (MIP) 
funding in a manner that best matches program requirements 
including increases in workload. The Committee expects CMS to 
report on its plans to provide this flexibility to contractors 
in its fiscal year 2007 congressional justification.
            Revitalization plan
    The Committee provides $24,205,000 to remain available for 
two years, as the third year of investment in CMS's efforts to 
make significant improvements to key aspects of managing both 
the agency and the Medicare program. This amount is the same as 
the budget request and fiscal year 2005 comparable level. 
Funding will target information technology involving 
modernization of Medicare fee-for-service claims processing, 
modernization of the data environment, and reduction of the CMS 
security perimeter.
            State survey and certification
    The Committee provides $260,735,000 for State inspections 
of facilities serving Medicare and Medicaid beneficiaries, 
which is $2,000,000 above the fiscal year 2005 comparable level 
and the same as the budget request.
    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety and program 
standards. On-site surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys. Almost 76,000 surveys and complaint 
investigations will be performed in fiscal year 2006.
            Federal administration
    The Committee provides $657,357,000 to support Federal 
administrative activities related to the Medicare and Medicaid 
programs, which is $75,864,000 above the fiscal year 2005 
comparable level and the same as the budget request. The 
substantial increase over fiscal year 2005 is due to the costs 
of implementing the Medicare Modernization Act, which is being 
charged to this account for the first time rather than the 
authorizing bill. This amount includes $13,000,000 for the 
Healthy Start, Grow Smart program as requested by the 
Administration. The Committee includes language requested by 
the Administration that is similar to language in last year's 
enacted bill to identify $79,934,000 for the contract costs of 
the Health-care Integrated General Ledger Accounting System.
    The Medicare, Medicaid, and Children's Health Insurance 
programs ensure the health care security of over 85 million 
beneficiaries. The Federal Administration budget provides funds 
for the staff and operations of CMS to administer these 
programs.
    While CMS has initiated a commendable and important 
partnership with the State Health Insurance Programs (SHIPs) to 
facilitate the initiation of the new Medicare Part D drug 
benefit and the transition of the 6.5 million dually eligible 
beneficiaries from Medicaid prescription coverage to the 
Medicare drug benefit, considerable evidence indicates that 
low-income dual eligible persons with mental disabilities will 
need direct help with Part D enrollment decisions and both 
pharmaceutical and formulary changes. The Committee urges CMS 
to support one-on-one pharmaceutical benefits counseling 
through community-based organizations and safety net mental 
health providers, if endorsed by these groups, in order to 
address this need.
    The Committee is pleased that The Quality of Life 
Chemotherapy Demonstration project, included in the Medicare 
Modernization Act, is underway. This one-year demonstration 
project will provide a better understanding from cancer 
patients receiving chemotherapy on such important issues as 
their pain control management, minimization of nausea and 
vomiting, and the reduction of fatigue. The Committee is 
concerned that CMS has excluded oral chemotherapy patients from 
being included in the demonstration's data collection. 
Regardless of the method of administering chemotherapy, the 
quality of life issues facing cancer patients are equally 
important. To gather a complete understanding of the quality of 
life issues impacting cancer patients, the Committee encourages 
CMS to permit physicians to collect quality of life data from 
patients receiving oral chemotherapy and to do so under the 
same guidelines to the extent possible as prescribed under the 
Quality of Life project.
    The Committee remains concerned about regulatory burdens on 
health care providers, which not only divert the time that can 
be spent on active patient care, but also impose large 
financial burdens on the health care industry. The Committee 
requests CMS to report to the Committee by no later than March 
1, 2006, on the regulatory burdens, identified by MedPAC in its 
December 2001 report to Congress, that were not addressed 
within the Medicare Modernization Act. As part of this report, 
the Committee requests CMS to examine the prevalence and burden 
of CMS regulations, whether in effect or under development, 
that have no statutory requirement. The Committee supports 
MedPAC's recommendation that providers and plans with sustained 
good performance should receive reductions from CMS in routine 
administrative compliance measures, and urges CMS to move 
forward in implementing this regulatory flexibility.
    The Committee requests that CMS report to the Committee 
what the expected annual costs, both administrative and 
programmatic, are for the revised Medicare obesity coverage 
policy announced in July, 2004.

                  HEALTH CARE FRAUD AND ABUSE CONTROL

    The Committee was not able to provide funding for this new 
discretionary account. The Administration had requested 
$80,000,000 as a contingent appropriation, with the funding to 
be made available as an adjustment to the 302(a) allocation for 
the Appropriations Committee. The conference budget resolution 
did not permit this scorekeeping adjustment. The Committee 
notes that $720,000,000 is available to CMS as a permanent 
appropriation for the Medicare Integrity Program, which will be 
available for the purposes of the proposed program.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

    The Committee provides $2,121,643,000 for the Child Support 
Enforcement and Family Support programs, the same as the budget 
request. The bill also provides $1,200,000,000 in advance 
funding for the first quarter of fiscal year 2007 to ensure 
timely payments for the child support enforcement program, the 
same as the request. The bill provides estimated funding of 
$33,000,000 for Payments to Territories, $10,000,000 above the 
fiscal year 2005 level and the same as the budget request. The 
bill provides $1,300,000 for the repatriation program, $300,000 
more than the fiscal year 2005 level and the same as the budget 
request.

                   LOW-INCOME HOME ENERGY ASSISTANCE

    The Committee provides an appropriation of $1,984,799,000 
for the Low-Income Home Energy Assistance State formula grants. 
This is $100,000,000 more than the fiscal year 2005 comparable 
level and $184,799,000 above the budget request. The Committee 
provides all of these funds through the regular formula program 
and does not include funding for the contingent emergency 
reserve. The budget request included $1,800,000,000 in formula 
grants and $100,000,000 in contingent emergency funding.
    The low-income home energy assistance program (LIHEAP) 
provides assistance to low-income households to help pay the 
costs of home energy. Funds are provided through grants to 
States, Indian Tribes and territories, and are used for summer 
cooling and winter heating/crisis assistance programs.
    The Committee is concerned that rising natural gas prices 
are limiting the effectiveness and impact of LIHEAP. While 
American consumers pay the highest natural gas prices in the 
world, the rest of the world, on average, pays many times less 
per thousand cubic feet for natural gas. The Committee directs 
that not less than 150 days after the date of enactment of this 
Act the Secretary of Health and Human Services shall submit a 
report on the estimated percentage of LIHEAP funds currently 
expended to assist consumers with natural gas bills; the degree 
to which this percentage will rise relative to future increases 
in the price of natural gas paid by American consumers; and the 
degree to which additional consumers may be served by LIHEAP 
should Congress enact policy changes which cause domestic 
natural gas prices to decrease in the future by 5 percent, 10 
percent, 20 percent, or 50 percent.

                     REFUGEE AND ENTRANT ASSISTANCE

    The Committee provides $560,919,000 for refugee assistance 
programs. This is $76,525,000 more than the fiscal year 2005 
comparable level and $8,879,000 more than the budget request.
    In addition, the bill provides the Office of Refugee 
Resettlement (ORR) the authority to carry over unexpended funds 
from fiscal year 2006 to reimburse the costs of services 
provided through September 30, 2008 for all programs within 
ORR's jurisdiction.

Transitional and medical services

    The Committee provides $264,129,000 for transitional and 
medical services. This is $72,101,000 more than the fiscal year 
2005 comparable level and the same as the budget request. The 
transitional and medical services program provides funding for 
the State-administered cash and medical assistance program that 
assists refugees who are not categorically eligible for TANF or 
Medicaid, the unaccompanied minors program that reimburses 
States for the cost of foster care, and the voluntary agency 
grant program in which participating National refugee 
resettlement agencies provide resettlement assistance with a 
combination of Federal and matched funds.

Victims of trafficking

    The Committee provides up to $9,915,000 for the victims of 
trafficking program. This is the same as the fiscal year 2005 
comparable level and the budget request. The funds will ensure 
continued administration of a National network for 
identification, tracking and certification of trafficking 
victims.

Social Services

    The Committee provides $160,000,000 for social services. 
This is $8,879,000 more than the budget request and $4,888,000 
less than the fiscal year 2005 comparable level. Funds are 
distributed by formula as well as through the discretionary 
grant making process for special projects. The Committee 
intends that funds provided above the request shall be used for 
Refugee School Impact Grants and for additional assistance in 
resettling and meeting the needs of the Hmong refugees expected 
to arrive during 2006 and 2007.
    Within the funds provided, the Committee has included 
$19,000,000 for support to communities with large 
concentrations of Cuban and Haitian entrants of varying ages 
whose cultural differences make assimilation especially 
difficult, justifying a more intense level and longer duration 
of Federal assistance.

Preventive health

    The Committee provides $4,796,000 for preventive health 
services. This is the same as the fiscal year 2005 comparable 
level and the budget request. These funds are awarded to the 
States to ensure adequate health assessment activities for 
refugees.

Targeted assistance

    The Committee provides $49,081,000 for the targeted 
assistance program. This is the same as the fiscal year 2005 
comparable level and the budget request. These grants provide 
assistance to areas with high concentrations of refugees.

Unaccompanied minors

    The Committee provides $63,083,000 for the unaccompanied 
minors program. This is $9,312,000 more than the fiscal year 
2005 comparable level and the same as the budget request. The 
program is designed to provide for the care and placement of 
unaccompanied alien minors who are apprehended in the U.S. 
pending resolution of their claims for relief under U.S. 
immigration law or released to an adult family member or 
responsible adult guardian.
    The Committee urges the Office of Refugee Resettlement 
(ORR) to maintain the privacy and confidentiality of all 
information gathered in the course of the care, custody and 
placement of unaccompanied alien children consistent with ORR's 
role and responsibility under the Homeland Security Act to act 
as guardian in loco parentis in the best interests of the 
unaccompanied alien child. ORR should consider the needs and 
privacy of these children to guarantee the confidentiality of 
their information in order to be trusting and truthful to ORR, 
clinicians, and its agents for purposes of receiving 
appropriate quality care and placement services.
    The Committee urges ORR to allow individual abused, 
abandoned or neglected children in its custody, when 
appropriate, to access State dependency proceedings for 
ultimate care and placement in State foster care or under legal 
guardianship as a necessary predicate for their eligibility for 
special immigrant juvenile status.
    The Committee encourages ORR to fund pilot programs to 
study and assess the benefits of providing pro bono counsel to 
children in ORR custody. The Committee also encourages ORR to 
give high priority to the availability of pro bono legal 
counsel when selecting facilities for housing unaccompanied 
children in ORR custody.
    The Committee understands that ORR carried out a successful 
pilot program in Chicago, Illinois through Heartland Alliance 
on the benefits of child advocates for unaccompanied children. 
The Committee encourages ORR to implement follow-up pilot 
programs to further develop the findings and best practices of 
the Chicago pilot program regarding the utilization of child 
advocates to identify the child's best interests from a child 
welfare perspective so that such information can be taken into 
consideration by attorneys and judges involved in a child's 
immigration proceedings.
    The Committee directs that not later than one year after 
the date of enactment of this Act the Secretary of Health and 
Human Services shall submit a report on progress made by ORR 
and programs funded under this Act to shift children from 
secured detention facilities to more age-appropriate shelter-
based facilities for unaccompanied children in its custody.

Victims of torture

    The Committee provides $9,915,000 to provide a 
comprehensive program of support for domestic centers and 
programs for victims of torture. This is the same as the fiscal 
year 2005 comparable level and the budget request.

                 CHILD CARE AND DEVELOPMENT BLOCK GRANT

    The Committee includes $2,082,910,000 for the Child Care 
and Development Block Grant program, $11,000 below the fiscal 
year 2005 comparable level and the same as the budget request.
    The Child Care and Development Block Grant program was 
originally enacted in the Omnibus Budget Reconciliation Act of 
1990 to increase the availability, affordability and quality of 
child care by providing funds to States, Territories and Indian 
Tribes for child care services for low-income families. The 
authorization for mandatory appropriations for childcare in the 
amount of $2,717,000,000 is also requested for fiscal year 
2006.

                      SOCIAL SERVICES BLOCK GRANT

    The bill provides $1,700,000,000 for the social services 
block grant (SSBG). This is the same as the fiscal year 2005 
level and the budget request.
    SSBGs are designed to encourage States to furnish a variety 
of social services to needy individuals to prevent and reduce 
dependency, help individuals achieve and maintain self-
sufficiency, prevent or reduce inappropriate institutional 
care, secure admission or referral for institutional care when 
other forms of care are not appropriate, and prevent neglect, 
abuse and exploitation of children and adults.
    Funds are distributed to the territories in the same ratio 
such funds were allocated in fiscal year 1981. The remainder of 
the appropriation is distributed to the States and the District 
of Columbia according to population.
    The bill includes a provision that modifies the percentage 
of funds that a State may transfer between the Social Services 
Block Grant and the Temporary Assistance to Needy Families 
programs to 10%.

                 CHILDREN AND FAMILY SERVICES PROGRAMS

    The Committee provides a program level total of 
$8,701,207,000 for children and family services programs. This 
is $317,063,000 less than the fiscal year 2005 comparable level 
and $304,414,000 more than the budget request. Within the total 
provided, $12,500,000 is provided through the evaluation set-
aside. This account finances a number of programs aimed at 
enhancing the well-being of the Nation's children and families, 
particularly those who are disadvantaged or troubled.

Head Start

    The Committee includes $6,899,000,000 for the Head Start 
program for fiscal year 2005, an increase of $55,886,000 over 
the fiscal year 2005 comparable amount and $336,000 below the 
budget request. Of this total, the Committee continues the 
policy of advancing $1,400,000,000 of this account into fiscal 
year 2007.
    Head Start provides comprehensive child development 
services to economically disadvantaged children and their 
families. Intended primarily for preschoolers from low-income 
families, the program promotes school readiness by enhancing 
the social and cognitive development of children through the 
provision of educational, health, nutritional, social and other 
services. Head Start programs engage parents in their 
children's learning and help them in making progress toward 
their educational, literacy and employment goals. At least ten 
percent of enrollment opportunities in each State are made 
available to handicapped children.
    Grants to carry out Head Start programs are awarded to 
public and private non-profit and for-profit agencies. Unless a 
waiver is approved grantees must contribute 20 percent of the 
total cost of the program from non-Federal funds; this is 
usually an in-kind contribution. No more than 15 percent of 
total costs may be for program administration.
    The Committee is aware that in May of 2005, the Secretary 
made $35,000,000 in additional fiscal year 2005 funds available 
to Migrant and Seasonal Head Start programs and that these 
funds, which will be awarded on competitive basis, will allow 
for at least 4,000 additional children to access Migrant and 
Seasonal Head Start. The Committee acknowledges that these 
expansion funds will increase access to this important program, 
however additional funding may be necessary to adequately serve 
this population. The Committee requests that the Secretary 
submit a report on the Head Start Bureau's ongoing plans to 
ensure that Migrant and Seasonal Head Start programs are able 
to serve a larger percentage of the children eligible for 
services. The Committee continues to point to the 2001 study 
published by the U.S. Department of Health and Human Services 
that documented that only 19 percent of eligible children were 
able to access Migrant and Seasonal Head Start.
    The Committee supports the provisions included in H.R. 
2123, the School Readiness Act of 2005 as approved by the House 
Education and Workforce Committee, which would address concerns 
about the potential funding shortfall for Migrant and Seasonal 
Head Start Programs and would require the Secretary, in 
consultation with Migrant and Seasonal Head Start Programs, to 
establish systems to document the demand for Migrant and 
Seasonal Head Start on an ongoing basis. The system should 
accurately determine the number of children who are eligible 
for services across the country and document how many of these 
children are accessing services so that quantifiable 
information is available to the Secretary upon which future 
funding decisions can be made. H.R. 2123 would ensure that 
additional resources are immediately available for these 
programs until such time that improved information is available 
to the Secretary. The Committee supports this effort that will 
enable policy makers and advocates to more effectively serve 
migrant and seasonal farmworker families and their children.
    The Committee is mindful of the conclusions of the 
Government Accountability Office in its May 17, 2005 report, 
``Head Start: Further Development Could Allow Results of New 
Test to be Used for Decision Making.'' The Committee expects 
the Secretary to submit a report to Congress, within one year, 
that includes: (1) a detailed justification on the planned uses 
of the National Reporting System results and data, including 
its use for program evaluation, professional development, 
technical assistance, and other activities; (2) an itemization 
of the costs of development, implementation, and analysis of 
the National Reporting System, detailing by name, amount, and 
description of activities each contract or grant to persons or 
entities involved in its design, development, implementation, 
or analysis; and (3) the recommendations made by the Technical 
Working Group established by the Secretary, including an 
explanation of how the Secretary has addressed or plans to 
address the Working Group's and the GAO's recommendations.
    The Committee notes that the current Head Start Act 
includes the provision of training and technical assistance in 
the area of family literacy services--a provision that is 
retained in the House version of Head Start reauthorization 
legislation. Pending the final resolution of the Head Start 
reauthorization process, the Committee encourages the Secretary 
to ensure the continuity of the important services that are 
being provided through the Head Start Family Literacy Project.
    The Committee is aware that approximately one-third of Head 
Start programs are affiliated with public school systems and 
often combine or coordinate the transportation of Head Start, 
preschool, and K-12 students. In addition, many center-based 
Head Start programs coordinate with local transit authorities 
to provide supervised transportation to Head Start children 
whose parents work non-traditional hours or whose geographical 
distance from the parent's place of employment creates a 
barrier to Head Start participation. Differences between Head 
Start transportation regulations, promulgated by the U.S. 
Department of Health and Human Services, and those promulgated 
by State and local authorities, may have the unintended 
consequence of reducing transportation services for Head Start 
students, and in turn, decrease transportation options for 
children. These differences may leave Head Start children 
without transportation or relying on parents to provide 
transportation in their vehicles.
    The Committee recognizes that children's safety is the most 
important consideration and that many students participating in 
Head Start programs need access to safe and reliable 
transportation provided by public schools or local transit 
systems. The Committee is aware that the Department of Health 
and Human Services currently offers a waiver option to local 
education agencies that dually serve as Head Start contractors, 
which will expire on January 1, 2006. In the absence of a 
permanent solution to this problem, the Committee directs the 
U.S. Department of Health and Human Services to extend another 
waiver option to local education agency-contracted Head Start 
programs that provide integrated transportation to Head Start 
students. In cases where public schools or local transit 
authorities provide Head Start services, local educational 
agencies should have the option to comply with transportation 
standards for preschool students mandated by the State or local 
education agencies a, transit agencies, State departments of 
Transportation or the U.S. Department of Health and Human 
Services.
    Furthermore, the Committee directs the Department to work 
towards a permanent fix to this problem in order to provide 
clearer standards and options to local education agencies 
transporting both Head Start and regular preschool and K-12 
children.

Consolidated runaway and homeless youth program

    The Committee provides $88,728,000 for runaway and homeless 
youth activities, an increase of $4,000 more than the fiscal 
year 2005 comparable level and the same as the budget request. 
The Runaway, Homeless, and Missing Children Protection Act of 
2003 reauthorized the runaway and homeless youth programs and 
established a statutory formula distribution between the Basic 
Center Program and the Transitional Living Program.
    The runaway and homeless youth programs provide grants to 
local public and private organizations to establish and operate 
runaway and homeless youth shelters to address the crisis needs 
of runaway and homeless youth and their families. Grants are 
used to develop or strengthen community-based shelters, which 
are outside the law enforcement, juvenile justice, child 
welfare, and mental health systems.
    It is the Committee's continued expectation that current 
transitional living program grantees will continue to provide 
transitional living opportunities and supports to pregnant and 
parenting homeless youth, as is their current practice. To 
further ensure that pregnant and parenting homeless youth are 
able to access transitional living opportunities and supports 
in their communities, the Committee encourages the Secretary, 
acting through the network of federally-funded runaway and 
homeless youth training and technical assistance providers, to 
offer guidance to grantees and others on the programmatic 
modifications required to address the unique needs of pregnant 
and parenting youth and on the various sources of funding 
available for residential services to this population.

Maternity group homes

    The Committee has not included funding for this new 
program. The budget request is $10,000,000.
    The Committee is aware of the need for and shares the 
Administration's interest in funding residential services for 
young mothers and their children who are unable to live with 
their own families because of abuse, neglect, or other 
circumstances. The Committee notes that pregnant and parenting 
youth are currently eligible for and served through the 
Transitional Living Program.

Prevention grants to reduce abuse of runaway youth

    The Committee provides $15,179,000 for prevention grants to 
reduce abuse of runaway youth. This is $1,000 more than the 
fiscal year 2005 comparable level and the same as the budget 
request. This program is designed to reduce the sexual abuse of 
runaway youth by providing grants to support street-based 
outreach and education to runaway, homeless, and street youth 
who have been sexually abused or who are at-risk of sexual 
abuse, in order to connect these young people with services so 
that they have a chance for a safe and healthy future. The 
street outreach program ensures rapid engagement with young 
people in an effort to prevent the most terrible situations 
that take place when they are subjected to life on the 
streets--physical and sexual abuse, assault, commercial sexual 
exploitation, disease, long-term homelessness, and even death.

Child abuse state grants and discretionary activities

    For child abuse State grants and discretionary activities, 
the Committee provides $58,925,000. This is $5,000 more than 
the fiscal year 2005 comparable level and the same as the 
budget request. Within this total, the recommendation includes 
$27,280,000 for State grants and $31,645,000 for child abuse 
discretionary activities.

Community-based child abuse prevention

    The Committee provides $42,859,000 for community-based 
child abuse prevention. This is $1,000 more than the fiscal 
year 2005 comparable level and the same as the budget request. 
The Keeping Children and Families Safe Act of 2003 reauthorized 
and renamed this program and added voluntary home visiting 
programs as a core local service. Funds are provided to lead 
State agencies and are used to develop, operate, expand, and 
enhance community-based efforts to strengthen and support 
families in order to prevent child abuse and neglect.

Abandoned infants assistance

    The Committee provides $11,955,000 for the Abandoned 
Infants Assistance program. This is the same as the fiscal year 
2005 comparable level and the budget request. The purpose of 
this program is to provide financial support to public and 
private community and faith-based entities to develop, 
implement, and operate demonstration projects that will prevent 
the abandonment of infants and young children exposed to HIV/
AIDS and drugs; identify and address their needs; assist such 
children to reside with their natural families or in foster 
care; recruit, train and retain foster parents as well as 
health and social services personnel; provide respite care for 
families and foster families; and prevent the abandonment of 
infants and young children.

Child welfare services and training

    The Committee provides $289,650,000 for child welfare 
services. This is the same as the fiscal year 2005 comparable 
level and the budget request. This program, authorized by title 
IV B of the Social Security Act, provides grants to States to 
assist public welfare agencies to improve child welfare 
services. State services include preventive intervention in 
order for children to stay in their homes, alternative 
placement like foster care or adoption if it is not possible 
for children to remain at home, and reunification programs so 
that, if appropriate, children can return home.
    The Committee provides $7,409,000 for child welfare 
training. This is the same as the fiscal year 2005 comparable 
level and the budget request. The Committee recognizes the need 
for trained, skilled and qualified child welfare service 
workers. This program provides grants to institutions of higher 
education to develop and improve education and training 
programs and resources for child welfare service providers as 
well as students seeking degrees in social work.

Adoption opportunities

    The Committee provides $27,119,000 for adoption 
opportunities. This is $3,000 more than the fiscal year 2005 
comparable level and the same as the budget request. The 
Adoption Opportunities Program provides funding specifically 
targeted to improving the adoption of children, particularly 
those with special needs, and for providing innovative services 
that support families involved in adoption.

Adoption incentives

    The Committee provides $31,846,000 for the adoption 
incentives program. This is the same as the fiscal year 2005 
comparable level and the budget request. The Adoption Promotion 
Act of 2003 reauthorized this program and now targets 
incentives specifically for older children. Funds are awarded 
to States using three baselines: one for the total number of 
children adopted, one for children with special needs under the 
age of nine, and one for children aged nine and older. The goal 
of this program is to increase the number of adoptions 
nationwide.

Adoption awareness

    The Committee provides $12,802,000 for the adoption 
awareness program. This is the same as the fiscal year 2005 
comparable level and the budget request. This program was 
authorized in the Children's Health Act of 2000. The adoption 
awareness program provides training to designated staff of 
eligible health centers in providing adoption information and 
referrals to pregnant women on an equal basis with all other 
courses of action included in non-directive counseling to 
pregnant women.

Compassion capital fund

    The Committee provides $75,000,000 for the compassion 
capital fund. This is $20,451,000 more than the fiscal year 
2005 comparable level and $25,000,000 less than the budget 
request. This program supports the creation of grants to 
public/private partnerships to support charitable organizations 
in expanding or emulating model social services agencies and 
provides capacity-building funds directly to faith- and 
community-based organizations.
    The Committee is pleased that the budget request included 
funding to focus on street outreach strategies to prevent youth 
gang involvement. Within the total provided for the compassion 
capital fund it is the Committee's intention that $25,000,000 
be provided for the youth gang prevention initiative.

Social services and income maintenance research

    The Committee provides a program level total of $10,621,000 
for social services and income maintenance research, $8,000,000 
of which is through the evaluation set-aside. This is 
$4,621,000 more than the budget request and $21,391,000 less 
than the fiscal year 2005 comparable level. These funds support 
research, demonstration, evaluation and dissemination 
activities. Recent topics funded through this program include 
welfare-to-work strategies and programs to strengthen family 
relationships and promote healthy marriages.
    The Committee notes the Administration for Children and 
Family's (ACF) efforts to assist States with meeting the 
extensive record-keeping, reporting and tracking requirements 
of the Temporary Assistance for Needy Families (TANF) program. 
Working through the State information technology consortium, 
ACF is providing States with the tools necessary to strengthen 
and improve the complex IT systems required to support TANF. 
Plans are now underway to pilot test a data exchange program 
that will offer States a faster, less expensive means of 
validating, accessing, modifying and recording TANF data 
elements. Similarly, on behalf of Child Support Enforcement, 
the consortium is helping to expand data exchange capabilities 
between the courts and State child support enforcement agencies 
as well as increase collection efficiency in States and tribal 
organizations. Next steps include accessing existing databases 
used as primary sources for collection-related data of non-
custodial parents, and enhancing data-matching capabilities to 
ensure the integrity of the information being collected.

Developmental disabilities

    For programs authorized by the Developmental Disabilities 
Assistance and Bill of Rights Act of 2000 as well as by the 
Help America Vote Act, the Committee provides $170,561,000. 
This is $1,986,000 more than the fiscal year 2005 comparable 
level and $2,000,000 more than the budget request.
    The account total includes $72,496,000 for allotments to 
the States to fund State Councils, the same as the budget 
request and the fiscal year 2005 comparable level. These 
Councils engage in such activities as planning, policy 
analysis, demonstrations, training, outreach, interagency 
coordination, and public education. They do not provide direct 
services to the developmentally disabled population.
    In addition, $38,109,000 will be available to the States to 
be used for operating a protection and advocacy system to 
protect the legal and human rights of the developmentally 
disabled. This is the same as the budget request and the fiscal 
year 2005 level.
    The Committee provides $14,879,000 for voting access for 
individuals with disabilities programs. This is the same as the 
fiscal year 2005 comparable level and the budget request. 
Within the funds provided, $9,919,000 is for payments to States 
to promote access for voters with disabilities and $4,960,000 
is for State protection and advocacy systems. These programs 
are intended to make polling places accessible and provide 
equal access and participation for individuals with 
disabilities. The protection and advocacy program will ensure 
that individuals can fully participate in the electoral 
process, including registering to vote, accessing polling 
places, and casting a vote.
    The Committee provides $11,529,000 for developmental 
disabilities projects of National significance. This is $13,000 
less than the fiscal year 2005 comparable level and the same as 
the budget request.
    The Committee provides a total of $33,548,000 for the 
university centers for excellence in developmental 
disabilities. This is $1,999,000 more than the fiscal year 2005 
comparable level and $2,000,000 more than the budget request. 
This funding provides discretionary grants to public or not-
for-profit entities associated with universities. The grants 
provide basic operational and administrative core support for 
these agencies. In addition, these funds support 
interdisciplinary training, community services, research and 
technical assistance and information dissemination. Funding 
above the request is provided to fully fund the new centers 
established in fiscal year 2005 and to establish one to two new 
centers in fiscal year 2006.

Native American programs

    The Committee provides $44,780,000 for Native American 
programs. This is the same as the budget request and $6,000 
less than the fiscal year 2005 comparable level. The Native 
American programs assist Tribal and Village governments, Native 
American institutions and organizations to support and develop 
stable, diversified local economies. In promoting social and 
economic self-sufficiency, this organization provides financial 
assistance through direct grants for individual projects, 
training and technical assistance, and research and 
demonstration programs.

Community services

    The Committee provides $384,672,000 for community services 
activities. This is $359,973,000 more than the budget request 
and $341,834,000 less than the fiscal year 2005 comparable 
level.
            State block grant
    For the State block grant, the Committee provides 
$320,000,000. This is $316,793,000 less than the fiscal year 
2005 comparable level. No funds were requested for this 
program. This program provides grants to States, territories 
and Indian Tribes for services to meet employment, housing, 
nutrition, energy, emergency services, and health needs of low-
income people. By law, 90 percent of these funds are passed 
directly through to local community action agencies that have 
previously received block grant funds.
            Community economic development
    The Committee provides $32,731,000 for community economic 
development grants. This is the same as the fiscal year 2005 
comparable level. No funds were requested for this program. 
These activities provide assistance to private, locally-
initiated community development corporations that sponsor 
enterprises providing employment, training and business 
development opportunities for low-income residents in poor 
communities. Within the total, $5,436,000 is provided for the 
Job Opportunities for Low-Income Individuals program, which 
provides competitive grant to non-profit organizations to 
create new employment and business opportunities for TANF 
recipients and other low-income individuals.
            Individual development accounts
    The Committee provides $24,699,000 for individual 
development accounts. This is $5,000 less than the fiscal year 
2005 comparable level and the same as the budget request. 
Individual development accounts are dedicated savings accounts 
that can be used by families with limited means for purchasing 
a first home, paying for postsecondary education or 
capitalizing a business. The intent of the program is to 
encourage participants to develop and reinforce strong habits 
for saving money. 501(c)(3) organizations are eligible to apply 
for the funds and applicants must match Federal funds with non-
Federal funds.
            Rural community facilities
    The Committee provides $7,242,000 for the rural community 
facilities program. This is the same as the fiscal year 2005 
comparable amount. No funds were requested for this program. 
The Committee includes these funds to be used solely for the 
purpose of improving water and wastewater facilities in poor, 
rural communities. As in the past, these funds should be 
allocated to regional, rural community assistance programs.
            National youth sports
    The Committee concurs with the budget request not to 
include funding for National youth sports. The fiscal year 2005 
funding level for this program is $17,856,000. These funds are 
made available to a private, non-profit organization to provide 
recreational activities for low-income youth, primarily in the 
summer months. College and university athletic facilities are 
employed in the program.
            Community food and nutrition
    The Committee concurs with the budget request not to 
include funding for the community food and nutrition program. 
The fiscal year 2005 funding level for this program is 
$7,180,000. This program provides grants to public and private 
agencies to coordinate existing food assistance programs, to 
identify sponsors of child nutrition programs and attempt to 
initiate new programs and to do advocacy work at the State and 
local levels.

Violent crime reduction programs

    The Committee provides $125,991,000 for family violence 
prevention and services and battered women's shelters. This is 
the same as the budget request and $361,000 more than the 
fiscal year 2005 comparable level. This program is designed to 
assist States and Indian Tribes in efforts to prevent family 
violence and to provide immediate shelter and related 
assistance for victims of family violence and their dependents, 
and to provide for technical assistance and training relating 
to family violence programs to State and local public agencies 
(including law enforcement agencies), nonprofit private 
organizations, and persons seeking such assistance.
    The Committee also includes $3,000,000 to continue funding 
the National domestic violence hotline. This is $224,000 less 
than the fiscal year 2005 comparable level and the same as the 
budget request.

Early learning fund

    The Committee concurs with the budget request and does not 
provide funding for the early learning fund. The fiscal year 
2005 level for this program is $35,712,000. This program was 
begun in fiscal year 2001 to help facilitate the development of 
learning readiness in young children.

Mentoring children of prisoners

    The Committee provides $49,993,000 for the mentoring 
children of prisoners program. This is $395,000 above the 
fiscal year 2005 comparable level and the same as the budget 
request. This program supports competitively awarded grants to 
States and local governments, Indian tribes and consortia, and 
faith- and community-based organizations to mentor children of 
prisoners and those recently released from prison.

Independent living training vouchers

    The Committee provides $50,000,000 for independent living 
training vouchers. This is $3,377,000 more than the fiscal year 
2005 comparable level and $9,999,000 less than the budget 
request. These funds support vouchers for college tuition or 
vocational training for individuals who age out of the foster 
care system, so they can be better prepared to live 
independently.

Abstinence education

    The Committee provides a program level total of 
$114,500,000 for the community-based abstinence education 
program, which is $10,802,000 above the fiscal year 2005 
comparable level and $28,045,000 below the budget request. 
Within the total, $4,500,000 is provided through the evaluation 
set-aside as requested. The program provides support to public 
and private entities for implementation of community-based 
abstinence education programs for adolescents aged 12 through 
18 as defined in sections (A) through (H) of Title 5, section 
510(b)(2) of the Social Security Act. The entire focus of these 
programs is to educate young people and create an environment 
within communities that supports teen decisions to postpone 
sexual activity until marriage. There is no funding match 
requirement for these grants. The Committee intends that up to 
five percent of these funds be used to provide technical 
assistance and capacity-building support to grantees. Within 
the total, up to $10,000,000 may be used to carry out a 
National Abstinence Education Campaign.
    The Committee is concerned that the funding for training 
and technical assistance is not being used effectively to help 
communities develop abstinence-only programs and to support 
existing community-based programs. The Administration for 
Children and Families (ACF) should fully utilize the set-aside 
to ensure that programs around the country are using 
appropriate and approved curricula that are evidence-based and 
comply with the appropriate Federal legislation. To that end, 
the Committee directs ACF to issue a report to the House and 
Senate Committees on Appropriations by no later than 90 days of 
enactment of this Act on the use of the five percent set-aside 
since the transfer of the program from the Health Resources and 
Services Administration and the intended use of the fiscal year 
2006 funds. Also include in this report the funds from the 
National Abstinence Education Campaign that are being used for 
training and technical assistance.
    The Committee reinforces the guidance from its report 
accompanying the fiscal year 2005 appropriation with respect to 
the abstinence messages given by the public health entities 
that are grantees in the community-based abstinence education 
program and to the conduct of evaluation activities for the 
program.
    The Committee encourages ACF to seek appropriate 
partnerships with the Corporation for National and Community 
Service to utilize its corps of volunteers to support and 
strengthen the community-based abstinence education program. 
The Corporation's programs include volunteer and mentoring 
personnel that could be accessed to further bolster the goals 
of abstinence-only education.

Faith-based center

    The Committee provides $1,400,000 for the faith-based 
center. This is the same as the budget request and $25,000 more 
than the fiscal year 2005 comparable level. The center will 
support implementation of faith-based and community initiatives 
in accordance with the President's executive order.

Program direction

    The Committee provides $185,217,000 for program direction 
expenses for the Administration for Children and Families. This 
is $7,000 more than the fiscal year 2005 comparable level and 
the same as the budget request.

                   PROMOTING SAFE AND STABLE FAMILIES

    The Committee provides $404,000,000 for the promoting safe 
and stable families program. This is $414,000 more than the 
fiscal year 2005 comparable level and $6,000,000 less than the 
budget request.

           PAYMENTS TO STATES FOR FOSTER CARE AND ASSISTANCE

    The bill provides $4,852,800,000 for payments to States for 
foster care and adoption assistance. This is $185,100,000 less 
than the fiscal year 2005 level and the same as the budget 
request. The bill also includes an advance appropriation of 
$1,730,000,000 for the first quarter of fiscal year 2007 to 
ensure timely completion of first quarter grant awards.
    Of the total appropriation, including the advance 
appropriation from the prior year, the bill provides 
$4,685,000,000 for the foster care program to provide 
maintenance payments to States on behalf of children who must 
live outside their homes. This is the same as the budget 
request and $210,500,000 less than the fiscal year 2005 level.
    Within the total appropriation, the bill provides 
$1,795,000,000 for adoption assistance. This is $24,900,000 
more than the fiscal year 2005 level and the same as the budget 
request. This program provides training for parents and State 
administrative staff as well as payments on behalf of 
categorically eligible children considered difficult to adopt. 
This annually appropriated entitlement is designed to provide 
alternatives to long, inappropriate stays in foster care by 
developing permanent placements with families.
    Within the total appropriation for this account, the bill 
provides $140,000,000 for the independent living program. This 
is the same as the fiscal year 2005 level and the budget 
request. The program is designed to assist foster children age 
16 or older to make successful transitions to independence. 
Funds assist children to earn high school diplomas, receive 
vocational training, and obtain training in daily living 
skills. Funds are awarded to States on the basis of the number 
of children on behalf of whom Federal foster care payments are 
received.

                        Administration on Aging


                        AGING SERVICES PROGRAMS

    For programs administered by the Administration on Aging, 
the Committee provides a total of $1,376,217,000. This is 
$17,125,000 less than the fiscal year 2005 comparable level and 
$7,189,000 more than the budget request. This account finances 
all programs under the Older Americans Act in this bill, with 
the exception of the Community Services Employment Program, 
which is administered by the Department of Labor.

Supportive services and centers

    The Committee provides $354,136,000 for supportive services 
and centers. This is the same as the fiscal year 2005 
comparable level and the budget request. Funds for supportive 
services and centers are awarded to States and territories for 
in-home and community-based services for frail elderly persons 
who are at risk of losing their self-sufficiency due to 
physical or mental impairments. The funds contained in the bill 
will support a variety of activities including transportation 
services, information and assistance, and personal care 
services.

Preventive health

    The Committee provides $21,616,000 for preventive health 
services authorized under part F of title III of the Act. This 
is the same as the fiscal year 2005 comparable level and the 
budget request. These funds are awarded to States and 
territories to support activities that educate older adults 
about the importance of healthy lifestyles and promote healthy 
behaviors that can prevent or delay chronic disease and 
disability.

Protection of vulnerable older americans

    The Committee provides $19,360,000 for the protection of 
vulnerable older Americans, authorized by title VII of the 
Older Americans Act. This is the same as the budget request and 
$72,000 more than the fiscal year 2005 comparable level. 
Funding is provided for both the long-term care ombudsman 
program, which protects the rights and interests of residents 
in nursing homes, board and care homes, assisted living 
facilities and similar adult care facilities, as well as for 
the prevention of elder abuse, neglect, and exploitation 
program, which trains law enforcement and medical professionals 
in how to recognize and respond to elder abuse.

National family caregiver support program

    The Committee provides $155,744,000 for the family 
caregivers program. This is the same as the fiscal year 2005 
comparable level and the budget request. The family caregiver 
program provides formula grants to States to provide a support 
system in each State for family caregivers. All States are 
expected to put in place five basic system components, 
including: individualized information on available resources; 
assistance to families in locating services from private and 
voluntary agencies; caregiver counseling, training and peer 
support; respite care; and other supplemental services.

Native american caregiver support program

    The Committee provides $6,304,000 for the Native American 
caregiver support program. This is the same as the fiscal year 
2005 comparable level and the budget request. The program 
assists Tribes in providing multifaceted systems of support 
services for family caregivers as well as for grandparents 
caring for grandchildren.

Nutrition programs

    For congregate and home delivered meals, as well as the 
nutrition services incentive program, the Committee provides 
$725,885,000. This is $7,188,000 more than the fiscal year 2005 
comparable level and $7,189,000 more than the budget request. 
These programs are intended to address some of the difficulties 
confronting older individuals, namely nutrition deficiencies 
due to inadequate income, lack of adequate facilities to 
prepare food, and social isolation.

Grants for Native Americans

    The Committee provides $26,398,000 for grants for Native 
Americans. This is the same as the fiscal year 2005 comparable 
level and the budget request. Grants are distributed to tribal 
organizations to be used to help Native American elders remain 
healthy and independent by providing transportation, nutrition, 
health screening and other services.

Program innovations

    The Committee provides $23,843,000 for program innovations. 
This is the same as the budget request and $19,443,000 less 
than the fiscal year 2005 comparable funding level. Funds under 
this program are used for competitive grants and contracts to 
support projects that develop new and promising practices to 
serve older adults and their families.
    Within the total the Committee provides $3,000,000 for 
social research into Alzheimer's disease care options, best 
practices and other Alzheimer's research priorities that 
include research into cause, cure and care, as well as respite 
care, assisted living, the impact of intervention by social 
service agencies on victims, and related needs. The Committee 
recommends this research utilize and give discretion to Area 
Agencies on Aging and their non-profit divisions in 
municipalities with aged populations (over the age of 60) of 
over 1 million, with preference given to the largest 
population. The Committee also recommends that unique 
partnerships to affect this research be considered for the 
selected Area Agency on Aging. The Committee is aware of 
innovative program models aimed at mobilizing older Americans, 
particularly the 77 million baby boomers, to serve their 
communities. The Committee encourages partnerships with 
organizations, such as Experience Corps, that enable older 
Americans to help meet critical social needs effectively.

Aging network support activities

    The Committee provides $13,266,000 for aging network 
support activities, which include five ongoing programs: the 
Eldercare Locator, Pension Counseling, Senior Medicare Patrols, 
the National Long-Term Care Ombudsman Resource Center, and the 
National Center on Elder Abuse. This is the same as the fiscal 
year 2005 comparable level and the budget request. These 
established programs, which began as demonstration projects, 
provide critical support for the national aging services 
network.

Alzheimer's disease demonstration grants

    The Committee provides $11,786,000 for Alzheimer's disease 
demonstration grants. This is the same as the budget request 
and the fiscal year 2005 comparable level. The program provides 
competitive grants to States to help them plan and establish 
programs to provide models of care to individuals with 
Alzheimer's disease. Funds are used for respite care and 
supportive services, clearinghouses, training, and 
administrative costs for State offices.

White House Conference on Aging

    The Committee concurs with the budget request and does not 
provide funding for the White House Conference on Aging. The 
fiscal year 2005 level, the third and final year of funding for 
the Conference, is $4,520,000. The Committee looks forward to 
the Conference, currently scheduled to occur December 11 
through 14 of 2005. Past White House conferences on aging have 
prompted the development of many of the programs that represent 
America's commitment to the elderly.

Program administration

    The Committee provides $17,879,000 for program 
administration expenses for the Administration on Aging (AoA). 
This is $422,000 less than the fiscal year 2005 level and the 
same as the budget request. This activity provides 
administrative and management support for all Older Americans 
Act programs administered by AoA.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

    The Committee provides $344,546,000 for general 
departmental management, which is $29,703,000 below the fiscal 
year 2005 comparable level and $14,630,000 below the budget 
request. Included in this amount is authority to spend 
$5,851,000 from the Medicare trust funds. In addition, the 
Office of the Secretary has access to $39,552,000 of policy 
evaluation funding.
    This appropriation supports those activities that are 
associated with the Secretary's roles as policy officer and 
general manager of the Department. The Office of the Secretary 
also implements Administration and Congressional directives, 
and provides assistance, direction and coordination to the 
headquarters, regions and field organizations of the 
Department. This account also supports several small health 
promotion and disease prevention activities that are centrally 
administered.

Adolescent Family Life

    The Committee provides $30,742,000 for the Adolescent 
Family Life program, which is $158,000 below the comparable 
2005 level and the same as the budget request. The Committee 
includes bill language requested by the Administration 
allocating all funds for prevention demonstrations to be 
available for abstinence education activities under section 
510(b)(2) of the Social Security Act. The program provides 
comprehensive and integrated approaches to the delivery of care 
services for pregnant and parenting adolescents, and prevention 
services that promote abstinence from sexual activity among 
non-parenting teens.

Office of Minority Health

    The Committee provides $47,236,000 for the Office of 
Minority Health, which is $3,282,000 below the fiscal year 2005 
comparable amount and the same as the budget request. The 
Office of Minority Health works with Public Health Service 
agencies and other agencies of the Department in a leadership 
and policy development role to establish goals and coordinate 
other activities in the Department regarding disease 
prevention, health promotion, service delivery and research 
relating to disadvantaged and minority individuals; concludes 
interagency agreements to stimulate and undertake innovative 
projects; supports research, demonstration, and evaluation 
projects; and coordinates efforts to promote minority health 
programs and policies in the voluntary and corporate sectors.
    IOM report on unequal treatment.--The Committee is 
committed to ensuring the overall improved health of the 
American people, and encourages the Secretary to intensify HHS 
efforts to work to implement recommendations developed by the 
Institute of Medicine's Unequal Treatment: Confronting Racial 
and Ethnic Disparities in Health Care study. The 
recommendations offer significant guidelines and opportunities 
for eliminating health disparities and improving health across 
all populations. The Committee requests the Secretary to report 
on the progress of this action during next year's 
appropriations hearings.
    Charles Drew University.--The Committee notes the 
challenges faced by Charles R. Drew University of Medicine and 
Science in Los Angeles. Because of problems with the health 
care delivery system in South Central Los Angeles, several of 
the key residency training programs sponsored by the 
institution are jeopardized. The Committee encourages the 
Office of Minority Health to take a leadership role in 
assisting the university in solving these challenges. The 
Office is urged to consider supporting faculty for the 
residency programs, and to coordinate a Public Health Service-
wide program of support for the institution.
    HIV/AIDS for faith-based communities.--The Committee 
commends the Department for its work with the National 
Coalition of Pastors' Spouses to develop HIV/AIDS: A Manual for 
Faith Communities. The Committee encourages the Department to 
continue this partnership for the translation of this manual 
into Spanish and Swahili.
    Meharry Medical College.--The Committee encourages OMH to 
continue its successful cooperative agreement with Meharry 
Medical College aimed at meeting the challenges of academic 
opportunity for disadvantaged students and improving health 
care services in underserved communities. In addition, the 
Committee continues to encourage OMH to support strategic 
planning and development activities at the Morehouse School of 
Medicine.

Office on Women's Health

    The Committee provides $28,715,000 for the Office on 
Women's Health, which is $103,000 below the fiscal year 2005 
comparable level and the same as the budget request. The Office 
on Women's Health advises the Secretary and provides 
Department-wide coordination of programs focusing specifically 
on women's health.

HIV/AIDS in minority communities

    The Committee provides $52,415,000 to be available to the 
Secretary to transfer to the Department's operating agencies 
for specific program activities to address the high-priority 
HIV prevention and treatment needs of minority communities. 
This is the same as the fiscal year 2005 comparable level and 
the same as the budget request. These funds are provided to 
promote an effective culturally competent and linguistically 
appropriate public health response to the HIV/AIDS epidemic.
    Within the total provided, the Committee expects that 
activities that are targeted to address the growing HIV/AIDS 
epidemic and its disproportionate impact upon communities of 
color, including African Americans, Latinos, Native Americans, 
Asian Americans, Native Hawaiians, and Pacific Islanders will 
be supported at no less than last year's funding level.

Afghanistan

    The Committee includes $5,952,000, which is the same as the 
Administration and the comparable fiscal year 2005 level. These 
funds will be used for the joint Department of Defense and HHS 
initiative to improve the largest women's hospital in Kabul, 
Afghanistan and to create four satellite teaching clinics. Bill 
language is included identifying the amount of assistance and 
citing as authority the Afghanistan Freedom Support Act of 
2002.

Embryo adoption awareness campaign

    The Committee provides $992,000 for the embryo adoption 
awareness campaign, which is the same as the Administration 
request and the comparable fiscal year 2005 level. These funds 
will be used for a competitive grant program to continue embryo 
adoption public awareness activities.

Information technology security and innovation fund

    The Committee does not provide funding for the information 
technology security and innovation fund, which is $14,695,000 
below the fiscal year 2005 comparable level and $14,630,000 
below the budget request. This fund supports HHS enterprise-
wide investments in such areas as common IT infrastructure 
services, and security and infrastructure to enable common 
administrative systems. Almost $67 million has been 
appropriated for this function over the past four years, in 
addition to the substantial contributions made by the HHS 
operating divisions.
    Office of Population Affairs.--The Committee is concerned 
by reports that the State Attorneys General in several States 
are requesting records to determine any role family planning 
providers may have had in failing to report criminal activity 
such as statutory rape. The appropriations bill has had a 
longstanding provision (sec. 212 of the fiscal year 2005 bill) 
and continues the provision in sec. 213 of the fiscal year 2006 
bill making clear that no family planning provider is exempt 
from any State law requiring notification or reporting of child 
abuse, child molestation, sexual abuse, rape or incest. The 
Committee directs the Office of Population Affairs to send 
Title X grantees a reminder notification of this Federal 
requirement. In addition, the Committee requests the Secretary 
to conduct an audit of a sample of Title X recipients to 
determine compliance with mandatory reporting requirements.
    Salt.--The Committee is aware that the Dietary Guidelines 
for Americans 2005 (published by the Department of Health and 
Human Services and the Department of Agriculture) recommends 
that Americans consume less salt because reducing salt intake 
may reduce blood pressure, lowering an individual's risk of 
coronary heart disease, stroke, congestive heart failure, and 
kidney disease. That recommendation echoes the conclusion of 
both a 2002 report by the National Institutes of Health and a 
2004 report by the Institute of Medicine. Older persons, 
African Americans, and people with high blood pressure tend to 
be especially sensitive to the blood pressure-raising effects 
of salt. While salt occurs naturally in some foods, the great 
majority of salt is consumed by eating processed foods. The 
Committee is also aware that in some processed foods salt--in 
addition to affecting taste--performs important functions, such 
as preventing the growth of bacteria. The Committee encourages 
the Secretary to focus on ways--including both voluntary 
actions by the food industry and regulatory actions by the Food 
and Drug Administration and the Department of Agriculture--to 
reduce salt in processed and restaurant foods.
    Cross-tracking program participants.--The Committee is 
interested in better understanding the full impact of federal 
assistance programs, including the number of individuals who 
access multiple programs, either concurrently or serially. As 
such, the Committee directs the U.S. Department of Health and 
Human Services to work with the Census Bureau to improve the 
Survey of Income and Program Participation (SIPP) and other 
infrastructure necessary to cross-reference individuals 
participating in multiple federal programs. As part of this 
effort, the Department of Health and Human Services is 
encouraged to partner with other federal agencies to improve 
Census Bureau survey measures of participation across all 
programs that will allow such cross-referencing to occur. The 
Department shall report to Congress, by March 1, 2006, on the 
status of this initiative, including a specific list of 
barriers that may preclude the agency from full compliance with 
this directive.
    Limited English proficiency.--The Committee is concerned 
about the implementation of the department's ``policy 
guidance'' issued pursuant to Executive Order 13166 regarding 
limited English proficiency. The Committee feels it is 
important to track the costs of this policy to make sure that 
the provision of language services is being done as cost 
effectively as possible. Therefore, HHS, should report to the 
Committee the total funding spent on the provision of HHS-
conducted services in languages other than English, including 
publications costs, web site development and maintenance costs, 
outreach activities, translation activities, and language line 
contracts. The Department should report the same cost 
categories as provided in the Limited English Proficiency 
Report requested in House report 108-10.
    Men's health.--The Committee understands that there is no 
entity in the Department responsible for the coordination and 
oversight of activities across the agency concerning men's 
health. The Committee is aware of reports that men are 25 
percent less likely than women to receive regular health 
screenings, and that one of the top problems facing men's 
health is that men are not likely to visit a doctor when they 
notice a problem. The Committee encourages the Secretary to 
expand departmental disease prevention and health promotion 
activities among men and to give consideration to establishing 
an office for men's health, similar to the HHS Office of 
Women's Health. The Committee expects the Secretary to be 
prepared to discuss in the fiscal year 2007 appropriations 
hearings the activities that have been undertaken with regard 
to men's health.
    Underage drinking.--The Committee strongly supports the 
efforts by the Department to combat underage drinking 
particularly the efforts by the Interagency Coordinating 
Committee to Prevent Underage Drinking (ICCPUD) to develop a 
National strategy on underage drinking. More than 7,000 teens 
under the age of 16 take their first drink every day. According 
to the latest data from Monitoring the Future, one in five 
eighth-graders report drinking in the past month, and that 
rises to one in three for 10th-graders and one in two for 12th-
graders. The Centers for Disease Control and Prevention (CDC) 
reported that, for the last year for which data were available, 
more than 4,500 persons under the age of 21 died as a result of 
excessive drinking. In addition, NIH has reported significant 
findings about the negative consequences of underage drinking 
on adolescent brain development. The Committee therefore 
includes within the total for the Office of the Secretary the 
third year of funding necessary to continue the Ad Council's 
parent-oriented National media campaign to combat underage 
drinking. Further, the Committee expects the public service 
announcement to be based on sound scientific research.
    HIV/AIDS grants.--The Committee is concerned that agencies 
at the state and local level which currently receive funding 
from multiple HHS agencies, such as those administering 
programs to prevent and treat HIV/AIDS, are burdened with 
inconsistent data collection and reporting requirements by 
Federal grants. In order to satisfy these requirements, 
agencies often must allocate funds to cover administrative 
costs that might otherwise go to providing direct services. In 
order to decrease administrative burden and make the most 
effective use of federal health care dollars, the Committee 
urges the Secretary to direct the HHS agencies engaged in 
cooperative agreements for HIV/AIDS services with State and 
local, private and public entities to address this situation by 
moving to coordinate data collection and reporting requirements 
for grantees.
    Sleep disorders.--At the National Institutes of Health's 
Frontiers of Knowledge in Sleep and Sleep Disorders conference 
in March of 2004, the U.S. Surgeon General reported on the 
profound impact that chronic sleep loss and untreated sleep 
disorders have on Americans of all ages and that the public 
health model is well suited to translate these essential health 
messages to society. The Committee encourages the Surgeon 
General to consider development of a Surgeon General's Report 
on Sleep and Sleep Disorders.
    Prostate cancer.--The Committee encourages the Secretary to 
work with the Director of the NIH and the Administrator of the 
FDA to resolve, as quickly as possible, all issues related to 
the adoption of clinical trial surrogate endpoints for prostate 
cancer research and drug approval. The Committee requests the 
Secretary to submit a progress report to Congress by July 1, 
2006.
    Hepatitis C-HIV co-infection.--The Committee is concerned 
with the growing co-infection of individuals with both HIV and 
hepatitis C and notes that the largest single cause of death of 
individuals with HIV infection is now liver disease. The 
Committee is pleased that, in response to this high co-
infection rate, approximately 20 of the state AIDS Drug 
Assistance Programs (ADAP) have now included Hepatitis C 
pharmaceuticals on their formularies. The Committee notes that 
the Ryan White Care Act requires the Secretary to issue 
guidelines regarding appropriate treatments under the program 
and requests that the Secretary review and re-issue these 
treatment guidelines to address the treatment issues and 
formulary requirements associated with the significant co-
infection rate of HIV and hepatitis C.
    Biosafety laboratories.--The Committee requests the 
Secretary of HHS to study if there is a need for additional 
biosafety level four (BSL-4) laboratories to combat biological 
threats from discovery to licensed products. With emerging 
infectious diseases, such as SARS and highly pathogenic avian 
influenza, increased incidence of drug resistant disease, and 
an increased potential for their use in bio-warfare, the 
Committee wants to be certain that an adequate number of such 
facilities exists to ensure that prophylaxis, therapeutics and 
diagnostics are available to combat these threats. The 
Committee requests the Secretary to conduct a coordinated 
review with relevant agencies to: (1) assess any need for 
additional BSL-4 facilities specifically designed to conduct 
animal model studies under Good Laboratory Practice guidelines; 
and (2) define the cost, critical design features, and possible 
construction timetable to establish new high security BSL-4 
research facilities. The Committee would like a report 
outlining the results of this review by no later than 180 days 
after enactment of this Act.
    NIH Library of Medicine infrastructure.--The Committee 
continues to support the work of the National Library of 
Medicine, the largest medical library in the world and the 
leader in digitized medical information resources. Previously, 
the Committee has taken steps to ensure that adequate funding 
was available for the architectural planning and design of a 
new NLM building to house the National Center for Biotechnology 
Information and other activities related to digital information 
development. With the preliminary work complete, the Committee 
encourages the Secretary to consider the commitment of 
necessary resources to begin construction of new physical 
facilities for the NLM to enable it to keep pace with the rapid 
increase in medical publishing and biotechnology information 
research and development.
    Evidentiary standards.--The Committee encourages the 
Secretary to work across the Department to direct its limited 
funding toward programs with the highest evidentiary standards, 
such as randomized trials. For example, the Committee is aware 
of extensive evidence that Nurse-Family Partnership, an early 
home visitation program for first-time low-income mothers, 
prevents child abuse and childhood injury, helps develop 
positive parent-child relationships, and helps the brain 
development of the children served. The Committee instructs the 
Secretary to apply the hig evidentiary standards to programs 
across the Department, and to support agencies within the 
Department, such as HRSA and ACF, adopting evidence-based 
programs.
    Obesity.--The Committee notes the serious nature of rising 
obesity rates, especially among girls in underrepresented 
populations or geographic areas where higher obesity rates 
prevail. The Committee further recognizes the multi-
institutional effort that is needed to attack the obesity 
problem in America and ensure that children and teens make 
healthy choices. The Committee understands that the Girl Scouts 
of the USA has begun a Healthy Living Initiative, which may be 
able to reach many of its members and their families with a 
healthy living, balanced lifestyle message to address obesity 
and other risky behaviors. The Committee encourages HHS to 
actively partner with organizations such as the Girl Scouts of 
the USA to promote the Department's obesity and wellness 
initiatives.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

    The Committee provides $60,000,000 for this function, which 
was previously supported under an interagency agreement between 
the Centers for Medicare and Medicaid Services and the Social 
Security Administration. Consistent with the requirements of 
the Medicare Modernization Act of 2003, this function was 
transferred to the Office of the Secretary. This amount is 
$2,464,000 above the comparable fiscal year 2005 level and 
$20,000,000 below the Administration request. This office will 
support the hearing at the administrative law judge level of 
the third level of Medicare claims appeals. 42,000 appeals are 
expected to be heard in fiscal year 2006.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

    The Committee provides $75,000,000 for the new health 
information technology office, of which $58,100,000 is 
available in budget authority and $16,900,000 in program 
evaluation tap funding. No budget authority was provided in 
fiscal year 2005, but $32,779,000 was made available via 
reprogramming from a combination of program evaluation tap 
funding and reallocated funds in the Agency for Healthcare 
Research and Quality and the Office of the Secretary. The 
Administration request is $2,750,000 above the amount provided 
by the Committee in the portion of the program supported by 
evaluation tap funding. In addition, $50,000,000 is available 
for health information technology activities in the Agency for 
Healthcare Research and Quality. This is the same as the 
Administration budget and the comparable fiscal year 2005 
level.
    This program is intended to bring together decision-makers 
to develop standards for modern information technology, to 
devise certification procedures, to develop electronic 
information architecture and to test privacy standards. The 
ultimate goal is the accurate and rapid transfer of a patient's 
health information electronically.
    The Committee is aware of several State e-health 
initiatives for sharing health care information among 
providers. The Committee encourages the Office of the National 
Coordinator for Health Information Technology (ONCHIT) to take 
advantage of the expertise of these States as it begins the 
process of developing standards and policies for a national 
health information network. The Committee urges the Office to 
address the information technology infrastructure needs of 
public and private non-profit community health care systems.

                    OFFICE OF THE INSPECTOR GENERAL

    The Committee provides $39,813,000 for the Office of the 
Inspector General (OIG), which is $117,000 less than the fiscal 
year 2005 comparable level and the same as the budget request. 
A permanent appropriation for this office is contained in the 
Health Insurance Portability and Accountability Act of 1996. 
Total funds provided between this bill and the permanent 
appropriation would be $199,813,000 in fiscal year 2006.
    The Office of the Inspector General was created by law to 
protect the integrity of Departmental programs as well as the 
health and 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.

                        OFFICE FOR CIVIL RIGHTS

    The Committee provides $34,996,000 for the Office of Civil 
Rights (OCR), which is $17,000 less than the fiscal year 2005 
comparable level and the same as the budget request. This 
includes authority to transfer $3,314,000 from the Medicare 
trust funds.
    The Office for Civil Rights is responsible for enforcing 
civil rights statutes that prohibit discrimination in health 
and human services programs. OCR implements the civil rights 
laws through a compliance program designed to generate 
voluntary compliance among all HHS recipients.

               MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

    The Committee provides an estimated $328,552,000 for 
medical benefits for commissioned officers of the U.S. Public 
Health Service. This is the same as the Administration request 
and $2,084,000 below the fiscal year 2005 comparable amount.
    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 for active duty and retired 
members and dependents and beneficiaries; and for payments to 
the Social Security Administration for military service 
credits.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

    The Committee provides $183,589,000 for the public health 
and social services emergency fund for homeland security 
related activities within the Office of the Secretary. Within 
the amount, $63,589,000 is for homeland security preparedness 
activities within the Office of the Secretary and $120,000,000 
is for influenza preparedness.
    In addition, the Committee also provides $2,213,744,000 
within the accounts of the managing agencies of jurisdiction, 
for homeland security activities requested in this account. The 
amounts are broken out by Agency as follows: $1,616,723,000 
within the Centers for Disease Control and Prevention; 
$500,000,000 within the Health Resources and Services 
Administration; and $97,021,000 within the National Institutes 
of Health for chemical, nuclear and radiological research.
    Since fiscal year 2002, terrorism preparedness and response 
funds have been requested and provided for within the Public 
Health and Social Services Emergency Fund (PHSSEF), with the 
exception of biodefense research funds within the National 
Institute of Allergy and Infectious Diseases. However, now that 
these programs and activities have become a central part of 
these Agencies annual management responsibilities, the 
Committee believes the funding more appropriately belongs 
within the managing Agency's account.
    After adjusting for these changes, the comparable total for 
homeland security related activities in the Committee 
recommendation is $2,397,333,000 for fiscal year 2006. This is 
$10,082,000 below the comparable fiscal year 2005 amount and 
$30,500,000 below the request.
    While the Committee has, for FY 2006, provided funding for 
these activities directly to the relevant agencies, the 
Committee expects Department-wide coordination to continue. The 
Committee directs the Secretary to submit to the Committee a 
detailed operating plan for bioterrorism preparedness 
activities, now funded in large measure in the agencies, prior 
to the commitment of funds for grants, or for contracts in 
excess of $1 million.
    The Committee bill also includes language to finance HHS's 
Project BioShield procurement management costs through the 
appropriation for the Strategic National Stockpile, consistent 
with the requirements of section 319F-2(c)(7)(B)(ii) of the 
Public Health Service Act. To cover these costs, the bill 
authorizes the transfer of $8,589,000 from the SNS 
appropriation (CDC) to the Public Health and Social Services 
Emergency Fund.
    The Committee does not provide funding within the Office of 
the Secretary for healthcare provider credentialing. The 
Committee believes a better use of resources would be to expand 
the ongoing credentialing program operated by HRSA to permit 
cross-state credentialing.
    Pandemic Preparedness.--The Committee directs the 
Department to finalize its August 2004 draft Pandemic Influenza 
Preparedness and Response Plan and make it publicly available. 
The final plan should provide the operational blueprint for the 
six pandemic phases as defined by the World Health 
Organization.
    The Committee believes that pandemic preparedness includes 
much more than just public health, and urges the Secretary to 
press for the appointment of a senior official, whose primary 
responsibility is to assure Cabinet-level planning and 
coordination between civil society (non-governmental economic 
infrastructure) and government during a pandemic period.
    The Committee commends the Secretary for taking steps to 
implement the draft Pandemic Influenza Preparedness and 
Response Plan, and it notes the important roles that both 
vaccines and antivirals will play in the event of pandemic. 
Given the potential lack of a match between available vaccines 
and a particular strain of influenza that could cause a 
pandemic, the Committee supports efforts to increase domestic 
manufacturing capabilities for rapid production of vaccines and 
antivirals and the purchase of vaccines and antivirals in the 
event of a pandemic influenza outbreak.

                           General Provisions

    Sec. 201. The Committee continues a provision to limit the 
amount available for official reception and representation 
expenses.
    Sec. 202. The Committee continues a provision to limit the 
number of Public Health Service employees assigned to assist in 
child survival activities and to work in AIDS programs through 
and with funds provided by the Agency for International 
Development, the United Nations International Children's 
Emergency Fund or the World Health Organization.
    Sec. 203. The Committee continues a provision to prohibit 
the use of funds to implement section 399F(b) of the Public 
Health Service Act or section 1503 of the NIH Revitalization 
Act of 1993.
    Sec. 204. The Committee continues a provision to limit the 
salary of an individual through an NIH, AHRQ, or SAMHSA grant 
or other extramural mechanism to not more than the rate of 
Executive Level I.
    Sec. 205. The Committee includes a provision limiting the 
compensation of an individual working in Head Start to the 
Federal Executive Level II salary.
    Sec. 206. The Committee continues a provision to prohibit 
the Secretary from using evaluation set-aside funds until the 
Committee receives a report detailing the planned use of such 
funds.
    Sec. 207. The Committee continues a provision, although 
changes the percentage provided in the fiscal year 2005 bill, 
permitting the Secretary to use up to 1.3 percent of funds 
authorized under the PHS Act for the evaluation of programs.

                          (TRANSFER OF FUNDS)

    Sec. 208. The Committee modifies a provision permitting the 
Secretary of HHS to transfer up to one percent of any 
discretionary appropriation from an account.

                          (TRANSFER OF FUNDS)

    Sec. 209. The Committee continues a provision to provide 
the Director of NIH, jointly with the Director of the Office of 
AIDS Research, the authority to transfer up to three percent of 
human immunodeficiency virus funds.

                          (TRANSFER OF FUNDS)

    Sec. 210. The Committee continues a provision to make NIH 
funds available for human immunodeficiency virus research 
available to the Office of AIDS Research.
    Sec. 211. The Committee continues a provision to prohibit 
the use of Title X funds unless the applicant for the award 
certifies to the Secretary that it encourages family 
participation in the decision of minors to seek family planning 
services and that it provides counseling to minors on how to 
resist attempts to coerce minors into engaging in sexual 
activities.
    Sec. 212. The Committee continues a provision related to 
the Medicare Advantage program.
    Sec. 213. The Committee continues a provision stating that 
no provider of services under title X shall be exempt from any 
State law requiring notification or the reporting of child 
abuse, child molestation, sexual abuse, rape, or incest.
    Sec. 214. The Committee continues a provision to exempt 
States from Synar provisions if certain funding criteria are 
met.
    Sec. 215. The Committee continues a provision to allow CDC 
international HIV/AIDS and other infectious disease, chronic 
and environmental disease, and other health activities abroad 
to be spent under the State Department Basic Authorities Act of 
1956.
    Sec. 216. The Committee continues a provision to permit the 
Division of Federal Occupational Health to use personal 
services contracting to employ professional management/
administrative and occupational health professionals.
    Sec. 217. The Committee includes a provision granting 
authority to the Office of the Director of the National 
Institutes of Health (NIH) to enter directly into transactions 
in order to implement the NIH Roadmap for medical research and 
permitting the Director to utilize peer review procedures, as 
appropriate, to obtain assessments of scientific and technical 
merit.
    Sec. 218. The Committee includes a provision that permits 
the Centers for Disease Control and Prevention and the Agency 
for Toxic Substances and Disease Registry to transfer funds 
that are available for Individual Learning Accounts to 
``Disease Control, Research, and Training''.
    Sec. 219. The Committee includes a provision rescinding 
$15,912,000 of unobligated balances in the Health Professions 
Student Loan program.

                   TITLE III--DEPARTMENT OF EDUCATION

    The Committee's recommendations for the Department of 
Education for fiscal year 2006 will bring total departmental 
funding to $56,692,772,000, the highest level in the agency's 
history.
    The Committee continues to emphasize the importance of 
developing clear, measurable outcomes for programs within the 
Department of Education as outlined in the Government 
Performance and Results Act. It is vital that the Committee be 
provided with information on the actual results achieved by the 
programs, not simply the number of students affected by the 
program or the quantity of materials distributed. Program 
outcomes should, to the extent possible, focus on the 
achievement improvements that result to students and teachers 
in the classroom as a result of the Federal investment. 
Programs that are able to demonstrate these results over time 
will be considered higher funding priorities than programs that 
are unable to clearly demonstrate their value to the American 
public.
    The Committee notes that urban school districts employ more 
people and manage larger budgets than many Fortune 500 
companies. Yet many schools--particularly in inner cities--are 
failing to prepare students for higher education, employment 
and productive citizenship. The Committee encourages the 
Secretary to examine the effects that various local district 
governance structures, including elected and appointed school 
boards, have had on academic achievement in public schools and 
be prepared to respond to questions relating to this topic in 
the fiscal year 2007 budget hearings.
    The Committee is aware that, nationally, only 61.5 percent 
of public education operational budgets reach the classroom, 
according to the National Center for Educational Statistics. 
However four states (Maine, New York, Tennessee and Utah) spend 
over 65 percent of their budget in the classroom. The Committee 
encourages the Secretary to examine the impact this spending 
priority has had on the academic achievement of students in 
these states and to examine efforts that would result in a 
greater percentage of all school district budgets being spent 
on classroom instruction, such as classroom teachers, 
personnel, instructional aides, supplies, activities and 
tuition.

                    EDUCATION FOR THE DISADVANTAGED

    The bill includes $14,728,735,000 for the disadvantaged 
programs. This amount is $1,702,738,000 less than the budget 
request and $115,239,000 below the fiscal year 2005 
appropriation. Of the total amount available, $7,144,426,000 is 
appropriated for fiscal year 2006 for obligation after July 1, 
2006 and $7,383,301,000 is appropriated for fiscal year 2007 
for obligation on or after October 1, 2006. This appropriation 
account includes compensatory education programs authorized 
under title I of the Elementary and Secondary Education Act of 
1965; and title VIII of the Higher Education Act.
    The Committee is aware that the method some states 
currently employ to calculate school expenditures masks huge 
gaps in per-pupil spending within districts. State funding 
analyses, and data which drive federal funding formulas, tend 
to average teacher salaries for entire districts instead of 
calculating the actual salaries of teachers assigned to any 
particular school. Many states actually spend less on teachers 
in schools serving low-income and minority students than they 
spend on teachers in schools serving more affluent students. 
The most highly-paid teachers, and therefore the more 
experienced and highly credentialed teachers, are concentrated 
in more affluent schools, leaving high-poverty and high-
minority schools with teachers who have less experience, less 
education, and face the most challenging assignments. The 
Education Trust has found that, in California, forty-two of the 
fifty largest school districts spend significantly more on 
teachers in their schools serving the fewest numbers of Latino 
and African-American students. For a student attending a high 
school that serves mostly Latino and African-American students, 
as much as $172,000 less may be spent on that student's 
teachers over the course of a K-12 career.
    The Committee urges the Secretary to examine this issue, 
determine how many states are using this practice, ascertain 
what effects the practice may have on title I grants to LEAs, 
and work with states to adopt data-collection policies that 
will make school-level teacher salary data publicly available, 
and to analyze and report on the factors that contribute to the 
teacher-spending gap, such as personnel and budgeting 
practices, in order to close the gap in teacher spending and 
quality within school districts. The Committee expects the 
Secretary to be prepared to report on this effort in the fiscal 
year 2007 budget hearings.

Grants to local educational agencies

    Of the amounts provided for Title I programs, 
$6,934,854,000 is available for basic grants to local education 
agencies. This amount is the same as last year's level and the 
request. The Committee rejects the inclusion of any 100% hold 
harmless provision because it unfairly penalizes 
underprivileged and immigrant children in states with growing 
populations.
    Funding for concentration grants, which targets funds to 
Local Educational Agencies in counties with high levels of 
disadvantaged children, is $1,365,031,000, the same as last 
year and the request level. The bill includes $2,269,843,000 
for targeted grants, an increase of $50,000,000 above last year 
and $552,738,000 below the request. A total of $2,269,843,000 
is also included for education finance incentive grants, 
$50,000,000 above the request and $50,000,000 above last year's 
level.
    Financial assistance flows to school districts by formula, 
based in part on the number of school-aged children from low-
income families. Within districts, local school officials 
target funds on school attendance areas with the greatest 
number or percentage of children from poor families. Local 
school districts develop and implement their own programs to 
meet the needs of disadvantaged students.
    Funds under this account will also be used to pay the 
Federal share of State administrative costs for title I 
programs. The maximum State administration grant is equal to 1 
percent of title I local educational agency plus State agency 
grants to the State, or $400,000, whichever is greater. These 
funds are included in the grants to local educational agencies 
account, rather than being a separate line item.
    Recent studies have demonstrated that comprehensive school-
improvement models, when well implemented, boost student 
achievement to a greater extent than other interventions 
designed to serve similar student populations. The Committee 
believes that comprehensive school reform provides an exemplary 
approach to raising academic achievement, particularly for 
schools that do not make adequate yearly progress under the No 
Child Left Behind Act. The Committee believes that States 
should utilize their four percent school improvement set aside 
funds, estimated at over $500,000,000 in fiscal year 2006, to 
support implementation of CSR models with demonstrated success. 
Further, the Committee intends that the Secretary shall notify 
States that schools currently receiving CSR subgrants shall 
receive priority for targeted grants and/or technical 
assistance under section 1003(a) of ESEA.
    In addition, the Committee is concerned that in some cases, 
States have distributed the funds set aside within the title I 
program for school improvement purposes equally to each school 
identified in need of improvement. The Committee believes that 
this is resulting in allocations for each school that may be 
too small to effectively leverage needed reforms. The Committee 
strongly urges States to examine methods for distributing 
school improvement funds that will result in awards of 
sufficient size and scope to support the initial costs of 
comprehensive school reforms and to limit funding to programs 
that include each of the reform components described in section 
1606(a) of the No Child Left Behind Act of 2001 and have the 
capacity to improve the academic achievement of all students in 
core academic subjects within participating schools.

Even Start

    The Committee provides $200,000,000 for Even Start, 
$25,095,000 below last year and $200,000,000 above the request. 
Even Start provides grants for programs focusing on the 
education of disadvantaged children, aged 1-7 years, who live 
in title I target school attendance areas, plus their parents 
who are eligible to be served under the Adult Education Act. 
These parents are not in school, are above the State's 
compulsory school attendance age limit, and have not earned a 
high school diploma (or equivalent). Even Start funds are 
allocated to the States, generally in proportion to title I 
basic grants.

Reading First State Grants

    The bill provides $1,041,600,000 for Reading First State 
grants, the same as the budget request and the same as the 
fiscal year 2005 level. This program provides assistance to 
states and school districts in establishing scientific 
research-based reading programs for children in kindergarten 
through grade three. The program also provides for professional 
development and other supports to ensure that teachers can 
identify children at-risk for reading failure and provide the 
most effective early instruction to overcome specific barriers 
to reading proficiency.
    The Committee urges the Department to ensure accountability 
of States and local education agencies through ongoing, 
reliable screening and diagnostic and classroom-based 
assessments of the literacy programs funded with Reading First 
grants.

Early Reading First

    The bill provides $104,160,000 for Early Reading First, the 
same as the budget request and the fiscal year 2005 level. This 
is a competitive grant program targeted toward children ages 
three through five, and would support the development of verbal 
skills, phonemic awareness, pre-reading development and 
assistance for professional development for teachers in 
evidence-based strategies of instruction.

Striving Readers

    The bill provides $30,000,000 for Striving Readers, 
$170,000,000 below the budget request and $5,200,000 above last 
year's level. Striving Readers will make competitive grants to 
develop, implement and evaluate reading interventions for 
middle- or high-school students who are reading significantly 
below grade level.

Literacy through school libraries

    The bill provides $19,683,000 for literacy through school 
libraries, the same as the budget request and the fiscal year 
2005 level. This program helps school districts provide 
students with increased access to up-to-date school library 
materials, a well-equipped, technologically advanced school 
library media center, and well-trained, and professionally 
certified school library media specialists. At appropriations 
of less than $100,000,000 the Department makes competitive 
awards to districts with a child poverty rate of at least 20 
percent.

High school intervention

    The bill does not include funding for the high school 
intervention program proposed by the Administration at 
$1,240,000,000. The Committee supports the Administration's 
goals in this program which are to increase the achievement of 
high school students, particularly students at risk of failing 
to meet challenging State academic content standards; eliminate 
gaps in achievement between students from different ethnic and 
racial groups and between disadvantaged students and their more 
advantaged peers; and enable all high school students to 
graduate with the education, skills, and knowledge necessary to 
succeed in postsecondary education and in a demanding, high-
technology economy. However, the Committee notes that this 
program has not been authorized.

State agency programs: migrant

    The bill includes $390,428,000 for the migrant education 
program, the same as the budget request and the fiscal year 
2005 appropriation. This program supports formula grants to 
State agencies for the support of special educational and 
related services to children of migratory agricultural workers 
and fishermen. The purpose of this program is to provide 
supplementary academic education, remedial or compensatory 
instruction, English for limited English proficient students, 
testing, plus guidance and counseling.

State agency programs: neglected and delinquent

    For the State agency program for neglected and delinquent 
children, the bill includes $49,600,000, the same as the budget 
request and the fiscal year 2005 appropriation. This formula 
grant program provides services to participants in institutions 
for juvenile delinquents, adult correctional institutions, or 
institutions for the neglected.

Evaluation

    The Committee provides $9,424,000 for evaluation, the same 
as the 2004 appropriation and the budget request. Title I 
evaluation supports large scale national evaluations that 
examine how title I is contributing to improved student 
performance at the State, local education agency, and school 
levels. It also supports short-term studies that document 
promising models and other activities to help States and local 
education agencies implement requirements in the title I 
statute.

Comprehensive school reform

    The bill includes $10,000,000 for the Comprehensive School 
Reform (CSR) Program, $10,000,000 above the request and 
$195,344,000 below last year's level, due to budget 
constraints. The Committee has provided sufficient funding to 
meet estimated continuation costs for the program in fiscal 
year 2006. The CSR program authorizes incentive grants of at 
least $50,000 per year, for 3 years, for schools to implement 
effective, research-driven strategies for schoolwide reform. 
Recent studies have demonstrated that comprehensive school-
improvement models, when well implemented, boost student 
achievement to a greater extent than other interventions 
designed to serve similar student populations. The Committee 
believes that comprehensive school reform provides an exemplary 
approach to raising academic achievement, particularly for 
schools that do not make adequate yearly progress under the No 
Child Left Behind Act. The Committee believes that States 
should utilize their four percent school improvement set aside 
funds, estimated at over $500,000,000 in fiscal year 2006, to 
support implementation of CSR models with demonstrated success. 
Further, the Committee intends that the Secretary shall notify 
States that schools currently receiving CSR subgrants shall 
receive priority for targeted grants and/or technical 
assistance under section 1003(a) of ESEA.
    In addition, the Committee is concerned that in some cases, 
States have merely divided the funds for school improvement 
purposes by the number of schools identified in need of 
improvement and that this is resulting in allocations for each 
school that may be too small to effectively leverage needed 
reforms. The Committee strongly urges States to examine methods 
for distributing school improvement funds that will result in 
awards of sufficient size and scope to support the initial 
costs of comprehensive school reforms and to limit funding to 
programs that include each of the reform components described 
in section 1606(a) of the No Child Left Behind Act of 2001 and 
have the capacity to improve the academic achievement of all 
students in core academic subjects within participating 
schools.

Migrant education, high school equivalency program

    The bill includes $18,737,000 for the high school 
equivalency program. This amount is the same as the budget 
request and the fiscal year 2005 level. The high school 
equivalency program recruits migrant students aged 16 and over 
and provides academic and support services to help those 
students obtain a high school equivalency certificate and 
subsequently to gain employment or admission to a postsecondary 
institution or training program.

College assistance migrant programs

    The bill includes $15,532,000 for the college assistance 
migrant programs. This amount is the same as the fiscal year 
2005 level and the budget request. The college assistance 
migrant program (CAMP) provides tutoring and counseling 
services to first-year, undergraduate migrant students and 
assists those students in obtaining student financial aid for 
their remaining undergraduate years.

                               IMPACT AID

    The bill provides $1,240,862,000 for Federal impact aid 
programs in fiscal year 2006, a decrease of $3,001,000 below 
the fiscal year 2005 appropriation and the same as the budget 
request. This account supports payments to school districts 
affected by Federal activities. Impact Aid represents a federal 
responsibility to local schools educating children whose 
families are connected with the military or who live on Indian 
land.
    The bill also includes language ensuring that schools 
serving the children of military personnel continue to receive 
Impact Aid funds when the military parents who live on-base are 
deployed and the child continues to attend the same school and 
in cases in which an on-base military parent is killed while on 
active duty and the child continues to attend the same school.
    The Committee notes that the Department of Defense is 
making plans to bring back to the continental United States 
over 70,000 U.S. military personnel currently stationed 
overseas, along with an estimated 100,000 family members. The 
Committee is concerned about the effect this action will have 
on the Impact Aid program and the schools enrolling 
approximately 32,000 military dependent students new to the 
Impact Aid Program. The Committee requests the Secretary to 
procure from the Secretary of Defense a timeline for this 
anticipated action along with the estimated total dollar 
savings this move will have on the Department of Defense 
Overseas Schools system and the financial impact the influx of 
these additional students will have on the Impact Aid Program 
and to report this information to the House and Senate 
authorizing and appropriation committees beginning October 1, 
2005 and every six months thereafter.

Basic support payments

    The bill includes $1,102,896,000 for basic support payments 
to local educational agencies, an increase of $27,878,000 above 
the fiscal year 2005 appropriation and the budget request. 
Basic support payments compensate school districts for lost tax 
revenue and are made on behalf of Federally-connected children 
such as children of members of the uniformed services who live 
on Federal property.

Payments for children with disabilities

    The Committee recommends $49,966,000 for payments on behalf 
of Federally-connected children with disabilities, the same as 
the budget request and the fiscal year 2005 appropriation. 
These payments compensate school districts for the increased 
costs of serving Federally-connected children with 
disabilities.

Facilities maintenance

    The Committee recommends $5,000,000 for facilities 
maintenance, $2,838,000 below the fiscal year 2005 amount and 
the budget request. These capital payments are authorized for 
maintenance of certain facilities owned by the Department of 
Education.

Construction

    The Committee recommends $18,000,000 for the construction 
program, $27,544,000 below the budget request and $30,545,000 
below the fiscal year 2005 level. This program provides formula 
and competitive grants to eligible locally owned school 
districts for building and renovating school facilities.

Payments for Federal property

    The bill provides $65,000,000 for payments related to 
Federal property, an increase of $2,504,000 above the fiscal 
year 2005 appropriation and the budget request. Funds are 
awarded to school districts to compensate for lost tax revenue 
as the result of Federal acquisition of real property since 
1938.

                      SCHOOL IMPROVEMENT PROGRAMS

    The bill includes $5,393,765,000 for school improvement 
programs. This amount is $225,891,000 less than the comparable 
fiscal year 2005 appropriation and $61,546,000 above the budget 
request for comparable programs. This appropriation account 
includes programs authorized under titles II, IV, V, VI, and 
VII of the Elementary and Secondary Education Act; the 
McKinney-Vento Homeless Assistance Act, title IV-A of the Civil 
Rights Act, and section 105 of the Compact of Free Association 
Amendments Act of 2003.

State grants for improving teacher quality

    The bill includes $2,916,605,000 for state grants for 
improving teacher quality, which is the same as the budget 
request and the fiscal year 2005 level. This program gives 
states and districts a flexible source of funding with which to 
meet their particular needs in strengthening the skills and 
knowledge of teachers and administrators to enable them to 
improve student achievement. States are authorized to retain 
2.5 percent of funds for state activities, including reforming 
teacher certification, re-certification or licensure 
requirements; expanding, establishing or improving alternative 
routes to state certification; carrying out programs that 
include support during the initial teaching and leadership 
experience, such as mentoring programs; assisting school 
districts in effectively recruiting and retaining highly 
qualified and effective teachers and principals; reforming 
tenure systems; and developing professional development 
programs for principals.
    States send funding to the local level by formula and by 
competitive grant. Among other things, local uses of funds 
include initiatives to assist recruitment of principals and 
fully qualified teachers; initiatives to promote retention of 
highly qualified teachers and principals; programs designed to 
improve the quality of the teacher force; teacher opportunity 
payments; professional development activities; teacher 
advancement initiatives and hiring fully qualified teachers in 
order to reduce class size.
    The Committee is aware that funding under the teacher 
quality program can be used for professional development and 
support for principals as well as teachers. The Committee 
recognizes the unique role that the principal plays as the 
instructional leader and CEO of a school, and strongly 
encourages states and school districts to devote a significant 
portion of professional development funds to providing high-
quality, ongoing professional development opportunities to 
principals. Particularly recommended is professional 
development to enhance principals' ability to work productively 
with families, provide staff development to teachers and other 
professionals, and to utilize data in decision-making. The 
Committee also encourages states and school districts to 
develop principals' professional development that is based on 
sound research on the most current models of leadership.

Early childhood educator professional development

    The bill includes $14,696,000 for early childhood educator 
professional development, the same as the budget request and 
the fiscal year 2005 level. This program provides competitive 
grants to partnerships to improve the knowledge and skills of 
early childhood educators and caregivers who work in 
communities that have high concentrations of children living in 
poverty.

Mathematics and science partnerships

    The bill includes $190,000,000 for mathematics and science 
partnerships, $79,000,000 below the budget request and 
$11,440,000 above the fiscal year 2005 level. This program 
promotes strong math and science teaching skills for elementary 
and secondary school teachers. Grantees may use program funds 
to develop rigorous math and science curricula, establish 
distance learning programs, and recruit math, science and 
engineering majors into the teaching profession. They may also 
provide professional development opportunities. Grants are made 
to States by formula based on the number of children aged 5 to 
17 who are from families with incomes below the poverty line, 
and States then award the funds competitively to partnerships 
which must include the State agency, and engineering, math or 
science department of an institution of higher education, and a 
high-need school district. Other partners may also be involved.

Innovative Education Program Strategies State Grants

    The bill includes $198,400,000 for State grants under 
Innovative Education Program Strategies, $98,400,000 above the 
budget request and the same as the fiscal year 2005 level. This 
program provides funding to State and local educational 
agencies for obtaining technology and training in technology 
related to the implementation of school based reform; acquiring 
and using educational materials; improving educational services 
for disadvantaged students; combating illiteracy among children 
and adults; addressing the educational needs of gifted and 
talented children; and implementing school improvement and 
parental involvement activities under ESEA Title I.

Education technology

    The bill includes $300,000,000 for education technology 
activities. This amount is $196,000,000 below the comparable 
fiscal year 2005 level. The President's budget proposed to 
terminate this program. Under this program, states are required 
to direct ninety-five percent of the funds to school districts 
for increasing access to technology, especially for high-need 
schools; improving and expanding teacher professional 
development in technology; and promoting innovative state and 
local initiatives using technology to increase academic 
achievement.

Supplemental education grants

    The bill provides $12,132,000 for supplemental education 
grants to the Federated States of Micronesia and $6,051,000 for 
supplemental education grants to the Republic of the Marshall 
Islands, the same as the budget request and the fiscal year 
2005 level. The Compact of Free Association Amendments Act of 
2003 (P.L. 108-188) authorizes these countries to receive 
funding for general education assistance.

21st century community learning centers

    The bill provides $991,077,000 for 21st century community 
learning centers, the same as the budget request and the fiscal 
year 2005 level. This program is a formula grant to states. 
Ninety-five percent of funds are distributed on a competitive 
basis from the state to local school districts, community-based 
organizations and other public entities and private 
organizations. Grantees must target students who attend low-
performing schools. Funds may be used for before and after 
school activities that advance student academic achievement 
including remedial education and academic enrichment 
activities; math, science, arts, music, entrepreneurial and 
technology education; tutoring and mentoring; recreational 
activities; and expanded library service hours.

State assessments

    The bill includes $411,680,000 for state assessments, the 
same as the budget request and the fiscal year 2005 level. This 
program provides states with funding to develop annual 
assessments and to carry out activities related to ensuring 
accountability for results in the state's schools and school 
districts.

High school assessments

    The bill does not include funding for the high school 
assessment initiative, proposed for funding by the 
Administration at $250,000,000. The Committee notes that this 
program is not authorized.

Javits gifted and talented education

    The bill does not include funding for gifted and talented 
education, the same as the budget request and $11,022,000 below 
fiscal year 2005 level. This program supports grants to build 
and enhance the ability of elementary and secondary schools to 
meet the needs of gifted and talented students. Competitive 
grants are awarded to states and school districts, institutions 
or higher education and other public and private entities.

Foreign language assistance grants

    The bill does not include funding for foreign language 
assistance grants, the same as the budget request. The program 
was funded at $17,856,000 in fiscal year 2005. The program 
supports competitive grants to school districts and states to 
increase the quality and quantity of elementary and secondary-
level foreign language instruction in the United States.

Education for homeless children and youth

    For the education of homeless children and youth program, 
the Committee recommends $62,496,000, the same as the budget 
request and the fiscal year 2005 appropriation. Grants are 
allocated to States in proportion to the total that each State 
receives under the title I program. For local grants, at least 
50 percent must be used for direct services to homeless 
children and youth, including tutoring or remedial or other 
educational services.

Training and advisory services

    The bill includes $7,185,000 for training and advisory 
services authorized by title IV-A of the Civil Rights Act. This 
amount is the same as the budget request and the same as the 
fiscal year 2005 amount. Title IV-A authorizes technical 
assistance and training services for local educational agencies 
to address problems associated with desegregation on the basis 
of race, sex, or national origin. The Department awards 3-year 
grants to regional equity assistance centers (EACs) located in 
each of the 10 Department of Education regions. The EACs 
provide services to school districts upon request. Typical 
activities include disseminating information on successful 
education practices and legal requirements related to 
nondiscrimination on the basis of race, sex, and national 
origin in educational programs; training designed to develop 
educators' skills in specific areas, such as the identification 
of race and sex bias in instructional materials; increasing the 
skills of educational personnel in dealing with race-based 
confrontations such as hate crimes; and providing technical 
assistance in the identification and selection of appropriate 
educational programs to meet the needs of limited English 
proficient students.

Education for Native Hawaiians

    The Committee recommends $24,770,000 for education for 
Native Hawaiians, $7,854,000 below the budget request and 
$9,454,000 below the fiscal year 2005 amount. A number of 
programs limited to Native Hawaiians are supported with these 
funds, including a model curriculum project, family-based 
education centers, postsecondary education fellowships, gifted 
and talented education projects, and special education projects 
for disabled pupils.

Alaska Native education equity

    The Committee recommends $31,224,000 for the Alaska Native 
education equity program, the same as the budget request and 
$3,000,000 below the fiscal year 2005 amount. These funds are 
used to develop supplemental educational programs to benefit 
Alaska Natives.

Rural Education

    The bill includes $170,624,000 for rural education 
programs, the same as the fiscal year 2005 level and the budget 
request. This fund includes two programs to assist rural school 
districts to improve teaching and learning in their schools. 
The small, rural schools achievement program provides funds to 
rural districts that serve a small number of students; the 
rural and low-income schools program provides funds to rural 
districts that serve concentrations of poor students, 
regardless of the number of students served by the district.

Comprehensive Centers

    The bill includes $56,825,000 for comprehensive centers, 
the same as the fiscal year 2005 level and the budget request. 
The Committee intends these funds to be used for the new 
comprehensive centers that will provide training, technical 
assistance, and professional development in reading, 
mathematics, and technology, particularly to schools that fail 
to meet their State's definition of adequate yearly progress.
    The Committee is pleased that the Department has decided to 
establish a Comprehensive Center in California and urges 
consideration be given for establishing such a center in 
southern California. Southern California has more than 60 
percent of California's 6.3 million students, the majority of 
schools in need of program improvement, the highest number of 
English Language Learner students, and the largest number of 
schools targeted for restructuring. In addition, southern 
California has 1.6 million Title I students--12 percent of the 
national total; 2,400 Title I schools--6 percent of the 
national total; and over 1 million Limited English Proficient 
students--22 percent of the national total.

                            INDIAN EDUCATION

    The bill includes $119,889,000 for Indian education. This 
amount is the same as the fiscal year 2005 appropriation and 
the budget request. This account supports programs authorized 
by part A of Title VII of the Elementary and Secondary 
Education Act and section 215 of the Department of Education 
Organization Act.

Grants to local educational agencies

    The bill provides $96,294,000 for grants to local education 
agencies, the same as the budget request and $1,128,000 above 
the fiscal year 2005 amount. This program provides assistance 
through formula grants to school districts and schools 
supported or operated by the Bureau of Indian Affairs. The 
purpose of this program is to reform elementary and secondary 
school programs that serve Indian students, including preschool 
children. Grantees must develop a comprehensive plan and assure 
that the programs they carry out will help Indian students 
reach the same challenging standards that apply to all 
students. This program supplements the regular school program 
to help Indian children sharpen their academic skills, bolster 
their self-confidence, and participate in enrichment activities 
that would otherwise be unavailable.

Special programs for Indian children

    The Committee recommends $19,595,000 for special programs 
for Indian children, the same as fiscal year 2005 and the 
budget request. These programs make competitive awards to 
improve the quality of education for Indian students. This 
program also funds a new Indian Teacher Corps, which hopes to 
train over 1,000 Indian teachers over a five-year period to 
take positions in schools that serve concentrations of Indian 
children.

National activities

    The bill provides $4,000,000 for national activities, 
$1,129,000 below fiscal year 2005 and the same as the budget 
request. Funds under this authority support research, 
evaluation and data collection to provide information on the 
status of education for the Indian population and on the 
effectiveness of Indian education programs.

                       INNOVATION AND IMPROVEMENT

    The bill includes $708,522,000 for innovation and 
improvement programs. This amount is $384,121,000 less than the 
comparable fiscal year 2005 appropriation and $599,349,000 
below the budget request for comparable programs. This 
appropriation account includes programs authorized under part G 
of title I and portions of titles II and V of the Elementary 
and Secondary Education Act.

Troops to teachers

    The bill includes $14,793,000 for troops to teachers, the 
same as the budget request and the fiscal year 2005 level. This 
program is designed to assist eligible members of the armed 
forces to obtain certification or licensure as elementary and 
secondary school teachers, or vocational or technical teachers. 
The transition to teachers program is based on the model of the 
troops to teachers program and would address the need of high-
need school districts for highly qualified teachers.

Transition to teaching

    The bill includes $44,933,000 for transition to teaching, 
the same as the budget request and the fiscal year 2005 level. 
Transition to teaching is designed to help mitigate the 
shortage of qualified licensed or certified teachers in many of 
our Nation's schools. The program provides grants to help 
support efforts to recruit, train and place talented 
individuals into teaching positions and to support them during 
their first years in the classroom. In particular, the program 
focuses on mid-career professionals with substantial career 
experience, and recent college graduates. Grants are made on a 
competitive basis.

National writing project

    The bill provides $20,336,000 for the National Writing 
Project, the same as the fiscal year 2005 level. The 
President's budget did not request funding for this program. 
Funds are provided to the National Writing Project, a nonprofit 
educational organization that supports teacher training 
programs in the effective teaching of writing, and supports 
classroom-level research on teaching writing that documents 
effectiveness in terms of student performance. To provide these 
services, the National Writing Project contracts with numerous 
institutions of higher education and nonprofit education 
providers to operate small teacher training programs. Federal 
funds support 50 percent of the costs of these programs, and 
recipients must contribute an equal amount.

Teaching of traditional American history

    The bill includes $50,000,000 for the teaching of 
traditional American history, $69,040,000 below the budget 
request and the fiscal year 2005 level. This program supports 
competitive grants to school districts to promote the teaching 
of American history in elementary and secondary schools as a 
separate academic subject.

School leadership

    The bill includes $14,880,000 for school leadership 
activities, the same as the fiscal year 2005 level. The 
President's budget did not propose funding for this program. 
The program provides competitive grants to assist high-need 
school districts with recruiting, training, and retaining 
principals and assistant principals.

Advanced credentialing

    The bill includes $16,864,000 for advanced credentialing, 
the same as the fiscal year 2005 level and $8,864,000 above the 
budget request. The program authorizes competitive grants to 
states, school districts, the National Board for Professional 
Teaching Standards (NBPTS) working with a district or states, 
the American Board for the Certification of Teacher Excellence 
working with a district or state, or another certification or 
credentialing organization working with a district or state. 
The program supports activities to encourage and support 
teachers seeking advanced certification or credentialing.
    The Committee intends that $9,920,000 of the funds be 
awarded to the National Board for Professional Teaching 
Standards and that $6,944,000 be awarded to the American Board 
for the Certification of Teacher Excellence. The Committee 
expresses concern that the National Board for Professional 
Teaching Standards has begun to move away from its primary 
focus of improving classroom teacher quality and into other 
arenas within the education field, such as school counseling. 
The Committee encourages the Board to retain its focus on 
improving the skills and credentials of classroom teachers.

Charter schools

    The Committee recommends $216,952,000 for support of 
charter schools, $1,750,000 below the budget request and the 
same as the fiscal year 2005 amount. Charter schools are 
developed and administered by individuals or groups of 
individuals, which may include teachers, administrators, and 
parents. These groups enter into charters for operation of 
their schools, which must be granted exemptions from State and 
local rules that limit flexibility in school operation and 
management. Under this program, grants are made to State 
educational agencies in States that have charter school laws; 
the State educational agencies will in turn make sub-grants to 
authorized public chartering agencies in partnerships with 
developers of charter schools.
    The demand for enrollment in charter schools is likely to 
increase substantially as a result of the focus on school 
choice created by the No Child Left Behind Act. The Committee 
is aware that both charter schools that operate within a school 
district, as well as those that operate as a separate school 
district, have had difficulty obtaining funds on a basis equal 
to traditional school districts and public schools. In 
addition, charter schools usually do not receive funding for 
facilities equivalent to traditional school districts. The 
Committee encourages the Secretary to examine means by which 
charter schools can receive their fair share of taxpayer 
dollars, particularly where federal funds are involved.

Credit enhancement for charter school facilities

    The bill includes $36,981,000 for credit enhancement for 
charter school facilities, the same as the budget request and 
fiscal year 2005. This program helps charter schools meet their 
facility needs by providing funding on a competitive basis to 
leverage other funds and help charter schools obtain school 
facilities by means such as purchase, lease and donation. 
Charter schools are more likely than traditional schools to 
have problems obtaining adequate facilities because they are 
perceived as more financially risky than other schools, and 
unlike traditional school districts, charter schools generally 
lack the ability to issue general obligation bonds backed by 
property taxes.

Voluntary public school choice

    The bill includes $26,543,000 for voluntary public school 
choice, the same as the budget request and the fiscal year 2005 
level. This program supports efforts to establish intradistrict 
and interdistrict public school choice programs to provide 
parents with greater choice for their children's education. 
Funds are used to make competitive awards to states, school 
districts or partnerships.

Magnet schools assistance

    The bill includes $107,771,000 for the magnet schools 
assistance program, the same as the budget request and the 
fiscal year 2005 level. The magnet schools assistance program 
awards competitive grants to local educational agencies for use 
in establishing or operating magnet schools that are part of a 
desegregation plan approved by a court or by the Department of 
Education's Office for Civil Rights. A magnet school is defined 
by the statute as ``a school or education center that offers a 
special curriculum capable of attracting substantial numbers of 
students of different racial backgrounds.'' A funding priority 
is given to local educational agencies that did not receive a 
grant in the preceding fiscal year.

Fund for the improvement of education

    The bill includes $27,000,000 for the fund for the 
improvement of education, $387,079,000 below the fiscal year 
2005 level and $129,296,000 below the comparable budget 
request. The fund for the improvement of education has a broad 
portfolio of activities. Under the fund, the Secretary of 
Education supports activities that identify and disseminate 
innovative educational approaches. Several separate program 
authorities are included in this line item, including 
Foundations for Learning grants. The Committee has included 
language allowing the Secretary to use funds under FIE to carry 
out an evaluation of the DC School Choice Incentive Act of 
2003.

Teacher Incentive Fund

    The Committee has included $100,000,000 for a pilot program 
to develop and implement innovative ways to provide financial 
incentives for teachers and principals who raise student 
achievement and close the achievement gap in some of our 
Nation's highest-need schools. The President requested 
$500,000,000 for this initiative.
    The Committee intends that the Secretary use this funding 
to award competitive grants to local educational agencies 
(LEAs), including charter schools that are LEAs, States, or 
partnerships of (1) a local educational agency, a State, or 
both and (2) at least one non-profit organization to design and 
implement fair, differentiated compensation systems for public 
school teachers and principals based primarily on measures of 
gains in student achievement, in addition to other factors, for 
teachers and principals in high-need areas.
    The Committee intends that each applicant demonstrate a 
significant investment in, and ensure the sustainability of, 
its project by committing to pay for an increasing share of the 
total cost of the project, for each year of the grant, with 
State, local, or other non-Federal funds. The Committee further 
intends that the Department assess each funded project through 
an outside, independent evaluator, to inform others interested 
in implementing similar reforms. The Department may use a 
portion of the funds available for this initiative to pay the 
costs of this evaluation.

Ready To Learn Television

    The bill does not include funding for the Ready to Learn 
Television program, $23,312,000 below both the budget request 
and the fiscal year 2005 level. Ready to Learn supports the 
development and distribution of educational video programming 
for preschool children, elementary school children and their 
parents. Only public telecommunications entities are eligible 
to receive awards.

Dropout prevention programs

    The bill does not include funding for the dropout 
prevention program, the same as the budget request. This 
program was funded at $4,930,000 in fiscal year 2005. The 
dropout prevention program provides assistance to help schools 
implement effective school dropout prevention and reentry 
programs. This program has only been funded for two years, and 
has made only about two dozen awards. The Committee notes that 
districts desiring to implement dropout prevention programs can 
use funds under title I for innovative programs to support such 
efforts; hence there is no need for a separately funded line-
item to accomplish this purpose.

Ellender fellowships/Close-Up

    The bill includes $1,469,000 for Ellender fellowships, the 
same as the fiscal year 2005 level. The budget did not propose 
funding for this program. The Ellender fellowship program makes 
an award to the Close-Up Foundation of Washington D.C. This 
organization provides 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.

Advanced placement test fee program

    The Committee recommends $30,000,000 for advanced placement 
fees. This recommendation is $21,500,000 below the budget 
request and $240,000 above the fiscal year 2005 amount. The 
advanced placement test fee program awards grants to States to 
enable them to cover part or all of the cost of advanced 
placement test fees of low-income students who are enrolled in 
advanced placement classes and plan to take the advanced 
placement test. This program also supports competitive grants 
to states, school districts and national nonprofit educational 
agencies for programs that encourage greater participation by 
low-income students in advanced placement courses.

                 SAFE SCHOOLS AND CITIZENSHIP EDUCATION

    The bill includes $763,870,000 for school improvement 
programs. This amount is $96,901,000 less than the comparable 
fiscal year 2005 appropriation and $367,103,000 above the 
budget request for comparable programs. This appropriation 
account includes programs authorized under parts of titles II, 
IV, and V of the Elementary and Secondary Education Act.

Safe and drug-free schools and communities: State grants

    The Committee bill includes $400,000,000 for the State 
grants program, $400,000,000 above the budget request and 
$37,381,000 below the fiscal year 2005 level. The program 
supports State formula grants for comprehensive, integrated 
approaches to drug and violence prevention. Local educational 
agencies must use their funds to implement a drug and violence 
prevention program for students and employees.

Safe and drug-free schools and communities: National programs

    For the national programs under the Safe and Drug-Free 
Schools and Communities Act, the bill provides $152,537,000, 
the same as the fiscal year 2005 amount and $115,430,000 below 
the budget request. Under this program, the Secretary of 
Education administers a variety of activities to prevent the 
illegal use of drugs and violence among, and promote safety and 
discipline for, students at all educational levels, preschool 
through postsecondary. Within the amount provided, the 
Committee intends that the student drug testing pilot program 
be funded at a level of at least $10,000,000.

Alcohol abuse reduction

    The bill does not include funding for grants to reduce 
alcohol abuse, the same as the budget request and $32,736,000 
below the fiscal year 2005 level. This program awards 
competitive grants to districts to develop and implement 
innovative and effective programs to reduce alcohol abuse in 
secondary schools.

Mentoring programs

    The bill includes $49,307,000 for mentoring programs which 
provide competitive grants to school districts and community-
based organizations to promote mentoring programs for children 
with the greatest need. This is the same as the budget request 
and the fiscal year 2005 level.

Character education

    The bill includes $24,493,000 for character education, the 
same as the fiscal year 2005 level and the budget request. This 
program provides support for the design and implementation of 
character education programs in elementary and secondary 
schools. Grantees may select the elements of character that 
will be taught, and must consider the views of parents and 
students to be served by the program.

Elementary and secondary school counseling

    The bill includes $34,720,000 for elementary and secondary 
school counseling, the same as the fiscal year 2005 level. The 
budget did not propose funding for this program. This program 
provides grants to school districts to enable them to establish 
or expand elementary school and secondary school counseling 
programs.

Physical education for progress

    The bill includes $73,408,000 for the physical education 
for progress program, $18,408,000 above the budget request and 
the same as the fiscal year 2005 level. The Committee expects 
that funds will be used to develop programs that can provide 
information to states, school districts and other youth 
organizations on the most effective methods for encouraging all 
students--not simply those who are already participating in 
competitive sports--to develop positive attitudes about fitness 
and increased levels of personal fitness.

Civic education

    The bill includes $29,405,000 for civic education, the same 
as the fiscal year 2005 level. The budget did not propose 
funding for this program. Program funds support the ``We the 
People'' and the Cooperative Education Exchange programs. ``We 
the People'' seeks to promote civic competence and 
responsibility among students. Cooperative Education Exchange 
provides support for education exchange activities in civics 
and economics between the United States and eligible countries 
in Central and Eastern Europe, the Commonwealth of Independent 
States, any country that was formerly a republic of the Soviet 
Union, the Republic of Ireland, the province of Northern 
Ireland and developing countries with a democratic form of 
government.

State grants for incarcerated youth offenders

    The bill does not include funding for state grants for 
incarcerated youth offenders, the same as the budget request 
and $26,784,000 below the fiscal year 2005 level. This program 
makes grants to state correctional agencies to assist and 
encourage incarcerated youths to acquire functional literacy 
skills and life and job skills.

                      ENGLISH LANGUAGE ACQUISITION

    The bill includes $675,765,000 for English language 
acquisition programs. This amount is the same as the budget 
request and the comparable fiscal year 2005 appropriation 
level.
    This program provides formula grants to states to serve 
limited English proficient students. Grants are based on each 
state's share of the Nation's limited English proficient and 
recent immigrant student population. Funds under this account 
also support professional development to increase the pool of 
teachers prepared to serve limited English proficient students 
and evaluation activities.

                           SPECIAL EDUCATION

    The bill includes $11,813,783,000 for programs for children 
with disabilities authorized under the Individuals with 
Disabilities Education Act (IDEA). This funding level is 
$312,347,000 below the budget request and $140,177,000 above 
the comparable fiscal year 2005 appropriation.

State Grants: Grants to States for special education

    The bill provides $10,739,746,000 for grants to States, 
$358,000,000 below the budget request and $150,000,000 above 
the fiscal year 2005 level. Out of the total made available for 
school year 2006-2007, $5,326,746,000 is appropriated for 
fiscal year 2006 for obligation after July 1, 2006 and 
$5,413,000,000 is appropriated for fiscal year 2007 for 
obligation on, or after, October 1, 2006.
    This program provides formula grants to assist the States 
in meeting the excess costs of providing special education and 
related services to children with disabilities. In order to be 
eligible for funds, States must make free appropriate public 
education available to all children with disabilities. Funds 
are distributed based on the amount that each State received 
from the fiscal year 1999 appropriation, and the numbers of 
children in the general population and who live in poverty in 
the age range for which each State mandates free appropriate 
public education for children with disabilities.

State grants: Preschool grants

    The bill provides $384,597,000 for preschool grants, the 
same as the fiscal year 2005 level and the budget request. This 
program provides grants to States on the basis of their 
proportionate share of the total number of children in the 3 
through 5 age range and the number of these children living in 
poverty. These funds are provided in order to assist States to 
make a free appropriate public education available to all 
children with disabilities in the 3 through 5 age range.

State Grants: Grants for infants and families

    The bill provides $440,808,000 for grants for infants and 
families, the same as the fiscal year 2005 level and the budget 
request. This formula grant program assists States in 
developing and implementing statewide systems of coordinated, 
comprehensive, multidisciplinary, interagency programs to make 
available early intervention services to all children with 
disabilities, aged birth through 2, and their families.

IDEA National Activities: State improvement

    The bill includes $50,653,000 for State improvement, the 
same as the fiscal year 2005 appropriation. The budget did not 
request funding for this program. This program supports 
competitive grants to State educational agencies to assist 
them, in partnership with parents, teachers, institutions of 
higher education, interest groups, and others, to improve 
results for children with disabilities by reforming and 
improving their educational, early intervention, and 
transitional service systems. Among these systems are those for 
professional development, technical assistance, and 
dissemination of knowledge about best practices. Awards are 
based on State improvement plans developed by the States.

Special Education--Vocational Rehabilitation Transition Initiative

    The bill does not include funding for a new program 
proposed by the Administration to develop systems for using 
data on secondary, employment and postsecondary school outcomes 
for students with disabilities. The Administration requested 
$5,000,000 for this initiative.

IDEA National Activities: Technical assistance and dissemination

    The bill includes $49,397,000 for technical assistance and 
dissemination, the same as the budget request and $2,999,000 
below the fiscal year 2005 appropriation. This program provides 
technical assistance and information through competitive awards 
that support institutes, regional resource centers, 
clearinghouses, and efforts to build State and local capacity 
to make systemic changes and improve results for children with 
disabilities.

IDEA National Activities: Personnel preparation

    The bill includes $90,626,000 for personnel preparation, 
which is the same as the budget request and the fiscal year 
2005 appropriation. This program supports competitive awards to 
help address State-identified needs for qualified personnel to 
work with children with disabilities, and to ensure that those 
personnel have the skills and knowledge they need to serve 
those children. Awards focus on addressing the need for 
personnel to serve low-incidence populations and high-incidence 
populations, leadership personnel, and projects of national 
significance.

IDEA National Activities: Parent information centers

    The bill includes $25,964,000 for parent information 
centers, the same as the fiscal year 2005 level and the budget 
request. This program makes awards to parent organizations to 
support parent training and information centers, including 
community parent resource centers. These centers provide 
training and information to meet the needs of parents of 
children with disabilities living in the areas served by the 
centers, particularly underserved parents and parents of 
children who may be inappropriately identified. Technical 
assistance is also provided under this program for developing, 
assisting and coordinating centers receiving assistance under 
this program.

IDEA National Activities: Technology and media services

    The bill includes $31,992,000 for technology and media 
services, which is $6,824,000 below the fiscal year 2005 
appropriation and the same as the budget request. This program 
makes competitive awards to support the development, 
demonstration, and use of technology and educational media 
activities of educational value to children with disabilities.
    The bill includes $11,400,000 for Recording for the Blind 
and Dyslexic Inc. These funds support continued production and 
circulation of recorded textbooks, increased outreach 
activities to print-disabled students and their teachers and 
accelerated use of digital technology. The Committee believes 
that the funds recommended will enable RFB&D; to significantly 
expand its service to students with print disabilities and to 
continue the digital production and use of its extensive 
library of educational materials.
    The Committee continues to recognize the importance of very 
small businesses in increasing the quality and cost 
effectiveness of the television-captioning program. As this 
program transitions into a mandated program as authorized by 
the Telecommunications Act, the Department shall give full and 
fair consideration to the applications for very small 
businesses.

            REHABILITATION SERVICES AND DISABILITY RESEARCH

    The bill includes $3,128,638,000 for rehabilitation 
services and disability research. This amount is $69,340,000 
above the budget request and $54,064,000 above the fiscal year 
2005 appropriation. The programs in this account are authorized 
by the Rehabilitation Act of 1973, the Helen Keller National 
Center Act, and the Assistive Technology Act of 1998.

Vocational rehabilitation grants to States

    For vocational rehabilitation State grants, the bill 
includes $2,720,192,000, the same as the budget request and 
$84,347,000 above fiscal year 2005. This program supports basic 
vocational rehabilitation services through formula grants to 
the States. These grants support a wide range of services 
designed to help persons with physical and mental disabilities 
prepare for and engage in gainful employment to the extent of 
their capabilities. Emphasis is placed on providing vocational 
rehabilitation services to persons with the most significant 
disabilities.

Client assistance

    The bill includes $11,901,000 for the client assistance 
program, the same as the budget request and the fiscal year 
2005 amount. A client assistance program is required in each 
State as a condition of receipt of a basic State grant. State 
formula grants are used to help persons with disabilities 
overcome problems with the service delivery system and improve 
their understanding of services available to them under the 
Rehabilitation Act.

Training

    For training personnel to provide rehabilitation services 
to persons with disabilities, the bill includes $38,826,000, 
the same as the budget request and the fiscal year 2005 amount. 
The program supports long-term and short-term training, in-
service personnel training, and training of interpreters for 
deaf persons. Projects in a broad array of disciplines are 
funded to ensure that skilled personnel are available to serve 
the vocational needs of persons with disabilities.

Demonstration and training programs

    The bill includes $6,577,000 for demonstration and training 
programs, the same as the budget request and $19,030,000 below 
the fiscal year 2005 level. These programs authorize 
discretionary awards on a competitive basis to public and 
private organizations to support demonstrations, direct 
services, and related activities for persons with disabilities.

Migrant and seasonal farmworkers

    For programs serving migrant and seasonal farmworkers, the 
bill provides $2,302,000, which is the same as the fiscal year 
2005 amount and $2,302,000 above the budget request. This 
program provides discretionary grants to make comprehensive 
vocational rehabilitation services available to migrant and 
seasonal farmworkers with vocational disabilities. Projects 
emphasize outreach activities, specialized bilingual 
rehabilitation counseling, and coordination of vocational 
rehabilitation services with services from other sources.

Recreational programs

    For recreational programs, the bill provides $2,543,000, 
the same as the fiscal year 2005 amount and $2,543,000 above 
the budget request. This program provides individuals with 
recreation and related activities to aid in their employment, 
mobility, independence, socialization, and community 
integration. Discretionary grants are made on a competitive 
basis to States, public agencies, and nonprofit private 
organizations, including institutions of higher education.

Protection and advocacy of individual rights

    For protection and advocacy for persons with disabilities, 
the bill provides $16,656,000, the same as the budget request 
and the fiscal year 2005 level. Grants are awarded to entities 
that have the authority to pursue legal, administrative, and 
other appropriate remedies needed to protect and advocate the 
rights of persons with disabilities.
    The Committee notes that returning military personnel who 
have sustained disabilities in the course of active service 
often encounter barriers that impede their ability to reenter 
civilian life. The Committee further notes that families of 
active duty service members that include children and other 
members with disabilities face many stresses and need 
assistance with accessing appropriate educational as well as 
health and other support services, such as respite care. The 
Committee urges the Secretary to provide outreach and advocacy 
services that supplement services and supports provided by the 
Veteran's Administration and other veteran and military family 
organizations.

Projects with industry

    For projects with industry, the bill provides $19,735,000, 
$1,890,000 below the fiscal year 2005 amount and $19,735,000 
above the budget request. This program is the primary Federal 
vehicle for promoting greater participation of business and 
industry in the rehabilitation process. The program provides 
training and experience in realistic work settings to persons 
with disabilities to prepare them for employment in the 
competitive labor market. Awards are made to a variety of 
agencies and organizations, including business and industrial 
corporations, rehabilitation facilities, labor organizations, 
trade associations, and foundations.

Supported employment State grants

    For supported employment State grants, the bill includes 
$30,000,000, which is $7,379,000 below the fiscal year 2005 
amount and $30,000,000 above the budget request. These formula 
grants assist States in developing collaborative programs with 
public agencies and nonprofit agencies for training and post-
employment services leading to supported employment. In 
supported employment programs, persons with significant 
disabilities are given special supervision and assistance to 
enable them to work in an integrated setting.

Independent living: State grants

    For State grants for independent living, the bill includes 
$22,816,000. This amount is the same as the budget request and 
the fiscal year 2005 level. This program supports formula 
grants to the States to provide services for independent living 
for persons with significant disabilities.

Independent living: Centers

    For centers for independent living, the bill provides 
$75,392,000, which is the same as the budget request and the 
fiscal year 2005 level. Discretionary grants support a network 
of consumer-controlled, nonresidential, community-based private 
nonprofit centers that provide a wide range of services to help 
persons with significant disabilities live more independently 
in family and community settings. Centers provide information 
and referral services, independent living skills training, peer 
counseling, and individual and systems advocacy. Discretionary 
grants are made to private nonprofit organizations.

Independent living: Services for older blind persons

    For independent living services for older blind 
individuals, the bill provides $33,227,000. This amount is the 
same as the fiscal year 2005 amount and the budget request. 
Discretionary grants support services for persons 55 years old 
or over whose severe visual impairment makes gainful employment 
extremely difficult to obtain, but for whom independent living 
goals are feasible.

Program improvement

    For program improvement activities, the bill provides 
$843,000, which is the same as the fiscal year 2005 level and 
the same as the budget request. The program: (1) provides 
technical assistance and consultative services to public and 
non-profit private agencies and organizations; (2) provides 
short-term training and technical instruction; (3) conducts 
special demonstrations; (4) collects, prepares, publishes and 
disseminates educational or informational materials; and (5) 
carries out monitoring and conducts evaluations.

Evaluation

    The bill includes $1,488,000 for program evaluation, the 
same as the budget request and the fiscal year 2005 level. 
These funds are used to evaluate the impact and effectiveness 
of individual programs authorized under the Rehabilitation Act. 
Contracts are awarded on an annual basis for studies to be 
conducted by persons not immediately involved in the 
administration of the programs authorized by the Act.

Helen Keller National Center

    For the Helen Keller National Center for Deaf-Blind Youth 
and Adults, the bill includes $8,597,000, $1,984,000 below the 
comparable fiscal year 2005 amount and the same as the budget 
request. These funds are used for the operation of the national 
center for intensive services for deaf-blind individuals and 
their families at Sands Point, New York and a network of 10 
regional offices for referral and counseling and technical 
assistance.

National Institute on Disability and Rehabilitation Research

    The bill includes $107,783,000 for the National Institute 
on Disability and Rehabilitation Research, the same as the 
budget request and the fiscal year 2005 level. The Institute 
supports research, demonstration and training activities that 
are designed to maximize the employment and integration into 
society of individuals with disabilities of all ages.

Assistive technology

    For assistive technology activities, the bill provides 
$29,760,000, the same as the fiscal year 2005 amount and 
$14,760,000 above the budget request. Technology assistance 
activities are authorized under the Assistive Technology Act of 
1998. This Act authorizes the following activities: 
discretionary grants to the States to assist them in developing 
statewide programs to facilitate the provision of devices for, 
and services to, persons with disabilities; protection and 
advocacy services related to assistive technology; 
discretionary grants to the states for alternative financing 
programs; and technical assistance activities.

           Special Institutions for Persons With Disabilities


                 AMERICAN PRINTING HOUSE FOR THE BLIND

    The bill provides $17,000,000 for the American Printing 
House for the Blind, an increase of $136,000 above the fiscal 
year 2005 appropriation and the budget request. This 
appropriation subsidizes the production of educational 
materials for legally blind persons enrolled in pre-college 
programs. The Printing House, which is chartered by the State 
of Kentucky, manufactures and maintains an inventory of special 
materials that is distributed free of charge to schools and 
States based on the number of blind students in each State. The 
Printing House also conducts research and field activities to 
inform educators about the availability of materials and how to 
use them.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

    The bill provides $56,137,000 for the National Technical 
Institute for the Deaf (NTID), an increase of $793,000 above 
the comparable fiscal year 2005 amount and $1,665,000 above the 
request. Within the total, $800,000 is specified for 
construction. The NTID was established by Congress in 1965 to 
provide a residential facility for postsecondary technical 
training and education for deaf persons with the purpose of 
promoting the employment of deaf individuals. The Institute 
also conducts applied research and provides training in various 
aspects of deafness. The Secretary of Education administers 
these activities through a contract with the Rochester 
Institute of Technology in Rochester, New York.

                          GALLAUDET UNIVERSITY

    The bill provides $107,657,000 for Gallaudet University, an 
increase of $3,100,000 above the fiscal year 2005 appropriation 
and the budget request. Gallaudet is a private, non-profit 
educational institution Federally-chartered in 1864 providing 
elementary, secondary, undergraduate, and continuing education 
for deaf persons. In addition, the University offers graduate 
programs in fields related to deafness for deaf and hearing 
students, conducts various research on deafness, and provides 
public service programs for deaf persons.

                     VOCATIONAL AND ADULT EDUCATION

    The bill includes $1,991,782,000 for vocational and adult 
education programs. This amount is $19,166,000 below the fiscal 
year 2005 appropriation and $1,776,048,000 above the budget 
request. This appropriation account includes vocational 
education programs authorized by the Carl D. Perkins Vocational 
and Applied Technology Education Act. The account also includes 
adult education programs originally authorized by the Adult 
Education Act and reauthorized under the Workforce Investment 
Act of 1998.

Vocational education basic grants

    This bill includes $1,194,331,000 for basic grants to 
States under the Carl D. Perkins Vocational and Technical 
Education Act of 1998, which is the same as the fiscal year 
2005 amount. The budget request proposed elimination of this 
program and moved the funds into the high school reform 
proposal. Out of the total for basic grants to States made 
available for school year 2004-2005, $403,331,000 is 
appropriated for fiscal year 2006 for obligation after July 1, 
2006 and $791,000,000 is appropriated for fiscal year 2007 for 
obligation on, or after, October 1, 2006.
    State grants support a variety of vocational education 
programs developed in accordance with the State plan. The Act 
concentrates federal resources on institutions with high 
concentrations of low-income students. The populations assisted 
by Basic Grants range from secondary students in pre-vocational 
courses to adults who need retraining to adapt to changing 
technological and labor markets.
    The Committee is concerned with instances where State 
agencies are not adequately communicating about the needs and 
supports for students with disabilities, especially those 
student with disabilities who participate in vocational and 
technical education curriculums housed either on-site at the 
local education agency (LEA) or at a career and technology 
center (CTC) apart from the LEA. State Educational Agencies 
have an obligation under the Individuals with Disabilities 
Education Act to ensure that all students with disabilities 
receive a free appropriate public education in the least 
restrictive environment. The Committee strongly encourages 
States to improve collaboration between State agencies and 
programs to ensure that appropriate resources are provided to 
ensure that all students are able to participate appropriately 
in vocational and technical education programs.

Tech-prep

    The bill includes $105,812,000 for tech-prep, the same as 
fiscal year 2005. The budget request did not propose separate 
line item funding for this program. This appropriation includes 
activities under title II of the Carl D. Perkins Vocational and 
Technical Education Act of 1998. The tech-prep education 
program provides planning and demonstration grants to consortia 
of local educational agencies and postsecondary institutions to 
develop and operate model technical education programs. These 
programs begin in high school and provide students with the 
mathematical, science, communications and technological skills 
needed to enter a 2-year associate degree or 2-year certificate 
program in a given occupational field, and to make a successful 
transition into further postsecondary education or begin their 
careers. The purpose of tech-prep is to develop structural 
links between secondary and postsecondary institutions that 
integrate academic and vocational education and better prepares 
students to make the transition from school to careers.

National programs

    For national programs, the Committee provides $11,757,000, 
which is the same as the fiscal year 2005 amount. The budget 
did not request separate funding for this program. This 
authority supports the conduct and dissemination of research in 
vocational education, and includes support for the National 
Centers for Research and Dissemination in Career and Technical 
Education, five regional curriculum coordination centers, and 
other discretionary research.

Tech-Prep Education Demonstration

    The bill does not include funding for the Tech-Prep 
Education Demonstration. The President's budget did not request 
funding for it. Last year this program was funded at 
$4,899,000. The program makes competitive grants to consortia 
to establish Tech-prep programs in secondary schools located on 
the sites of community colleges.

Occupational and Employment Information Program

    The bill does not include funding for the Occupational and 
Employment Information Program. The President's budget did not 
request funding for it. Last year this program was funded at 
$9,307,000. The program provides career information and 
guidance services to students and adults through a network of 
state agencies.

State programs for adult education

    For state grants, the Committee recommends $569,672,000, 
which is the same as the fiscal year 2005 amount, and 
$369,672,000 above the comparable budget request. State formula 
grants support programs to enable all 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.
    Grants are provided on a formula basis to States under the 
new Adult Education and Family Literacy Act. The formula 
provides an initial allotment of $25,000 for each state and 
$100,000 to each outlying area, with additional allotments 
distributed on the basis of population aged 16 through 60 who 
are without a high school diploma or equivalent who are not 
enrolled in secondary school.
    States may use 12.5 percent of their allotments for state 
leadership activities and may use an additional 5 percent or 
$65,000 for state administration. States and localities must 
give priority to adult education and literacy activities that 
are built on a strong foundation of research on effective 
practices and that effectively employ technology. Funds are 
provided on a forward-funded basis.
    The Committee notes that over 40 percent of new adult 
education entrants are seeking English as-a-second language 
(ESL) services and that ESL accounts for 51 percent of all 
adults receiving adult education services and 76 percent of the 
hours of instruction received. The Committee expects that the 
funds provided in this program will be used by states with 
large concentrations of students who seek English language 
proficiency training to meet the needs of those individuals. 
The Committee bill retains language similar to that contained 
in last year's bill that guarantees a portion of the funds will 
be used to provide civics education services to new immigrants.

National Programs--National Leadership Activities

    The Committee provides $9,096,000 for national leadership 
activities. This amount is the same as the fiscal year 2005 
level and the budget request. Through applied research, 
development, dissemination, evaluation, and program improvement 
activities, this program assists State efforts to improve the 
quality of adult education. The funds support such projects as 
evaluations on the status and effectiveness of adult education 
programs, national and international adult literacy surveys, 
and technical assistance on using technology to improve 
instruction and administration that show promise of 
contributing to the improvement and expansion of adult 
education.

National Institute for Literacy

    For the National Institute for Literacy, the bill provides 
$6,638,000, which is the same as the fiscal year 2005 amount 
and the budget request. The Institute supports research and 
development projects, tracks progress made toward national 
literacy goals, supports research fellowships, disseminates 
information through a national clearinghouse, and coordinates 
literacy information data from national and State sources.

Smaller learning communities

    The bill includes $94,476,000 for the smaller learning 
program, the same as the fiscal year 2005 level. The 
Administration did not request funding for this program. As in 
past years, the bill specifies that these funds shall be used 
only for activities related to the redesign of large high 
schools enrolling 1,000 or more students.

Community technology centers

    The bill does not include funding for community technology 
centers, $4,960,000 below the fiscal year 2005 level and the 
same as the request. The program provides competitive grants to 
create and expand community technology centers that offer 
disadvantaged residents of economically distressed urban and 
rural communities access to information technology and related 
training. Other Federal programs also exist that fund 
communities that want to establish and operate technology 
centers.

                      STUDENT FINANCIAL ASSISTANCE

    The bill provides $15,283,752,000 for student financial 
assistance programs, an increase of $1,018,003,000 over the 
comparable fiscal year 2005 appropriation and $232,775,000 
above the budget request.

Pell grants

    The bill increases the maximum Pell Grant to $4,100, $50 
below the budget request and $50 above the fiscal year 2005 
amount. The bill provides $13,383,000,000 in new budget 
authority for the Pell Grant program, $184,000,000 above the 
request and $1,018,003,000 above the comparable fiscal year 
2005 amount. Pell Grants provide portable education vouchers to 
postsecondary students who may use them at any of over 6,000 
eligible schools. The bill does not include funding for 
enhanced Pell grants for state scholars, which the 
administration requested at $33,000,000. The Committee notes 
that this program has not been authorized.

Federal Supplemental Educational Opportunity Grants

    The bill provides $778,720,000 for federal supplemental 
educational opportunity grants, the same as the request and the 
fiscal year 2005 level. The SEOG program provides grants 
through postsecondary institutions to qualified students who 
demonstrate exceptional financial need. Institutions have broad 
flexibility within the eligibility criteria for awarding these 
grants with the exception that priority must be given to Pell 
Grant recipients.

Work-study

    The bill provides $990,257,000 for the work-study program, 
the same as the comparable fiscal year 2005 appropriation and 
the budget request. Funding for this program is provided 
through institutions to students who work part-time to meet the 
cost of education. Institutions receive funding according to a 
statutory formula and may allocate it for job location and job 
development centers.

Perkins loans cancellations

    The bill provides $66,132,000 for federal Perkins loans 
cancellations, $66,132,000 above the budget request and the 
same as the fiscal year 2005 amount. The Federal Government 
reimburses institutional Perkins revolving loan funds for loan 
cancellations permitted under Federal law. Loans may be 
canceled when the borrower pursues a career in one of 12 
statutorily-designated professions including corrections, 
medical technical work, and peace corps or VISTA service.

Leveraging educational assistance partnership

    The bill includes $65,643,000 for the leveraging 
educational assistance partnership (LEAP) program, the same as 
the fiscal year 2005 level and $65,643,000 above the budget 
request. LEAP provides dollar-for-dollar matching funds to 
States as an incentive for providing need-based grant and work 
study assistance to eligible postsecondary students. Federally 
supported grants and job earnings are limited to $5,000 per 
award year for full-time students. By law, each State's 
allocation is based on its relative share of the total national 
population of students eligible to participate in the programs, 
except that no state is to receive less than it received in 
1979. If LEAP amounts are below this level, each State is 
allocated an amount proportional to the amount of funds it 
received in 1979. If a state does not use all of its 
allocation, the excess funds are distributed to other States in 
the same proportion as the original distribution. States must, 
at a minimum, match LEAP grants dollar for dollar with state 
funds provided through direct state appropriations for this 
purpose.

                       STUDENT AID ADMINISTRATION

    The bill includes $124,084,000 in discretionary resources 
for the Student Aid Administration account. The Committee 
recommendation is $5,000,000 more than the comparable fiscal 
year 2005 funding level and $20,201,000 below the request, when 
adjusted for discretionary-scored spending. Funds appropriated 
to the Student Aid Administration account, in addition to 
mandatory funding available through Section 458 of the Higher 
Education Act, will support the Department's student aid 
management expenses. The Federal Student Aid Office and the 
Office of Postsecondary Education have primary responsibility 
for administering Federal student financial assistance 
programs. The Committee bill does not include the 
Administration's legislative proposal to fund this new account 
solely through annual appropriations.

                     LOANS FOR SHORT-TERM TRAINING

    The bill does not include a new program to provide loans 
for short-term training proposed for funding by the 
Administration at $11,000,000. This program would help 
dislocated, unemployed, transitioning or older workers and 
students acquire or upgrade specific job-related skills through 
short-term training programs of less than 10 weeks. The 
Committee notes that this program is not authorized.

                            HIGHER EDUCATION

    The bill provides $1,936,936,000 for higher education 
programs, a decrease of $179,762,000 below the fiscal year 2005 
appropriation and $734,621,000 above the budget request.

Strengthening institutions

    The bill provides $80,338,000 for the regular strengthening 
institutions program, the same as the budget request and the 
fiscal year 2005 level. This program provides general operating 
subsidies to institutions with low average educational and 
general expenditures per student and significant percentages of 
low-income students. Awards may be used for faculty and 
academic program development, management, joint use of 
libraries and laboratories, acquisition of equipment, and 
student services.

Hispanic-serving institutions

    The bill provides $95,873,000 for the Hispanic-serving 
institutions program, the same as the budget request and 
$767,000 above the fiscal year 2005 level. The HSI program 
provides operating subsidies to schools that serve at least 25 
percent Hispanic students of whom at least half are low-income 
students.
    Despite the gains by Hispanics in higher education, 
including a 300 percent increase over the past 25 years in the 
enrollment of Hispanic-Americans at degree-granting 
institutions of higher education, the Committee is concerned 
that Hispanics continue to lag behind their non-Hispanic peers 
in overall education achievement. In 2001, only 21.7 percent of 
all Hispanics in the age group 18-24 years were enrolled in 
degree-granting institutions, versus 39.3 percent of all non-
Hispanic white students. In 2001-2002, Hispanics earned only 
6.4 percent of the bachelor's degrees, 4.6 percent of the 
master's degrees, and 3.2 percent of the PhDs awarded in the 
U.S. despite the fact that Hispanics comprise over 13 percent 
of the population. The Committee supports legislative efforts 
in the reauthorization of the Higher Education Act to expand 
graduate opportunities for Hispanic-serving institutions and 
encourages the Department to submit a budget request for 
graduate programs for HSIs in the event that such a program 
expanding graduate opportunities is authorized.

Strengthening historically black colleges and universities

    The bill provides $240,500,000 for strengthening 
historically black colleges and universities (HBCUs), 
$1,924,000 above the fiscal year 2005 appropriation and the 
same as the budget request.
    This program provides operating subsidies to accredited, 
legally authorized HBCUs established prior to 1964 whose 
principal mission is the education of black Americans. Funds 
may be used to support both programs and management and are 
distributed through a formula grant based on the enrollment of 
Pell Grant recipients, number of graduates, and the number of 
graduates entering graduate or professional schools in which 
blacks are underrepresented. The minimum grant is $500,000.

Strengthening historically black graduate institutions

    The bill provides $58,500,000 for the strengthening 
historically black graduate institutions program, the same as 
the budget request and $468,000 above the fiscal year 2005 
appropriation.
    The program provides 5-year grants to the following 18 
post-secondary institutions that are specified in section 
326(e)(1) of the Higher Education Act: Morehouse School of 
Medicine, Meharry Medical School, Charles R. Drew Postgraduate 
Medical School, Clark-Atlanta University, Tuskegee University 
School of Veterinary Medicine, Xavier University School of 
Pharmacy, Southern University School of Law, Texas Southern 
University Schools of Law and Pharmacy, Florida A&M; University 
School of Pharmaceutical Sciences, North Carolina Central 
University School of Law, Morgan State University qualified 
graduate program, Hampton University qualified graduate 
program, Alabama A&M; qualified graduate program, North Carolina 
A&T; State University qualified graduate program, University of 
Maryland Eastern Shore qualified graduate program, Jackson 
State qualified graduate program, Norfolk State University and 
Tennessee State University. Of the amount appropriated, the 
first $26,600,000 is used to make grants to the first 16 
institutions listed above. Any amount appropriated in excess of 
$26,600,000 but less than $28,600,000 is used to make grants to 
Norfolk State University and Tennessee State University and any 
remaining appropriation is made available to each of the 18 
institutions based on a formula. Awards may be used for 
building endowments as well as the same purposes for which the 
strengthening HBCU grants may be used.

Strengthening Alaska Native and Native Hawaiian-serving institutions

    The Committee recommends $6,500,000 for strengthening 
Alaska Native and Native Hawaiian-serving institutions, 
$5,404,000 below the fiscal year 2005 level and the same as the 
budget request.

Strengthening tribally controlled colleges and universities

    The Committee recommends $23,808,000 for the strengthening 
tribally controlled colleges and universities program, the same 
as the budget request and the fiscal year 2005 level.

International education and foreign languages studies

            Domestic programs
    The bill provides $92,466,000 for the domestic activities 
of the international education and foreign languages studies 
programs, the same as the fiscal year 2005 appropriation and 
the budget request. The program assists graduate and 
undergraduate foreign language and area studies programs and 
students at institutions of postsecondary education. Programs 
include national resource centers, foreign language and area 
studies fellowships, undergraduate international studies and 
foreign language programs, international research and studies 
projects, business and international education projects, 
international business education centers, language resource 
centers, American overseas research centers, and technological 
innovation and cooperation for foreign information access. In 
general, the Secretary has discretion to allocate funding among 
these various activities.
            Overseas programs
    The bill provides $12,737,000 for the overseas programs in 
international education and foreign language studies authorized 
under the Mutual Educational and Cultural Exchange Act of 1961, 
popularly known as the Fulbright-Hays Act. The appropriation is 
the same as the budget request and the fiscal year 2005 
appropriation. Funding for these programs support group 
projects abroad, faculty research abroad, special bilateral 
projects, and doctoral dissertation research abroad.

Institute for International Public Policy

    The bill provides $1,616,000 for the Institute for 
International Public Policy, the same as the budget request and 
the fiscal year 2005 appropriation. This program provides a 
grant to an eligible recipient to operate the Institute through 
sub-grantees chosen among minority serving institutions.

Fund for the improvement of postsecondary education

    The Committee recommends $49,211,000 for the fund for the 
improvement of postsecondary education (FIPSE), $27,000,000 
above the budget request and $112,897,000 below the fiscal year 
2005 amount. FIPSE awards grants and contracts to a variety of 
postsecondary institutions and other organizations to improve 
the quality and delivery of postsecondary education.

Minority science and engineering improvement

    The bill provides $8,818,000 for the minority science and 
engineering improvement program (MSEIP), the same as the fiscal 
year 2005 appropriation and the budget request.
    The MSEIP program awards grants to improve mathematics, 
science, and engineering programs at institutions serving 
primarily minority students and to increase the number of 
minority students who pursue advanced degrees and careers in 
those fields.

Interest subsidy grants

    The bill does not include funding for interest subsidy 
grants authorized under section 121 of the Higher Education 
Act, the same amount requested in the budget and $1,488,000 
below the fiscal year 2005 appropriation. This program provides 
loan subsidies to higher education institutions for facilities 
acquisition, construction and renovation loans taken prior to 
1974. All loans will terminate by the fiscal year 2013. The 
authority to initiate new loan subsidy commitments was repealed 
in the 1992 amendments to the Higher Education Act.

Tribally controlled postsecondary vocational and technical institutions

    The bill includes $7,440,000 for grants for tribally 
controlled postsecondary vocational and technical institutions, 
the same as the budget request and the fiscal year 2005 amount. 
This program provides grants for the operation and improvement 
of training programs to ensure continuation and expansion of 
vocational training opportunities for Indian youth.

TRIO

    The bill provides $836,543,000 for the TRIO programs, 
$467,153,000 above the budget request and the same as the 
fiscal year 2005 appropriation. The TRIO programs provide a 
variety of outreach and support services to encourage low-
income, potential first-generation college students to enter 
and complete college. Discretionary grants of up to four or 
five years are awarded competitively to institutions of higher 
education and other agencies. At least two-thirds of the 
eligible participants in TRIO must be low-income, first-
generation college students.

GEAR UP

    The bill includes $306,488,000 for the GEAR UP program, the 
same as last year's level and $306,488,000 above the budget 
request. GEAR UP provides grants to states and partnerships of 
low-income middle and high schools, institutions of higher 
education and community organizations to target entire grades 
of students and give them the skills and encouragement to 
successfully pursue postsecondary education.

Byrd scholarships

    The bill does not include funding for the Byrd scholarships 
program, the same as the budget request and $40,672,000 below 
the fiscal year 2005 appropriation. The Byrd scholarship 
program provides formula grants to States to award $1,500 
scholarships to students who demonstrate academic excellence in 
high school.

Javits fellowships

    The Committee recommends $9,797,000 for the Javits 
fellowship program, the same as the budget request and the 
fiscal year 2005 appropriation. Under the Javits program, 
institutions receive Federal support to make fellowship awards 
to students pursuing doctoral study in the arts, humanities, 
and social sciences.

Graduate assistance in areas of national need program

    The Committee recommends $30,371,000 for the graduate 
assistance in areas of national need (GAANN) program, the same 
as the budget request and the fiscal year 2005 appropriation. 
The GAANN program awards grants to institutions of higher 
education to provide fellowships to economically disadvantaged 
students who have demonstrated academic excellence and who are 
pursuing graduate education in designated areas of national 
need.

Teacher quality enhancement grants

    The Committee recommends $58,000,000 for teacher quality 
enhancement grants, $58,000,000 above the budget request and 
$10,337,000 below the fiscal year 2005 appropriation. Teacher 
quality enhancement grants have three components: state grants, 
partnership grants and recruitment grants. By statute, state 
and partnership grants each receive 45 percent of the 
appropriation, and recruitment grants receive 10 percent.
    Under the state grant component, states apply to receive up 
to three years of funding to improve the quality of their 
teaching force through promoting reform activities such as 
teacher licensing and certification, accountability for high 
quality teacher preparation and professional development and 
recruiting teachers for high-need schools. States must match 50 
percent of the federal award.
    Under the partnership component, partnerships apply to 
receive a five-year grant to strengthen the capacity of K-12 
educators in designing and implementing effective teacher 
education programs, and by increasing collaboration among these 
practitioners and departments of arts and sciences and schools 
of education at institutions of higher education. Partnerships 
must match 25 percent of the federal grant in the first year, 
35 percent in the second year, and 50 percent for the remaining 
years.
    The recruitment component supports the efforts to reduce 
shortages of qualified teachers in high-need school districts. 
States or partnerships may apply to receive these grants.
    The Committee believes that colleges of education play a 
key role in improving teacher quality. The Committee urges 
colleges receiving teacher quality enhancement grants to 
consider the recommendations made by the Teaching Commission, 
including recruiting stronger students from all major fields of 
study, requiring education majors to receive at least a minor 
in an academic subject in addition to education, using 
research-based practices and pedagogy and offering 
opportunities to learn and observe in a real world setting.

Child care access means parents in school

    The Committee recommends $15,970,000 for child care access 
means parents in school program, the same as the budget request 
and the fiscal year 2005 appropriation. Under this program, 
institutions may receive discretionary grants of up to four 
years to support or establish a campus-based childcare program 
primarily serving the needs of low-income students enrolled at 
the institution. Priority is given to childcare programs that 
leverage significant local or institutional resources and 
utilize a sliding fee scale. Grants can only be used to 
supplement childcare services or start new programs.

Community college access

    The bill does not include funding for a proposed community 
college access program, which was requested by the 
Administration at $125,000,000. This program would support 
competitive awards to States providing dual-enrollment programs 
through which high school students take college-level courses 
through community colleges and receive both high school and 
postsecondary credit. The Committee notes that this program has 
not been authorized.

Demonstration projects to ensure quality higher education for students 
        with disabilities

    The Committee does not recommend funding for demonstration 
projects in disabilities, the same as the budget request. The 
program was funded at $6,944,000 in fiscal year 2005.
    This program provides discretionary grants for three years 
to support model demonstration projects that provide technical 
assistance and professional development activities for faculty 
and administrators in institutions of higher education in order 
to provide students with disabilities a high-quality 
postsecondary education. A number of models have now been 
developed and are being disseminated to other institutions.

Underground railroad program

    The Committee does not recommend funding for the 
underground railroad program, which is the same as the budget 
request. This program was funded at $2,204,000 in fiscal year 
2005. The underground railroad program provides grants to non-
profit institutions to research, display, interpret and collect 
artifacts relating to the history of the underground railroad.

GPRA data/HEA program evaluation

    The Committee recommends $980,000 for program evaluation 
and development of data required under the Government 
Performance and Results Act for Higher Education programs 
administered by the Department. This is the same as the fiscal 
year 2005 appropriation and the budget request.
    The Committee understands that for many higher education 
programs, baseline and performance indicator data are sparse, 
nonexistent or difficult to collect. Funding under this 
activity will support the Department in developing high-quality 
data as required under the Government Performance and Results 
Act.

Olympic Scholarships

    The bill includes $980,000 for Olympic Scholarships, the 
same as the fiscal year 2005 level. The budget did not request 
funding for this program. This program provides financial 
assistance to athletes who are training at the U.S. Olympic 
Education Center or one of the U.S. Olympic Training Centers 
and who are pursuing a postsecondary education at an 
institution of higher education.

Thurgood Marshall legal education opportunity program

    The bill does not include funding for the Thurgood Marshall 
legal education opportunity program, the same as the budget 
request. The program was funded at $2,976,000 in fiscal year 
2005. This program provides low-income, minority and 
disadvantaged college students with the information, 
preparation and financial assistance needed to gain access to 
and complete law school study.

                           HOWARD UNIVERSITY

    The bill provides $240,790,000 for Howard University, 
$2,000,000 above the budget request and the fiscal year 2005 
appropriation. The bill includes a minimum of $3,524,000 for 
the endowment, which is the same as the current level.
    Howard University is a ``Research I'' university located in 
the District of Columbia. Direct appropriations for Howard 
University are authorized by 20 U.S.C. 123, originally enacted 
in 1867. Howard University provides undergraduate liberal arts, 
graduate and professional instruction to approximately 11,000 
students from all 50 States. Masters degrees are offered in 
over 55 fields and Doctor of Philosophy degrees in 26 fields.

         COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

    The bill provides $573,000 for the Federal administration 
of the college housing and academic facilities loan (CHAFL) 
program, the Higher Educational Facilities Loans program and 
the College Housing Loans program, the same as the budget 
request and the fiscal year 2005 appropriation.

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL AND FINANCING PROGRAM

Federal administration

    The bill provides $210,000 for the administration of the 
historically black college and university capital financing 
program authorized under part D of title III of the Higher 
Education Act, the same as the fiscal year 2005 appropriation 
and the same as the budget request. The program is intended to 
make capital available for repair and renovation of facilities 
at historically black colleges and universities. In exceptional 
circumstances, capital provided under the program can be used 
for construction or acquisition of facilities.

Bond subsidies

    Under the HBCU capital program, a private, for-profit 
``designated bonding authority'' issues construction bonds to 
raise capital for loans to historically black colleges and 
universities for construction projects. The Department provides 
insurance for these bonds, guaranteeing full payment of 
principal and interest to bond holders. Federally insured bonds 
and unpaid interest are limited by statute to $375,000,000. The 
letter of credit limitation establishes the total amount of 
bonds which can be issued by the designated bonding authority. 
The credit limitation must be explicitly stated in an 
appropriation Act according to the authorizing legislation.

                    INSTITUTE OF EDUCATION SCIENCES

    The bill includes $522,696,000 for the Institute of 
Education Sciences. This amount is $43,632,000 above the budget 
request, and $538,000 below the fiscal year 2005 level. This 
account supports education research, statistics, and assessment 
activities.

Research

    This bill includes $164,194,000 for educational research, 
the same as the fiscal year 2005 level and the budget request. 
The Institute of Education Sciences supports research, 
development and national dissemination activities that are 
aimed at expanding fundamental knowledge of education and 
promoting the use of research and development findings in the 
design of efforts to improve education.

Statistics

    This bill includes $90,931,000 for the activities of the 
National Center for Education Statistics, exclusive of the 
National Assessment of Educational Progress. This amount is the 
same as the budget request and the fiscal year 2005 level.
    Statistics activities are authorized under the Education 
Sciences Reform Act of 2002, title I of P.L. 107-279. The 
Center collects, analyzes, and reports statistics on all levels 
of education in the United States. Activities are carried out 
directly and through grants and contracts. Major publications 
include ``The Condition of Education'' and ``Digest of 
Education Statistics.'' Other products include projections of 
enrollments, teacher supply and demand, and educational 
expenditures. Technical assistance to state and local education 
agencies and postsecondary institutions is provided. 
International comparisons are authorized.

Regional educational laboratories

    The Committee has included $66,132,000 for the regional 
educational laboratories. This amount is the same as the fiscal 
year 2005 level. The budget request did not include funding for 
this program. The Committee believes that the regional 
educational laboratories can play a key role in supporting the 
achievement of all children by focusing and aligning their work 
to help states and education practitioners implement the 
requirements contained in the No Child Left Behind Act (NCLB). 
This assistance should include product development, applied 
research, technical assistance and professional development. 
The Committee intends that each regional educational laboratory 
identify priority NCLB issues in their designated region and 
provide assistance with the implementation of NCLB. Particular 
focus should be placed on helping states and schools implement 
the provisions contained in the Highly Qualified Teacher 
regulations.

IDEA National Activities: Research and innovation

    The bill includes $72,566,000 for research and innovation, 
$10,538,000 below the fiscal year 2005 level and the same as 
the budget request. This program supports competitive awards to 
produce and advance the use of knowledge to improve services 
and results for children with disabilities. The program focuses 
on producing new knowledge, integrating research and practice 
and improving the use of knowledge.

Special education studies and evaluations

    The bill includes $10,000,000 for special education studies 
and evaluations, the same as the budget request and $6,000,000 
below the comparable fiscal year 2005 level. This program 
awards competitive grants, contracts and cooperative agreements 
to assess the implementation of the Individuals with 
Disabilities Education Act and the effectiveness of State and 
local efforts to provide special education and early 
intervention programs and services to infants, toddlers, and 
children with disabilities. Funding for this activity was 
previously supported through funds set aside under the special 
education grants to states program.

Statewide data systems

    The bill includes $24,800,000 for statewide data systems 
development, the same as the budget request and the fiscal year 
2005 level. This program awards grants, on a competitive basis, 
to State educational agencies to enable such agencies to 
design, develop, and implement statewide, longitudinal data 
systems to efficiently and accurately manage, analyze, 
disaggregate, and use individual student data, consistent with 
the No Child Left Behind Act.
    The Committee supports the design, development and 
implementation of longitudinal data systems that will enable 
States to use data to close achievement gaps. The Committee 
notes that much of this data is already being collected and is 
available for free on various websites, such as 
www.schoolmatters.com, and the Committee encourages the 
Department, states, school districts, researchers and the 
public to make use of available data to improve education and 
management of taxpayer resources.

Assessment

    This bill includes $94,073,000 for the National Assessment 
of Educational Progress, $22,500,000 below the budget request, 
and the same as the fiscal year 2005 level. The Assessment is 
authorized under section 303 of the National Assessment of 
Educational Progress Authorization Act, and is the only 
nationally representative survey of educational ability and 
achievement of American students. The primary goal of the 
Assessment is to determine and report the status and trends of 
the knowledge and skills of students, subject by subject. 
Subject areas assessed in the past have included reading, 
writing, mathematics, science, and history, as well as 
citizenship, literature, art, and music. The Assessment is 
operated by contractors through competitive awards made by the 
National Center for Education Statistics; a National Assessment 
Governing Board formulates the policy guidelines for the 
program. Within the amounts provided, $5,088,000 is for the 
National Assessment Governing Board.
    The Committee is concerned that a key purpose of public 
education is being neglected: the civic mission of schools to 
educate our young people for democracy and to prepare them to 
be engaged citizens. The National Assessments of Educational 
Progress in civics and history are the best way we have to 
measure how well schools are doing in fulfilling this purpose. 
Therefore, the Committee requests that the National Assessment 
Governing Board, in consultation with the Commissioner, 
National Center for Education Statistics, prepare a report on 
the feasibility of the National Assessment of Educational 
Progress conducting state level assessments in the subjects of 
U.S. history and civics at grades 8 and 12 and, if feasible, 
the earliest schedule under which such assessments could be 
administered. The Governing Board shall, within 180 days of 
enactment of the FY 2006 appropriation, submit the feasibility 
report to the House and Senate Appropriations Committees, the 
House Education and the Workforce Committee, the Senate Health, 
Education, Labor and Pensions Committee, and the Secretary of 
Education.

                        DEPARTMENTAL MANAGEMENT

    The bill includes $559,518,000 for departmental management 
(salaries and expenses) at the Department of Education. This 
amount is $3,536,000 above the fiscal year 2005 appropriation 
and $408,000 below the budget request. These activities are 
authorized by the Department of Education Organization Act, 
P.L. 96-88, and include costs associated with the management 
and operations of the Department as well as separate costs 
associated with the Office for Civil Rights and the Office of 
the Inspector General.
    The Committee continues to be pleased with the emphasis the 
Department's senior management team has placed on complying 
with the Government Performance and Results Act. The Committee 
expects the Department to continue to develop and refine GPRA 
measures for all programs, focusing particularly on student 
achievement outcomes.
    The Committee urges the Department of Education to fully 
investigate whether Xavier University of Louisiana is entitled 
to approximately $1,142,465 as a result of errors by the 
Department of Education with respect to Federal Cash 
Transaction Reports (ED-PMS-272) and the Grant Administrative 
and Payment System (GAPS) from the period of March 31, 1987 
through June 30, 2002. If the results of an investigation 
determine that such errors were made by the Department of 
Education, the Committee urges the Department of Education to 
reimburse all funds owed to Xavier University as a result of 
such errors.

Program administration

    The bill includes $418,992,000 for program administration. 
This amount is $288,000 below the fiscal year 2005 
appropriation and the same as the budget request. These funds 
support the staff and other costs of administering programs and 
activities at the Department. Items include personnel 
compensation and health, retirement and other benefits as well 
as travel, rent, telephones, utilities, postage fees, data 
processing, printing, equipment, supplies, technology training, 
consultants and other contractual services.
    The Committee recognizes the invaluable role that the 
Communities Can program has served over the last five years and 
the important financial support for this endeavor arranged by 
the Federal Interagency Coordinating Council (FICC) through the 
Departments of Education and of Health and Human Services, 
among others. Communities Can efforts have proven valuable in 
ensuring the integration into their communities of children and 
youth with disabilities and their families by promoting models 
of coordinated services that have ensured effective utilization 
of scarce resources. The models have generated support from the 
private sector, including faith-based organizations, which has 
amplified the impact of public resources. In light of the 
dissolution of the FICC, the Committee is concerned that 
Communities Can be able to continue its work in promoting 
effective models of coordinated services for this population. 
Therefore, the Committee requests the Office of Special 
Education and Rehabilitative Services to provide it a plan of 
action for carrying forward this activity in the absence of the 
FICC.
    The Committee is aware that the Department of Education is 
taking steps to restructure the Rehabilitation Services 
Administration's system for providing oversight and monitoring 
of the Vocational Rehabilitation program. The Committee is 
interested in ensuring that the Department have a replacement 
system and plan in place for accountability, monitoring and 
technical assistance of these programs prior to the dismantling 
of the current system. The Committee directs the Department to 
develop such a plan and discuss such a plan with state 
vocational Rehabilitation agencies and stakeholders in advance 
of further staffing reductions.

Office for Civil Rights

    The bill includes $91,526,000 for the salaries and expenses 
of the Office for Civil Rights. This amount is $2,151,000 above 
the fiscal year 2005 appropriation and the same as the budget 
request. This Office is responsible for enforcing laws that 
prohibit discrimination on the basis of race, color, national 
origin, sex, disability, membership in a patriotic society, and 
age in all programs and institutions that receive funds from 
the Department. These laws extend to 50 State educational 
agencies, 16,000 local educational agencies, 3,500 institutions 
of higher education, as well as to proprietary schools, State 
rehabilitation agencies, libraries, and other institutions 
receiving Federal funds.

Office of the Inspector General

    The bill includes $49,000,000 for the Office of the 
Inspector General. This amount is $1,673,000 above the fiscal 
year 2005 appropriation and $408,000 below the budget request. 
This Office has authority to inquire into all program and 
administrative activities of the Department as well as into 
related activities of grant and contract recipients. It 
conducts audits and investigations to determine compliance with 
applicable laws and regulations, to check alleged fraud and 
abuse, efficiency of operations, and effectiveness of results.

                           General Provisions

    Sec. 301. The Committee continues a provision which 
prohibits funds under this Act from being used for the 
transportation of students or teachers in order to overcome 
racial imbalances or to carry out a plan of racial 
desegregation.
    Sec. 302. The Committee continues a provision which 
prohibits funds under this Act from being used to require the 
transportation of any student to a school other than the school 
which is nearest the student's home in order to comply with 
title VI of the Civil Rights Act of 1964.
    Sec. 303. The Committee continues a provision which 
prohibits funds under this Act from being used to prevent the 
implementation of programs of voluntary prayer and meditation 
in public schools.
    Sec. 304. The Committee continues a provision which allows 
up to 1 percent of any discretionary funds appropriated for the 
Department of Education to be transferred between 
appropriations accounts, provided that no appropriation is 
increased by more than 3 percent by any such transfer. This 
provision requires the Secretary to notify the Appropriations 
Committees of both Houses of Congress at least 15 days in 
advance of a transfer.
    Sec. 305. The Committee includes a provision, pursuant to 
section 303 of H. Con. Res. 95, the concurrent resolution on 
the budget for fiscal year 2006, which provides $4,300,000,000 
for the purpose of eliminating the estimated Pell grant 
shortfall.

                       TITLE IV--RELATED AGENCIES


 Committee for Purchase From People Who Are Blind or Severely Disabled

    The bill provides $4,669,000 for the Committee for Purchase 
From People Who Are Blind or Severely Disabled, the same as the 
comparable fiscal year 2005 appropriation and the budget 
request.
    The Committee for Purchase From People Who Are Blind or 
Severely Disabled was established by the Wagner-O'Day Act of 
1938 as amended. Its primary objective is to increase the 
employment opportunities for people who are blind or have other 
severe disabilities and, whenever possible, to prepare them to 
engage in competitive employment.

             Corporation for National and Community Service

    The Corporation for National and Community Service was 
established by the National and Community Service Trust Act of 
1993 to enhance opportunities for national and community 
service and provide national service educational awards. The 
Corporation makes grants to States, institutions of higher 
education, public and private nonprofit organizations, and 
others to create service opportunities for a wide variety of 
individuals through full-time national and community service 
programs. The Committee requests that the Chief Executive 
Officer of the Corporation be prepared to discuss the economic 
impact of its programs at the fiscal year 2007 appropriations 
hearing.

                  DOMESTIC VOLUNTEER SERVICE PROGRAMS

    The Committee recommends $357,962,000 for the Domestic 
Volunteer Service Programs that are administered by the 
Corporation for National and Community Service. This is 
$4,217,000 above the fiscal year 2005 appropriation and 
$2,000,000 below the budget request. Appropriations for these 
programs are not authorized in law for fiscal year 2006.

VISTA

    The Committee recommends $96,428,000 for the Volunteers in 
Service to America (VISTA) program, this is $2,188,000 above 
the fiscal year 2005 level and the same as the budget request. 
The VISTA program supports individuals who recruit volunteers 
and organize community volunteer activities but who do not 
provide direct volunteer services.

Teach for America

    The Committee recommends $2,000,000 for capacity building 
for Teach for America. This is $2,000,000 less than the budget 
request.

National Senior Volunteer Corps

    The Committee recommends a total of $219,784,000 for the 
National Senior Volunteer Corps, $3,927,000 above the fiscal 
year 2005 level and the same as the budget request.
    The Committee recommends $112,058,000 for the Foster 
Grandparents program, $634,000 above the fiscal year 2005 level 
and the same as the budget request. This program provides 
volunteer service opportunities for low-income people aged 60 
and over.
    The Committee recognizes the valuable contributions of 
seniors participating in the Foster Grandparent Program [FGP]. 
In accordance with the Domestic Volunteer Service Act [DVSA], 
the Committee intends that one-third of the increase over the 
fiscal year 2005 level shall be used to fund Program of 
National Significance [PNS] expansion grants to allow existing 
FGP programs to expand the number of volunteers serving in 
areas of critical need as identified by Congress in the DVSA. 
All remaining funds shall be used to fund an administrative 
cost increase for each Foster Grandparent Program nationwide. 
The amount to be allocated to individual grantees shall be 
calculated based on a percentage of the entire federal grant 
award in fiscal year 2005, including the amount specified for 
payment of non-taxable stipends to Foster Grandparent 
volunteers. The Corporation for National and Community Service 
(CNCS) shall comply with the directive that use of PNS funding 
increases in the FGP shall not be restricted to any particular 
activity. The Committee further directs that CNS shall not 
stipulate a minimum or maximum amount for PNS grant 
augmentation.
    In addition, the maximum dollars CNCS may use in FY 2006 
for Communications and Training, Technical Assistance, and 
Recruitment and Retention activities shall not exceed the 
amount enacted for these two activities in FY 2005.
    Funds appropriated for FY 2006 may not be used to implement 
or support service collaboration agreements or any other 
changes in the administration and/or governance of national 
service programs prior to passage of a bill by the authorizing 
committee of jurisdiction specifying such changes.
    The CNCS shall comply with the directive that use of 
funding increases in the FGP, RSVP, SCP and VISTA not be 
restricted to any particular activity. In addition, none of 
these increases may be used to fund demonstration activities.
    The Committee recommends $47,438,000 for the Senior 
Companion program, $1,533,000 above the fiscal year 2005 
appropriation and the same as the budget request. The program 
provides project grants to private, non-profit organizations 
and State and local public agencies to offer volunteer service 
opportunities to low-income individuals aged 60 and over. These 
volunteers assist older adults with physical, mental or 
emotional impairments that put them at risk for 
institutionalization.
    The bill provides $60,288,000 for the Retired Senior 
Volunteer Program (RSVP), $1,760,000 above the fiscal year 2005 
appropriation and the same as the budget request. This program 
provides part-time volunteer service opportunities for low-
income individuals aged 55 and over to recruit volunteers and 
organize volunteer activities relating to a variety of social 
needs.

Program administration

    The Committee recommends $39,750,000 for program 
administration, $1,062,000 above the fiscal year 2005 
appropriation and the same as the budget request.

      NATIONAL AND COMMUNITY SERVICE PROGRAMS, OPERATING EXPENSES

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $523,087,000 for National and 
Community Service Programs operating expenses, including the 
Trust. This is $18,430,000 less than the comparable fiscal year 
2005 level and $5,000,000 less than the budget request. The 
Committee recommends $270,000,000 for AmeriCorps State and 
National grants (authorized under subtitle C) and education 
awards only grants (authorized under subtitle H), plus an 
additional $146,000,000 for the Trust, including $10,000,000 to 
be held in reserve, and $4,000,000 for the President's Freedom 
Scholarships.
    The Committee recommendation includes the following program 
levels:

Learn and Serve.........................................     $40,000,000
National Civilian Community Corps.......................      25,500,000
Innovation and Demonstration............................       9,945,000
Evaluation..............................................       4,000,000
State Commissions.......................................      12,642,000
Points of Light Foundation..............................      10,000,000
America's Promise.......................................       5,000,000

                         SALARIES AND EXPENSES

    The Committee recommends $27,000,000 for salaries and 
expenses associated with the administrative activities of the 
Corporation. This is $1,208,000 more than the comparable fiscal 
year 2005 level and the same as the budget request.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $6,000,000 for Office of Inspector 
General, $48,000 more than the comparable fiscal year 2005 
level and the same as the budget request. The Committee directs 
the Inspector General to continue to review the Corporation's 
management of the National Service Trust.
    The Office of Inspector General is authorized by the 
Inspector General Act of 1978, as amended. This Office provides 
an independent assessment of all Corporation operations and 
programs, including those of the Volunteers in Service to 
America and the National Senior Service Corps, through audits, 
investigations, and other proactive projects.

                       ADMINISTRATIVE PROVISIONS

    The Committee recommendation includes a number of 
administrative provisions carried previous years: (1) language 
regarding qualified student loans eligible for education 
awards; (2) language regarding the availability of funds for 
the placement of volunteers with disabilities; (3) language 
directing the Inspector General to levy sanctions in accordance 
with standard Inspector General audit resolution procedures, 
which include, but are not limited to, debarment of any grantee 
found to be in violation of AmeriCorps' program requirements, 
including using grant or program funds to lobby the Congress; 
(4) language which requires the Corporation to ensure that 
significant changes to program requirements or policy are made 
only through public notice and comment rulemaking; and (5) 
language prohibiting an officer or employee of the Corporation 
from disclosing any grant selection information to any person 
not authorized to receive such information.

                  Corporation for Public Broadcasting

    The Committee has provided $400,000,000 in advance funding 
for fiscal year 2008 for the Corporation for Public 
Broadcasting (CPB). The Administration did not request any 
advance funding.
    The Committee has included authority for CPB to spend up to 
$30,000,000 in previously appropriated fiscal year 2006 funds 
for digital conversion activities. The Committee has also 
included authority for CPB to spend up to $52,000,000 in fiscal 
year 2006 funds the Satellite Interconnection system.
    The Committee rescinds $100,000,000 in funds previously 
appropriated for fiscal year 2006.

               Federal Mediation and Conciliation Service

    The bill provides $42,331,000 for the Federal Mediation and 
Conciliation Service (FMCS), a decrease of $2,108,000 below the 
comparable fiscal year 2005 appropriation the same as the 
budget request.
    The FMCS attempts to prevent and minimize labor-management 
disputes having a significant impact on interstate commerce or 
national defense, except in the railroad and airline 
industries. The agency convenes boards of inquiry appointed by 
the President in emergency disputes and conducts dispute 
mediation, preventive mediation, and arbitration. In addition, 
the Service offers alternative dispute resolution services and 
training to other Federal agencies to reduce litigation costs 
and speed Federal administrative proceedings.
    The bill also includes provisions first enacted in the 
fiscal year 1996 Appropriations Act granting the agency the 
authority to accept gifts and to charge fees for certain 
services.

            Federal Mine Safety and Health Review Commission

    The bill provides $7,809,000 for the Federal Mine Safety 
and Health Review Commission, which is the same as the fiscal 
year 2005 level and the same as the budget request. The 
Commission is responsible for reviewing the enforcement 
activities of the Secretary of Labor under the Federal Mine 
Safety and Health Act. The Commission's administrative law 
judges hear and decide cases initiated by the Secretary of 
Labor, mine operators, or miners. The five-member Commission 
hears appeals from administrative law judge decisions, rules on 
petitions for discretionary review, and may direct, of its own 
initiative, review of cases that present unusual questions of 
law.

                Institute of Museum and Library Services

    The Committee recommends $249,640,000 for the Institute of 
Museum and Library Services. This is $30,924,000 below the 
fiscal year 2005 level and $8,965,000 below the budget request. 
The Institute makes state formula grants for library services 
and discretionary national grants for joint library and museum 
projects.
    For Library Services, the Committee recommends $165,500,000 
for State Grants and $3,500,000 for library services to Native 
Americans and Native Hawaiians. The Committee recommends 
$12,500,000 for national leadership grants.
    In honor of her career as a librarian and lifelong 
dedication to early learning, early reading, and literacy, the 
Committee has renamed the Librarians for the 21st Century 
program, the Laura Bush 21st Century Librarian Program. The 
Committee has included $24,000,000 for this program that 
recruits and educates librarians. This program is helping 
recruit new professionals for public, academic, research and 
school libraries; building the capacity of library schools 
through faculty and curriculum development; and updating the 
skills of current library workers. The Committee is 
particularly interested in the program's work in enhancing 
school library media centers. Research has established the 
value of the school library media center to student 
achievement, but there is a great need to raise awareness among 
teachers and school administrators about the role that the 
library and librarian can play. School library media centers 
can contribute to improved student achievement by providing 
instructional materials aligned to the curriculum; by 
collaborating with teachers, administrators and parents; and by 
extending their hours of operation beyond the school day. The 
Committee encourages IMLS to establish a priority within the 
Laura Bush 21st Century Librarian Program to develop or enhance 
programs to promote collaboration between educators and 
librarians employed in educational institutions.
    For Museum Services, the Committee recommends $17,325,000 
for the Museums for America program, $992,000 for the 21st 
Museum Professionals program, and $446,000 for Museum 
Assessment programs. The Committee recommends $2,800,000 for 
Conservation Project Support; $815,000 for the Conservation 
Assessment Program; $8,000,000 for National Leadership Grants 
for Museums, and $845,000 for Native American and Native 
Hawaiian Museum Services. The Committee has included $1,000,000 
and in first time funding for Museum Grants for African 
American History and Culture.
    The Committee recommends $11,917,000 for program 
administration, the same as the budget request.

                  Medicare Payment Advisory Commission

    The Committee recommends $10,168,000 for the Medicare 
Payment Advisory Commission, an increase of $269,000 above the 
comparable fiscal year 2005 appropriation and the budget 
request. The Commission advises Congress on matters of 
physician and hospital reimbursement under the Medicare and 
Medicaid programs.

        National Commission on Libraries and Information Science

    The Committee recommends $993,000 for the National 
Commission on Libraries and Information Science. This is the 
same as the fiscal year 2005 level and the budget request.

                     National Council on Disability

    The bill provides $2,800,000 for the National Council on 
Disability (NCD), a decrease of $544,000 below the comparable 
fiscal year 2005 appropriation and the same as the budget 
request. The Council monitors implementation of the Americans 
with Disabilities Act and makes recommendations to the 
President, the Congress, the Rehabilitation Services 
Administration, and the National Institute on Disability and 
Rehabilitation Research on public policy issues of concern to 
individuals with disabilities.

                     National Labor Relations Board

    The bill provides $252,268,000 for the National Labor 
Relations Board (NLRB). This is $2,408,000 above the fiscal 
year 2005 level and the same as the budget request. The NLRB 
receives, investigates, and prosecutes unfair labor practice 
charges filed by businesses, labor unions, and individuals. It 
also schedules and conducts representation elections. The five-
member Board considers cases in which an administrative law 
judge decisions are appealed.
    The Committee remains concerned about the involuntary 
expansion of the mandatory jurisdiction of the National Labor 
Relations Board (NLRB) and its ever increasing burden on small 
businesses. The Committee asks the administration to 
investigate the heavy caseload taken on by the NLRB and how the 
backlog might be reduced through an adjustment of the 
jurisdictional thresholds set in 1959. The Committee urges NLRB 
to examine the scope of its original jurisdiction, and report 
to the Committee by March 1, 2006 on how its jurisdiction has 
increased since 1959 due to the absence of adjustments on the 
mandatory jurisdiction thresholds to account for inflation. 
Additionally, the Committee urges NLRB to report on the number 
of cases brought before NLRB annually, delineated by 
incremental thresholds of gross receipts and/or purchases, and 
bargaining unit size, with special attention paid to cases 
involving small businesses. Inasmuch as current NLRB reporting 
requirements may not capture this information in such detail, 
the Committee urges the NLRB to revise all necessary forms and 
regulations to capture such data on an individual basis (or, at 
a minimum, in an appropriate ``banded'' aggregate).

                        National Mediation Board

    The bill provides $11,628,000 for the National Mediation 
Board (NMB), the same as the comparable fiscal year 2005 
appropriation and the budget request. The NMB mediates labor 
disputes between employees and railroad and airline carriers 
subject to the Railway Labor Act. The Board also resolves 
representation disputes involving labor organizations seeking 
to represent railroad or airline employees.

            Occupational Safety and Health Review Commission

    The bill provides $10,510,000 for the Occupational Safety 
and Health Review Commission, the same as the fiscal year 2005 
level and the budget request. The Commission adjudicates 
contested citations issues by the Occupational Safety and 
Health Administration against employers for violations of 
safety and health standards. The Commission's administrative 
law judges settle and decide cases at the initial level of 
review. The agency's three appointed Commissioners also review 
cases, issue rulings on complicated issues, and may direct 
review of any decision by an administrative law judge.

                       Railroad Retirement Board


                         DUAL BENEFITS ACCOUNT

    The bill provides $97,000,000 for dual benefits, a decrease 
of $10,136,000 below the comparable fiscal year 2005 
appropriation and the same as the budget request. These funds 
are used to pay dual benefits to those retirees receiving both 
railroad retirement and social security benefits. The bill 
includes a provision permitting a portion of these funds to be 
derived from income tax receipts on dual benefits as authorized 
by law. The Railroad Retirement Board estimates that 
approximately $7,000,000 may be derived in this manner.

           FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNT

    The bill provides $150,000 for the interest earned on 
unnegotiated checks, the same as the budget request and the 
comparable amount provided for fiscal year 2005.

                      LIMITATION ON ADMINISTRATION

    The bill provides a consolidated limitation of $102,543,000 
on the expenditure of railroad retirement and railroad 
unemployment trust funds for administrative expenses of the 
Railroad Retirement Board, the same as the comparable fiscal 
year 2005 appropriation and the budget request. The bill 
includes a provision from the fiscal year 1999 Appropriations 
Act prohibiting the transfer of resources formerly identified 
in a Memorandum of Understanding from the RRB to the Inspector 
General.
    The Railroad Retirement Board (RRB) administers 
comprehensive retirement-survivor and unemployment-sickness 
insurance benefit programs for railroad workers and their 
families. This account limits the amount of funds in the 
railroad retirement and railroad unemployment insurance trust 
funds that may be used by the RRB for administrative expenses. 
The Committee prohibits funds from the railroad retirement 
trust fund from being spent on any charges over and above the 
actual cost of administering the trust fund, including 
commercial rental rates.
    The bill includes language (Sec. 516) limiting the 
availability of funds to the Railroad Retirement Board to enter 
into an arrangement with a nongovernmental financial 
institution to serve as disbursing agent for benefits payable 
under the Railroad Retirement Act of 1974.
    The Committee is pleased with the management of the Board 
and reiterates its interest in quickly and comprehensively 
implementing the Government Performance and Results Act.

             LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

    The bill provides authority to expend $7,196,000 from the 
railroad retirement and railroad unemployment insurance trust 
funds for the Office of Inspector General, the same as the 
comparable fiscal year 2005 appropriation and the budget 
request. This account provides funding for the Inspector 
General to conduct and supervise audits and investigations of 
programs and operations of the Board.
    The Committee compliments the work of the Office of the 
Inspector General of the Railroad Retirement Board for their 
work in obtaining information on actual collections, offsets, 
and funds put to better use as required in House Report 105-
635. This information is of great use to the Committee and the 
Committee understands the difficulty encountered by the OIG in 
obtaining it. The Committee expects that the Office of 
Inspector General will continue to report the information to 
it.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

    The bill provides $20,470,000 for mandatory payments 
necessary to compensate the Old Age and Survivors Insurance 
(OASI) and Disability Insurance (DI) Trust Funds for special 
payments to certain uninsured persons (for which no payroll tax 
is received), costs incurred for administration of pension 
reform activities and interest lost on the value of benefit 
checks issued but not negotiated. This appropriation restores 
the trust funds to the position they would have been in had 
they not borne these costs properly charged to the general 
funds.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

    The Committee provides $29,533,174,000 for the Supplemental 
Security Income (SSI) program. The Committee also provides 
$11,110,000,000 in advance funding for the first quarter of 
fiscal year 2007.

Beneficiary services

    In addition to Federal benefits, the Social Security 
Administration (SSA) administers a program of supplementary 
State benefits for those States that choose to participate. The 
funds are also used to reimburse the trust funds for the 
administrative costs of the program. The bill provides 
$52,000,000 for beneficiary services, the same as the budget 
request, within the total appropriation for SSI. This funding 
reimburses State vocational rehabilitation services agencies 
for successful rehabilitation of SSI recipients.

Research and demonstration

    Within the appropriation for SSI, the bill provides 
$27,000,000 for research and demonstration activities conducted 
under section 1110 of the Social Security Act.

Administration

    Within the appropriation for SSI, the Committee provides 
$2,897,000,000 for payment to the Social Security trust funds 
for the SSI Program's share of SSA's base administrative 
expenses. This is the same funding level as the budget request.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

    The Committee provides a limitation on administrative 
expenses for the Social Security Administration (SSA) of 
$9,159,700,000 to be funded from the Social Security and 
Medicare trust funds. This is $554,799,000 more than the fiscal 
year 2005 comparable level and $108,700,000 less than the 
budget request.

Social Security Advisory Board

    The Committee provides that not less than $2,000,000 within 
the limitation on administrative expenses shall be available 
for the Social Security Advisory Board, the same as both the 
fiscal year 2005 level the budget request.

User fees

    In addition to other amounts provided in the bill, the 
Committee provides an additional limitation of $120,000,000 for 
administrative activities funded from user fees. This is 
$5,000,000 less than the fiscal year 2005 level and the same as 
the request.

                      OFFICE OF INSPECTOR GENERAL

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee provides $92,805,000 for the Office of the 
Inspector General (OIG), $2,427,000 more than the fiscal year 
2005 comparable level and $195,000 less than the budget 
request. The bill also provides authority to expend $66,805,000 
from the Social Security trust funds for activities conducted 
by the Inspector General, $1,969,000 more than the fiscal year 
2005 comparable level and $195,000 less than the budget 
request.

                      TITLE V--GENERAL PROVISIONS

    Sec. 501. The Committee continues a provision to allow the 
Secretaries of Labor, Health and Human Services, and Education 
to transfer unexpended balances of prior appropriations to 
accounts corresponding to current appropriations to be used for 
the same purpose and for the same periods of time for which 
they were originally appropriated.
    Sec. 502. The Committee continues a provision to prohibit 
the obligation of funds beyond the current fiscal year unless 
expressly so provided.
    Sec. 503. The Committee continues a provision to prohibit 
appropriated funds to be used to support or defeat legislation 
pending before the Congress or any State legislature, except in 
presentation to the Congress or any State legislature itself.
    Sec. 504. The Committee continues a provision to limit the 
amount available for official reception and representation 
expenses for the Secretaries of Labor and Education, the 
Director of the Federal Mediation and Conciliation Service, and 
the Chairman of the National Mediation Board.
    Sec. 505. The Committee continues a provision to prohibit 
funds to be used to carry out a needle distribution program.
    Sec. 506. The Committee continues a provision to require 
grantees receiving Federal funds to clearly state the 
percentage of the total cost of the program or project that 
will be financed with Federal money.
    Sec. 507. The Committee continues a provision to prohibit 
appropriated funds to be used for any abortion.
    Sec. 508. The Committee continues a provision to provide 
exceptions for Sec. 507 and adds a limitation prohibiting funds 
from the bill to be made available to a Federal, State or local 
government or program if they discriminate against 
institutional or individual health care entities if they do not 
provide, pay for, or refer for abortions.
    Sec. 509. The Committee continues a provision to prohibit 
the use of funds in the Act concerning research involving human 
embryos. However, this language should not be construed to 
limit federal support for research involving human embryonic 
stem cells listed on an NIH registry and carried out in 
accordance with policy outlined by the President.
    Sec. 510. The Committee continues a provision to prohibit 
the use of funds for any activity that promotes the 
legalization of any drug or substance included in schedule I of 
the schedules of controlled substances.
    Sec. 511. The Committee continues a provision related to 
annual reports to the Secretary of Labor.
    Sec. 512. The Committee continues a provision to prohibit 
the use of funds to promulgate or adopt any final standard 
providing for a unique health identifier until legislation is 
enacted specifically approving the standard.
    Sec. 513. The Committee continues a provision that 
prohibits the transfer of funds from this Act except by 
authority provided in this Act or another appropriation Act.
    Sec. 514. The Committee includes a provision to limit funds 
in the bill for public libraries to those libraries that comply 
with the requirements of the Children's Internet Protection 
Act.
    Sec. 515. The Committee includes a provision to limit 
technology funds in the bill for elementary and secondary 
schools to those schools that comply with the requirements of 
the Children's Internet Protection Act.
    Sec. 516. The Committee includes language limiting the 
availability of funds to the Railroad Retirement Board to enter 
into an arrangement with a nongovernmental financial 
institution to serve as disbursing agent for benefits payable 
under the Railroad Retirement Act of 1974.
    Sec. 517. The Committee maintains a provision clarifying 
the procedures for reprogramming of funds. The Committee notes 
that this provision is consistent with reprogramming language 
included in other bills within the Committee's jurisdiction.
    Sec. 518. The Committee includes a provision extending the 
availability of funds appropriated under section 1015 of P.L. 
108-173 for an additional year, allowing CMS and SSA more 
flexibility to implement the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003.

                        CONSTITUTIONAL AUTHORITY

    Clause 3(d)(1) of rule XIII of the Rules of the House of 
Representatives states that:
    Each report of a committee on a public bill or public joint 
resolution shall contain the following:

          (1) A statement citing the specific powers granted to 
        Congress in the Constitution to enact the law proposed 
        by the bill or joint resolution.

    The Committee on Appropriations bases its authority to 
report this legislation on Clause 7 of Section 9 of Article I 
of the Constitution of the United States of America which 
states:

          No money shall be drawn from the Treasury but in 
        consequence of Appropriations made by law * * *.

    Appropriations contained in this Act are made pursuant to 
this specific power granted by the Constitution.

                   COMPARISON WITH BUDGET RESOLUTION

    Clause 3(c)(2) of rule XIII of the Rules of the House of 
Representatives requires an explanation of compliance with 
section 308(a)(1)(A) of the Congressional Budget Act of 1974 
(Public Law 93-344), as amended, which requires that the report 
accompanying a bill providing new budget authority contain a 
statement detailing how the authority compares with the report 
submitted under section 302 of the Act for the most recently 
agreed to concurrent resolution on the budget for the fiscal 
year. This information follows:


                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  302(b) allocation             This bill
                                                             ---------------------------------------------------
                                                                 Budget                    Budget
                                                               authority     Outlays     authority     Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary...............................................      142,514      143,702      142,514      143,802
Mandatory...................................................      402,591      404,083      402,591      404,083
----------------------------------------------------------------------------------------------------------------

    In accordance with the Congressional Budget Act of 1974 
(Public Law 93-344), as amended, the following information was 
provided to the Committee by the Congressional Budget Office:

                         FIVE-YEAR PROJECTIONS

    In compliance with section 308(a)(1)(B) of the 
Congressional Budget Act of 1974 (Public Law 93-344), as 
amended, the following table contains five-year projections 
associated with the budget authority provided in the 
accompanying bill:

Outlays:                [In millions of dollars]
        2006..................................................   370,337
        2007..................................................    58,474
        2008..................................................    15,470
        2009..................................................     3,789
        2010 and beyond.......................................       542

          FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

    In accordance with section 308(a)(1)(C) of the 
Congressional Budget Act of 1974 (Public Law 93-344), as 
amended, the financial assistance to State and local 
governments is as follows:

                        [In millions of dollars]

New budget authority..........................................   220,961
Fiscal Year 2006 outlays resulting therefrom..................   159,308

                           TRANSFER OF FUNDS

    Pursuant to clause 3(f)(2), rule XIII of the Rules of the 
House of Representatives, the following table is submitted 
describing the transfers of funds provided in the accompanying 
bill.
    The table shows, by Department and agency, the 
appropriations affected by such transfers.

                                 APPROPRIATION TRANSFERS RECOMMENDED IN THE BILL
----------------------------------------------------------------------------------------------------------------
                                                                 Account from which transfer is
      Account to which transfer is made             Amount                    made                    Amount
----------------------------------------------------------------------------------------------------------------
Department of Labor:                           ...............  Department of Labor
    Special Benfits..........................            (\1\)    Postal Service...............            (\1\)
    Various Agencies \1\.....................                     Energy Employee Occupational   ...............
                                                                   Illness Compensation Fund
                                                                   \1\.
    Employment Standards Administration--          $33,050,000  Black Lung Disability Trust          $33,050,000
     Salaries and Expenses.                                      Fund.
    Departmental Management--Salaries and           24,239,000  Black Lung Disability Trust           24,239,000
     Expenses.                                                   Fund.
    Office of Inspector General..............          344,000  Black Lung Disability Trust              344,000
                                                                 Fund.
Department of Health and Human Services:                        Department of Health and Human
                                                                 Services:
    National Institutes of Health:                              National Institutes of Health
        Various Institutes and centers for            up to 3%  Various institutes and centers          up to 3%
         AIDS.                                                   for AIDS.
        Various institutes and centers for               (\2\)  Office of AIDS Research........            (\2\)
         AIDS.
        Various institutes and centers.......         up to 1%  Various institutes and centers.         up to 1%
Related Agencies:
    National Service Trust...................      146,000,000  Corp. for National and               146,000,000
                                                                 Community Service.
    National Service Trust...................            (\1\)  Corp. for National and                     (\1\)
                                                                 Community Service.
    Social Security Administration:..........
        Office of Inspector General..........       66,805,000  Federal Old-Age and Survivors         66,805,000
                                                                 Insurance Trust Fund and
                                                                 Federal Disability Insurance
                                                                 Trust Fund.
----------------------------------------------------------------------------------------------------------------
\1\ Such sums.
\2\ Amount det'd to be AIDS.

                              RESCISSIONS

    Pursuant to clause 3(f)(2), rule XIII of the Rules of the 
House of Representatives, the following table is submitted 
describing the rescissions recommended in the accompanying 
bill.

------------------------------------------------------------------------
                       Account                               Amount
------------------------------------------------------------------------
Department of Labor, National Emergency Grants.......       -$20,000,000
Department of Labor, Training and Employment Service.         -5,000,000
Department of Labor, Training and Employment Service.       -125,000,000
Department of Labor, Workers Compensation Programs...       -120,000,000
Department of HHS, Health Professions Student Loans..        -15,912,000
Corporation of Public Broadcasting, Fiscal Year 2006        -100,000,000
 Advance.............................................
------------------------------------------------------------------------

                 Changes in Application of Existing Law

    Pursuant to clause 3, rule XIII of the Rules of the House 
of Representatives, the following statements are submitted 
describing the effect of provisions in the accompanying bill 
which may directly or indirectly change the application of 
existing law.
    In some instances the bill includes appropriations for 
certain ongoing programs which are not yet authorized for 
fiscal year 2006.
    The bill provides that appropriations shall remain 
available for more than one year for some programs for which 
the basic authorizing legislation does not presently authorize 
such extended availability.
    In various places in the bill, the Committee has earmarked 
funds within appropriation accounts in order to fund specific 
sections of a law. Whether these actions constitute a change in 
the application of existing law is subject to individual 
interpretation, but the Committee felt that this fact should be 
mentioned.
    In several instances, the bill provides advance 
appropriations for fiscal year 2007 or 2008 for programs for 
which such advances are not authorized by law.

                      TITLE I--DEPARTMENT OF LABOR


                    Training and Employment Services

    Language prohibiting the use of funds from any other 
appropriation to provide meal services at or for Job Corps 
centers.

     State Unemployment Insurance and Employment Service Operations

    Language allowing the use of funds for amortization 
payments to States which had independent retirement plans in 
their State employment service agencies prior to 1980.
    Language allowing the Labor Department to withhold from 
State allotments funds available for penalty mail under the 
Wagner-Peyser Act.
    Language providing that funds in this Act for one-stop 
career centers and unemployment insurance national activities 
may be used for contracts, grants or agreements with non-State 
entities.
    Language providing that funds in this Act may be used by 
the States for integrated Employment Service and Unemployment 
Insurance automation efforts.

                  Employment Standards Administration


                         SALARIES AND EXPENSES

    Language authorizing the Secretary of Labor to accept and 
spend all sums of money ordered to be paid to the Secretary, in 
accordance with the terms of a Consent Judgment in U.S. 
District Court for the Northern Mariana Islands.
    Language authorizing the Secretary of Labor to collect user 
fees for processing certain applications and issuing certain 
certificates and registrations under the Fair Labor Standards 
Act and the Migrant and Seasonal Agricultural Worker Protection 
Act.

                            SPECIAL BENEFITS

    Language providing funds may be used under the Federal 
Employees' Compensation Act in which the Secretary of Labor may 
reimburse an employer, who is not the employer at the time of 
injury, for portions of the salary of a reemployed, disabled 
beneficiary.
    Language allowing the Secretary of Labor to transfer 
certain administrative funds from the Postal Service fund and 
certain other government corporations and agencies related to 
the administration of the Federal Employees' Compensation Act.
    Language allowing the Secretary of Labor to require any 
person filing a claim for benefits under the Federal Employees' 
Compensation Act or the Longshore and Harbor Workers' 
Compensation Act to provide such identifying information as the 
Secretary may require, including a Social Security number.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

    Language establishing a maximum amount available for grants 
to States under the Occupational Safety and Health Act, which 
grants shall be no less than 50 percent of the costs of State 
programs required to be incurred under plans approved by the 
Secretary under section 18 of the Act.
    Language authorizing the Occupational Safety and Health 
Administration to retain and spend up to $750,000 of training 
institute course tuition fees for training and education 
grants.
    Language allowing the Secretary of Labor to collect and 
retain fees for services provided to Nationally Recognized 
Testing Laboratories.
    Language prohibiting OSHA from obligating or expending any 
of these funds to enforce the annual fit test requirement of 
the General Industry Respiratory Protection Standard with 
respect to exposure to tuberculosis.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

    Language allowing the Mine Safety and Health Administration 
to collect up to $750,000 at the National Mine Health and 
Safety Academy for room, board, tuition, and the sale of 
training materials, otherwise authorized by law to be 
collected, to be available for mine safety and health education 
and training activities, notwithstanding 31 U.S.C. 3302.
    Language allowing the Mine Safety and Health Administration 
to accept land, buildings, equipment, and other contributions 
from public and private sources; to prosecute projects in 
cooperation with other agencies, Federal, State, or private; 
and to promote health and safety education and training in the 
mining community through cooperative programs with States, 
industry, and safety associations.
    Language allowing the Secretary of Labor to use any funds 
available to the Department to provide for the costs of mine 
rescue and survival operations in the event of major disasters.

                           General Provisions

    Language is included deeming certain payments for workers 
compensation to be consistent with P.L. 107-17.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES


              Health Resources and Services Administration


                     HEALTH RESOURCES AND SERVICES

    Language providing that $39,180,000 from general revenues, 
not-withstanding section 1820(j) of the Social Security Act, 
shall be available for carrying out the Medicare rural hospital 
flexibility grants program under section 1820 of such Act.
    Language providing that in addition to fees authorized by 
section 427(b) of the Health Care Quality Improvement Act of 
1986, fees shall be collected for the full disclosure of 
information under the Act sufficient to recover the full costs 
of operating the National Practitioner Data Bank, and shall 
remain available until expended to carry out that Act.
    Language providing that fees collected under the Health 
Care Fraud and Abuse Data Collection Program shall be 
sufficient to recover the full costs of operating the program, 
and shall remain available until expended to carry out that 
Act.
    Language providing that $26,000,000 of the funding provided 
for community health centers is to be allocated to high-poverty 
counties, notwithstanding current law.
    Language providing that all pregnancy counseling under the 
family planning program shall be nondirective.
    Language making $25,000,000 available under section 241 of 
the Public Health Service Act to fund special programs for the 
care and treatment of individuals with HIV disease.
    Language identifying a specific amount for maternal and 
child health SPRANS activities, notwithstanding current law.

               Centers for Disease Control and Prevention

    Language permitting the Centers for Disease Control and 
Prevention to purchase and insure official motor vehicles in 
foreign countries.
    Language providing the Centers for Disease Control and 
Prevention to purchase, hire, maintain and operate aircraft.
    Language providing that $30,000,000 is available until 
expended for equipment and construction and renovation of 
facilities.
    Language providing that $123,883,000 is available until 
September 30, 2006 for International HIV/AIDS.
    Language providing that collections from user fees may be 
credited to the Centers for Disease Control and Prevention 
appropriation.
    Language making specific amounts under section 241 of the 
Public Health Service Act available to carry out: National 
Immunization Surveys; National Center for health Statistics 
surveys; information systems standards development and 
architecture and applications-based research used at local 
public health levels; Public Health Research; and the National 
Occupational Research Agenda.
    Language allowing the Director of the Centers for Disease 
Control and Prevention to redirect certain funds appropriated 
under Public Law 101-502.
    Language providing that not to exceed $12,500,000 may be 
made available for grants under section 1509 of the Public 
Health Service Act to not more than 15 States, tribes, or 
tribal organizations.
    Language permitting the Centers for Disease Control and 
Prevention to proceed with property acquisition, including a 
long-term ground lease for construction on non-federal land, 
for construction of a replacement laboratory in the Ft. 
Collins, Colorado area.
    Language permitting the Centers for Disease Control and 
Prevention to exempt from any personnel ceiling applicable to 
the Agency both civilian and Commissioned Officers detailed to 
the States, municipalities, or other organizations under 
authority of section 214 of the Public Health Service Act for 
purposes related to homeland security during the period of 
detail or assignment.

                     National Institutes of Health


                      NATIONAL LIBRARY OF MEDICINE

    Language providing that the National Library of Medicine 
may enter into certain personal services contracts.
    Language making $8,200,000 available under section 241 of 
the Public Health Service Act to carry out National Information 
Center on Health Services Research and Health Care Technology 
and related health services.

                         OFFICE OF THE DIRECTOR

    Language providing that the National Institutes of Health 
is authorized to collect third party payments for the cost of 
the clinical services that are incurred in NIH research 
facilities and that such payments shall be credited to the NIH 
Management Fund and shall remain available for one fiscal year 
after they are deposited.
    Language providing the Director of NIH authority to 
transfer funds between appropriation accounts in this or any 
other Act.
    Language providing that a uniform percentage of the amounts 
appropriated to the Institutes and Centers may be transferred 
and utilized for the NIH Roadmap for Medical Research.

       Substance Abuse and Mental Health Services Administration


               SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

    Language making specific amounts available under section 
241 of the Public Health Service Act to fund technical 
assistance, National data, data collection and evaluation 
activities; $16,000,000 to carry out national surveys on drug 
abuse; and, $4,300,000 to evaluate substance abuse treatment 
programs.

               Agency for Healthcare Research and Quality

    Language is included to permit the Agency for Healthcare 
Research and Quality to retain and expend amounts received from 
Freedom of Information Act fees, reimbursable and interagency 
agreements and the sale of data tapes.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

    A provision that in the administration of title XIX of the 
Social Security Act, payments to a state for any quarter may be 
made with respect to a State plan or plan amendment in effect 
during any such quarter, if submitted in, or prior to, such 
quarter and approved in that or any such subsequent quarter.

                PAYMENTS TO THE HEALTH CARE TRUST FUNDS

    Language providing indefinite authority for paying benefits 
if the annual appropriation is insufficient.

                           PROGRAM MANAGEMENT

    A provision that all funds collected in accordance with 
section 353 of the Public Health Service Act, together with 
such sums as may be collected from authorized user fees, 
administrative fees collected relative to Medicare overpayment 
recovery activities, and the sale of data, shall be available 
for expenditure by the Center for Medicare and Medicaid 
Services.
    Language allowing fees charged in accordance with 31 U.S.C. 
9701 to be credited to the Centers for Medicare and Medicaid 
Services administrative account.
    Language providing that funds under this heading are 
available for the Healthy Start, Grow Smart program.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

    Language providing that the sum of the amounts available to 
a State with respect to expenditures under title IV-A of the 
Social Security Act in fiscal year 1997 under this 
appropriation and under such title IV-A as amended by the 
Personal Responsibility and Work Opportunity Reconciliation Act 
of 1996 shall not exceed the limitations under section 116(b) 
of such Act.

                      SOCIAL SERVICES BLOCK GRANT

    Language providing that States may transfer up to 10 
percent of Temporary Assistance for Needy Family funds to the 
Social Services Block Grant.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

    Language making $6,000,000 available under section 241 of 
the Public Health Service Act to carry out provisions of 
section 1110 of the Social Security Act.
    Language providing that unexpended Community Services Block 
Grant funds may be carried over to the next fiscal year by 
local grantees.
    Language making $4,500,000 available under section 241 of 
the Public Health Service Act to carry out evaluations of 
adolescent pregnancy prevention approaches.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

    Language making $39,552,000 available under section 241 of 
the Public Health Service Act to carry out national health or 
human services research and evaluation activities.
    Language providing $13,120,000 for prevention service 
demonstration grants under the Adolescent Family Life program, 
notwithstanding current law.

                HEALTH INFORMATION TECHNOLOGY INITIATIVE

    Language making $16,900,000 available under section 241 of 
the Public Health Service Act to carry out health information 
technology network development activities.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

    Language providing for the transfer of $8,589,000 from 
amounts appropriated to the Centers for Disease Control and 
Prevention for activities authorized by Section 319F-2(a) of 
the Public Health Service Act.

                   TITLE III--DEPARTMENT OF EDUCATION


                               IMPACT AID

    Language ensuring that schools serving the children of 
military personnel continue to receive Impact Aid funds when 
the military parents who live on-base are deployed and the 
child continues to attend the same school and in cases in which 
an on-base military parent is killed while on active duty and 
the child continues to attend the same school.

                      SCHOOL IMPROVEMENT PROGRAMS

    Language allowing the Republic of the Marshall Islands and 
the Federated States of Micronesia to reserve up to five 
percent of their supplemental education grants for technical 
assistance, administration and oversight purposes.

                     VOCATIONAL AND ADULT EDUCATION

    Language stating that a portion of the amount provided for 
Adult Education State Grants shall be for integrated English 
literacy and civics education services to immigrants and other 
limited English proficient populations, and specifying the 
distribution of such funds.

                      STUDENT FINANCIAL ASSISTANCE

    Language providing that the maximum Pell grant a student 
may receive in the 2005-2006 academic year shall be $4,100.

                            HIGHER EDUCATION

    Language providing that funds are available to fund 
fellowships for academic year 2006-2007 under part A, subpart 1 
of title VII of the Higher Education Act of 1965, under the 
terms and conditions of part A, subpart 1.
    Language providing that notwithstanding any other provision 
of law, funds made available to carry out title VI of the 
Higher Education Act and section 102(b)(6) of the Mutual 
Educational and Cultural Exchange Act of 1961 may be used to 
support visits and study in foreign countries by individuals 
who are participating in advanced foreign language training and 
international studies in areas that are vital to United States 
national security and who plan to apply their language skills 
and knowledge of these countries in the fields of government, 
the professions, or international development.

                           HOWARD UNIVERSITY

    Language providing that Howard University shall use not 
less than $3,524,000 for the endowment program pursuant to the 
Howard University Endowment Act.

                       TITLE IV--RELATED AGENCIES


             Corporation for National and Community Service


        DOMESTIC VOLUNTEER SERVICE PROGRAMS, OPERATING EXPENSES

    Language prohibiting certain funds from being used for 
stipends or other monetary incentives for volunteers or 
volunteer leaders whose incomes exceed 125 percent of the 
national poverty level.

      NATIONAL AND COMMUNITY SERVICE PROGRAMS, OPERATING EXPENSES

    Language allowing certain funds to be used for education 
award-only grants.
    Language allowing certain additional funds to be 
transferred to the National Service Trust, upon a determination 
that it is necessary to support the activities of national 
service participants and after notice is transmitted to the 
Congress.
    Language prohibiting certain funds from being used to 
support salaries and related expenses (including travel) 
attributable to employees of the Corporation for National and 
Community Service.
    Language requiring certain funds to be provided in an 
manner that is consistent with the recommendations of peer 
review panels in order to ensure that priority is given to 
programs that demonstrate quality, innovation, replicability, 
and sustainability.
    Language allowing certain funds to support an endowment 
fund, and permitting certain investments of the endowment fund.
    Language prohibiting funds for national service programs 
run by certain other Federal agencies.
    Language requiring the Corporation for National and 
Community Service to increase significantly the level of 
matching funds and in-kind contributions provided by the 
private sector, and to reduce the total Federal costs per 
participant in all programs.
    Language allowing certain funds to be made available to 
provide assistant to State commissions on national and 
community service.
    Language allowing certain funds to be used for grant 
application reviews.

                       ADMINISTRATION PROVISIONS

    Language allowing certain loans to be considered qualified 
student loans.
    Language allowing certain grantees to be eligible for 
grants targeted to individuals with disabilities.
    Language requiring the Inspector General of the Corporation 
for National and Community Service to conduct random audits of 
the grantees that administer activities under the AmeriCorps 
programs, to levy sanctions for violations, and to obtain 
reimbursements of misused funds from grantees committing 
substantial violations.
    Language requiring the Corporation for National and 
Community Service to make significant changes to program 
requirements or policies only through public notice and comment 
rulemaking.
    Language prohibiting personnel of the Corporation for 
National and Community Service from making unauthorized 
disclosures of covered grant selection information.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

    The bill includes language specifying that notwithstanding 
31 U.S.C. 3302, fees charged by the Federal Mediation and 
Conciliation Service, up to full-cost recovery, for special 
training activities and for arbitration services shall be 
credited to and merged with its administrative account, and 
shall remain available until expended; that fees for 
arbitration services shall be available only for education, 
training, and professional development of the agency workforce; 
and that the Director of the Service is authorized to accept on 
behalf of the United States gifts of services and real, 
personal, or other property in the aid of any projects or 
functions within the Director's jurisdiction.

                     National Labor Relations Board


                         SALARIES AND EXPENSES

    The bill includes a provision requiring that appropriations 
to the NLRB shall not be available to organize or assist in 
organizing agricultural laborers or used in connection with 
investigations, hearings, directives, or orders concerning 
bargaining units composed of agricultural laborers as referred 
to in 2(3) of the Act of July 5, 1935 (29 U.S.C. 152), and as 
amended by the Labor-Management Relations Act, 1947, as 
amended, and as defined in 3(f) of the Act of June 25, 1938 (29 
U.S.C. 203), and including in said definition employees engaged 
in the maintenance and operation of ditches, canals, 
reservoirs, and waterways, when maintained or operated on a 
mutual non-profit basis and at least 95 per centum of the water 
stored or supplied thereby is used for farming purposes.

                       Railroad Retirement Board


                     DUAL BENEFITS PAYMENTS ACCOUNT

    The bill includes language providing that the total amount 
provided for railroad retirement dual benefits shall be 
credited to the Dual Benefits Payments Account in 12 
approximately equal amounts on the first day of each month in 
the fiscal year.

                      LIMITATION ON ADMINISTRATION

    The bill includes language providing that the Railroad 
Retirement Board shall determine the allocation of its 
administrative budget between the railroad retirement accounts 
and the railroad unemployment insurance administration fund.

                     Social Security Administration


                 LIMITATION ON ADMINISTRATIVE EXPENSES

    Language providing that unobligated balances at the end of 
fiscal year 2006 shall remain available until expended for the 
agency's information technology and telecommunications hardware 
and software infrastructure, including related equipment and 
non-payroll administrative expenses associated solely with this 
information technology and telecommunications infrastructure; 
language authorizing the use of up to $15,000 for official 
reception and representation expenses; and language providing 
that reimbursement to the trust funds under this heading for 
expenditures for official time for employees of the Social 
Security Administration pursuant to section 7131 of title 5, 
United States Code, and for facilities or support services for 
labor organizations pursuant to policies, regulations, or 
procedures referred to in 7135(b) of such title shall be made 
by the Secretary of the Treasury, with interest, from amounts 
in the general fund not otherwise appropriated, as soon as 
possible after such expenditures are made.
    Language providing that funds may be derived from 
administration fees collected pursuant to 1616(d) of the Social 
Security Act or 212(b)(3) of Public Law 93-66 and that, to the 
extent that the amounts collected pursuant to such sections in 
fiscal year 2006 exceed $119,000,000, the amounts shall be 
available in fiscal year 2007 only to the extent provided in 
advance in appropriations Acts.
    Language providing that funds may be derived from fees 
collected pursuant to section 303(c) of the Social Security 
Protection Act of Public Law 108-203 and shall remain available 
until expended.
    Language providing that unobligated funds previously 
appropriated for Federal-State partnerships shall be 
transferred to the Supplemental Security Income Program and 
remain available until expended.

                      OFFICE OF INSPECTOR GENERAL

    Language permitting the transfer of a certain amount of 
funds into this account from the SSA administrative account 
provided that the Appropriations Committees are promptly 
notified.

                           General Provisions

    Sections 102, 201, 202, 203, 204, 205, 206, 207, 208, 209, 
210, 211, 212, 213, 214, 215, 216, 217, 218, 219, 301, 302, 
303, 304, 501, 504, 505, 507, 508, 509, 510, 511, 512, 513, 
514, 516, 517, 518 and 519 of the bill are general provisions, 
most of which have been carried in previous appropriations 
acts, which place limitations on the use of funds in the bill 
or authorize or require certain activities, and which might, 
under some circumstances, be construed as changing the 
application of existing law.

              DEFINITION OF PROGRAM, PROJECT, AND ACTIVITY

    During fiscal year 2006 for purposes of the Balanced Budget 
and Emergency Deficit Control Act of 1985 (Public Law 99-177), 
as amended, the following information provides the definition 
of the term ``program, project, and activity'' for departments 
and agencies under the jurisdiction of the Labor, Health and 
Human Services, and Education and Related Agencies 
Subcommittee. The term ``program, project, and activity'' shall 
include the most specific level of budget items identified in 
the Departments of Labor, Health and Human Services, and 
Education, and Related Agencies Appropriations Act, 2006, the 
accompanying House and Senate Committee reports, the conference 
report and accompanying joint explanatory statement of the 
managers of the committee of conference.

         Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII of the Rules of the 
House of Representatives, the following is a statement of 
general performance goals and objectives for which this measure 
authorizes funding:
    The Committee on Appropriations considers program 
performance, including a program's success in developing and 
attaining outcome-related goals and objectives, in developing 
funding recommendations.

                  Appropriations Not Authorized by Law

    Pursuant to clause 3 of rule XIII of the Rules of the House 
of Representatives, the following table lists the 
appropriations in the accompanying bill which are not 
authorized by law:

----------------------------------------------------------------------------------------------------------------
                                                                            Appropriations in
        Agency/Program              Last year of      Authorization  level     last year of    Appropriations in
                                   authorization                              authorization        this bill
----------------------------------------------------------------------------------------------------------------
     DEPARTMENT OF LABOR

Employment and Training        2003.................  Such Sums...........     $5,217,070,000         $5,121,792
 Administration--Training and
 Employment Services.

   DEPARTMENT OF HEALTH AND
        HUMAN SERVICES

HRSA:

Health Professions, except     2002.................  Such Sums...........       $295,111,000        $47,128,000
 certain nursing programs.
Healthy Start................  1995.................  Such Sums...........       $102,543,000        $97,747,000
Newborn Hearing Screening....  2002.................  Such Sums...........         $9,995,000        $10,000,000
Organ Transplantation........  1993.................  Such Sums...........        $24,990,000        $23,282,000
Bone Marrow Donor Registry...  2003.................  Such Sums...........        $21,891,000        $25,416,000
Rural and Community Access to  2003.................  25,000,000..........        $12,500,000         $1,960,000
 Emergency Devices.
State Offices of Rural Health  2002.................  Such Sums...........         $7,996,000         $8,223,000
Family Planning..............  1985.................  158,400,000.........       $142,500,000       $285,963,000

CDC:

Birth Defects................  2002.................  Such Sums...........        $98,040,000       $127,179,000
Cancer Registries............  2003.................  Such Sums...........        $45,649,000        $48,584,000
Prostate Cancer..............  2004.................  Such Sums...........        $15,452,000        $14,071,000
Breast and Cervical Cancer     2003.................  Such Sums...........       $199,371,000       $204,425,000
 Prevention.
Wisewoman....................  2003.................  Such Sums...........        $12,500,000        $12,500,000
Prevention Centers...........  2003.................  Such Sums...........        $26,830,000        $29,700,000
Health Statistics............  2003.................  Such Sums...........       $125,899,000       $109,021,000
Infectious Disease Control...  2005.................  Such Sums...........       $225,589,000       $229,471,000
Diabetes.....................  2005.................  Such Sums...........        $63,457,000        $64,960,000
Safe Motherhood/Infant Health  2005.................  Such Sums...........        $44,738,000        $44,740,000
 Promotion.
Childhood Obesity............  2005.................  Such Sums...........        $41,930,000        $41,930,000
Oral Health Promotion........  2005.................  Such Sums...........        $11,204,000        $12,000,000
Preventive Health Services     1998.................  Such Sums...........       $149,092,000       $100,000,000
 Block Grant.
HIV/AIDS Prevention..........  2005.................  Such Sums...........       $662,267,000       $657,694,000
Sexually Transmitted Diseases  1998.................  Such Sums...........       $112,117,000       $159,633,000
 Grants.
Tuberculosis Grants..........  2002.................  Such Sums...........       $132,689,000       $138,811,000
Asthma Prevention............  2005.................  Such Sums...........        $32,422,000        $32,422,000
Lead Poisoning Prevention....  2005.................  Such Sums...........        $36,474,000        $36,474,000
Injury Prevention and Control  2005.................  Such Sums...........       $138,237,000       $138,237,000
Loan Repayment...............  2002.................  Such Sums...........           $500,000           $500,000

NIH:

National Institutes of         1996.................  Such Sums...........       $416,992,000                 $0
 Health--Research Training.
National Cancer Institute....  1996.................  Such Sums...........     $2,248,000,000     $4,841,774,000
National Heart, Lung, and      1996.................  Such Sums...........     $1,354,945,000     $2,951,270,000
 Blood Institute.
National Institute on Aging..  1996.................  Such Sums...........       $453,541,000     $1,057,203,000
National Institute on Alcohol  1994.................  Such Sums...........       $185,538,000       $440,333,000
 Abuse and Alcoholism.
National Institute on Drug     1994.................  Such Sums...........       $424,315,000     $1,010,130,000
 Abuse.
National Institute of Mental   1994.................  Such Sums...........       $613,352,000     $1,417,692,000
 Health.
National Institute of          2003.................  Such Sums...........       $280,100,000       $299,808,000
 Biomedical Imaging and
 Bioengineering.
National Library of Medicine.  1996.................  Such Sums...........       $140,936,000       $318,091,000

SAMSHA:

Substitute Abuse and Mental    FY 2003..............  Such Sums...........     $3,158,068,000     $3,230,744,000
 Health Services
 Administration programs.

ACF:

Low Income Home Energy         FY 2004..............  2,605,300,000.......     $1,888,790,000     $1,984,799,000
 Assistance.
Office of Refugee              FY 2002..............  Such Sums...........       $439,894,000       $478,006,000
 Resettlement, except:
 Unaccompanied Alien
 Children, Trafficking
 Victims and Torture Victims.
Trafficking Victims..........  FY 2005..............  15,000,000..........   up to $9,915,000   up to $9,915,000
Torture Victims..............  FY 2005..............  20,000,000..........         $9,915,000         $9,915,000
Child Care Development Block   FY 2002..............  1,000,000,000.......     $2,099,994,000     $2,082,910,000
 Grant.
Head Start...................  FY 2003..............  Such Sums...........     $6,815,570,000     $6,899,000,000
Voting Access for individuals  FY 2005..............  35,000,000..........        $14,879,000        $14,879,000
 with Disabilities.
Native American programs.....  FY 2002..............  Such Sums...........        $45,946,000        $44,780,000
Community Services Block       FY 2003..............  Such Sums...........       $739,315,000       $389,672,000
 Grant programs.

AOA:

Aging Services Programs......  FY 2005..............  Such Sums...........     $1,393,342,000     $1,376,217,000

OFFICE OF THE SECRETARY

Adolescent Family Life (Title  1985.................  30,000,000..........        $14,716,000        $30,742,000
 XX).

DEPARTMENT OF EDUCATION

Education for the              FY 2003..............  Such Sums...........        $34,750,000        $34,269,000
 Disadvantaged--Migrant
 Education.
Innovation and Improvement--   FY 2003..............  Such Sums...........        $24,838,000        $36,981,000
 Credit Enhancement for
 Charter School Facilities.

Special Education:

Grants to States Part B......  FY 2002..............  Such Sums...........     $7,528,533,000    $10,739,746,000
Preschool Grants.............  FY 2002..............  Such Sums...........       $390,000,000       $384,597,000
Grants for Infants and         FY 2002..............  Such Sums...........       $417,000,000       $440,808,000
 Families.
IDEA National Activities.....  FY 2002..............  Such Sums...........       $337,271,000       $248,632,000
Rehabilitation Services and    FY 2003..............  Such Sums...........     $3,013,305,000     $3,128,638,000
 Disability Research.

Special Institutions for
 Persons with Disabilities:

National Technical Institute   FY 2003..............  Such Sums...........        $53,800,000        $56,137,000
 for the Deaf.
Gallaudet University.........  FY 2003..............  Such Sums...........       $100,800,000       $107,657,000
Vocational and Adult           FY 2003..............  Such Sums...........     $2,121,690,000     $1,991,782,000
 Education.
Student Financial Assistance.  FY 2004..............  Such Sums...........    $14,007,296,000    $15,281,752,000
Student Aid Administration...  FY 2004..............  Such Sums...........       $116,727,000       $124,084,000

Higher Education:

Aid for Institutional          FY 2004..............  Such Sums...........       $485,065,000       $505,519,000
 Development.
International Education and    FY 2004..............  Such Sums...........       $103,680,000       $106,819,000
 Foreign Language.
Domestic Program.............  FY 2004..............  Such Sums...........        $89,211,000        $92,466,000
Institute for International    FY 2004..............  Such Sums...........         $1,629,000         $1,616,000
 Public Policy.
Fund for Improvement of Post   FY 2004..............  Such Sums...........       $157,700,000        $59,211,000
 Secondary Education.
Minority Science and           FY 2004..............  Such Sums...........         $8,889,000         $8,818,000
 Engineering Improvement.
Tribally Controlled Post-      FY 2004..............  $4,000,000..........         $7,185,000         $7,440,000
 Secondary Vocational and
 Technical Institutions.
Federal TRIO Programs........  FY 2004..............  Such Sums...........       $832,559,000       $836,543,000
GEAR UP......................  FY 2004..............  Such Sums...........       $298,230,000       $306,488,000
Javitts Fellowships..........  FY 2004..............  Such Sums...........         $9,876,000         $9,797,000
Graduate Assistance in Areas   FY 2004..............  Such Sums...........        $30,616,000        $30,371,000
 of National Need.
Teacher Quality Enhancement    FY 2004..............  Such Sums...........        $88,887,000        $58,000,000
 Grants.
Child Care Access Means        FY 2004..............  Such Sums...........        $16,098,000        $15,970,000
 Parents in School.
GPRA Data/HEA program          FY 2004..............  Such Sums...........           $988,000           $980,000
 evaluation.
B.J. Stupak Olympic            FY 2004..............  Such Sums...........           $988,000           $980,000
 Scholarships.
Howard University--Endowment   FY 1985..............  $2,000,000..........         $2,000,000         $3,524,000
 Program.
Institute of Education         FY 2002..............  Such Sums...........        $78,380,000        $72,566,000
 Sciences--Research and
 Innovation in Special
 Education.

RELATED AGENCIES

Corporation for National and   FY 1996..............  Such Sums...........       $600,385,000       $918,949,000
 Community Service.
Corporation for Public         FY 1993..............  $200,000,000........        $65,327,000        $52,000,000
 Broadcasting,
 Interconnection.
Corporation for Public         FY 2001..............  $20,000.............        $20,000,000        $30,000,000
 Broadcasting, Digitalization.
National Council on            FY 2003..............  Such Sums...........         $2,858,000         $2,800,000
 Disability.
----------------------------------------------------------------------------------------------------------------

          Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

   SECTION 1015 OF THE MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND 
                       MODERNIZATION ACT OF 2003


                          (Public Law 108-173)


SEC. 1015. FUNDING START-UP ADMINISTRATIVE COSTS FOR MEDICARE REFORM.

    (a) * * *
    (b) Availability.--Amounts provided under subsection (a) 
shall remain available until September 30, [2005] 2006.

           *       *       *       *       *       *       *




                             MINORITY VIEWS

    This bill is the clearest demonstration of what happens 
when Congress puts $140,000 tax cuts for those making more than 
a million dollars a year ahead of basic investments in 
education, healthcare, job training and job protection.
    As Majority Leader Tom DeLay pointed out two months ago 
during debate on the conference report on the FY 2006 budget 
resolution,

          This is the budget that the American people voted for 
        when they returned a Republican House, a Republican 
        Senate and a Republican White House last November.

    The average American family wants Congress to focus on 
creating conditions that make it easier for them to get a good 
education for their kids; keep secure and decent paying jobs at 
home; and provide affordable healthcare so that everyone has 
access to a doctor.
    This bill is the most visible and recent evidence that this 
Congress isn't doing that.
    Because the Republican Majority has already made a decision 
to borrow huge sums to provide super-sized, six-digit tax cuts 
to the most fortunate people in our society, they have to 
produce the kind of cuts we see in this bill.
    This spring, the Majority party in the House passed a 
budget resolution that provides $16 billion less than the 
amount necessary just to maintain current service levels for 
non-defense programs. At the same time, that budget resolution 
extended and expanded on the four years of successive tax cut 
bills that have reduced overall federal revenues to the lowest 
level since at least 1965, measured relative to the size of the 
economy. This bill implements that budget plan.
    On the budget resolution, the House Majority voted to cut 
an abstract category called ``domestic discretionary 
spending''. This bill, and other domestic appropriations bills, 
contains the very real cuts in specific programs that the House 
previously voted for in the abstract.
    In nominal dollar terms, this bill provides $1.6 billion 
less than the comparable FY 2005 level.* After adjusting for 
inflation and population growth, it represents a $5.7 billion 
cut in real purchasing power. As a result, this bill cuts 
ongoing services that Americans rely on to have a decent 
quality of life, engaging fully in work, family and their 
communities.
---------------------------------------------------------------------------
    * In computing the comparable level for FY 2005, we include about 
$1 billion in costs for administration of the new Medicare drug benefit 
that were covered in FY 2005 by a one-time special appropriation made 
in the authorizing legislation but which must be covered through 
regular discretionary appropriations in this bill starting in FY 2006. 
The figure used in the text refers to spending on programs, leaving 
aside rescissions, FY 2005 emergency designations, and other 
``scorekeeping adjustments''.
---------------------------------------------------------------------------
    This bill is so inadequate it even cuts deeply into the 
President's signature programs in training, healthcare and 
education. The bill cuts his Community College skills training 
initiative in half. It cuts the $300 million increase he 
proposed for Community Health Centers by two-thirds, and it 
completely eliminates his $1.5 billion High School reform 
initiative.
    We do not doubt that Chairman Regula and the Majority 
members of the Subcommittee tried to do the best they could 
with the budget figure they were given. The problem does not 
lie so much with how the Majority selected the particular 
education or health care or job training programs to be cut, as 
with the overall budget policy that mandates cuts in such high 
priority programs.

                                WORKERS

     The bill disinvests in job training and help for 
the unemployed--cutting these programs by $346 million below 
the current level while 7.6 million Americans remain out of 
work.
     It again cuts Adult Training Grants by another $31 
million (3.4 percent) below the 2005 level to $866 million--a 9 
percent cut below the $955 million provided in FY 1998 and the 
lowest funding level in 10 years.
     It cuts the U.S. Employment Service, which 
provides essential information about job openings to people 
looking for work, by $116 million (13.7 percent) below the 
current level and $67 million (8.4 percent) below the FY 2001 
level. The bill would eliminate job search assistance for 2.5 
million people.
     It further cuts critical services for at-risk 
youth--the very group the President says he and the First Lady 
are making a priority. Youth Training Grants serving high 
school drop outs are cut by $36 million (3.7 percent) below the 
current level to $950 million, eliminating training and work 
experience for 12,000 youth. The bill provides nearly 33 
percent less funding for youth training than provided in FY 
2001.
     It even cuts Job Corps below its current funding 
level. Job Corps is one of the most successful job training 
programs ever--placing 85 percent of disadvantaged, young 
adults into jobs and college, and taking them off the street.
     The bill eliminates the $50 million Youthful 
Offender initiative, eliminating skills training for 9,500 
young people who have gotten in trouble with the law.
     On the worker protection front, the Republican 
Majority has gutted the program that is supposed to act as a 
whistle blower on countries that compete for American jobs with 
child and slave labor. Eleven years after NAFTA, labor abuses 
continue in Mexico, China, and Central America. But, this bill 
takes the cop off the beat by cutting International Labor 
Affairs by 87 percent.

                                 HEALTH

    On healthcare, the Committee bill--like the President's 
budget--takes a step backward in efforts to maintain basic 
health services for the 45 million people without health 
insurance. In fact, it includes slightly less than proposed by 
the President for the Health Resources and Services 
Administration, the HHS agency whose mission it is to improve 
access to health care.
     The bill wipes out almost all of the HHS Title VII 
health professions training programs. In total, these programs 
see a reduction from $300 million to $47 million, a cut of 84 
percent. Of 12 programs in this category, only two remain. Some 
of the grants being terminated help students from minority and 
disadvantaged backgrounds attend health professions schools to 
alleviate the shortage of doctors and dentists in low-income 
and minority communities. Others provide training opportunities 
for medical students and residents in rural and other under-
served areas, to encourage them to go into practice in those 
areas.
     It also eliminates the Healthy Communities Access 
Program, which tries to repair some of the holes in the health 
care safety net and help health centers and public hospitals 
and other providers build more effective local systems of care 
for the uninsured.
     The bill cuts funding to help improve health care 
in rural areas by 41 percent. This includes a 73 percent cut in 
Rural Health Outreach grants, meaning no new grants and a big 
cut in ongoing projects.
     It cuts the Maternal and Child Health Block Grant 
by $24 million--producing a 20 percent reduction in per-capita 
purchasing power relative to four years earlier. This program 
helps states provide prenatal care for mothers and preventive 
health services and medical treatment for children lacking 
other sources of health care, including children with 
disabilities and other special needs.
     The bill reduces the increase requested by the 
President for Community Health Centers by two-thirds, from $304 
million to $100 million. More than half of the remaining 
increase has already been committed by the Department of HHS to 
fund applications for new health center sites and services that 
have been approved but for which FY 2005 funds were not 
available. Under the bill, relatively small amounts will be 
available in FY 2006 to cover rising health care costs at 
existing centers or to fund additional applications for new or 
expanded health centers.
     The measure eliminates the $100 million 
contribution to the Global Fund to Fight HIV/AIDS, Malaria and 
Tuberculosis, which had been included in the NIH budget for the 
past four years.
     With just a couple of exceptions, most health care 
programs that aren't cut by the bill have their funding frozen, 
with no increases to cover rising health care costs or 
caseloads or anything else. For example, the Ryan White AIDS 
programs--other than drug assistance--receive slightly less 
funding (in nominal dollars) than three years earlier, even 
though the number of patients with AIDS has been rising by more 
than 6 percent per year.
    As for research at the National Institutes of Health to try 
to find cures for diseases like Parkinson's disease or 
Alzheimer's, the Committee essentially adopted the President's 
budget. It provided an increase of only 0.5 percent--the 
smallest percentage increase in 36 years, and 2.6 percent short 
of what NIH estimates would be needed just to keep up with 
inflation in research costs. One result will be that NIH can 
support about 505 fewer research grants than just two years 
earlier.
    For the programs of the Centers for Disease Control that 
help protect the public against infectious and other diseases, 
some of the largest cuts come in assistance to state and local 
health departments. In particular, the Preventive Health Block 
Grant is cut by $31 million or 24 percent, relative to the FY 
2005 enacted level. These grants are used by states and 
localities for basic public health functions such as responding 
to disease outbreaks, immunizing children, and improving care 
for people with chronic diseases like diabetes and asthma. 
Further, grants that help health departments improve their 
preparedness against bio-terrorism and other public health 
emergencies are cut by $75 million.
    Most other CDC programs have their funding frozen. This 
includes prevention and control of HIV/AIDS, sexually 
transmitted diseases, tuberculosis, and most other infectious 
diseases, as well as environmental health. There is a welcome 
addition of $50 million for immunization against the flu, but 
no increase at all is provided for childhood immunization, 
despite rising vaccine costs.

                             HUMAN SERVICES

    In the human services area, the Committee cuts in half the 
Community Services Block Grant, a program aimed at helping the 
poorest people in our communities who often have no other place 
to turn. This is an improvement over the President's plan to 
abolish the program entirely, but it still leaves more than 
1,000 local community services agencies seriously short of 
resources to assist low-income people. The purpose of this 
block grant is to provide flexible funds to meet whatever a 
local community considers their most important needs, whether 
it be for job training, emergency food aid, programs for low-
income seniors, or home weatherization.
    The bill also cuts the Low-Income Energy Assistance Program 
(LIHEAP) by almost $200 million--even though there's no reason 
to expect that we won't have another winter of sky-high heating 
oil and natural gas prices. Over the past four years, the 
average cost of heating a home with oil has almost doubled, and 
the share of that cost covered by the average LIHEAP grant has 
fallen by half, from 49 percent to 25 percent.
    Further, the legislation includes an increase of just 0.7 
percent for Head Start--less than what would be needed to keep 
up with rising costs for teacher salaries, heating, 
transportation for children and other necessary expenses. It 
freezes appropriations for the Child Care Block Grant--marking 
the fourth year in a row that this block grant has been either 
frozen or cut and leading to a 13 percent reduction below FY 
2002 in terms of inflation-adjusted per capita purchasing 
power. It provides only a one percent increase for seniors' 
nutrition programs, such as Meals on Wheels, and no increase at 
all for other key programs at the Administration on Aging.

                               EDUCATION

    On the education front, the Republican Majority has 
essentially imposed the first freeze on education funding in a 
decade. At the same time, No Child Left Behind requires our 
schools to do more for a record 55 million school children. 
This bill, however, offers them little additional help. It 
takes a number of actions that shift more of the burden of 
financing education to the local property tax, even as Federal 
mandates to those same communities grow.
     It cuts No Child Left Behind by $806 million (3.3 
percent) below the current level. Under this bill, the NCLB 
funding shortfall will be $13.2 billion next year and over $40 
billion since enactment.
     The bill cuts the $603 million increase the 
Administration proposed for Title 1 to help low-income children 
improve their reading and math skills to only $100 million. The 
Administration's request was already inadequate. However, under 
this bill, Title 1 funding will be $9.9 billion below NCLB's 
funding promise for FY 2006.
     The Republican Majority again breaks its funding 
promise on IDEA, the program that is aimed at helping local 
communities pay for the costs of educational services to 
disabled children mandated by Federal law. The bill is $3.9 
billion below the Republican promise in the IDEA Improvement 
Act of 2004 to put special education funding on a glidepath to 
full funding. It even cuts the $508 million increase requested 
by the Administration to only $150 million. The entire idea of 
IDEA was to raise the federal share of special education costs 
to 40 percent over time. Under this bill, the federal share of 
special education costs will actually drop from 18.6 percent 
this year to 18.1 percent next year.
     The bill freezes After School Centers, virtually 
for the fourth year in a row at $991 million even though only 
38 percent of all after school applications nationwide could be 
funded last year. We are turning away children when more than 
14 million kids are unsupervised after school each day.
     It slashes Education Technology by $196 million 
(39.5 percent) on top of a $196 million cut last year. One in 
four states have no other dedicated technology funds to track 
NCLB student achievement data, improve teachers' use of 
technology, and close the achievement gap through online 
learning.
     It eliminates Comprehensive School Reform grants 
to 1,000 high-poverty schools by eliminating the program. 
Rigorous independent evaluations have shown that comprehensive 
school reform models such as Success for All, America's Choice, 
High Schools That Work, First Things First, and Talent 
Development are making a significant difference in helping 
schools implement integrated, schoolwide reform strategies. 
This bill turns its back on these schools.
     The bill cuts investments in teachers. It freezes 
the main NCLB program to put qualified teachers in every 
classroom--Teacher Quality State Grants--at $2.9 billion for 
the 3rd consecutive year of a freeze or cut. The bill denies 80 
percent of the Administration's $500 million request to provide 
an incentive for the best teachers to teach in the most 
challenging high-poverty schools. It cuts funds requested for 
math and science teachers by $79 million (29 percent). It even 
cuts teacher training in American history by $69 million (58 
percent).
     It freezes Impact Aid payments to 1,300 school 
districts for over 1 million military and other Federally-
connected children, funding Impact Aid at approximately 35 
percent below the maximum payments authorized for FY 2006. The 
bill also freezes flexible innovative education grants, English 
language training, civic education, State assessments, and 
rural education. Some of these programs have been frozen for 
four years in a row.
     Although the Republican Majority promised low-
income students a $100 increase in the maximum Pell Grant in 
the 2006 Budget Resolution, this bill provides only half that. 
The $50 increase would offset only 2 percent of the additional 
$2,300 in four-year public college costs since 2001.

                          PUBLIC BROADCASTING

    While we are pleased that the Committee adopted the 
Democratic amendment to restore $400 million in fiscal year 
2008 advance appropriations for the Corporation for Public 
Broadcasting, this bill still includes harmful cuts in Federal 
support for local television and radio stations, and for 
acclaimed children's programs such as Sesame Street, Mr. 
Rogers, and Reading Rainbow.
    This bill rescinds $100 million or 25 percent of the funds 
Congress has already enacted for the Corporation for Public 
Broadcasting for FY 2006. In addition, out of this reduced 
appropriation, the bill asks public broadcasters to absorb up 
to $82 million for the mandatory costs of digital conversion 
and replacement of the public television satellite 
interconnection system. In all, the bill would cut federal 
assistance to stations by as much 46 percent below the prior FY 
2006 enacted level. These cuts come at a time when commercial 
broadcasters are engaged in a race to the bottom to bolster 
ratings, while public broadcasting offers us refreshing, 
innovative, educational and in-depth alternative programming.

                               CONCLUSION

    What is at stake in this bill is not just the question of 
how much money will be provided. We are really facing the 
larger question of how well we will meet our obligations to the 
country's future. The President wants to blow up Social 
Security's guarantees as we know them and force Americans to 
count on their personal investments for their retirement. He 
has expended great time and energy to convince Americans they 
must invest for their future.
    The country needs to do the same thing. We have to count on 
our investments. However, this bill walks away from the 
investment we should be making in our human capital. One year 
of cuts might be tolerated. But, the LHHS bill is targeted for 
deeper and deeper cuts over time. One needs to look no further 
than No Child Left Behind.
           Four years ago, we fell $4.2 billion short 
        of the NCLB funding promise.
           Three years ago, we fell $5.4 billion short.
           Two years ago, the gap was $7.6 billion.
           Last year, the gap grew to $9.8 billion.
           Under this bill, the gap will exceed $13 
        billion.
    The same disinvestment is now occurring in programs such as 
job training, health professions training, child care, after 
school centers, and teacher training. And, this quiet erosion 
in these needed investments will get worse under the Majority's 
long-term plan.
    This is a prescription for America walking away from our 
commitment to equal opportunity and a better quality of life 
for all Americans. The only guarantee we are providing them in 
this bill is that greater access to better jobs and higher 
wages, affordable healthcare and quality educational and 
lifetime opportunities will not be achieved.

                       THE DEMOCRATIC ALTERNATIVE

    The Democratic Amendment offered during Appropriations 
Committee consideration of this bill would have invested an 
additional $11.8 billion for priority job training, education 
and health programs, and fully offset these funds by reducing 
super-sized, six-digit tax cuts that provide the greatest 
benefit to those who need it the least. It also included $11.8 
billion for deficit reduction. Under the Democratic Amendment, 
the average tax cut of a person making more than a million 
dollars would have been reduced from about $140,000 to $36,500. 
Unfortunately, the Democratic Amendment was defeated on a party 
line vote of 29 to 35.
    The Democratic Amendment invested an additional $7.8 
billion to provide real educational opportunity. The Amendment 
provided:
           $3 billion more for Title 1 reading and math 
        services for nearly 1 million additional low-income 
        students;
           $250 million more for teacher and school 
        improvement, which would have resulted in 22,000 
        additional teachers receiving high-quality professional 
        development and prevented 1,000 high-poverty schools 
        from losing ongoing comprehensive school reform grants;
           $939 million more for after school centers, 
        child care and Head Start centers to help working 
        families obtain high-quality childcare, an early 
        ``headstart'' on education, and after-school learning 
        opportunities for their children;
           $1.56 billion more for special education to 
        keep us on a glidepath toward full funding, instead of 
        losing ground as this bill would do; and
           A $450 increase in the maximum Pell Grant 
        for the lowest income students.
    The Democratic Amendment invested an additional $738 
million to provide more unemployed Americans with the job 
search assistance and training they need for the Jobs of the 
21th Century. The Amendment:
           Restored the $125 million cut from the 
        President's signature job training initiative so that 
        workers can qualify for the high-skills jobs that 
        employers in growth industries have found difficult to 
        fill;
           lnvested more in science, math and 
        technology education programs today so that we will 
        have a technologically proficient workforce tomorrow; 
        and
           Reversed the 87 percent cut in the Labor 
        Department funding that helps countries improve their 
        labor standards and eliminate abusive child labor.
    In terms of heath care and human services, the Democratic 
Amendment avoided most of the cuts made in the Committee bill 
and included additional funds for certain high priority 
investments. The Amendment:
           Restored funding for the health professions 
        programs, which help increase the number of minorities 
        in medical and dental schools and encourage medical 
        students to go into primary care and consider practice 
        in rural and underserved areas;
           Fully funded the President's request for 
        Community Health Centers, so that the many communities 
        applying for funds to start or expand a health center 
        have a better chance of actually receiving assistance;
           Expanded programs to address the special 
        health needs of rural areas, rather than cutting these 
        programs 41 percent as the Committee's bill does;
           Restored funding for grants to state and 
        local health departments to help combat infectious 
        diseases and other health threats and improve 
        preparedness against bioterrorist attack or natural 
        epidemic;
           Invested in biomedical research at NIH by 
        providing a sufficient increase to keep up with 
        inflation in research costs and to avoid the need to 
        reduce the number of research grants supported;
           Restored the $100 million contribution to 
        the Global AIDS Fund;
           Reversed cuts in the LlHEAP energy 
        assistance program, in order to help low-income 
        families and senior citizens avoid having to choose 
        between heating and eating next winter; and
           Raised funding for Community Services Block 
        Grant to its FY 2002 level of $650 million to help 
        local organizations operating in almost every county in 
        the U.S. provide basic services to poor people.
    One particular focus of the Democratic Amendment was 
increases in a series of programs that help young mothers and 
families in difficult circumstances care for infants and 
children, in part to reduce some of the economic pressures that 
might cause a woman to decide not to carry a pregnancy to term. 
We hear many expressions of concern for life. These concerns 
need to go beyond the rhetorical and attack the real life 
conditions that can lead a woman to make another choice. 
Lectures from politicians will not help unless we extend a hand 
to assist women to overcome economic pressures and other life 
challenges that sometimes make a pregnancy and the thought of 
another child seem overwhelming. Concern about life cannot end 
at the checkbook's edge.
    That is why the Amendment--
           Added $175 million to the Maternal and Child 
        Health Block Grant, to restore its purchasing power to 
        the FY 2002 level, and added $98 million to double the 
        Healthy Start program; both of these programs support 
        prenatal and infant health services and help young, 
        low-income mothers learn to care for their babies and 
        gain access to the services they need.
           Added $300 million to Child Care grants, 
        restoring purchasing power to FY 2002, to help low-
        income families secure safe and affordable child care.
           Added $418 million to restore the purchasing 
        power of the Community Services Block Grant, to help 
        local community-based agencies meet basic needs of low-
        income families, such as emergency assistance with food 
        and other needs, parenting education, child care, and 
        job training and placement.
           Added $126 million to double grants to 
        states and tribes for family violence prevention 
        programs and to provide shelter to victims of violence 
        and their children.
           Added $212 million to restore the purchasing 
        power of adult job training grants to FY 2002 levels, 
        to help parents acquire the skills needed to obtain 
        well-paying jobs to support their families.
    This Amendment also would have reversed a number of harmful 
cuts that would result in costs passed down to state and local 
governments, already squeezed by a wide array of cuts in 
programs across the Federal government that provide important 
services to the public.
    What is at stake in this bill is not just the question of 
how much money will be provided for education, healthcare, or 
job training. We are really facing the larger question of who 
we are as a people and what kind of nation we want to be. The 
Democratic Amendment sought to move us in the right direction.
                                   David R. Obey.
                                   Steny Hoyer.
                                   Rosa DeLauro.
                                   Jesse Jackson, Jr.
                                   Lucille Roybal-Allard.