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110th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 110-231
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2008
----------
R E P O R T
of the
COMMITTEE ON APPROPRIATIONS
together with
MINORITY AND ADDITIONAL VIEWS
[to accompany h.r. 3043]
July 13, 2007.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION,
AND RELATED AGENCIES APPROPRIATIONS BILL, 2008
110th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 110-231
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS BILL, 2008
_______
July 13, 2007.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Obey, from the Committee on Appropriations, submitted the following
R E P O R T
together with
MINORITY AND ADDITIONAL VIEWS
[To accompany H.R. 3043]
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
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, 2008,
and for other purposes.
INDEX TO BILL AND REPORT
_______________________________________________________________________
Page number
Bill Report
Summary of Estimates and Appropriations....................
3
General Summary of the Bill................................
3
Administration-Directed Spending...........................
4
Crosscutting Initiatives...................................
6
Title I--Department of Labor:
Employment and Training Administration............. 2
34
Employee Benefits Security Administration.......... 12
45
Pension Benefit Guaranty Corporation............... 12
46
Employment Standards Administration................ 13
47
Occupational Safety and Health Administration...... 19
51
Mine Safety and Health Administration.............. 23
54
Bureau of Labor Statistics......................... 24
55
Office of Disability Employment Policy............. 25
56
Departmental Management............................ 25
56
Veterans Employment and Training........... 27
61
Office of the Inspector General............ 28
61
General provisions................................. 28
62
Title II--Department of Health and Human Services:
Health Resources and Services Administration....... 33
63
Centers for Disease Control and Prevention......... 38
96
National Institutes of Health...................... 41
125
Substance Abuse and Mental Health Services
Administration................................. 48
174
Agency for Healthcare Research and Quality......... 50
183
Centers for Medicare and Medicaid Services......... 50
185
Administration for Children and Families........... 54
189
Administration on Aging............................ 62
204
Office of the Secretary............................ 62
208
Office of the Inspector General............ 64
214
Public Health and Social Services Emergency Fund... 65
215
General provisions................................. 67
219
Title III--Department of Education:
Education for the Disadvantaged.................... 77
221
Impact Aid......................................... 78
228
School Improvement Programs........................ 79
229
Indian Education................................... 81
234
Innovation and Improvement......................... 81
235
Safe Schools and Citizenship Education............. 83
244
English Language Acquisition....................... 84
247
Special Education.................................. 84
248
Rehabilitation Services and Disability Research.... 85
250
Special Institutions for Persons With Disabilities. 86
253
Career and Technical Education and Adult Education. 86
254
Student Financial Assistance....................... 89
257
Student Aid Administration......................... 89
259
Higher Education................................... 90
259
Howard University.................................. 91
270
College Housing and Academic Facilities Loans...... 91
270
Historically Black College and University Capital
Financing...................................... 91
270
Institute of Education Sciences.................... 92
271
Departmental Management............................ 92
274
Office for Civil Rights............................ 92
275
Office of the Inspector General.................... 93
275
General provisions................................. 93
275
Title IV--Related agencies:
Committee for Purchase From People Who Are Blind or
Severely Disabled.............................. 97
276
Corporation for National and Community Service..... 97
276
Corporation for Public Broadcasting................ 103
279
Federal Mediation and Conciliation Service......... 104
280
Federal Mine Safety and Health Review Commission... 106
280
Institute of Museum and Library Services........... 106
280
Medicare Payment Advisory Commission............... 106
282
National Commission on Libraries and Information
Science........................................
283
National Council on Disability..................... 107
283
National Labor Relations Board..................... 107
283
National Mediation Board........................... 108
284
Occupational Safety and Health Review Commission... 108
284
Railroad Retirement Board.......................... 108
284
Social Security Administration..................... 110
285
Title V--General Provisions:
House of Representatives Report Requirements.......
289
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations including trust funds for fiscal year 2007, the
budget request for fiscal year 2008 and the Committee
recommendation for fiscal year 2008 in the accompanying bill.
2008 LABOR, HHS, EDUCATION APPROPRIATIONS BILL
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year-- 2008 committee compared
----------------------------------------- to--
---------------------------
2007 2008 budget 2008 2007
comparable committee comparable 2008 budget
----------------------------------------------------------------------------------------------------------------
Department of Labor........................ $14,691 $13,942 $14,891 +$200 +$949
Advances............................... 2,531 2,525 2,525 -6 0
Department of Health and Human Services.... 422,185 472,056 477,406 +55,221 +5,350
Advances............................... 69,456 71,457 71,457 +2,001 0
Department of Education.................... 60,310 59,099 62,971 +2,661 +3,872
Advances............................... 15,034 15,034 17,004 +1,970 +1,970
Related Agencies........................... 48,774 52,492 52,659 +3,885 +167
Advances............................... 17,210 14,800 15,220 -1,990 +420
Grand Total, current year.................. 545,960 597,589 607,927 +61,967 +10,338
Advances............................... 104,231 103,816 106,206 +1,975 +2,390
Current year total using 302(b) 545,834 596,394 607,428 +61,594 +11,034
scorekeeping..............................
Mandatory.............................. 401,224 455,478 455,680 +54,456 +202
Discretionary.......................... 144,610 140,916 151,748 +7,138 +10,832
----------------------------------------------------------------------------------------------------------------
PROGRAM LEVEL DISCRETIONARY
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year-- 2008 committee compared
----------------------------------------- to--
---------------------------
2007 2008 budget 2008 2007
comparable committee comparable 2008 budget
----------------------------------------------------------------------------------------------------------------
Department of Labor........................ $11,686 $10,964 $11,913 +$227 +$949
Department of Health and Human Services.... 64,054 63,195 68,344 +4,290 +5,149
Department of Education.................... 57,473 56,225 62,068 +4,595 +5,843
Related Agencies........................... 11,522 11,326 11,913 +391 +587
Subtotal Program Level................. $144,735 $141,710 $154,238 +$9,503 +$12,528
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
Funding levels in the fiscal year 2008 appropriation bill
for the Departments of Labor, Health and Human Services,
Education and Related Agencies reflect the Committee's efforts
to understand the challenges that the nation faces over the
next ten years and what the nation must do to address them.
While reducing the Federal deficit is a worthy goal, the nation
has a number of other deficits that are equally important--
deficits in worker development, safety and protection; deficits
in health access, affordability and quality; and deficits in
educational access and opportunity. In this bill, theCommittee
makes crucial investments in priority programs that will help to begin
the process of erasing these deficits over the next several years.
Bill total.--Total funding, including offsets, for the
Departments of Labor, Health and Human Services, Education and
Related Agencies Appropriations Act, 2008 is $607,428,474,000.
Discretionary programs.--For Discretionary accounts for
fiscal year 2008 the bill provides $151,748,000,000, including
offsets. This is $7,137,515,000 and 4.9 percent above the
fiscal year 2007 comparable level.
Mandatory programs.--The bill provides $455,680,474,000 for
entitlement programs in fiscal year 2008. This is
$54,456,359,000 above the fiscal year 2007 comparable level.
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 2007
and 2008.
MANDATORY
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
Program Fiscal year 2007 Fiscal year 2008 Change
----------------------------------------------------------------------------------------------------------------
Department of Labor:
Federal Unemployment Benefits and Allowances....... $837,600 $888,700 +$51,100
Advances to the UI and other trust funds........... 465,000 437,000 -28,000
Special Benefits................................... 227,000 203,000 -24,000
Special Benefits for Disabled Coal Miners.......... 229,373 208,221 -21,152
Energy Employees Occupational Illness Compensation 102,307 104,745 +2,438
Fund..............................................
Black Lung Disability Trust Fund................... 1,069,546 1,068,000 -1,546
Department of Health and Human Services:
Vaccine Injury Compensation Trust Fund............. 55,871 57,547 +1,676
Medicaid current law benefits...................... 155,467,869 194,109,000 +38,641,131
Medicaid State and local administration............ 9,881,583 10,014,716 +133,133
CMS Vaccines for Children.......................... 2,905,330 2,763,957 -141,373
Medicare Payments to Healthcare Trust Funds........ 176,298,480 188,828,000 +12,529,520
Welfare Payments................................... 39,000 39,000 0
Child Support Enforcement.......................... 4,424,678 3,910,713 -513,965
Social Services Block Grant........................ 1,700,000 1,700,000 0
Promoting Safe and Stable Families................. 345,000 345,000 0
Payments to States for Foster Care and Adoption.... 4,912,000 5,082,000 +170,000
Medical Benefits for Commissioned Officers......... 370,698 402,542 +31,844
Department of Education:
Vocational Rehabilitation.......................... 2,837,160 2,837,160 0
Related Agencies:
Federal Payments to the Railroad Retirement Account 150 150 0
Payments to Social Security Trust Funds............ 20,470 28,140 +7,670
Supplemental Security Income....................... 37,231,000 40,738,000 +3,507,000
----------------------------------------------------------------------------------------------------------------
Administration-Directed Spending
Directed spending.--The Committee notes that Congress has
made significant reforms in the way it reviews funding for the
Federal government; reforms which the Committee takes very
seriously as it executes its constitutional authority. For
example, the Committee has committed to reducing the number of
earmarks in order to ensure that these projects are adequately
vetted and evaluated. Nonetheless, earmarking or directed
spending of Federal dollars does not begin with Congress. It
begins with the Executive Branch.
For example, the Administration's own fiscal year 2008
request for this bill includes a number of requests to earmark
funds to certain organizations. These earmark requests include:
$10,000,000 for Reach Out and Read; $10,000,000 for Teach for
America; $8,900,000 for the Points of Light Foundation;
$4,450,000 for America's Promise; $1,774,000 for the Mind-Body
Institute; and, $1,429,000 for the YMCA of America.
The Executive Branch also engages in another practice which
steers or directs money to specific entities or purposes
through a process of providing grants or contracts to support
various activities and services. The practice of contracting
has increased significantly in the past five years. For
example, Department of Health and Human Services contract
obligations have more than doubled from $4,970,200,000 in
fiscal year 2001 to $13,199,400,000 in fiscal year 2006. The
number of contract employees at HHS exceeds 32,000, about half
the number of civil service employees. A significant share of
these contracts was awarded on a non-competitive basis. In
fiscal year 2006 alone, HHS awarded nearly 21,000 contracts
worth $1,954,600,000 with less than full and open competition.
In contrast, this bill is expected to limit Congressionally-
directed earmarks by Members of the House of Representatives to
approximately one quarter of that amount.
The Committee also notes recent audits and reports that
have revealed egregious, potentially extralegal activities,
which were aimed at steering funding to specific individuals
and entities through non-competitive grants and contracts.
For example, between September 2006 and March 2007, the
Department of Education Office of Inspector General (OIG)
completed one of its most exhaustive investigations, which
resulted in six separate audits of the reading first program.
These audits documented efforts by the Department of Education
to steer billions in reading first funds for the purchase of
certain reading textbooks and assessments in order to benefit
favored publishers and individuals.
In September 2006, the Department of Education OIG found
that the Department's program officials strongarmed States and
school districts until they selected the reading textbooks and
assessments favored by Administration officials. (Office of
Inspector General, U.S. Department of Education, Final
Inspection Report, The Reading First Program's Grant
Application Process (2006)). After further investigation of
reading first, the OIG found that Department of Education
administrators improperly promoted commercial reading programs
in potential violation of Federal law (Office of Inspector
General, U.S. Department of Education, Final Inspection Report,
The Department's Administration of Selected Aspects of the
Reading First Program (2007)). For example, the Madison School
District in Wisconsin had substantial data demonstrating that
its students were learning at the rate that reading first was
aiming for. Nonetheless, the district lost its $2,000,000
reading first grant when the district would not purchase the
unproven commercial reading program promoted by the Department
of Education's contractors. Across the country, including in
Illinois, Kentucky, Massachusetts, Maine and New Jersey, States
and districts with programs that were not on the Department's
preferential list were either rejected for grants or pressured
to change their methods even though some argued, as did
Wisconsin, that their programs met the law's standard. This is
the type of pressure that the OIG found to be in potential
violation of Federal law.
Finally, the OIG found significant bias and conflicts of
interest on the part of contractors and their subcontractors
who were hired to provide unbiased technical assistance to
States and school districts, potentially in violation of
Federal law (Office of Inspector General, U.S. Department of
Education, Final Inspection Report, RMC Research Corporation's
Administration of Reading First Program Contracts (2007)).
Recently, ABC News reported that, after receiving millions
of dollars in reading first contracts, one publisher with
political connections to the Administration sold his company--
once valued at $5,000,000--for $360,000,000. (ABC World News
With Charles Gibson (May 2007)). Some of these same publishers
and individuals continue to reap financial gains under reading
first because the Administration has failed to address ongoing
conflicts of interest.
The seriousness of the OIG's findings is underscored by
reports that the OIG has made criminal referrals to the Justice
Department as a result of these investigations.
At the same time that the Department of Education was
promoting certain reading products that lacked evidence of
their validity, reading programs such as Reading Recovery and
Success for All with strong evidence of effectiveness,
according to the Department's own what works clearinghouse,
were virtually shut out of reading first. In fact, Department
of Education data show that schools without Reading first funds
were more likely to use Reading Recovery and Success for All--
proven approaches--than were schools receiving reading first
grants.
The Committee finds, however, that efforts to steer funding
to favored entities are not limited to the Department of
Education. Recently, the Congressional Research Service
documented an unusually large number of sole source grants
issued by the Employment and Training Administration within the
Department of Labor, which resulted in 90 percent of
discretionary funds for the High Growth Job Training Initiative
being awarded on a non-competitive basis over a five-year
period.
Finally, the Committee notes that this bill contains more
than $68,000,000,000 for discretionary grant programs under
which all or a portion of the funds are allocated on a
discretionary basis to grantees selected by the Administration.
Altogether, the Administration steers or directs far greater
spending to specific projects, individuals, and companies than
is directed or earmarked by Congress.
CROSSCUTTING INITIATIVES
The following section of the report highlights nine
initiatives within the bill that target various needs of the
American people--access to different types of health care and
public health preparedness, biomedical research to inform and
improve that health care, education for kindergarteners through
twelfth graders and post-secondary students, and training and
protecting adult workers. A number of programs supported by the
bill appear more than once in the initiatives, appropriately so
because some of the programs have broad, multi-layered
missions. For example, community health centers are an
important source of primary care for the uninsured. They also
provide dental care in many communities, as well as pre-natal
care to mothers considering how to manage their pregnancy. All
these programs stand on their own, but also participate in
individual or multiple cross-cutting initiatives that serve
those most in need.
INCREASING ACCESS TO HEALTH CARE FOR THE UNINSURED
The Committee includes a $622,875,000 increase over fiscal
year 2007 and $645,302,000 over the request for critical safety
net health programs in order to respond to the nation's
healthcare crisis.
Twenty years ago, fewer than 30 million Americans lacked
health care insurance. Today, Census Bureau data show that
there are approximately 46.6 million uninsured Americans. This
means life-saving care is out of reach for almost 16 percent or
one in six Americans. If current trends continue, the ranks of
the uninsured will balloon to 56 million by 2013.
To date, the Federal government has responded to the health
insurance crisis by patching the frayed safety net of health
programs, chiefly through Medicaid and the State Children's
Health Insurance Program (SCHIP).
Nationally, 50 million Americans, including 24 million
children, will be enrolled in Medicaid during fiscal year 2008.
An average of 4.4 million children were enrolled in the SCHIP
program at a particular point in time last year. However, these
programs do not generally cover adults without children or
those with incomes above $20,420, which is 200 percent of the
Federal poverty level for one person. In addition, 1.8 million
eligible children are not yet enrolled in either Medicaid or
SCHIP.
The Committee first addressed the problem of the uninsured
by funding State planning grants during fiscal years 2000 to
2005. States used these grants to collect data about the
characteristics of the uninsured within their State and to
develop proposals to offer affordable health insurance
coverage.
Planning grants were the genesis of some of the
comprehensive programs States like Massachusetts, Maine,
Vermont, and California are now putting in place. These
programs rely on a mix of State, Federal, participant, and
provider/insurer contributions. Other States were not able, for
fiscal or political reasons, to move beyond initial planning
activities but are now ready to undertake more serious health
system reform efforts.
The Committee believes that now is the time to build on the
earlier State planning grants program to help States make
further advances in covering uninsured Americans. Due to the
considerable differences in the share of the population that
has access to employer-based health insurance, the share
covered by government benefit programs, and the geographic
distribution of health care providers, these new State grants
will be able to target programs in a way that is specific to
their particular needs.
State health access grants.--The Committee bill provides
$75,000,000 for a State health access initiative to be
administered by the Health Resources and Services
Administration. Grants would be awarded competitively to States
that demonstrate they have a program design ready to implement
and that they have achieved the necessary State and local
statutory or regulatory changes to permit their project to move
forward. The types of activities that could be supported
through the Federal grant include ``three share'' community
coverage (State/Federal, employer and beneficiary), reinsurance
plans, subsidized high risk insurance pools, health insurance
premium assistance, creation of a state insurance ``connector''
authority to develop benefit packages for small employers,
development of statewide or automated enrollment systems for
public assistance programs and innovative strategies to insure
low-income childless adults.
State high risk insurance pools.--The Committee provides
funding for a second important health care access program--
$50,000,000 to support State high risk insurance pools. This
program was not funded in fiscal year 2007. The Administration
did not request funding for fiscal year 2008.
The Committee feels it is important to provide a Federal
contribution to this health care safety net program. 33 States
currently operate high-risk pools that act as the health
insurers of last resort for almost 200,000 individuals who have
lost or are ineligible for group insurance coverage, and who
are medically high-risk and unable to purchase individual
health insurance in the commercial market. The program also
produces the side benefit of reducing costs for insured people
by providing coverage to individuals who would otherwise be
uninsured and very costly to care for--thus reducing the cost-
shifting that results in higher premiums to those with
coverage. High-risk pools are a successful public/private
partnership. All risk pool participants pay a monthly premium,
capped at 125 to 200 percent of the average market premium.
Insurers and health care providers support the program through
assessments, and some States contribute to their pools. Federal
funding allows States with high risk pools to reduce premiums
charged to participants and to improve benefits.
The Committee has also tried to deal with the problem of
the uninsured by expanding existing safety net programs that
provide health care to uninsured and disadvantaged populations:
ACCESS TO HEALTH CARE FOR THE UNINSURED INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/Program Fiscal Year 2008 -------------------------------------
Committee Fiscal Year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Services................ 6,423,769 +602,875 +625,302
Health Resources and Services Administration:
State Health Access Grants..................... 75,000 +75,000 +75,000
State High Risk Insurance Pools................ 50,000 +50,000 +50,000
Community Health Centers....................... 2,188,000 +199,961 +199,533
Ryan White AIDS Programs....................... 2,237,086 +99,291 +79,174
Maternal & Child Health Block Grant............ 750,000 +57,000 +57,000
Healthy Start.................................. 120,000 +18,482 +19,497
Family Planning................................ 310,910 +27,764 +27,807
National Health Service Corps.................. 131,500 +5,827 +15,541
CDC Childhood Immunization..................... 516,273 +58,750 +91,150
Medicare SHIP Programs......................... 45,000 +10,800 +10,600
Department of Labor.................................... 20,000 +20,000 +20,000
Gap Filler Grants for TAA Health Coverage Tax 20,000 +20,000 +20,000
Credit\1\
========================================================
Total.................................................. 6,443,769 +622,875 +645,302
----------------------------------------------------------------------------------------------------------------
\1\Funding for these grants comes from H1B fee revenues under the American Competitiveness and Workforce
Improvement Act.
Community health centers.--A $199,961,000 or 10.1 percent
increase over fiscal year 2007 is provided for community health
centers (CHCs). CHCs now provide primary and dental care for
over 16 million patients, 75 percent of whom are either
uninsured or on Medicaid. This increase will expand services to
an additional one million patients in the neediest and most
underserved areas, providing a critical point of primary care
for many uninsured Americans.
Ryan White AIDS Act.--A $99,291,000 or 4.7 percent increase
over the fiscal year 2007 level is provided for the Ryan White
AIDS programs. The Committee provides the maximum authorized
level for the Ryan White Act. These programs provide vital
health services to over 500,000 people with HIV or AIDS,
including medications, primary care, dental services, mental
health care, home health care and health insurance continuation
grants.
Maternal and child health (MCH) block grant.--A $57,000,000
or 8.2 percent increase over the fiscal year 2007 level is
provided for the maternal and child health block grant. States
use the block grant to improve access to care for mothers,
children, and their families; reduce infant mortality; provide
pre- and post-natal care; support screening and health
assessments for children; and provide systems of care for
children with special health care needs. Approximately 28
million children are served by MCH block grant funding.
Healthy start.--A $18,482,000 or 18.2 percent increase over
the fiscal year 2007 level is provided for the Healthy Start
program. Healthy Start provides discretionary grants to
communities with high rates of infant mortality to provide
ongoing sources of primary and preventive health care to
mothers and their infants. The increase provided will support
almost 20 new grants to communities. Healthy Start is a
significant source of health care for uninsured mothers who
have extensive need for the costly medical care associated with
their pregnancies.
Family planning.--A $27,764,000 increase over fiscal year
2007 is recommended for the family planning program. 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.
More than five million people receive services from Title X
each year.
National health service corps.--A $5,827,000 or 4.6 percent
increase over fiscal year 2007 is provided for the national
health service corps (NHSC). The NHSC supports 4,600 clinicians
across the country who provide medical and dental services to
four million people in low-income and underserved communities.
NHSC clinicians provide services in underserved areas as
repayment for loan repayments or scholarships.
CDC childhood immunization.--A $58,750,000 or 13 percent
increase above the fiscal year 2007 level is provided for the
discretionary CDC immunization program, which provides vaccines
to children, adolescents, and adults who are not eligible for
the vaccines for children mandatory program and cannot
otherwise afford the cost of immunization. In 1999, 747,000
children were fully vaccinated through this program. However,
by 2006, only an estimated 279,000 children were served--a 63
percent reduction. The resources provided in the bill will
enable an additional 42,000 children and adults to receive
recommended vaccinations. The Committee intends this to be an
initial step toward restoring services under this important
safety net program.
Medicare SHIP program.--An $10,800,000 or 32 percent
increase above the fiscal year 2007 funding level is provided
for the State Health Insurance program (SHIP). The program
operates in every State to provide health insurance counseling
to help the 45 million Medicare beneficiaries understand and
utilize their Medicare benefits, including Medicare preventive
benefits.
TAA health coverage tax credit.--The bill provides that
$20,000,000 of funds available to the Department of Labor under
the American Competitiveness and Workforce Improvement Act of
1998 may be used for ``gap filler'' grants to help more trade-
impacted workers take advantage of the Health Coverage Tax
Credit. Various studies show that as few as 10-12 percent of
Trade Assistance Act participants currently take advantage of
the Health Coverage Tax Credit that was authorized by the Trade
Adjustment Assistance Reform Act of 2002.
IMPROVING ACCESS TO DENTAL CARE
The Committee bill includes a $264,288,000 or 9.0 percent
increase over the fiscal year 2007 level for several programs
and new initiatives to expand urgently needed dental health
services. The increase over the Administration's request is
$367,280,000.
Oral disease is a ``silent epidemic'' impacting the most
vulnerable Americans--poor children, the elderly, and many
members of racial and ethnic minorities. Lack of dental care is
not a minor problem. Children have died because of infections
brought on by the absence of dental services.
More Americans are without dental insurance than health
insurance. For every child without health insurance there are
at least 2.6 children without dental insurance. For adults,
there are at least three lacking dental insurance for every one
without medical coverage.
Since oral health is progressive and becomes more complex
over time, a prolonged lack of dental care can threaten an
individual's overall health status.
This bill expands critical dental services to these
underserved populations and takes a first step toward
alleviating the crisis in dental health.
DENTAL CARE INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/Program Fiscal Year 2008 -------------------------------------
Committee Fiscal Year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Health Resources and Services Administration:
Community Health Centers........................... 2,188,000 +199,961 +199,533
Maternal and Child Health Block Grant.............. 750,000 +57,000 +57,000
Pediatric Dentistry Leadership Training 610 0 0
Programs [nonadd].............................
Oral Health Service Grants [nonadd]............ 12,000 +7,000 +7000
National Health Service Corps...................... 131,500 +5,827 +15,541
Ryan White AIDS Programs AIDS Dental Services...... 13,086 0 0
Scholarships for Disadvantaged Students............ 46,657 0 +36,924
Training in Primary Care Medicine and Dentistry.... 48,851 0 +48,851
Public health, preventive med. & dental pgms....... 7,920 0 +7,920
Centers for Disease Control and Prevention:
Oral Health........................................ 13,140 +1,500 +1,511
========================================================
Total.............................................. 3,199,154 +264,288 +367,280
----------------------------------------------------------------------------------------------------------------
Community health centers.--A $199,961,000 or 10.1 percent
increase over fiscal year 2007 is provided for community health
centers (CHCs), which provide access to high quality, family
oriented care for at-risk, low-income Americans. In calendar
year 2005, 17 percent of all CHC patients were receiving dental
services and 73 percent of all CHCs offered on-site dental
services. All new CHCs are required to provide primary oral
health care services in order to expand access to low-income
individuals. The funding increase for the program will also
permit existing centers to initiate or expand dental services.
Maternal and child health block grant.--A $57,000,000 or
8.2 percent increase over fiscal year 2007 is provided for the
maternal and child health (MCH) block grant. Within the MCH
special projects demonstration authority, $12,000,000 is
provided for up to 25 competitive State grants to help expand
access to oral health services. These grants can be used to:
encourage more dentists to practice in shortage areas through
existing mechanisms or new demonstrations of loan forgiveness
and repayment; provide grants to establish or expand oral
health services in community-based facilities; expand dental
residency programs; integrate oral health services into the
medical home concept for children with special health care
needs; and provide grants to ensure low-income pregnant women
and women of child-bearing age have access to appropriate oral
health services. The block grant also provides approximately
$1,000,000 for pediatric dentistry leadership training
programs. These programs fund a variety of oral health grants
that support the infrastructure of State and local oral health
programs and facilitate training in general pediatric dentistry
to serve the population served by the maternal and child health
block grant.
National health service corps.--A $5,827,000 or 4.6 percent
increase is provided for the national health service corps
(NHSC). The Corps provides physicians, dentists, nurses and
other clinicians who serve in health professional shortage
areas in every State. The NHSC provides access to primary care
and dental services for underserved populations who are not
able to get care because of the costs of services, the small
share of clinicians who pursue primary care or dentistry, and
the geographic misdistribution of health professionals. More
than 10 percent of the current 4,600 NHSC assignees are
dentists.
AIDS dental services.--$13,086,000 is provided for AIDS
dental services. The program includes two components: the
dental reimbursement program, which reimburses dental education
programs for non-reimbursed costs incurred in providing care to
AIDS patients; and the community-based dental partnership,
which increases access for AIDS patients to oral health
services and provider training in community settings. This
program provides dental services to 31,000 HIV positive
patients.
Scholarships for disadvantaged students.--$46,657,000 is
provided for the scholarships for disadvantaged students
program, the same as fiscal year 2007 and a $36,924,000
increase over the President's request. This program includes
scholarships to disadvantaged dental and dental hygiene
students. In 2006, 653 dental students and 110 dental hygiene
students received scholarships.
Training in primary care medicine and dentistry.--
$48,851,000 is provided for training in primary care medicine
and dentistry, which includes both general dentistry programs
and pediatric dentistry programs. The Administration's request
did not include funding for this program.
Public health, preventive medicine and dental programs.--
$7,920,000 is provided for the public health, preventive
medicine and dental programs. The President did not request
funding for this program. The dental public health programs
support the education and training of the public health
workforce, with an emphasis on placing public health dentists
in medically underserved areas. These programs support students
with traineeships and fellowships in programs that have
demonstrated they serve underrepresented minorities and those
entering practice in underserved areas.
Oral health.--A $1,500,000 or 13 percent increase over the
fiscal year 2007 level is provided for the oral health program
within the Centers for Disease Control and Prevention. The oral
health program supports leadership and staff of State oral
health programs in monitoring, improving, and evaluating oral
health programs. The CDC works with all States to develop
programs to reach children at high risk for oral disease, to
expand the fluoridation of community water systems, and to
track oral diseases. In addition to these activities, the CDC
also provides funds to States to support their oral health
programs.
ADVANCING BIOMEDICAL RESEARCH
The knowledge foundation that underlies the treatments
provided by virtually every doctor in the nation is the result
of advances in biomedical research conducted in large part by
the National Institutes of Health (NIH). In fiscal year 1999,
Congress made a commitment to double the NIH budget over five
years in order to capitalize on scientific advances so that
they could be translated into treatment and cures for
debilitating diseases like Parkinson's, cancer, Alzheimer's and
diabetes. This investment has helped NIH to lead the way toward
important medical discoveries that improve people's health and
save lives. For example, the first map of the human genome has
been completed, much more is known about the links between
genetics, molecular processes and diseases, and new techniques
have been developed in biomedical imaging.
Since the completion of the doubling period, however,
Congress has reversed direction. The NIH enterprise has
languished with inadequate budget increases since fiscal year
2003, and even received a funding cut in fiscal year 2006, the
first cut in 36 years. As a result of shrinking resources in
real terms, young researchers drawn to the field during the
expansion and even their senior mentors are now seeing their
research applications being rejected. Universities who have
made investments in their research enterprise now wonder if
they took on a bad risk.
The Committee has made the difficult choices necessary to
provide a $750,000,000 increase over fiscal year 2007 for NIH.
This level is $1,028,646,000, over the President's request and
the largest increase in four years. The Committee hopes to put
NIH on a path of stable, sustainable funding rather than the
feast or famine approach of the last decade.
The sizeable investment the Committee makes in biomedical
research for fiscal year 2008 will accomplish a number of
important goals. First, it will increase the number of new and
competing research grants by approximately 545 new grants over
last year for a total of 10,666. Total new and continuing
grants will rise to 39,003. The Committee also funds a two
percent increase in the average cost of new research grants,
which has been frozen for two years.
In addition, the Committee reaffirms its strong support for
the National Children's Study by providing $110,900,000 for
this critical investment for which the Administration proposed
no funds. The study will examine important health issues,
including: birth defects and pregnancy-related problems,
injuries, asthma, obesity and diabetes, and behavior, learning,
and mental health disorders. By establishing links between
children's environments and their health, and charting their
development through infancy, childhood, and early adulthood,
the study hopes to determine the root causes of many childhood
and adult diseases. The Committee also provides $300,000,000
for the global fund for AIDS, malaria and tuberculosis.
Consistent with the new NIH authorization, the bill provides
$495,153,000 for the Common Fund, which will be the incubator
for the promising cross-disciplinary research of the future.
The Committee believes the next generation of medical
advances will depend, in part, on the next generation of new
researchers. The bill continues funding for several
initiatives--Bridge awards, New Innovator awards, and Pathways
to Independence--to ensure that new, talented researchers in
the pipeline are sustained and supported. The Committee also
provides an average two percent increase for research training
stipends, which have been frozen since 2004. Support for high-
risk, high reward research will be maintained through Pioneer
awards. In addition, the bill increases funding for NIH's
research infrastructure to ensure adequate facilities for NIH-
supported scientists.
Reducing the Need for Abortions
The Committee bill includes a $647,021,000, increase over
the fiscal year 2007 level, and $1,374,882,000 over the
request, for several programs and new initiatives that are
intended to help reduce the number of abortions in America by
alleviating the economic pressures and other real life
conditions that can sometimes cause women to decide not to
carry their pregnancies to term.
Nearly half of all pregnancies in the United States are
unintended, and of these four in ten end in abortion. Women
living below the federal poverty level are more than four times
more likely to have an abortion than those with incomes above
300 percent of the federal poverty level.
Over the last several years, Federal investments aimed at
preventing unintended pregnancies and providing critical health
and social support services that can help vulnerable women and
families overcome economic pressures and other life challenges
have been significantly curtailed. This bill provides a first
installment toward restoring and expanding prevention and
support services to address this important issue.
REDUCING THE NEED FOR ABORTIONS INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/Program Fiscal Year 2008 -------------------------------------
Committee Fiscal Year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.................................... 15,000 +15,000 +15,000
Job Corps\1\....................................... 5,000 +5,000 +5,000
Young Parents Training Pilot Projects.............. 10,000 +10,000 +10,000
Department of Health and Human Services................ 13,569,700 +553,171 +1,246,382
Community Health Centers........................... 2,188,000 +199,961 +199,533
Maternal and Child Health Block Grant.............. 750,000 +57,000 +57,000
Increasing Public Awareness and Resources for 15,000 +15,000 +15,000
Women Preparing for Birth [nonadd]............
Healthy Start...................................... 120,000 +18,482 +19,497
Family Planning.................................... 310,910 +27,764 +27,807
CDC Teen Pregnancy Prevention Demos................ 10,000 +10,000 +10,000
CDC National Survey of Family Growth............... 1,000 +200 +120
Child Care Development Block Grant................. 2,137,081 +75,000 +75,000
Head Start......................................... 6,963,571 +75,000 +175,000
Runaway and Homeless Youth......................... 97,837 +10,000 +10,000
ACF Home Visits for Mothers........................ 10,000 +10,000 0
ACF Infant Adoption Awareness...................... 14,674 +2,000 +2,000
Community Services Block Grant..................... 660,425 +30,000 +660,425
Domestic Violence Program.......................... 134,731 +10,000 +10,000
Abstinence Education............................... 141,164 +27,764 0
Adolescent Family Life (Title XX).................. 30,307 0 0
Department of Education................................ 129,310 +78,850 +113,500
21st Century After-School Centers\2\............... 50,000 +50,000 +50,000
Elementary and Secondary School Counselors......... 61,500 +26,850 +61,500
Child Care Access for Student Parents.............. 17,810 +2,000 +2,000
========================================================
Total.......................................... 13,714,010 +647,021 +1,374,882
----------------------------------------------------------------------------------------------------------------
\1\This $5,000,000 is part of a larger $42.6 million increase provided by the Committee for the Job Corps.
\2\This $50,000,000 is part of a larger $125 million increase provided by the Committee for 21st Century After-
School Centers.
Job Corps child centers.--$5,000,000 is recommended for the
development of new child care centers at Job Corps centers
within the $42,621,000 or 2.7 percent increase over the
comparable fiscal 2007 level provided for Job Corps. The new
child care centers will support single parent families and help
recruit women into the program. The Job Corps program provides
intensive occupational skills training, academic tutoring, and
mentoring that can help young women achieve economic self-
sufficiency, addressing the most often cited reason for women
having abortions--the inability to financially support a child.
Young parents demonstration program.--A new $10,000,000
initiative is recommended for a young parents demonstration
program in order to target educational and occupational skills
training that fosters family economic self-sufficiency to young
parents (both mothers and fathers) and expectant mothers ages
16 to 24. Projects funded under this new initiative will be
encouraged to serve young parents in high-risk categories,
including those under the jurisdiction of the justice system,
in the child welfare or foster care system, homeless
individuals, or victims of child abuse.
Community health centers.--A $199,961,000 or 10.1 percent
increase over fiscal year 2007 is provided for community health
centers (CHCs), which are important sources of access to high
quality, family oriented, and comprehensive primary and
preventive health care for at risk, low-income patients. In
fiscal year 2005, 59 percent of the patients served by CHCs
were female and 25 percent were children under 12 years of age.
These additional resources will help centers serve additional
pregnant women and mothers and expand the types of services for
that population, such as ultrasound scans.
Increasing public awareness of resources available to women
preparing for birth.--A $57,000,000 or 8.2 percent increase
over fiscal year 2007 is provided for the maternal and child
health (MCH) block grant, of which $15,000,000 is provided for
new competitive grants to States to increase public awareness
of resources available to women and new parents preparing for
childbirth through advertising campaigns and toll-free
hotlines. The remainder of MCH block grant resources will
provide assistance to States to: assure access to care,
especially for those with low incomes or limited availability
of care; reduce infant mortality; provide and ensure access to
comprehensive prenatal and postnatal care to women; and,
provide preventive and treatment services for children,
especially children with special health care needs.
Healthy start.--A $18,482,000 or 18.2 percent increase over
fiscal year 2007 is provided for Healthy Start, which provides
discretionary grants to communities with high rates of infant
mortality to provide ongoing sources of primary and preventive
health care to mothers and their infants. The increase provided
will support approximately 20 new grants to communities. The
availability of services through the Healthy Start program,
including the counseling and home visits, encourages young
women to follow through with their pregnancies and avoid the
choices sometimes made in the absence of supportive services.
Family planning.--A $27,764,000 increase over fiscal year
2007 is recommended for the family planning program. This
increase will allow clinics to serve an additional 98,000
clients, expand access to contraceptive services that prevent
pregnancy, and offer related preventive health services. The
$27,764,000 increase for family planning is identical to that
recommended for the community-based abstinence education
program. The funds provided are expected to prevent more than
one million unintended pregnancies.
Teen pregnancy prevention demonstration grants.--A new
$10,000,000 initiative is recommended within the Centers for
Disease Control and Prevention for grants to support factually
and medically accurate, complete, and age-appropriate
approaches to preventing teen pregnancies, including
information about both abstinence and contraception, and
dissemination of science-based tools and strategies to prevent
HIV, STD, and teen pregnancy. The Secretary of Health and Human
Services shall require each applicant for financial assistance
under this program to certify that all materials proposed in
the application and funded during the project period of the
grant are medically accurate. The Secretary of Health and Human
Services shall require a panel of medical experts to review all
grant applications and assess whether the materials proposed
are medically accurate. These demonstration projects shall be
evaluated based on their success in reducing the rate of teen
pregnancies in their respective communities.
National survey of family growth.--$1,000,000 is provided
for the National Survey of Family Growth, within the
$10,979,000 or 10.1 percent increase over fiscal year 2007 that
is provided for national health statistics within the Centers
for Disease Control and Prevention, which collects statistical
data that informs public health interventions and policies.
These funds will improve the timeliness and reliability of the
National Survey of Family Growth, which collects national data
on pregnancy and birth rates and information on the
characteristics of women who choose to end their pregnancies
and their reasons for choosing abortion.
Child care development block grant.--A $75,000,000 or 3.6
percent increase over fiscal year 2007 is included for the
child care development block grant, which provides support to
States to assist low-income families who are working or
receiving education or training. This increase will expand
Federally funded quality child care to vulnerable families,
making it easier for them to raise their children.
Approximately 13,000 additional children and their families
will be served in fiscal year 2008.
Head start.--A $75,000,000 or 1.1 percent increase over
fiscal year 2007, and a $175,000,000 or 2.6 percent increase
over the President's request, is provided for Head Start, which
supports comprehensive educational, health, nutritional,
social, and other child development services to low-income
children and families. This increase will ensure that
vulnerable parents gain access to high quality preschool
services for their children.
Runaway and homeless youth.--A $10,000,000 or 11.4 percent
increase over fiscal year 2007 is provided for the runaway and
homeless youth activities. These funds will support programs
that provide homeless youth a safe environment while teaching
them essential life-skills and connecting them to education and
workforce assistance, as well as other support. The increased
funding will also allow the program to provide expanded
services to pregnant women and young parents.
Home visitation initiative.--A new $10,000,000 home
visitation initiative for mothers is included under the child
abuse discretionary program. These funds will be used for
evidence-based home visitation projects designed to help
mothers improve prenatal health, teach them to become better
parents, and improve their quality of life by assisting them
with education services and employment opportunities. Research
has shown that home visitation can reduce incidents of child
abuse and neglect and improve other important outcomes for
mothers and their children.
Infant adoption awareness.--A $2,000,000 or 15.8 percent
increase over fiscal year 2007 is provided for the infant
adoption awareness program. This increase will expand training
activities for adoption agency staff, resulting in enhanced
information to, and counseling of, young pregnant women about
adoption, as well as expanded referrals to adoption agencies.
Funds will also be used to develop best practice guidelines in
adoption counseling.
Community services block grant.--A $30,000,000 or 4.8
percent increase over fiscal year 2007 is provided for the
community services block grant, which provides housing, child
care, job training and job placement, home weatherization,
parenting education, adult literacy classes, domestic violence
prevention, and emergency food assistance in over 1,000
counties across the country. The increase will enable States to
expand these critical services that help struggling, low-income
families raise their children.
Domestic violence prevention services program.--A
$10,000,000 or 8.0 percent increase over fiscal year 2007 is
included for the domestic violence program, which provides
immediate shelter and related assistance for victims of family
violence and their children. It also supports prevention and
intervention services for families in abusive situations that
include shelter, counseling, self-help, and substance-abuse
referral. Four million women experience a serious violent
assault by their partner in an average year and for 30 percent
of these women that abuse begins during pregnancy. The
recommended $10,000,000 increase will permit States to expand
domestic violence prevention services to more at-risk women.
Community-based abstinence education.--A $27,764,000
increase over fiscal year 2007 is included for the community-
based abstinence education program, which provides support for
the development and implementation of community-based
abstinence-until-marriage education programs. The $27,764,000
increase for the community-based abstinence education program
is identical to that recommended for the family planning
program.
Adolescent family life.--$30,307,000 is included for the
adolescent family life program, the same amount as fiscal year
2007. This program supports projects that provide integrated
health, education, family, and social services (including life
and career planning, education, job training, safe housing, and
home visitation services) to pregnant women and mothers. It
also supports demonstration projects that encourage students
between the ages of 9 and 14 to postpone sexual activity until
marriage. These funds will serve approximately 92,000 teenagers
and their families in fiscal year 2008.
After-school centers.--A $50,000,000 increase over fiscal
year 2007 is provided for the 21st century after-school centers
program to serve middle and high school students, as part of a
total $125,000,000 increase in the bill for after-school
centers. The after-school program offers extended learning
opportunities before and after school for children,
particularly in communities with a high percentage of low-
income families. The additional resources will help serve an
additional 65,000 teenagers who are unsupervised in the after
school hours. A recent study found that youth who do not spend
time in structured activities are 37 percent more likely to
become teen parents than those enrolled in after-school
programs. The recommended increase will expand after-school
services to middle and high school girls who are at risk of
unintended pregnancies and help working families obtain
affordable after school child care.
School counseling services.--A $26,850,000 or 77.5 percent
increase above the fiscal year 2007 level is provided for the
elementary and secondary education school counseling program.
These funds enable school districts to hire academic
counselors, psychologists, and social workers. The additional
resources will be targeted to improving and expanding academic
and mental health counseling to middle- and high-school
adolescents. These counselors are trained to provide critical
prevention and early identification and intervention services.
They also work in close collaboration with mental health
providers in the community to ensure students and their
families receive appropriate care.
Child care for college parents.--A $2,000,000 or 12.7
percent increase over fiscal year 2007 is included for the
child care access means parents in school program, which helps
low-income parents who qualify for Pell grants attend college
by supporting campus-based child care services. This increase
will expand the number of low-income parents receiving
convenient and high quality child care services, enhancing
their ability to earn a college degree and, ultimately, achieve
economic self-sufficiency for themselves and their children.
PREPARING FOR A PANDEMIC INFLUENZA
The Committee includes $1,146,172,000 for activities to
prepare for and respond to an influenza pandemic. This amount
is an increase of $1,041,336,000 over fiscal year 2007 and
$5,000,000 over the request. In fiscal year 2006, the Committee
included $5,637,000,000 in supplemental appropriations for
pandemic influenza activities throughout the Department of
Health and Human Services. The funding included in this bill
fulfills the Administration's original emergency request to
begin protecting the United States against a potential
pandemic.
The Committee believes that the avian flu is a ticking time
bomb with potentially devastating consequences for the country
and the world. Leading scientists and public health researchers
estimate that 90 million people in the United States could
become ill, nearly 10 million people could require
hospitalization, and 1.9 million Americans could die if a
pandemic flu similar to the 1918 pandemic occurs. Some
scientists have estimated that the global death toll from a flu
pandemic could reach 62 million people.
In order to ensure sufficient and sustained resources to
prepare and protect the United States and other countries in
the event of an influenza pandemic, the Committee has included
the following amounts:
PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/program Fiscal year 2008 -------------------------------------
committee Fiscal year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Services:
Centers for Disease Control and Prevention......... 158,245 +88,245 0
National Institutes of Health...................... 34,836 0 0
Public Health and Social Services Emergency Fund... 948,091 +948,091 0
Covered Countermeasure Process Fund................ 5,000 +5,000 +5,000
========================================================
Total.......................................... 1,146,172 +1,041,336 +5,000
----------------------------------------------------------------------------------------------------------------
Centers for Disease Control and Prevention (CDC).--An
$88,245,000 increase over fiscal year 2007 is provided so that
CDC can take significant steps to help the nation prepare for a
pandemic influenza.
The pandemic influenza activities within CDC's coordinating
center for infectious diseases will be used to prepare the U.S.
health and public health systems, including laboratories. Funds
will be used to increase demand for influenza vaccine with the
intention that by doing so, U.S. vaccine production capacity
also will be stimulated; develop a repository of pandemic virus
reference strains, which will improve laboratory capacity to
analyze large quantities of viral samples to identify suitable
vaccine candidates; and increase the stock of diagnostic
reagents for influenza to improve rapid testing capacity.
Within CDC's coordinating center for health information and
service, funds will be used to develop a vaccine registry to
monitor vaccine use and distribution to ensure that vaccines
and other countermeasures are administered appropriately and
for real-time assessment and evaluation of influenza
interventions to improve decision makers' situational
capabilities.
To protect the U.S. population, it is imperative that CDC
continue to improve its global outreach. Within the
coordinating office for global health, funds will be used for
rapid outbreak response for high-priority countries, which will
allow CDC in-country teams to take swift and decisive action
once a pandemic influenza strain is identified; enhance human-
animal interface studies to analyze epidemiological studies of
risk factors in high risk populations; and for international
surveillance, diagnosis, and epidemic investigations.
Additionally, funds are provided within CDC's coordinating
office of terrorism preparedness and emergency response to
increase border security through the establishment of
additional quarantine stations at airports and other major
sites of entry into the U.S. These funds will support up to 25
quarantine stations by the end of fiscal year 2008, up from
only eight stations in fiscal year 2004.
National Institutes of Health (NIH).--Included in this bill
is $34,836,000 to continue NIH's pandemic influenza research
activities. These funds will support clinical trials in
Southeast Asia, research studies on antibody prevalence, and
studies on the rapid characterization of influenza viruses. NIH
is also supporting research leading to the development of new
vaccines and therapeutics. This pandemic influenza funding is
in addition to more than $200,000,000 NIH supports in general
influenza research.
Public Health and Social Services Emergency Fund.--A
$948,091,000 increase over fiscal year 2007 is provided for
pandemic influenza preparedness and response activities that
are coordinated by the Office of the Secretary of Health and
Human Services.
Of the funds provided, $870,000,000 is for critical
activities to implement the national strategy for pandemic flu.
These activities include the development and purchase of the
H5N1 influenza vaccine, antivirals, necessary medical supplies,
diagnostics, and other surveillance tools. The majority of the
funding will be used to procure egg-based vaccines and
accelerate development of next-generation vaccines to address
the goal that the entire U.S. population has access to vaccines
within six months of the start of a pandemic. Additionally, a
significant portion of funds will be allocated to increasing
the U.S. supply of antivirals in order to protect no less than
25 percent of the U.S. population.
The remaining $78,091,000 within the Office of the
Secretary will help ensure effective communications to educate
the public, including the maintenance of the U.S. government's
pandemic flu website and the release of public service
announcements; support international in-country advanced
development and industrialization of human pandemic influenza
vaccines; and spur the advanced development of rapid tests and
detection techniques.
Covered Countermeasure Process Fund.--A total of $5,000,000
is provided for a new fund to compensate individuals that may
be harmed by the administration or use of the H5N1 influenza
vaccine.
Department of Labor.--The Committee is dissatisfied with
the Occupational Safety and Health Administration's (OSHA) lack
of action to ensure that health care workers and emergency
responders will be adequately protected in the event of a flu
pandemic. The Committee asks that the Department reconsider its
denial of a petition requesting the issuance of an emergency
standard, and directs the Department to, at a minimum, develop
a permanent standard on an expedited basis to ensure that
measures to protect health care workers and responders from an
outbreak of pandemic influenza are in place as soon as
possible, and requires a timeline and quarterly progress report
on developing this standard. The Committee also requests that
the Secretary of Labor submit a report addressing the full
range of policy and regulatory issues under the Department's
jurisdiction, including those that relate to the economic
impacts identified in the national strategy for pandemic
influenza implementation plan, such as the application of
workplace regulations for family and medical leave.
FULFILLING PROMISES TO AMERICA'S CHILDREN
The Committee recommends a $2,544,855,000 increase over
fiscal year 2007 for education programs authorized under the No
Child Left Behind Act and the Individuals with Disabilities
Education Act, which is a $1,845,797,000 increase over the
Administration's request.
The Committee believes that the nation faces immense
challenges in raising the academic performance of America's
students in an increasingly competitive global economy.
America's students are not achieving at the levels needed to be
competitive with our international competitors, particularly in
math, science, and technology.
In 2005, only 48 percent of low-income 4th graders and 37
percent of low-income 8th graders performed at a basic level in
science. Among 17-year olds, math scores have been flat over
the past 15 years, while reading scores have actually gone
down. The rest of the world is implementing aggressive
education improvements, while the United States, at best, is
making only modest gains.
These challenges also extend to providing meaningful
educational opportunities for low-income and minority children.
The Subcommittee on Labor-HHS-Education-Related Agencies heard
testimony concerning the unconscionably large achievement gaps
that exist between white students and racial and ethnic
minorities. By the end of 12th grade, African American and
Latino students perform at about the same level as white 8th
graders in both reading and math. The picture is even worse for
students with disabilities. Only 6 percent of 8th graders with
disabilities are proficient in reading, compared with 33
percent of students without disabilities.
The country and our schools face fast-changing demographics
that will make the job of erasing the nation's education
deficits even more difficult. Over the next decade, public
school enrollments will continue to swell to new record
levels--more than 58 million students by 2015. That means 2.6
million new students will be in the nation's classrooms. By
2020, nearly half of these school children will be minorities.
During the Subcommittee's Overview Hearing: America's
Workers and Education for the 21st Century, the Subcommittee
heard testimony that the nation's education and achievement
gaps can only be surmounted by a full scale assault starting
with broad-based access to early childhood education and
continuing with expanded higher education opportunity.
In this bill, the Committee begins to chart a path to a
better future for millions of America's children by investing
significant new resources in the No Child Left Behind Act
(NCLB) and the Individuals with Disabilities Act (IDEA). These
laws are the cornerstone of the Federal commitment to America's
children. The additional resources in the bill will help to pay
for the extra instructional time, high quality teachers,
technology, and enrichment programs that special needs children
require in order to succeed. By providing this assistance, the
Committee takes another step toward fulfilling our promises to
America's children. This action will help to ensure that they
are adequately prepared to compete with students around the
world for college and careers of the 21st century.
K-12 EDUCATIONAL OPPORTUNITY INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/program Fiscal year 2008 -------------------------------------
committee Fiscal year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Education:
No Child Left Behind (NCLB), Total................. 25,686,557 +2,036,891 +1,020,113
Key NCLB Programs:
Title I Grants to School Districts [nonadd].... 14,362,824 +1,524,699 +452,924
Title I School Improvement Fund [nonadd]....... 500,000 +375,000 0
Improving Teacher Quality [nonadd]............. 3,187,439 +300,000 +399,951
Educational Technology [nonadd]................ 272,250 0 +272,250
21st Century After-School Centers [nonadd]..... 1,106,166 +125,000 +124,986
English Language Acquisition [nonadd].......... 774,614 +105,607 +103,795
Individuals with Disabilities Education Act (IDEA), 12,310,831 +507,964 +825,684
Total.............................................
Key IDEA Program:
IDEA (Part B) State Grants [nonadd]............ 11,292,425 +509,464 +800,484
========================================================
NCLB and IDEA, Total........................... 37,997,388 +2,544,855 +1,845,797
----------------------------------------------------------------------------------------------------------------
No Child Left Behind.--A $2,036,891,000 or 8.6 percent
increase over fiscal year 2007 is provided for the No Child
Left Behind Act (NCLB). This amount is $1,020,113,000 more than
the Administration's request. The bill's significant increase
for NCLB reflects the Committee's recognition that States and
school districts will need substantially greater assistance to
achieve the law's goal that every child reaches high academic
standards by 2014.
Funding levels in the bill for key NCLB programs are listed
below.
Title I assistance.--A $1,899,699,000 or 14.7 percent
increase over fiscal year 2007 is provided for title I
assistance for low-income children--the largest increase in the
history of the title I program. This increase will provide a
total of $14,362,824,000 for title I grants to school districts
and $500,000,000 for the title I school improvement fund in
fiscal year 2008.
Title I grants, which help support schools in high-poverty
areas, are the engine behind NCLB reforms. Nonetheless, in the
last two school years, two-thirds of the nation's school
districts have received flat or reduced title I grants,
hampering their ability to assist low-performing students. The
2007 Continuing Appropriations Resolution provided a
$250,000,000 increase for title I grants to school districts
and the title I school improvement fund to begin to reverse
title I funding shortfalls. The Committee's recommendation is
another step toward reversing these funding shortfalls.
The $1,899,699,000 increase over fiscal year 2007 will
benefit nearly 55,000 title I schools and fully fund an
additional 161,000 low-income students who must make the
greatest educational progress in order to meet NCLB's rigorous
academic achievement standards. Within this total increase, the
additional $375,000,000 recommended for the title I school
improvement fund will direct targeted assistance to a rising
number of schools identified for improvement. These additional
resources demonstrate the Committee's commitment to ensuring
that low-performing schools--which tend to have the greatest
academic challenges but less experienced teachers, lower
teacher salaries, and higher teacher turnover--have the
financial means to pay for high quality instruction, teacher
professional development, and extended learning opportunities
that can boost student academic performance.
Improving teacher quality.--A $300,000,000 or 10.4 percent
increase over fiscal year 2007 is provided for teacher quality
grants, which provide States and school districts with flexible
funding to ensure that teachers receive the support and
training they need to be effective in the classroom. Under the
Committee recommendation, an additional 51,000 teachers will
receive high quality professional development than in fiscal
year 2007. The Committee provides $399,951,000 more than the
Administration's request for these teacher quality grants
because research shows that teacher quality is the most
important school-related factor in determining student
achievement growth.
Education technology.--The bill includes $272,250,000 for
education technology grants to States and school districts,
which support teacher professional development, well-equipped
classrooms, technology-based communication, effective software,
and a curriculum that recognizes the role technology plays in
all disciplines. The Committee provides the same level as in
fiscal year 2007, and rejects the Administration's proposal to
terminate this program.
21st century after-school centers.--A $125,000,000 or 12.7
percent increase over the fiscal year 2007 level is provided
for the 21st century after-school program, with a particular
focus on expanding after school opportunities for students in
middle and high schools. The Committee's recommendation
reflects its concern that, between 3 p.m. and 6 p.m., the rate
of juvenile crime triples, as well as the likelihood that
teenagers will become victims of crime. Self-care and boredom
can increase the likelihood that a young person will experiment
with drugs and alcohol. Under the bill, an additional 163,000
students (including 65,000 teenagers) will benefit from
supervised after school activities, including academic
assistance, athletic programs, career exploration, skills
development and internships, and cultural enrichment.
English language acquisition.--A $105,607,000 or 15.5
percent increase over the fiscal year 2007 level is included
for assistance to States and school districts to address
dramatic increases in the number of children who need
assistance to learn to read and speak English. According to the
U.S. Census Bureau, the number of limited English proficient
students has risen from less than 1 million in 1980 to more
than 4.6 million in 2004. These funds will also help to
increase the pool of teachers prepared to serve limited English
proficient students through professional development
activities.
Individuals with Disabilities Education Act (IDEA) Part B
grants.--A $509,464,000 or 4.72 percent increase over the
fiscal year 2007 level, and a $800,484,000 increase over the
Administration's request, is provided for IDEA Part B State
grants. These grants help States and localities pay for the
rising costs of special education for 6.9 million children with
disabilities. Almost 14 percent of public school students
receive special education because they have a disability.
Nearly every general education classroom across the country
includes students with disabilities. Over the past 10 years,
the number of students enrolled in special education programs
has risen 18 percent. The Committee's recommendation rejects
the deep cut in IDEA proposed by the Administration, and stops
the decline in the Federal percentage share of special
education costs, in order to sustain educational and related
services for these special needs children who are most at risk
of being left behind.
EXPANDING COLLEGE ACCESS AND OPPORTUNITY
The Committee recommends a $2,029,752,000 increase over
fiscal year 2007 and a $3,250,322,000 increase over the
President's request for Federal student financial assistance
programs.
On February 15, 2007, the Subcommittee on Labor-HHS-
Education-Related Agencies held an Overview Hearing on
America's Workers and Education for the 21st Century, during
which the Subcommittee heard from a panel of national experts
on the critical importance of postsecondary education to the
nation's economic well being.
Today, the economic, social, and civic value of a college
education has never been higher. Over a lifetime, a person who
completes a college degree will earn one million dollars more
than someone with just a high school diploma. A college degree
is associated with greater earnings, less unemployment, lower
poverty, better health benefits and better health, and larger
pensions.
Despite the obvious benefits for Americans as individuals
and to the country as a whole, financial barriers continue to
prevent many talented students from achieving their college
dreams.
According to one witness who testified before the
Subcommittee, each year approximately 400,000 students are
priced out of attending a four-year college and 170,000
students are unable to afford community college. This will
cause the nation to lose between 1.4 and 2.4 million bachelor's
degrees, a blow that will undermine America's competitiveness
in the increasingly global economy.
Another witness pointed out the disturbing fact that
students from high-income families who have low test scores are
more likely to complete college than high-testing students from
lower-income families.
By 2015, college enrollments are expected to rise by an
additional 2.2 million students or 12.6 percent. Most of this
growth will be among students--minority, low-income, and first-
generation--who most need Federal financial assistance in order
to enter and complete college.
In the 21st century, a nation that fails to fully develop
its intellectual capital consigns itself to a future of
economic decline. Therefore, the Committee aims to invest
robustly in college access and opportunity by providing
significant increases across a wide range of financial aid
programs. In total, the Committee recommendations will benefit
more than 8.5 million students who deserve the chance at a
college education.
COLLEGE ACCESS AND OPPORTUNITY INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/program Fiscal Year 2008 -------------------------------------
committee Fiscal year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Education................................ 18,856,407 +1,992,327 +3,184,702
Pell Grants--Maximum Grant......................... (4,700) +390 +650
Pell Grants........................................ 15,583,000 +1,922,289 +2,169,000
Supplemental Educational Opportunity Grants........ 770,933 0 +770,933
Work Study......................................... 980,492 +138 0
Perkins Loan Cancellations......................... 65,471 0 +65,471
Leveraging Education Assistance Partnerships....... 64,987 0 +64,987
TRIO............................................... 868,178 +40,000 +40,000
GEAR UP............................................ 323,423 +20,000 +20,000
Title VI Foreign Languages......................... 115,651 +9,900 +9,900
Byrd Honors Scholarships........................... 40,590 0 +40,590
Javits Fellowships................................. 9,699 0 -98
Graduate Assistance in Areas of National Need...... 30,067 0 +3
Olympic Scholarships............................... 970 0 +970
Legal education opportunity program................ 2,946 0 +2,946
Department of Health and Human Services................ 119,097 +37,425 +65,620
Health Careers Opportunity Program................. 28,440 +24,480 +28,440
Scholarships for Disadvantaged Students............ 46,657 0 +36,924
Nurse Loan Repayment and Scholarship Program....... 44,000 +12,945 +256
========================================================
Total.................................................. 18,975,504 +2,029,752 +3,250,322
----------------------------------------------------------------------------------------------------------------
Pell grants.--A $1,922,289,000 or 14.1 percent increase
above the fiscal year 2007 level, and $2,169,000,000 above the
Administration's discretionary request, is included to increase
the maximum Pell grant to $4,700. The Committee recommendation
will help nearly 5.5 million low- and middle-income students
obtain a college degree. Approximately 79 percent of all Pell
grant recipients have annual family incomes of $30,000 or less.
Between 2001 and 2006, the cost of attending a four-year
public college increased by $3,764 or 42 percent; however, the
maximum Pell grant increased by just $300--only 8 percent of
the college cost increase.
The 2007 Continuing Appropriations Resolution raised the
Pell maximum grant by $260, from $4,050 to $4,310, providing
the first increase in four years to help disadvantaged students
pay for rising college costs. This bill will raise the maximum
Pell award by another $390 to $4,700. Over two years, the
maximum Pell Grant will have increased by $650--one of the
largest expansions of the Pell grant program in its history.
The Committee recommendation is another step forward in
expanding college access and opportunity for more Americans.
Federal supplemental educational opportunity grants.--
$770,933,000 is provided for the supplemental educational
opportunity grants program (SEOG), the same as fiscal year 2007
level. The Committee strongly disagrees with the
Administration's proposal to terminate SEOGs, which are need-
based grants of up to $4,000 to undergraduates who demonstrate
exceptional financial need. Approximately 65 percent of
dependent SEOG recipients have annual family incomes under
$30,000 and nearly 80 percent of independent SEOG recipients
have annual family incomes under $20,000. Institutions must
contribute a 25 percent match toward their Federal SEOG
allocations. Thus, the amount recommended will result in nearly
$1,000,000,000 in need-based student financial aid, benefiting
more than one million students.
Federal work study.--$980,492,000 is provided for the work-
study program, which supports part-time employment for students
who qualify based on financial need. This amount is $138,000
more than the fiscal year level and the same as the request.
Work-study jobs must pay at least the Federal minimum wage and
institutions must provide 25 percent of student earnings. Thus,
the $980,492,000 provided in the bill will result in more than
$1,100,000,000 in need-based student aid for approximately
880,000 undergraduate and graduate students.
Federal Perkins loan cancellations.--$65,471,000 is
provided for Federal Perkins loans cancellations, the same as
the fiscal year 2007 level. The Committee disagrees with the
Administration's proposal to terminate funding for this
program, which reimburses college revolving loan funds for
loans that are forgiven under Federal law. Perkins Loans may be
forgiven when a student borrower pursues a public service
career in 1 of 12 statutorily-designated areas, including
teaching in low-income communities and in shortage subjects,
Head Start programs, military service in areas of imminent
danger, Peace Corps and ACTION service, nurses and medical
technicians providing health care services, and law
enforcement/corrections.
LEAP program.--$64,987,000 is provided for the LEAP
program, the same as the fiscal year 2007 level. The Committee
disagrees with the Administration's proposal to terminate
funding for this program, which provides dollar-for-dollar
matching funds to states for grant and work study assistance to
eligible postsecondary students who demonstrate financial need.
Over half of LEAP grants go to students with annual family
incomes under $20,000. The amount provided in the bill will
leverage nearly $165,000,000 in need-based aid to nearly
165,000 students.
Federal TRIO programs.--A $40,000,000 or 4.8 percent
increase is provided for the TRIO programs above the fiscal
year 2007 level and the budget request, of which $10,000,000 is
dedicated to college completion grant aid for students served
under the Student Services Support Program. 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. Under the Committee recommendation,
over 850,000 students will receive TRIO services, including
approximately, 14,000 students who will receive new college
completion grants.
GEAR UP.--A $20,000,000 or 6.6 percent increase above the
fiscal year 2007 level and the budget request is provided for
the GEAR UP program. 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.
Under the Committee recommendation, approximately 785,000
students--nearly 46,000 more than last year--will benefit from
early invention services and financial assistance for college
in fiscal year 2008.
Title VI foreign languages.--A $9,900,000 or 9.4 percent
increase above the fiscal year 2007 level and the budget
request is provided for the title VI international education
and foreign languages studies program, which addresses the
national need for international experts, particularly in
critical world areas and languages. A portion of these funds
will support 1,026 graduate academic fellowships and 700
graduate summer fellowships in foreign language training--about
10 percent more than last year.
Byrd honors scholarships.--$40,590,000 is provided for Byrd
scholarships, the same as the fiscal year 2007 level. The
President did not propose funding for this program. The Byrd
scholarship program provides formula grants to States to award
$1,500 scholarships for up to four years of higher education to
students who demonstrate academic excellence in high school.
Under the Committee bill, approximately 27,000 students will
receive merit scholarships in fiscal year 2008.
Javits fellowships.--$9,699,000 is provided for Javits
fellowships for students pursuing doctoral study in the arts,
humanities, and social sciences. The Committee recommendation
will support fellowships for approximately 226 students in
fiscal year 2008.
Graduate assistance in areas of national need.--$30,067,000
is provided for the graduate assistance in areas of national
need (GAANN) program, which is $3,000 more than the budget
request and the same as the fiscal year 2007 level. The GAANN
program supports fellowships to economically disadvantaged
students who have demonstrated academic excellence and who are
pursuing graduate education in designated areas of national
need, such as the sciences, mathematics, engineering, and
nursing. The Committee recommendation will support fellowships
for approximately 700 students.
B.J. Stupak Olympic scholarships.--$970,000 is provided for
B.J. Stupak Olympic scholarships, the same as the fiscal year
2007 level. The Administration proposed to terminate this
activity, which provides financial assistance to Olympic
athletes who are pursuing a postsecondary education. The
Committee recommendation will provide scholarships to
approximately 149 student athletes.
Thurgood Marshall legal education opportunity program.--
$2,946,000 is provided for the Thurgood Marshall legal
education opportunity program, the same as in fiscal year 2007.
The Administration proposed to terminate this activity, which
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. The Committee recommendation will provide financial
assistance of up to $10,000 for 150 fellows and support
educational activities for more 1,000 students to improve
retention, graduation, and bar passage rates.
Health careers opportunity program.--A $24,480,000 increase
or six-fold increase of the program from the fiscal year 2007
level is provided for the health careers opportunity program
(HCOP), which seeks to increase the number of individuals from
disadvantaged backgrounds entering and graduating from health
professions programs. HCOP focuses on early intervention to
develop a pool of academically prepared students.
Scholarships for disadvantaged students.--$46,657,000 is
provided for the scholarships for disadvantaged students
program, the same as in fiscal year 2007 and a $36,924,000
increase over the President's request. This program awards
scholarships to students from disadvantaged backgrounds who
train in the health professions and in nursing. The bill will
support scholarships for nearly 16,000 disadvantaged students.
Nurse loan repayment and scholarship program.--An
$12,945,000 or 41.7 percent increase over fiscal year 2007 is
provided for the nurse loan repayment and scholarship program,
which provides loan forgiveness and scholarships to nurses who
agree to work in health care facilities with a critical
shortage of nurses. This funding will support almost 1,300
students with loan repayment and scholarships.
INVESTING IN THE SKILLS AND EARNING CAPACITY OF AMERICA'S WORKERS
The Committee recommends a $148,168,000 increase over
fiscal year 2007, which is $1,530,280,000 over the President's
request, for important Federal workforce development programs.
In making this investment, the Committee rejects
Administration-proposed cuts in employment and training
programs that would have left the Departments of Labor and
Education unprepared to deal with the important challenges
faced by Americans who want to succeed in the 21st century
workforce.
Education and training programs serve to strengthen the
American workforce and enhance American economic
competitiveness. Department of Labor projections show that 90
percent of the fastest growing job fields will require
education and training beyond high school. These jobs may be
out of reach for nearly half of workers who have no education
beyond high school.
Despite recent improvements in some economic indicators,
6.8 million Americans remain unemployed--14 percent more than
in January 2001. This year, the number of Americans who have
been out of work for 27 weeks or longer rose to 1.1 million--67
percent more than in January 2001. Unemployment rates for
African American and Hispanic workers remain significantly
higher than the national average.
Wages remain stagnant. Over the past six years, both
inflation-adjusted hourly and weekly pay rose by less than one
half of one percent. At the same time, the threat of
outsourcing has the effect of further depressing pay and
benefits for American workers--both blue and white collar.
Economists estimate that half of all U.S. jobs today are in
industries or occupations that could be outsourced overseas.
Americans simply are not receiving the benefits of their
hard work. American workers raised their productivity 17.4
percent over the last six years but those gains have not flowed
to workers in the form of wages. Instead, wages have remained
largely flat while corporate profits have soared by 108 percent
over this period.
In a January 31, 2007 ``State of the Economy'' address,
President Bush noted that ``The fact is that income inequality
is real; it's been rising for more than 25 years. . . . The
earnings gap is now twice as wide as it was in 1980--and it
continues to grow.'' He then proposed a budget that would cut
employment, training and vocational education programs by $1.5
billion.
The Committee rejects the proposed cuts and instead chooses
to make strategic investments in these areas to help middle and
low-income Americans acquire the job skills they need to
compete in the global economy.
WORKER TRAINING INITIATIVE
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Agency/program Fiscal year 2008 -------------------------------------
committee Fiscal year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.................................... 6,485,789 +123,168 +923,727
Training and Employment Services1,2................ 3,579,530 +23,258 +607,491
Migrant Workers [nonadd]....................... 83,740 +3,988 +83,740
Native Americans [nonadd]...................... 56,381 +2,685 +11,381
Reintegration of Ex-Offender2 [nonadd]......... 68,746 0 +29,146
Young Parents Training [nonadd]................ 10,000 +10,000 +10,000
YouthBuild [nonadd]............................ 60,000 +10,500 +10,000
Employment Service State Grants.................... 725,883 +10,000 +37,104
Community Service Employment for Older Americans... 530,900 +47,289 +180,900
Job Corps1......................................... 1,649,476 +42,621 +98,232
Department of Education................................ 1,206,553 25,000 +606,553
Career & Technical Education State Grants.......... 1,206,553 +25,000 +606,553
========================================================
Total.................................................. 7,692,342 +148,168 +1,530,280
----------------------------------------------------------------------------------------------------------------
\1\Adjusted for transfer of Job Corps to Departmental Management.
\2\Program consolidation.
Training and employment services.--$3,579,530,000 is
provided for training and employment services under the
Workforce Investment Act (WIA), which is $23,258,000 above the
comparable fiscal year 2007 level and $607,491,000 above the
request. Within this amount $3,276,602,000 is to provide
services for an estimated 10.5 million participants in the WIA
adult, dislocated and youth programs. In making these resources
available, the Committee has rejected the Administration's
proposed cut of $584,233,000 in training and employment
services for fiscal year 2008. WIA provides for a decentralized
system of services, delivered primarily through one-stop career
centers in local communities that serve to increase the
employment, occupational skills attainment, and retention in
employment of participants. While further investment is
deferred as the Workforce Investment Act is awaiting
reauthorization, the reduction proposed in the President's
budget in programs that have seen a loss of over $300 million
in real dollars since fiscal year 2005 is unwarranted.
Migrant and seasonal farmworkers program.--Within training
and employment services, a $3,988,000 increase over fiscal year
2007 is provided for this program, which is designed to serve
members of economically disadvantaged families whose principal
livelihood is derived from migratory and other forms of
seasonal farm work. For the fifth year in a row the budget
request did not include funds for this program. The fiscal year
2008 funding level of $83,740,000 will allow for services to an
estimated 22,800 participants.
Native Americans.--$56,381,000 is provided for training and
employment services to Native Americans. The Committee does not
agree with the budget request that would have cut over 3,000
participants in this program and has provided a $2,685,000
increase over the fiscal year 2007 level. This will allow for
services to an estimated 23,790 participants in fiscal year
2008.
Re-integration of ex-offenders.--Within training and
employment services, $68,746,000 is provided for fiscal year
2008, which is $29,146,000 above the budget request. While the
Committee sees merit in a program consolidation of the existing
adult and youth ex-offender programs, the proposed cut was not
in line with the need for services to this population. This
program benefits ex-offenders and their communities by
providing employment, mentoring, and transitional services
designed to reduce recidivism. Of the amount provided, not less
than $48,000,000 is dedicated for activities for youthful
offenders.
Young parents demonstration program.--Within training and
employment services, $10,000,000 is provided under the WIA
pilots and demonstrations authority for a young parents
demonstration program, providing competitive grants to
organizations to provide educational and occupational skills
training leading to family economic self-sufficiency for young
parents and expectant mothers ages 16 to 24. This
recommendation is part of the Committee's initiative to help
reduce the number of abortions in America by alleviating the
economic pressures and other real life conditions that can
sometimes cause women to decide not to carry their pregnancies
to term.
YouthBuild.--Within training and employment services,
$60,000,000 is provided for the YouthBuild program which was
transferred from the Department of Housing and Urban
Development in fiscal year 2006. YouthBuild is an approach to
workforce development that supports at-risk youth aged 16-24 in
gaining high school credentials and receiving skills training
by engaging in the construction or rehabilitation of low-income
housing. The $10,500,000 increase for fiscal year 2008 will
allow the program to increase participation by 20 percent above
fiscal year 2007 to over 3,900 youth.
Employment Service.--A $10,000,000 increase over the fiscal
year 2007 level for employment service grants to States is
provided. The budget request would have decreased State grants
by $27,104,000, and the Administration's legislative proposal
would have eliminated the Employment Service, which serves
approximately 13 million people annually who are seeking
employment, linking them to potential employers. The Committee
believes that the labor exchange activities provided by State
employment service agencies should be the primary source of
core services for local one-stop systems, thus freeing up
Workforce Investment Act funds to focus on intensive services
and training, and begins a process of restoring the capacity of
the Employment Service to provide this key labor exchange role
through this increase in State grants.
Community service employment for older Americans.--A
$47,289,000 increase over fiscal year 2007 is provided for this
program, which provides subsidies that allow low-income seniors
to work in community service activities. This amount is
$180,900,000 above the budget request, which would have reduced
the number of seniors served by 43 percent below the fiscal
year 2007 level. The increased funding will allow 103,000 low
income seniors to participate in the program and to receive an
anticipated Federal minimum wage increase to $6.55 an hour
during program year 2008.
Job Corps.--A $42,621,000 increase over fiscal year 2007 is
provided for the Job Corps program. Job Corps is a nationwide
network of residential facilities that provide a comprehensive
and intensive array of training, job placement and support
services to at-risk young adults, aged 16 to 24. The
recommended funding level is $98,232,000 over the budget
request, which would have decreased the number of student
training slots by 4,310. The increase in funding will allow the
program to add an additional 300 student training slots for a
new center opening during program year 2008.
Career and technical education State grants.--
$1,181,553,000 is provided for basic grants to States under the
Carl D. Perkins Career and Technical Education Act of 2006,
which is the same as the fiscal year 2007 level. This level is
$581,553,000 above the budget request, which would have reduced
funding for State grants nearly in half. State grants support a
variety of vocational education programs developed in
accordance with the State plan. In addition to resources to
institutions serving high concentrations of low-income
students, this program supports vocational education for adults
who need retraining to adapt to changing technologies and labor
markets.
PROTECTING AMERICAN WORKERS
The Committee recommends $45,488,000 over fiscal year 2007,
and $56,007,000 over the President's budget request, for
Department of Labor agencies responsible for worker protection
and worker rights.
Since the 1970s when the Occupational Safety and Health Act
(OSHA) and the Federal Mine Safety and Health Act (MSHA) were
passed, workplace safety and health conditions have improved
significantly. Yet, as demonstrated by events such as the Sago,
West Virginia mine disaster and the Texas City, Texas BP
explosion, too many workers still remain at risk, and face
death, injury or disease as a result of their jobs.
Recent progress in protecting workers' safety and health is
slowing, and for some groups of workers, jobs are becoming more
dangerous. The most recent job fatality data show 5,734 fatal
workplace injuries reported in 2005, with significant increases
in fatalities among Hispanic, African-American, foreign-born
and young workers. With regulatory action virtually halted at
the Department of Labor, health and safety rules are not
keeping up with changes in the economy and the workplace. The
Committee is deeply concerned that we are failing to protect
workers from both new and existing workplace hazards.
Similar concerns extend to the enforcement of employment
standards. Since 2001, the Wage and Hour Division's
investigations of low-wage industries have fallen dramatically:
agriculture industry (including poultry processing)
investigations are down by 39 percent; health care industry
(including nursing homes) investigations are down by 32
percent; and garment manufacturing industry investigations are
down by 68 percent.
In these and additional industries, wage theft and overtime
abuses are prevalent. Uninvestigated overtime violations, the
misclassification of employees as independent contractors, and
efforts to undermine family and medical leave all result in
workers being exploited in ways prohibited under the law.
Workers are increasingly forced to resort to the courts for
remedies because the Federal institutions that should be
protecting them are not.
Pension and health protections are also a critical
component of the worker protection agenda. Today, 45 percent of
workers in the private sector lack health insurance from their
employer, up from 41 percent in 2000. The share of jobs without
a pension also rose--from 50 percent in 2000 to 55 percent in
the most recent year of data (2005).
Throughout the Department of Labor, worker protection
staffing levels have declined over the past six years. OSHA
staffing declined 8.6 percent from fiscal year 2001 to fiscal
year 2007. Staffing at the Employment Standards Administration
declined 9.4 percent during the same period. Even after the
addition of 170 coal inspectors as part of a 2006 emergency
supplemental appropriation, MSHA staffing declined 2.2 percent
during that period.
Creating a level playing field for American workers also
involves addressing workers' rights abroad, especially among
our trading partners. The Committee believes that the
Administration's repeated requests to reduce funding for
international labor activities, which for fiscal year 2008
amounts to more than 80 percent, is not in keeping with the
need for the U.S. to be a leader in promoting international
worker rights, both because of our leadership role in the world
and the impact that labor practices in other countries have on
our own workers due to the global nature of our economy.
The Department of Labor has established a number of
strategic goals, and the Committee is pleased that these goals
include promoting workplaces that are safe, healthful and fair.
In the past six years, however, the Department's budget has not
adequately supported the resources necessary to ensure that
safety, health and fairness are the hallmarks of the American
workplace. With this budget, the Committee is beginning to
address the decline in federal enforcement staff, with a goal
of rebuilding the capacity of the Department of Labor to
fulfill its mission to protect Americans in the workplace.
The decline in enforcement is not an issue of staffing
alone. The Committee is also concerned by the fact that
constant delays in the issuance of worker protection standards
have resulted in workplaces that are less safe and less fair.
Bill language is included to expedite the regulatory process
and send the clear signal that inaction is not acceptable when
it jeopardizes the safety and health of American workers. But
even while the Committee is pursuing improved standards for
workplace safety and fairness, the Committee can at least take
action to ensure that current laws and standards are enforced.
The Committee cannot reverse the damage done over the past
six years in one year alone, but the Committee can begin the
job. Within the amounts appropriated for worker protection and
worker rights for fiscal year 2008, some highlighted
investments include:
Occupational Safety and Health Administration (OSHA).--A
$16,591,000 increase above the fiscal year 2007 level is
provided to the agency responsible for ensuring that 113
million Americans benefit from safe and healthy workplaces.
Within the $13,155,000 increase provided for Federal
enforcement, $7,082,000 is dedicated to adding 47 positions to
begin to rebuild the enforcement capacity of OSHA, with a
special emphasis on process safety management inspections and
the hiring of bilingual inspectors. These additional positions
are a downpayment toward a goal of restoring the enforcement
capabilities of OSHA within the next several years. In
providing these enforcement positions, the Committee moves
resources from voluntary compliance programs until the
Department collects the data necessary for a full evaluation of
the effectiveness of these programs. Also included in the
recommendation is $10,116,000 for the Susan Harwood training
grant program that supports worker safety and health training
and education programs that the Committee believes are an
important component of a comprehensive approach to worker
protection. An additional investment of $1,225,000 is also
provided to the Bureau of Labor Statistics (BLS) to allow for
focused research studies on work-related injuries and
illnesses. These studies were conducted previously by BLS
through its work injury reports, but were suspended due to lack
of resources. The studies provided detailed information on the
causes and means of preventing injuries and illnesses and the
new funding is designed to help re-establish this series of
reports, so as to provide important information to employers,
researchers and policy makers.
Mine Safety and Health Administration (MSHA).--An
$11,908,000 increase above the fiscal year 2007 level is
provided to continue a revitalization of enforcement activities
to ensure the safety and health of more than 300,000 people who
work in the mining industry. These resources support the
retention of 170 coal inspectors that MSHA reports it is on
target to hire by the end of fiscal year 2007. The initial
funding for these positions was provided in emergency
supplemental appropriations for fiscal year 2006 following the
coal mine tragedies in West Virginia and Kentucky. Because the
hiring and retention of coal inspectors is of importance to the
mission of MSHA, quarterly reports on the agency's progress in
filling all allocated inspector positions and completing the
training of new inspectors, is required.
Wage and Hour Division (WHD).--A $12,145,000 increase above
the fiscal year 2007 level is provided. Included in this amount
is $5,000,000 to support an additional 36 enforcement positions
to increase activities in low-wage industries. The new
resources will allow WHD to increase inspections and
investigations of industries with high concentrations of low-
wage and other vulnerable workers, and industries with high
levels of wage and hour violations. The Committee also believes
it is important to increase the number of front-line
investigators that are fluent in the languages of the
workforces in which non-English-speaking workers predominate.
International Labor Affairs Bureau (ILAB).--In addition to
enforcing our worker protection laws at home, the Committee
believes that America must be a leader abroad. For this reason,
the Committee does not agree with the Administration's budget
request to eliminate international cooperative agreements and
grants aimed at eliminating child labor, promoting worker
rights, and improving labor standards around the world. The
Committee provides $58,419,000 above the budget request for
ILAB for a total of $72,516,000. These funds include resources
to continue the successful program of international grants to
reduce child labor and $5,000,000 to implement model programs
to address worker rights issues through technical assistance in
countries with which the United States has trade preference
programs.
Comparisons
The program descriptions that follow, and the detailed
table at the back of the report, compare the Committee
recommendations to comparable fiscal year 2007 levels and the
Administration's budget requests. One-time and emergency
supplementals are not included for purposes of these
comparisons.
Operating Plans
The Committee considers the numbers identified in this
bill, this report and the detailed table accompanying this
report to be determinative of agency budgets funded in this
bill. Unless specified otherwise in the bill, the report, or
the detailed table, the amounts provided for fiscal year 2008
shall be the amounts included in agency budget requests. Funds
should be apportioned and allocated accordingly, and any
changes in funding are subject to reprogramming and
notification procedures. Within 45 days of enactment each
Department and related Agency funded by this Act shall submit
an operating plan to the Committees on Appropriations in the
House and the Senate for approval. The operating plan should
detail any reprogramming requests which are based on
information obtained since the submission of the budget in
February 2007 or based on the effects of the amounts provided
in this Act.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
(INCLUDING RESCISSIONS)
The Committee recommends $3,579,530,000 for this account,
which provides funding authorized primarily by the Workforce
Investment Act of 1998 (WIA). This amount is $23,258,000 above
the fiscal year 2007 level and $607,491,000 above the budget
request, after adjusting for the transfer of the Office of Job
Corps.
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 activities and related services. The
account is mostly forward-funded on a July to June cycle, with
funds provided for fiscal year 2008 supporting these activities
from July 1, 2008 through June 30, 2009.
The Committee repeats a provision allowing for local boards
to transfer of up to 30 percent of funds made available for
dislocated workers and adult activities between these funding
streams, upon approval by the Governor. The Administration's
request was to increase transfer authority to 40 percent, which
the Committee believes is unnecessary based on current use of
transfer authority under this language, and the fact that
waivers of the funds transfer limit have already been granted
to 35 States who requested such flexibility.
Adult employment and training activities
For adult employment and training activities, the Committee
recommends $864,199,000, which is the same amount as the fiscal
year 2007 level and $152,199,000 above the budget request. Of
the amount recommended, $712,000,000 will become available on
October 1, 2008. 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 career center system and most customers receiving training
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.
There is evidence that the core services of the adult,
dislocated and youth programs at local one-stop career centers
sometimes overlap with the statewide labor exchange services
provided with funds in the state unemployment insurance and
employment services operations account. This diminishes the
overall effectiveness of the two programs by creating
unnecessary duplication. Assuring that labor exchange and other
services provided by State agencies under the Wagner-Peyser Act
serve as the primary source of those core services within local
one-stop systems would free up WIA funds to focus on intensive
services and training. To address this overlap, the Committee
instructs the Department to establish guidance to require that
local one-stop career centers have coordination agreements with
the Employment Service and to ensure that personnel funded out
employment service allotments to States are the primary
providers of labor exchange services within one-stop career
centers. To the maximum extent possible, the Department should
ensure that adult, dislocated and youth funds primarily support
the provision of training and more intensive services required
by individuals who are not able to secure employment through
core services. The Department should request that State and
local plans include the establishment of coordination
agreements and should establish measures to ensure that local
entities comply with this guidance.
Dislocated worker employment and training activities
For dislocated worker employment and training activities,
the Committee recommends $1,471,903,000, which is the same
amount as the fiscal year 2007 level and $356,964,000 above the
budget request. Of the amount recommended, $1,060,000,000 will
become available on October 1, 2008. Of the total,
$1,189,811,000 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 Committee recommendation includes $282,092,000 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
otherwise be anticipated, and for statewide and multiple sector
activities, as well as technical assistance and training and
demonstration projects. The Committee recommends that these
activities be coordinated with area economic development needs.
As in prior years, the bill provides that dislocated worker
funds available under section 171(d) may used for demonstration
projects that provide assistance to new entrants in the
workforce and incumbent workers. The bill provides $2,600,000
of the funds available for national reserve activities shall be
available on October 1, 2007 for the purpose of a grant to
continue the work of the National Center on Education and the
Economy. The Committee is concerned that the Department has
used dislocated worker assistance national reserve funds, and
other pilot and demonstration resources, to advance the
Administration's career advancement account proposal, and its
predecessor proposal for personal reemployment accounts, and
directs that no additional grants be made for these activities
prior to a specific authorization of this approach.
The Committee supports the efforts of the Department in
making dislocated worker assistance national reserve funds
available for grants to the States to provide ``gap filler''
services to Trade Adjustment Act (TAA) participants to maximize
the number of trade-certified workers who will qualify for the
health coverage tax credit. Nevertheless, the Committee
believes that increased outreach and support is needed to
States to provide these ``gap filler'' services, and that
health care coverage assistance should be extended to
dislocated workers awaiting TAA certification. A general
provision in the bill addresses this need by permitting a
portion of funds under the American Competitiveness and
Workforce Improvement Act to be used for this purpose.
Community-based job training grants.--The Committee does
not include separate funds for this initiative but provides
that up to $125,000,000 of the amount made available for the
dislocated worker assistance national reserve shall be
available for community-based job training grants. This amount
is the same as provided in fiscal year 2007, and $25,000,000
less than the budget request. These funds are for competitive
grants to community colleges and one-stop career centers, and
the amount provided will fund over 70 new grantees. The
Committee repeats a request that all applicants describe the
role area one-stop centers will play in the proposed project in
their applications. The Committee is interested in programs
that result in training outcomes and instructs the Department
to give priority to grant applications that will result in
participants obtaining industry-recognized credentials. The
Committee requests that the Secretary provide a report to the
House and Senate Committees on Appropriations by March 1, 2008
on training outcomes achieved thus far by community college
grantees.
Youth employment and training activities
For youth activities, the Committee recommends
$940,500,000, which is the same amount as the fiscal year 2007
level and $100,000,000 above 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 in accordance with the Workforce Investment Act of 1988.
These funds are made available one quarter earlier than the
adult and dislocated worker funds to allow for summer jobs
programming.
Native Americans
For Native Americans, the Committee recommends $56,381,000,
which is $2,685,000 above the fiscal year 2007 level and
$11,381,000 above 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 in securing 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.
Census data indicates that American Indians and Alaska
Natives are by far the most impoverished groups in the nation.
The Committee does not agree with the budget request that would
have resulted in cutting participation by over 3,000
individuals.
Migrant and seasonal farmworkers
The migrant and seasonal farmworkers 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 farm work, fishing, or logging activities. Enrollees
and their families are provided with training and related
services intended to prepare them for stable, year-round
employment within and outside of the agriculture industry.
For migrant and seasonal farmworkers, the Committee
recommends $83,740,000, which is $3,988,000 above the fiscal
year 2007 level. For the fifth year in a row the budget request
did not include funds for this program. The Committee is
unwilling to terminate the program, as requested, until the
Department has demonstrated that mainstream job training
programs, as well as related health, welfare and housing
programs, are in place to provide the combination of services
needed to help secure permanent employment for farm and
forestry workers. The Committee is concerned that the
Department believes that the program is not sufficiently
focused on job training and includes language requiring that
not less than 70 percent of the funds for the program be spent
on employment and training services.
As in prior years, the bill directs that of the amounts
made available, $5,000,000 is targeted for migrant and seasonal
farmworker housing grants. The bill further directs that not
less than 70 percent of this amount be used for permanent
housing grants. The Committee is concerned about the use of
funds for temporary housing and the conditions under which
these funds are used. The Committee directs the Department of
Labor to report by March 1, 2008 on the use of farmworker
housing funds. In particular the Department should provide
information on the amount of funds used for permanent and
temporary housing activities, respectively, a list of the
communities served, a list of the grantees and the States in
which they are located, the total number of individuals or
families served, and a list of allowable temporary housing
activities.
YouthBuild
For the YouthBuild program, the Committee recommends
$60,000,000, which is $10,500,000 above the fiscal year 2007
level and $10,000,000 above the request.
The YouthBuild program was transferred from the Department
of Housing and Urban Development in fiscal year 2007.
YouthBuild is an approach to workforce development that
supports at-risk youth aged 16-24 in gaining high school
credentials and receiving skills training that leads to
employment. Training and educational opportunities are provided
while participants are engaged in constructing or
rehabilitating affordable housing for low-income or homeless
families in their communities, with time split between the
construction site and the classroom.
The Committee recognizes the importance of skilled trades
training and education in construction to helping troubled
youth become members of this high growth industry's workforce.
The Committee encourages the Department to seek out the
experience of employer-based groups and labor-management
partnerships to help students enrolled in the YouthBuild
program reap the benefits of skilled trades training and career
opportunities in the building industry.
YouthBuild grants are awarded on a competitive basis. The
increase for fiscal year 2008 will allow for the selection of
YouthBuild projects in approximately 20 additional communities.
Women in apprenticeship
For the Women in Apprenticeship and Non-Traditional
Occupations Act of 1992, the Committee recommends $1,000,000
for grants to employers, unions, and community-based
organizations for support of activities to train, retrain, and
place women in non-traditional jobs and occupations so as to
provide expanded access to careers with family-sustaining
wages. The Committee is not in agreement with the budget
request to terminate this program and continues the program at
the fiscal year 2007 level.
National competitive grant 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.
Reintegration of ex-offenders.--The Committee recommends
$68,746,000 for this program, which consolidates two prior
programs--responsible reintegration of youthful offenders and
the prisoner re-entry initiative--into a single program. This
is $29,146,000 above the budget request and the same as the
combined, comparable fiscal year 2007 level for ex-offender
reintegration activities. While the Committee sees merit in a
program consolidation, the budget request does not meet the
need for reintegration assistance for ex-offenders. The
Committee notes that nearly 650,000 people are released from
State and Federal prison yearly. According to the Bureau of
Justice Statistics (BJS) over 50 percent of those released from
incarceration will be in some form of legal trouble within 3
years. Providing job training programs and career counseling
targeted toward prisoner re-entry is critical to preventing
recidivism and to promoting the effective reintegration of
offenders back into communities. The Committee urges the
Department to include the approach piloted under the
incarcerated veterans transition program in competitions for
funding under this program to ensure that the employment needs
of this population are addressed. Within the combined
reintegration of ex-offenders program, the bill provides that
no less than $48,000,000 be utilized for youthful offender
activities.
Pilots, demonstrations and research.--The Committee
recommends $28,140,000 for grants or contracts to conduct
research, pilots or demonstrations that improve techniques or
demonstrate the effectiveness of programs. This is $13,440,000
above the fiscal year 2007 level and $15,140,000 above the
budget request.
The bill provides that $10,000,000 be used for a new young
parents demonstration program in order to provide educational
and occupational skills training leading to family economic
self-sufficiency to young parents (both mothers and fathers)
and expectant mothers ages 16 to 24. The Committee intends that
competitive awards be made to local workforce investment
boards, one-stop career centers, community-based organizations
(CBOs), community colleges, and other applicants that
demonstrate linkages to the local workforce investment system.
Eligible projects should provide a range of activities
including education and training leading to skills and
credentials valued in the local labor market, career ladder
programs, paid work experience, supportive services, and
counseling on self-sufficiency measures particular to the local
community, as well as post-employment retention and advancement
supportive services. Projects are to be encouraged to serve
young parents in high-risk categories, including those under
the jurisdiction of the justice system, in the child welfare or
foster care system, homeless individuals, or victims of child
abuse. The Department should assure that pilot projects adhere
to common performance measures and be subject to evaluation.
The Committee directs that the Employment and Training
Administration administer the pilot program in partnership with
the Women's Bureau. The Committee's recommendation includes
this $10,000,000 grant program as part of its initiative to
help reduce the number of abortions in America by alleviating
the economic pressures and other real life conditions that can
sometimes cause women to decide not to carry their pregnancies
to term.
For the funds in this account not designated for the young
parents initiative, the Committee includes the following
projects in the following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Adelante Development Center, Albuquerque, NM for $200,000
employment and training services....................
Agudath Israel of America Community Services, Inc., 300,000
Brooklyn, NY for its Fresh Start job training and
counseling program..................................
Arc of Blackstone Valley, Pawtucket, RI for a 150,000
workforce development initiative....................
Bellingham Technical College, Bellingham, WA for a 125,000
Process Technology Workforce Development Project....
Bismarck State College, Bismarck, ND for an 100,000
instrumentation and control training program for the
energy industry.....................................
Brookdale Community College, Lincroft, NJ for 150,000
workforce training programs through its Center for
Excellence in Technology, Telecommunications and
Economic Development................................
Capital IDEA, Austin, TX for workforce development 50,000
services for disadvantaged adults...................
Center for Employment Training, San Jose, CA for its 250,000
building trades program for out-of-school youth.....
Central Carolina Tech College, Sumter, SC for 350,000
training in healthcare professions..................
Central Maine Community College, Auburn, ME for a 150,000
training program in precision metalworking and
machine tool technology.............................
Chinese-American Planning Council, New York, NY for 200,000
counseling, vocational training, job placement, and
ESL services........................................
City College of San Francisco, San Francisco, CA for 300,000
a health care workforce training initiative through
the Welcome Back Center.............................
City of Alexandria, VA for an automotive industry 275,000
workforce development and training initiative.......
City of Baltimore, MD for the Park Heights 250,000
Partnership for Jobs................................
City of Milwaukee, WI for a project to train youth in 205,000
construction trades.................................
City of Palmdale, Palmdale, CA for a business 150,000
resource network to enhance worker skills
development.........................................
City of Suffolk, VA for training programs at the 250,000
Suffolk Workforce Development Center................
City of West Palm Beach, FL for training programs for 300,000
at-risk youth.......................................
Clarian Health Partners, Indianapolis, IN for 125,000
workforce development in the health care industry...
College of Southern Maryland, La Plata, MD, for its 300,000
Partnership for the Advancement of Construction and
Transportation Training Project.....................
Community Learning Center, Fort Worth, TX for 350,000
expansion of the Advanced Manufacturing Training
Partnership Program.................................
Des Moines Area Community College, Arkeny, IA for 250,000
workforce recruitment and training to address area
skill shortages.....................................
Dillard University, New Orleans, LA for recruitment 200,000
and training of nursing assistants..................
East Los Angeles Community Union, Los Angeles, CA for 300,000
a workforce training initiative.....................
Easter Seals Arc of Northeast Indiana, Inc., Fort 100,000
Wayne, IN for the Production and Worker Training
Services program....................................
Edgar Campbell Foundation, Philadelphia, PA for 300,000
counseling, job placement and work readiness
programs............................................
Employment & Economic Development Department of San 175,000
Joaquin County, Stockton, CA for a work experience
program for at-risk youth...........................
Essex County Community Organization, Lynn, MA for its 250,000
E-Team Machinist Training Program...................
Foundation of the Delaware County Chamber, Media, PA 150,000
for workforce development and job readiness services
Goodwill of Southern Nevada, North Las Vegas, NV for 300,000
workforce development programs......................
Greater Akron Chamber, Akron, OH for a summer 300,000
apprenticeship program for youth....................
Groden Center, Providence, RI for job readiness 150,000
training for adults with Asperger's Syndrome........
Guam Community College, Mangilao, Guam for skilled 250,000
craft training......................................
Hamilton County Government, Chattanooga, TN for 440,000
training activities related to manufacturing
processes...........................................
Home of Life Community Development Corp., Chicago, IL 150,000
for a financial services training and placement
program.............................................
Homecare Workers Training Center, Los Angeles, CA for 100,000
nurse assistant training............................
International Fellowship of Chaplains, Inc., Saginaw, 200,000
MI for the Road to Hope training program in Seneca
County, OH..........................................
Iowa Valley Community College, Marshalltown, IA for 100,000
job training activities.............................
Ivy Tech Community College of Indiana--Columbus 150,000
Region, Indianapolis, IN for the Center for
Cybersecurity for workforce development.............
Ivy Tech Community College of Indiana Lafayette, 140,000
Indianapolis, IN for job training programs at the
Center for Health Information Technology............
Kansas City Kansas Community College, Kansas City, KS 200,000
for workforce training and placement for the retail
and hospitality industries..........................
Kent State University/Trumbull County, Warren, OH for 250,000
regional training through the Northeast Ohio
Advanced Manufacturing Institute....................
Louisiana Delta Community College, Monroe, LA for a 200,000
job training initiative.............................
Louisiana National Guard, Carville, LA for the Job 150,000
Challenge Program...................................
Manufacturing Association of Central New York, 250,000
Syracuse, NY for a workforce training project.......
Massachusetts College of Pharmacy and Health 150,000
Sciences, Manchester, NH for training of nurses,
physician assistants, and pharmacists...............
McHenry County Community College, Woodstock, IL for 375,000
employer-identified occupational training...........
Minot State University, Minot, ND for the Job Corps 100,000
Executive Management Program........................
Mission Language and Vocational School, San 250,000
Francisco, CA for a training program in health-
related occupations.................................
Neighborhood First Program, Inc., Bristol, PA for 125,000
services for at-risk youth..........................
NewLife Academy of Information Technology, East 150,000
Liverpool, OH for training for information
technology careers..................................
North West Pasadena Development Corp., Pasedena, CA 100,000
for job training for low-income individuals.........
Northcott Neighborhood House, Milwaukee, WI for 70,000
construction industry training for youth............
Oakland Community College, Bloomfield Hills, MI to 450,000
lead a consortium on workforce development for
emerging business sectors...........................
Opportunity, Inc., Highland Park, IL for workforce 250,000
development activities..............................
Our Piece of the Pie, Hartford, CT for education and 500,000
employment services for out-of-school youth.........
Parish of Rapides Career Solutions Center, 200,000
Alexandria, LA for a job training initiative........
Philadelphia Shipyard Development Corporation, 350,000
Philadelphia, PA for on-the-job training in
shipbuilding technology.............................
Piedmont Virginia Community College, Charlottesville, 100,000
VA for the Residential Construction Academy.........
Poder Learning Center, Chicago, IL for immigrant 200,000
neighborhood education and job development services.
Precision Manufacturing Institute, Meadville, PA for 100,000
high-technology training programs...................
Project One Inc., Louisville, KY for summer job 150,000
activities for disadvantaged youth..................
Project QUEST, Inc., San Antonio, TX for workforce 75,000
development services to low-income residents........
PRONTO of Long Island, Inc., Bayshore, NY for a 100,000
vocational training initiative......................
Schoenbaum Family Enrichment Center, Charleston, WV 250,000
for its Enterprise Development Initiative...........
Schuylkill Intermediate Unit 29, Marlin, PA for a 150,000
workforce training program..........................
South Bay Workforce Investment Board, Hawthorne, CA 260,000
for its Bridge-to-Work program......................
Southeast Missouri State University, Cape Girardeau, 300,000
MO for equipment and training.......................
Southern University at Shreveport, Shreveport, LA for 100,000
healthcare worker training activities...............
Southside Virginia Community College, Alberta, VA for 200,000
the Heavy Equipment Training Program................
Southwestern Oklahoma State University, Weatherford, 250,000
OK for workforce development in the manufacturing
sector..............................................
St. Louis Agency on Training and Employment, St. 350,000
Louis, MO for a summer jobs program for youth.......
Towson University, Towson, MD for education and 250,000
training services for careers in homeland security..
United Mine Workers of America, Washington, PA for 750,000
the UMWA Career Center's mine worker training and
reemployment programs...............................
University of West Florida, Pensacola, FL to provide 200,000
teacher training to veterans........................
Veteran Community Initiatives, Inc., Johnstown, PA 500,000
for employment services and support programs for
veterans............................................
Vincennes University, Vincennes, IN for heavy 350,000
equipment operator training for the mining industry.
Wayne County, NY Planning Department, Lyons, NY for 250,000
workforce development programs in Central New York..
West Los Angeles College, Culver City, CA for a craft 300,000
and technican training program......................
Women Work and Community, Augusta, ME for a women's 300,000
workforce training and development program..........
------------------------------------------------------------------------
Evaluation.--The Committee recommends $4,921,000 to provide
for the continuing evaluation of programs 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 2007 level and
$2,079,000 below the budget request.
The Committee directs the Department of Labor to continue
to submit quarterly reports to the House and Senate
Appropriations Committees on the status of grants made from H-
1B fees, national emergency grants (including grants made under
the up to 10 percent authority for dislocated worker
demonstration and pilot projects), high-growth job training
initiative awards from all sources, and awards made for pilot,
demonstration, multi-service, research, and multi-State
projects. These reports shall be submitted to the House and
Senate Committees on Appropriations no later than 15 days after
the end of each quarter and shall summarize by funding source
all grants awarded. This report shall also include a list of
all awards made during the quarter and for each award shall
include the grantee; the amount of the award; the funding
source of the award; whether the award was made competitively
or by sole source and, if sole source, the justification; the
purpose of the award, the number of workers to be trained, and
other expected outcomes. This will allow for continued
evaluation of the use of sole-source contracting for those
remaining grants where the bill does not require competitive
procurement.
The bill repeats a provision in the 2007 Continuing
Appropriations Resolution that requires the Secretary of Labor
to award grants for training for employment in high growth
industries on a competitive basis. The bill also includes
language that requires that funds available to the Department
under the American Competitiveness and Workforce Improvement
Act be available only for grants for training in the
occupations and industries for which employers use the visas
that generate these funds, and that related activities be
limited to those necessary to support such training. The
Committee does not apply this restriction to competitive grant
awards made in response to solicitations issued prior to April
15, 2007, or to the grants authorized to assist States in
addressing the gap in health coverage for trade-impacted
workers. This permits the Department to fund the obligations
made in three rounds of Workforce Innovation in Regional
Economic Development (WIRED) grants to States. To the extent
possible, however, the Committee urges that WIRED grantees be
asked to address the training needs in their regions for the
same target industries and occupations identified in this
section. The Committee urges that preference for these grants
be given to sector-based approaches that involve multiple
employers, including those that involve labor-management
partnerships, to address skill shortages. The Committee is also
interested in career ladder approaches in targeted industries,
including information technology, engineering and advanced
manufacturing, and health care.
The Committee includes a provision rescinding $335,000,000
in prior year unexpended balances from Workforce Investment Act
programs. The Committee also rescinds $44,000 in unexpended
funds originally provided for the activities of the National
Skill Standards Board, as requested.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
The Committee recommends $530,900,000 for community service
employment for older Americans, which is $47,289,000 above the
fiscal year 2007 level and $180,900,000 above 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.
The Committee does not agree with the budget request, which
would cut the number of seniors served by 44,000 or 43 percent
below the fiscal year 2007 level, from 103,000 to 59,000 in
fiscal year 2008. The Committee recommendation will continue
the current slot level of 103,000 low-income seniors, and
provides funds for the second anticipated increment of a
Federal minimum wage increase, from $5.85 to $6.55 an hour, for
program participants.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
The Committee recommends $888,700,000 for this account,
which is $51,100,000 above the fiscal year 2007 level and the
same as the budget request.
The trade adjustment assistance program (TAA) provides
assistance to certified workers adversely affected by imports
or from trade with countries covered by the North America Free
Trade Agreement, the Andean Trade Preference Act, African
Growth and Opportunity Act, or the Caribbean Basin Economic
Recovery Act. The Trade Adjustment Assistance Reform Act of
2002 expanded eligibility to include secondary workers whose
layoffs were caused by the loss of business by a supplier of
component parts, a final assembler, or a finisher, for a firm
employing a worker group that has received TAA certification.
Funding will provide for the payment of trade adjustment
benefit payments; training, job search allowances, relocation
allowances and associated administrative costs; and alternative
trade adjustment assistance (ATAA) wage supplements.
For fiscal year 2006, approximately 120,000 workers were
potentially eligible to apply for TAA benefits and service.
However, of these potentially eligible workers, roughly 40,000
individuals begin receiving TAA-funded benefits or services
each year, together with another 40,000 individuals who entered
the program in previous years and continue to receive benefits
or services. The Committee believes that the Department can do
more to conduct outreach to trade affected workers to ensure
that eligible workers learn about the program. The lack of
outreach is particularly acute in regard to the secondary
worker populations where take up rates are far below what was
expected when the new eligibility was established.
The Committee also is concerned by the fact that only a
small percentage of TAA participants take advantage of the
health coverage tax credit (HCTC) that was authorized by the
Trade Adjustment Assistance Reform Act of 2002. The low take-up
rate may largely be a function of the high costs of health
insurance coverage overall, but there is also evidence that
some eligible workers are affected by the gap in time between
their application for TAA benefits, their certification for
those benefits, and the certification by the Internal Revenue
Service (IRS) for the HCTC itself. The Committee is in
agreement with the Department's use of dislocated worker
assistance national reserve funds to help States address this
issue, but believes that additional outreach and assistance is
necessary to ensure that workers who can benefit from the HCTC
do not lose their health care coverage while awaiting
certification for either TAA by the Department, or the tax
credit by IRS. To ensure that there are sufficient funds for
this purpose, the bill includes a general provision providing
that up to $20,000,000 from funds available to the Department
under the American Competitiveness and Workforce Improvement
Act of 1998 may be used for this purpose.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
The Committee recommends $3,382,614,000 for this account,
which is $42,264,000 above the fiscal year 2007 level and
$43,861,000 above the budget request. Included in the total
available is $3,296,669,000 authorized to be drawn from the
employment security administration account of the Unemployment
Trust Fund and $85,945,000 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 $2,561,223,000. This is $53,553,000 above the fiscal
year 2007 level and the same as the budget request. The total
includes $2,550,723,000 for State operations and $10,500,000
for national activities. Included in the amount provided for
State operations is an additional $40,000,000, for a total of
$50,000,000 for in-person reemployment and eligibility
assessments in one-stop centers. These reviews are conducted by
State employment security agency staff. The Committee concurs
with the budget request, which cites that a number of studies
have found that attention to eligibility and reemployment needs
assessments result in relatively shorter claims duration for
beneficiaries. The Committee also concurs with the
recommendation in the House report accompanying the fiscal year
2008 budget resolution, which states that these program
integrity funds are not intended to finance activities that
would adversely affect workers who receive unemployment
benefits. The bill requires the Secretary to submit a report to
the Congress no later than 180 days following the end of the
fiscal year containing comprehensive information on the savings
that result from the assessments of unemployment insurance
claimants and identifying best practices in program integrity
and reemployment reviews. The bill provides for contingency
funding for increased workloads that States may face in the
administration of unemployment insurance by specifying that an
additional $28,600,000 be available from the Unemployment
Insurance Trust Fund for every 100,000 increase in average
weekly insured claims above 2,786,000.
For grants to the States for employment service (ES)
activities, the Committee recommends $725,883,000, which
includes $23,203,000 in general funds together with an
authorization to spend $702,680,000 from the employment
security administration account of the Unemployment Trust Fund.
This is $10,000,000 above the fiscal year 2007 level and
$37,104,000 above the budget request. This increase represents
the first enhancement for ES grants to the States in six years.
The Committee believes that the labor exchange activities
provided by State employment service agencies should be primary
source of labor exchange services for the local one-stop
system, thus freeing up Workforce Investment Act funds to focus
on intensive services and training.
The Committee recommends $32,766,000 for ES national
activities, which is $662,000 below the fiscal year 2007 level
and the same as the budget request.
The Committee recommends $52,985,000 for one-stop career
centers and labor market information, which is $10,870,000
below the fiscal year 2007 level and $3,000,000 below the
budget request. This funding supports access for customers in
labor market transactions and career information, as well as
supporting performance management systems. The Committee
believes that the emphasis for these funds should be on the
workforce information grants to States and directs that these
grants be funded at not less than $32,430,000, which is the
average of the prior two fiscal years. The Committee believes
that funds above this amount should be dedicated to the
investments needed to sustain the tools and activities that
provide self-service career information and guidance to youth
and adults and workforce information and analysis to policy-
makers and counselors, through America's career information
network, America's service locator, the career voyages system,
and the occupational information network (O*NET), and
recommends that these activities be maintained at the fiscal
year 2007 level. Remaining funds may be applied to other
elements of the infrastructure of the labor market information
system, including the wage record interchange system (WRIS) and
the workforce investment streamlined performance reporting
system (WISPR). The Committee believes it is inappropriate to
use these funds for further capacity building grants to parties
outside the public workforce investment system.
The Committee recommends $9,757,000 for the work incentive
grants program, which is $9,757,000 below the fiscal year 2007
level. The budget request recommended elimination of this
program. The program has funded grants to the States to
demonstrate approaches to improving accessibility to one-stop
career center services for new job seekers with disabilities.
All States have now had an opportunity to receive grants for
this purpose. However, due to the fact that workforce
investment system funding has not been increased during the
period of these grants, it will be difficult for the one-stop
system to sustain these activities without continuation
funding. The Committee provides 50 percent of the fiscal year
2007 funding level and recommends that the Department use these
funds to provide matching grants to the States that have hired
disability navigators to assure that the navigator positions
and practices are incorporated in the regular operations of
their workforce system.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee recommends $437,000,000 for this account,
which is $28,000,000 below the fiscal year 2007 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 insurance laws and
the Black Lung Disability Trust Fund, whenever balances in such
accounts prove insufficient.
Program Administration
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.
The Committee recommends $170,500,000 for fiscal year 2008,
which is $45,662,000 below the budget request. The total amount
includes $88,451,000 in general funds and authority to expend
$82,049,000 from the employment security administration account
of the Unemployment Trust Fund. The Committee recommendation
provides $28,872,000 of the amount recommended by the President
for this account under the Office of Job Corps for its
administrative expenses. After this transfer is taken into
account, the Committee recommendation for program
administration is $630,000 below the comparable fiscal year
2007 level.
Employee Benefits Security Administration
SALARIES AND EXPENSES
The bill provides $142,925,000 for the Employee Benefits
Security Administration (EBSA), which is $1,352,000 above the
fiscal year 2007 level and $4,500,000 below the budget request.
This reduction reflects the funding of the EFAST2 electronic
filing system in fiscal year 2007, rather than in fiscal year
2008.
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.
Funds were provided in fiscal year 2007 for the Department
of Labor's EFAST2 electronic Form 5500 filing system and an
additional $500,000 is included in the Committee recommendation
for changes in reporting requirements mandated by the Pension
Protection Act. The Committee expects that EBSA will contribute
an additional amount of $2,500,000 from its fiscal years 2007
and 2008 appropriations for this system, generated by one-time
cost savings proposed in the last two years' budget requests.
The Committee expects EBSA to minimize any potential negative
impact of the project's financing on enforcement, compliance
outreach, and education programs. The Department is directed to
provide a schedule for completion of the EFAST2 system within
30 days of enactment and to report monthly on progress relative
to that schedule to the House and Senate Committees on
Appropriations.
The Committee recommends that EBSA devote resources to the
issuance of regulations that provide understandable and uniform
reporting of all fees charged to 401(k) plans and participants
with all fees required to be broken down by identifiable and
meaningful categories and by source of payment. EBSA should
also create a national education program to educate pension
plan administrators and participants of 401(k) investment
options, fees charged, and prohibitions on conflicts of
interest. In addition, the Committee is concerned with the
Department of Labor's lack of statistics on the continuation of
health care coverage program known as COBRA. The Committee
requests that the Department of Labor upgrade its data
collection on participants in the COBRA program with specific
emphasis on those who utilize COBRA benefits for the full
extent of the authorized timeframe and subsequently lose health
insurance coverage.
Pension Benefit Guaranty Corporation
The Corporation's budget for fiscal year 2007 is
$411,151,000, which is $5,761,000 above the fiscal year 2007
level and the same as the budget request.
The Corporation is a wholly owned government corporation
established by 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,
collection 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 repeats language that permits workload driven
increases in obligational authority based on the number of new
plan participants in plans terminated by the Corporation. In
addition, the bill includes new language that permits similar
workload driven increases to cover the investment management
fees based on increases in assets received by the Corporation
as a result of new plan terminations, after approval by the
Office of Management and Budget and notification of the House
and Senate Committees on Appropriations.
Employment Standards Administration
SALARIES AND EXPENSES
(INCLUDING RESCISSION)
The Committee recommends $436,508,000 for this account,
which is $15,637,000 above the fiscal year 2007 level and
$11,151,000 below the budget request. The bill includes
$434,397,000 in general funds for this account and contains
authority to expend $2,111,000 from the Special Fund
established by the Longshore and Harbor Workers' Compensation
Act.
The Employment Standards Administration (ESA) 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 provisions). The agency also administers Executive
Order 11246 related to affirmative action by Federal
contractors and the Labor-Management Reporting and Disclosure
Act.
The Committee recommends a $5,000,000 increase for the wage
and hour division (WHD) to support an additional 36 full time
equivalents (FTE) for stronger enforcement activities in low-
wage industries and the Gulf Coast region, as requested. Even
with these new positions, the number of enforcement staff in
the division will have declined by 12.6 percent from 1,528 in
fiscal year 2001 to 1,336 in fiscal year 2008. The Committee
sees this recommendation as a downpayment on a longer-term
investment in rebuilding enforcement capacity.
The Committee is particularly concerned that WHD's
investigations of low-wage industries have fallen
precipitously, with dramatic declines in industries such as
garment manufacturing, health care (especially nursing homes),
and agriculture (especially poultry processing). The Committee
directs the Department to target the additional resources
provided to increase inspections and investigations of
industries with high concentrations of low-wage and other
vulnerable workers, and industries with high levels of wage and
hour violations, including overtime violations. In hiring new
investigators, WHD should frame position qualifications so as
to increase the number of front-line investigators that are
fluent in the languages of the workforces in which non-English-
speaking workers predominate.
Within the agriculture industry, the Committee is concerned
about the lack of WHD inspections of potential child labor
violations. Current law permits children as young as 12 to work
in the fields under very specific limitations, such as non-
hazardous work that occurs beyond school hours. However, WHD
inspections to ensure that employers adhere to these
restrictions are inconsistent at best. The Committee therefore
encourages WHD to use its allocation within the bill to assign
additional inspectors to monitor child labor law violations
that occur in the fields. The Committee recommends that the
Secretary of Labor, in collaboration with the Secretary of
Agriculture, develop a plan to address child labor violations
within the agriculture industry in order to increase compliance
with child labor laws and requests that the plan be submitted
to the House and Senate Committees on Appropriations by March
1, 2008.
The misclassification of employees as independent
contractors undermines enforcement of the nation's worker
protection laws and has cost the U.S. Treasury an estimated $35
billion between 1996 and 2004. Misclassification also deprives
workers of critical benefits such as unemployment insurance,
workers' compensation, Social Security, and Medicare, and
important rights such as rights to family and medical leave,
employee benefits, and a safe and nondiscriminatory workplace.
The Committee requests that WHD compile a detailed report to
the House and Senate Committees on Appropriations by March 1,
2008, on the Department's enforcement strategy on
misclassification and the investigation activity to date in
this area, including recovery of back pay and other
compensatory measures, assessment of penalties, and policies
for cross-referral of complaints to the Internal Revenue
Service.
The Committee directs WHD to work with the U.S. Forest
Service, the Department of Homeland Security and the Department
of State on the issue of fair wages and compliance with safety
regulations for Federal contractors that employ H-2B forestry
workers, or ``pineros.'' Of the estimated 66,000 guest workers
in this country, forest workers are the second-largest group,
after landscape laborers. Yet Federal forestry contractors
often are in violation of basic wage and safety standards. The
Forest Service is taking steps to compile a comprehensive
database of forestry contractors, current and past violators,
and registered H-2B forestry workers. As the Forest Service
develops its database, the Committee directs WHD to populate
the database with violations of wage disbursements, and to
coordinate with the Department's Occupational Safety and Health
Administration (OSHA), so as to include additional safety and
health enforcement information pertaining to this population in
the database. The Committee requests that the Department of
Labor provide a report to the House and Senate Committees on
Appropriations no later than March 1, 2008 on its enforcement
activities regarding those contractors that employ pineros and
have violated Federal employment and/or safety standards.
The Committee does not agree with the budget request to add
additional positions for the office of labor-management
standards (OLMS). Since 2001, OLMS staffing has increased by
over 25 percent while staffing in other Employment Standards
Administration divisions and other DOL enforcement agencies has
dramatically declined. For example, the wage and hour division,
which enforces minimum wage, overtime, and child labor laws,
will have experienced a drop in staff of 12.6 percent since
fiscal year 2001, even with the additional resources provided
for fiscal year 2008. The staff level at the office of federal
contract compliance programs (OFCCP), which protects workers
from unfair employment practices by Federal contractors, will
have dropped by 23 percent from fiscal year 2001 to fiscal
2008. The Committee is concerned that Department's continued
budget requests for additional staffing and funding for OLMS
are at the expense of other priorities to protect workers'
wages, hours, and working conditions. The Department's budget
justification states that the acceptability rate for unions in
meeting Labor-Management Reporting and Disclosure Act (LMRDA)
reporting requirements is 96 percent. The Committee believes
that adding resources for LMRDA enforcement is the wrong
priority when enforcement activities in other areas of the
Department of Labor have been neglected.
The Committee rescinds $70,000,000 of the unobligated funds
collected pursuant to section 286(v) of the Immigration and
Nationality Act. This amount is $20,000,000 more than the
amount in the budget request, and reflects the Department's
estimates of the unobligated balance at the end of fiscal year
2006. This action does not affect anticipated obligations for
fiscal year 2007, nor does it affect fees to be collected in
fiscal year 2008. The Department has recommended language to
expand the authorized use of these funds for wage and hour
investigations that is more appropriately addressed by the
authorizing committees.
SPECIAL BENEFITS
(INCLUDING TRANSFER OF FUNDS)
The bill includes $203,000,000 for special benefits, which
is $24,000,000 below the fiscal year 2007 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 2008,
an estimated 140,000 injured Federal workers or their survivors
will file claims; 55,000 will receive long-term wage
replacement benefits for job-related injuries, diseases, or
death.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
The Committee recommends an appropriation of $208,221,000
for special benefits for disabled coal miners, as requested.
This amount is in addition to the $68,000,000 appropriated last
year as an advance for the first quarter of fiscal year 2008.
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
$62,000,000 for the first quarter of fiscal year 2009, which is
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
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends $104,745,000 for the Energy
Employees Occupational Illness Compensation Program Act
(EEOICPA) authorized by Title XXXVI of the National Defense
Authorization Act of 2001. This amount is $2,438,000 above the
fiscal year 2007 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.
In addition to the $55,358,000 that the budget request
indicates will be transferred for the National Institute of
Occupational Safety and Health (NIOSH) within the Department of
Health and Human Services for its activities, the bill directs
that the Secretary provide, within 30 days of enactment,
$4,500,000 to NIOSH for use by or in support of the advisory
board on radiation and worker health to carry out its statutory
responsibilities under EEOICPA, including obtaining audits,
technical assistance and other support from the Board's audit
contractor with regard to radiation dose estimation and
reconstruction efforts, site profiles, procedures, and review
of special exposure cohort petitions and evaluation reports.
BLACK LUNG DISABILITY TRUST FUND
(INCLUDING TRANSFER OF FUNDS)
The Committee recommends such sums as necessary for payment
of benefits and interest on advances. The Committee estimates
that $1,068,000,000 will be required for this account, which is
$1,546,000 below the fiscal year 2007 level and the same as the
Administration estimate.
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-mined coal. Additional
funds come from reimbursement payments from mine operators for
benefit payments made by the trust fund before the mine
operator is found liable. 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 Committee recommends $503,516,000 for the Occupational
Safety and Health Administration (OSHA), which is $16,591,000
above the fiscal year 2007 level and $13,239,000 above the
budget request. This agency is responsible for enforcing the
Occupational Safety and Health Act of 1970 in the nation's
workplaces.
For Federal enforcement, the bill provides $190,128,000, an
increase of $13,155,000 over fiscal year 2007. The Committee is
concerned that the number of full time equivalents (FTE)
dedicated to Federal enforcement has declined by 141, or 8.4
percent, from 1,683 in fiscal year 2001 to 1,542 in fiscal year
2007. No additional enforcement positions were proposed in the
budget request. While it is not possible under funding
constraints to totally erase the deficit of enforcement
positions in one year, the Committee recommends $7,082,000
above the budget request to begin to restore the enforcement
capacity of OSHA over the next several years. These funds will
support an additional 47 positions in federal enforcement. The
Committee intends that a portion of these positions be used to
reestablish the capacity to conduct comprehensive process
safety management (PSM) inspections. The Committee takes note
of the Chemical Safety Board recommendations following the BP
Texas City disaster and believes that OSHA needs to pursue
comprehensive enforcement of its process safety management
standard. The additional enforcement positions not dedicated to
PSM should be used to begin to rebuild and enhance OSHA's
overall enforcement capacity. The Committee urges OSHA to give
special emphasis in its hiring and promotion activities to the
number of bilingual inspectors. This action would allow OSHA to
better address the disproportionately high number of injury and
fatalities among immigrant workers. The Committee directs that
OSHA provide reports to the House and Senate Committees on
Appropriations not later than 90 days after enactment, and
quarterly thereafter on OSHA's progress in filling these
additional enforcement positions.
The Committee bill provides $75,566,000 for Federal
compliance assistance, an increase of $2,907,000 over fiscal
year 2007 and a decrease of $4,041,000 below the request, which
targeted increased funds for the voluntary protection program.
The Committee agrees with a March 2004 GAO report that
recommended that OSHA's voluntary compliance strategies should
not be expanded until they are fully evaluated. This evaluation
is not possible until OSHA collects complete, comparable data
that would enable a comparison of the relative effectiveness of
these approaches. Therefore, the Committee directs OSHA to
utilize a portion of the increased funds for federal compliance
assistance to develop methodologies and to collect the data
necessary for a full evaluation of the effectiveness of
voluntary compliance programs.
The Committee is concerned about OSHA's lack of progress in
developing and issuing important safety and health standards
and the repeated failures to meet the agency's timetables for
action announced in the semi-annual regulatory agendas. Thus,
the Committee directs the Secretary to provide to the House and
Senate Appropriations Committees detailed timetables for the
development and issuance of occupational safety and health
standards on beryllium, silica, cranes and derricks, confined
space entry in construction, and hazard communication global
harmonization. Each of these standards has appeared on the
Department's regulatory agenda over a period of years, yet
deadlines have consistently slipped. In order to better
understand the reasons for these delays, the reports, which
shall be provided within 90 days of the enactment of this Act
with updates provided every 90 days thereafter, shall include
an explanation of the reasons for any delays in meeting the
projected timetables for action.
The Committee is dissatisfied with OSHA's activities on
ergonomics and the prevention of musculoskeletal disorders,
which continue to be the leading cause of workplace injuries.
The agency's comprehensive plan on ergonomics announced in 2002
has resulted in the issuance of only three industry guidelines,
the last one issued in 2004, and only 17 general duty
citations, the last one issued in 2005. The Committee directs
the agency to enhance its activities by developing guidelines
for the 13 other industries recommended by the national
advisory committee on ergonomics in 2004, and to submit a
timetable to the Committee specifying when these additional
guidelines will be completed. The Committee expects the agency
to step up enforcement on ergonomic hazards through the use of
the general duty clause, as outlined in the Secretary of
Labor's 2002 ergonomics plan, and to conduct follow-up
inspections to determine if ergonomic hazards have been abated.
For the past four years, the Committee has included
language in its report expressing disappointment and concern
about the Department's lack of progress in completing
rulemaking on the issue of payment for personal protective
equipment (PPE), and urging OSHA to act expeditiously to issue
the final rule. The Committee pointed out that the rule is
particularly important for Hispanic workers who
disproportionately work in low-wage hazardous jobs, and have a
much higher fatality rate than other groups of workers.
However, no action was taken and OSHA repeatedly missed the
timetable for action set in its regulatory agenda. In response
to a lawsuit filed in early 2007, OSHA has now announced that
it will issue a final payment for PPE rule by the end of
November 2007. However, OSHA has not committed to issue a final
rule that maintains its longstanding policy that employers have
the responsibility to pay for all safety equipment, with few
exceptions. Given the Department of Labor's repeated failure to
meet its announced deadlines, the bill includes a provision to
ensure that these protections will finally be put in place.
The Committee is dissatisfied with OSHA's lack of action to
ensure that health care workers and emergency responders will
be adequately protected in the event of an influenza pandemic.
The Department of Labor has denied a petition for an OSHA
emergency standard on grounds that a pandemic has not yet
occurred. Moreover, the guidelines issued by the Department in
May fail to recognize the urgency of the problem or the
responsibility of employers to provide adequate protections for
health care workers. In addition, reliance on guidelines
instead of standards eliminates the opportunity for public
review and comment. The Committee believes that it is important
to plan and put protections in place before a pandemic occurs.
The Committee asks that the Department reconsider the issuance
of an emergency standard. The Committee directs the Department
to, at a minimum, develop a permanent standard on an expedited
basis to ensure that plans and measures to protect health care
workers and responders from an outbreak of pandemic influenza
are in place as soon as possible. The Committee directs that
OSHA submit a report to the House and Senate Committees on
Appropriations within 90 days of enactment, and quarterly
thereafter, detailing its anticipated timeline for issuing a
standard on an emergency or expedited basis, and its progress
in meeting that timeline.
The Committee also believes that the OSHA response to
serious health hazards posed by exposure to the chemical
diacetyl, a butter flavoring agent used in microwave popcorn
and other foods is inadequate. Despite urgent warnings from
NIOSH that exposure to diacetyl poses a risk of a rare and
fatal lung disease (bronchiolitis obliterans) and should be
controlled, and a growing number of documented cases of the
disease, OSHA has failed to act. There has been no response to
a petition for an emergency standard filed last year by unions
and health scientists. The Committee believes this matter
warrants an emergency standard, but at a minimum, OSHA should
develop a permanent standard on an expedited basis. Only
recently has OSHA announced it will initiate a special emphasis
program, but only for those establishments that manufacture
butter-flavored microwave popcorn. The Committee understands
that OSHA is also in the process of finalizing a national
emphasis program that will expand enforcement activities beyond
microwave popcorn plants to other food manufacturing and
flavoring plants where diacetyl is used or produced, and that
both emphasis programs will apply existing standards (including
personal protective equipment, respiratory protection, and
hazard communication), as well as OSHA's general duty
authority, to require that exposures to this very toxic agent
be controlled. The Committee directs that OSHA submit a report
to the House and Senate Committees on Appropriations within 90
days of enactment, and quarterly thereafter, detailing its
anticipated timeline for issuing a diacetyl standard on an
emergency or expedited basis, and its progress in meeting that
timeline. The Committee also requests that a separate report be
provided no later than March 1, 2008, on the special and
national emphasis programs, detailing the number of
establishments inspected, citations issued, and follow-up
activities taken to ensure that hazardous conditions are
abated.
The bill includes $10,116,000 for the Susan Harwood
training grant program, which is the same as the fiscal 2007
level. This program was not included in the budget request. The
Committee is concerned that OSHA has again proposed elimination
of this program, which supports worker safety and health
training and education programs that are an important component
of a comprehensive approach to worker protection. Within these
funds, the bill provides $3,200,000 to extend funding for the
institutional competency building training grants which
commenced in September 2000 for program activities for the
October 1, 2007, to September 30, 2008, period, provided that
the grantees demonstrate satisfactory performance.
The May 12, 2007 incident involving a U.S. citizen with
drug-resistant tuberculosis traveling via commercial airline
demonstrates how serious this disease can be. Therefore, the
bill does not include prior language prohibiting OSHA from
enforcing the general industry respiratory protection standard
for the annual fit testing of respirators for occupational
exposure to tuberculosis (TB). OSHA's respiratory protection
standard requires that respirators be provided to protect
workers exposed to chemical and biological hazards. The
Committee sees no reason to treat exposure to TB differently
than exposure to all other hazards subject to OSHA's respirator
standard. Annual fit testing of respirators for health care
workers exposed to tuberculosis will also help protect these
workers from other airborne infectious diseases. The Centers
for Disease Control and Prevention (CDC) issued guidelines for
preventing the transmission of tuberculosis in health care
settings in December 2005. Those guidelines recommend that
after a risk assessment is conducted to validate the need for
respiratory protection, that fit testing should be performed
during the initial respiratory protection program training, and
that the period for testing thereafter be in accordance with
the relevant Federal, State and local regulations. The
Committee believes that it is appropriate that OSHA's
respiratory protection standard apply to occupational exposure
to tuberculosis and that the agency should not be further
prevented from enforcing the annual fit testing requirements to
address occupational exposure to tuberculosis in health care
settings.
Mine Safety and Health Administration
SALARIES AND EXPENSES
The Committee recommends $313,478,000 for this agency,
which is $11,908,000 above the fiscal year 2007 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 recommendation supports the retention of 170
inspector positions that MSHA reports it is on target to hire
by the end of fiscal year 2007. The initial funding for these
positions was provided in emergency supplemental appropriations
for fiscal year 2006 following the coal mine tragedies in West
Virginia and Kentucky. It is critical that MSHA maintain an
adequate number of compliance inspectors, and the Committee is
concerned by reports that the agency may be losing senior coal
inspectors to retirement so swiftly that the plan to increase
the inspector ranks could be jeopardized.
The Committee recognizes that passage of the Mine
Improvement and New Emergency Response (MINER) Act in June 2006
is the first revision to Federal mine safety law since the
Federal Mine Safety and Health Act became law in 1977. The
Committee is concerned that progress on implementation of these
provisions, which are critical to improving the safety of the
nation's mines, has been slower than anticipated.
Thus, the Committee directs that the Secretary provide
reports to the House and Senate Committees on Appropriations
not later than 90 days after enactment, and quarterly
thereafter on: (1) MSHA's progress in filling all allocated
inspector positions, and completing the training of new
inspectors, by district office; (2) MSHA's strategic plan for
dealing with anticipated retirements from all positions during
fiscal years 2008 through fiscal year 2012; (3) changes in the
rate of employer contests, with particular regard to whether
the formula used to determine the ratio of legal counsel to
inspectors needs to be adjusted to ensure the office of the
solicitor has resources consistent to ensure effective
enforcement; (4) MSHA's progress in implementing the MINER Act,
including the finalization of emergency response plans; and (5)
information on resources devoted to emergency, ventilation and
roof control plan reviews and approvals.
The Committee directs MSHA to provide annual reports on the
random audits performed each year on mining machines and their
certified components, starting with a report on fiscal year
2007 audits that shall be provided to the House and Senate
Committees on Appropriations not later than 90 days after
enactment. This report should also address agency
recommendations to increase surveillance and enforcement of the
misuse of ``2G'' tags, including the activities of repair and
rebuilding shops.
The Committee concurs with the Department's plans to
implement the Brookwood-Sago mine safety training grants and
directs that no less than $500,000 be provided for the first
round of these grants, which were authorized by the MINER Act.
Bureau of Labor Statistics
SALARIES AND EXPENSES
The Committee bill includes $576,118,000 for the Bureau of
Labor Statistics (BLS), which is $27,995,000 above the fiscal
year 2007 level and $1,675,000 above the budget request. The
bill includes $497,854,000 in general funds for this account
and authority to spend $78,264,000 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 bill provides that $5,000,000 may be used for the mass
layoff statistics program under section 15 of the Wagner-Peyser
Act. This program provides information on mass layoff actions
that result in workers being separated from their jobs. This
information is of assistance in identifying the causes and
scope of worker dislocation and the characteristics of
dislocated workers and can be used by the workforce investment
and economic development systems in assisting employers and/or
workers at the local level. The bill also continues language
providing that the Current Employment Survey shall maintain
content with respect to the collection of data for the women
worker series.
The Committee recommends $192,599,000 for prices and cost
of living, which is $450,000 above the budget request. While
data are currently collected to measure changes in the cost of
living by metropolitan area, the Committee sees benefit in
measuring the differences in the level of the cost of living
for those areas and for States. The Committee includes $450,000
to develop a methodology for determining the cost of living by
State that accounts for the different costs of housing, goods
and services in each State. The Committee understands that BLS
requires two years before it is able to transmit this
methodology to the Congress, and requests that BLS provide an
interim progress report as part of its fiscal year 2009 budget
request. In addition, the Committee requests that the final
report on a State-specific cost of living methodology include
an estimate of what it would cost to implement the recommended
methodology. That final report shall be provided to the House
and Senate Committees on Appropriations no later than September
30, 2009.
Within the $86,084,000 provided for compensation and
working conditions, the additional $1,225,000 above the request
is to be used to conduct focused research studies on work-
related injuries and illnesses. Such studies provide detailed
information on the causes and means of preventing injuries and
illnesses of particular concern, such as amputations, injuries
and illnesses among truck drivers, and injuries and illnesses
in high-risk industries. These types of studies were conducted
previously by BLS through its work injury reports, but were
largely suspended due to lack of resources. The additional
funding over the request will help reestablish this useful
series of reports, and provide important information to
employers, researchers, and policymakers for their prevention
activities.
Office of Disability Employment Policy
SALARIES AND EXPENSES
The Committee recommends $27,712,000 for the Office of
Disability Employment Policy (ODEP), which is the same as the
fiscal year 2007 level and $9,110,000 above the budget request.
The Office provides policy guidance and leadership to eliminate
employment barriers to people with disabilities.
The Administration only requested the funds necessary for
the office to focus on its core mission of policy analysis,
technical assistance, and the dissemination of effective
practices that increase the employment opportunities for people
with disabilities. The Committee believes that continuing the
grant program will enhance the knowledge that will allow ODEP
to provide optimal policy and technical assistance to the
workforce investment system and its Federal partner agencies to
ensure access and improve results for disabled customers.
Departmental Management
SALARIES AND EXPENSES
The Committee recommends $293,261,000 for departmental
management activities, which is $5,659,000 below the fiscal
year 2007 level and $39,025,000 above the budget request. This
includes $292,943,000 in general funds, along with authority to
transfer $318,000 from the employment security administration
account of the Unemployment Trust Fund. The departmental
management appropriation finances staff 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.
Departmental management crosscut.--The Committee recommends
a reduction of $250,000 below the request to eliminate the
funds requested for competitive sourcing. This account is
clearly not the only source of funds for this initiative.
Significant resources have been spent by the Department over
the last several years on contracting out government jobs.
While the goal of this government-wide effort has been to make
the government more efficient, OMB reports that in fiscal year
2006 government employees won competitions in more than 85
percent of the cases where competitive sourcing was used. The
Committee has not seen compelling evidence of cost savings or
increased efficiency achieved by competitive sourcing and is
concerned that in some cases the competitions appear to
encompass functions that could be considered inherently
governmental or inappropriate for contractor performance.
Therefore, the bill includes language providing that no funds
appropriated in this title shall be used to carry out
competitions under OMB Circular A-76 or any administrative
directives on competitive sourcing until the Government
Accountability Office (GAO) conducts a study of the
Department's practices and the Committee has had 60 days to
review GAO's recommendations. This moratorium does not affect
the Department's ability to contract with the private sector
for services not available in-house.
The Committee requests that GAO review the extent to which
the Department has established a reliable and comprehensive
system to track costs, savings, and the quality of work
performed by contractors, as well as conducting an assessment
of the Department's adherence to principles adopted in 2002 by
the commercial activities panel chaired by the Comptroller
General. Those principles include pursuing other methods to
achieve a high performing workforce, establishing a fair
process that would include allowing government employees to
compete for new work, and the recognition that inherently
governmental functions should be performed by Federal workers.
International Labor Affairs Bureau.--The Committee
recommendation includes $72,516,000 for the international labor
affairs bureau (ILAB), which is the same as the fiscal year
2007 level and $58,419,000 above the budget request. The
Committee rejects the Administration's proposal to slash
funding for ILAB by over 80 percent. In May 2006, the
International Labor Organization (ILO) issued a report entitled
``The End of Child Labor: Within Reach''. The report states
that child labor is in decline worldwide and that if the
current pace of decline were to be sustained, the global
commitment to stop child labor could feasibly eliminate most of
the worst forms of this practice within 10 years. The Committee
is therefore particularly concerned that the Department's
budget request eliminates funding for child labor grants,
including the U.S. contribution to sustain the successful
efforts of the ILO's international program for the elimination
of child labor. Withdrawing from these efforts would damage the
credibility and reputation of the United States in the
countries whose governments are real partners to the United
States in this effort.
The Committee is aware of the ILO garment sector working
conditions improvement project in Cambodia, and its success in
improving worker conditions in garment factories, increasing
worker and employer awareness of, and adherence to, core
international labor standards and the rights of workers under
Cambodian labor law. Another model which has not been linked
directly to trade, but which has helped to address human rights
issues in Central America, is the ombudsperson model. The
Committee believes that some combination of these approaches
could be helpful in other countries. Accordingly, the bill
designates $5,000,000 within ILAB for activities to adapt these
model programs to address worker rights in countries with trade
preference programs with the United States. The Committee
believes that implementation of this activity should be done in
consultation with the Department of State.
Women's Bureau.--The Committee recommends $10,500,000 for
the women's bureau, which is $834,000 over fiscal year 2007 and
$668,000 over the request. The Committee encourages the women's
bureau to continue to support national networks for women's
employment that advance women in the workplace through
education and advocacy. The Committee believes that
organizations that continue to exceed annual performance goals
and that are strategically aligned with the goals of the
women's bureau deserve increased support.
Pandemic influenza preparedness.--The Secretary of Labor's
role in pandemic influenza preparedness goes beyond the health
and safety standards for health care workers and emergency
responders discussed earlier in this report. The national
strategy for pandemic influenza implementation plan recognizes
that an influenze pandemic would have a government- and
society-wide impact. The health and economic impact of a
pandemic on the U.S. workforce would be profound. The American
workforce would face illness, death, and significant health
care expenses, as well as potential job loss due to business
closures due to breakdowns in the supply chain or due to public
health measures (such as banning of large public gatherings or
quarantine orders). In addition, with shortages of workers due
to absence for illness or to care for family members, or to
comply with public health orders, some businesses or critical
industries may face challenges complying with existing
workplace regulations (e.g., wage and hour rules or staffing
requirements). The national strategy plan states that ``the
Secretary of Labor will be responsible for promoting the
health, safety, and welfare of employees and tracking changes
in employment, prices, and other economic measurements.'' The
Committee therefore requests that the Secretary submit a report
to the House and Senate Committees on Appropriations by March
1, 2008 addressing the policy and regulatory issues under the
Department's jurisdiction that would require review and
adaptation in response to a pandemic, including, but not
limited to, the Occupational Safety and Health Act, the Fair
Labor Standards Act, the Family and Medical Leave Act, and
disaster unemployment assistance.
Disparity in rates of unemployment.--The Committee notes
with concern the continuing disparity in rates of unemployment
for certain minority groups (including African Americans,
Latinos, and Native Americans) and directs the Secretary to
report to the House and Senate Committees on Appropriations by
March 1, 2008 with a specific plan for addressing this problem.
OFFICE OF JOB CORPS
The Committee recommends $1,649,476,000 for Job Corps,
which is $42,621,000 over fiscal year 2007 and $98,232,000
above the request on a comparable basis. 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 people in
the 16 to 24 age range who are unemployed, have dropped out of
school, or who are at risk of being involved in the criminal
corrections system.
The bill includes provisions transferring Job Corps
operations, construction and renovation funding from the
training and employment services account to the Office of the
Secretary to reflect the current organizational status of the
program. The Committee does not agree with the budget request
to return Job Corps to the Employment and Training
Administration. The bill therefore transfers $28,872,000 for
Job Corps administration from Employment and Training
Administration program administration to the Office of the
Secretary. The bill also includes language that provides
contracting authority to the Office of Job Corps.
For Job Corps operations the Committee recommends
$1,507,684,000, which is $37,327,000 above the level for fiscal
year 2007 and $85,312,000 above the budget request. Of the
amount recommended, $916,684,000 is available for the period
July 1, 2008 through June 30, 2009, and $591,000,000 is
available for the period October 1, 2008 through June 30, 2009.
The Committee does not agree with the budget request to reduce
Job Corps slots by 4,310, reducing opportunities for
disadvantaged youth who are left behind by traditional
education programs to benefit from participation in Job Corps.
Rather, the Committee's recommended increase in operations
funding is designed to support 44,791 student training slots,
reflecting an increase of 300 slots above the fiscal year 2007
level to accommodate the opening of a new center during fiscal
year 2008. The bill includes a provision that this new student
training slot level be achieved by the end of program year
2008.
The Committee is concerned that enrollment levels be
maintained, and believes that an appropriate mix of national,
regional and facility-specific outreach and recruitment
strategies is needed to address this issue. Given the fact that
the Job Corps only has the capacity to serve one percent of the
over six million youth in our country that have been left
behind by traditional education programs, the Committee is
concerned that all available slots be filled. The Committee
understands that there has been an ongoing assessment of
outreach and recruitment strategies and directs the Department
to submit a report to the House and Senate Committees on
Appropriations within 90 days of enactment outlining the
strategies that the Office of Job Corps believes are necessary
to address the issue of maintaining enrollment levels. The
Committee requests that the report address concerns that the
failure to transfer public affairs and public information staff
from the Employment and Training Administration to the Office
of Job Corps may be impeding critical outreach and recruitment
activities.
The Committee understands that there is an ongoing need
within Job Corps to make the salaries of academic and
vocational instructors competitive with those of comparable
institutions. The Committee agrees with the Department's plan
to use $5,000,000 to provide a 5 percent increase in teacher
salaries, in addition to the 2.5 percent increase in teacher
salaries provided in fiscal year 2006 and the 2.5 percent
increase scheduled for fiscal year 2007.
The Committee recognizes the importance of training and
education for the construction industry and urges the
Department to continue its partnerships to train Job Corps
youth for careers in construction, including the high growth
residential construction industry. The Committee encourages the
Department to identify sites for potential expansion of
construction trades training by employer-based industry groups
and labor-management partnerships, so as to increase its
capacity to address the workforce needs of this high growth
industry. Increasing the number of students benefiting from
industry-recognized training can help alleviate the shortage of
skilled workers in this industry and further the goal of
American homeownership.
The bill provides $112,920,000 for construction and
renovation, which is $5,000,000 above the fiscal year 2007
level and $12,920,000 above the budget request. Of the amount
recommended, $12,920,000 is available from July 1, 2008 through
June 30, 2011, and $100,000,000 is available for the period
October 1, 2008 through June 30, 2011.
Included in the amount for construction and renovation is
$5,000,000 for a competitive program for existing Job Corp
Centers to establish child care development centers.
Historically, low-income young people with children have been
the most difficult to serve population in Job Corps. Further
expanding child care services on Job Corps campuses will enable
more economically disadvantaged single parents to obtain the
education, training, and parenting skills needed to make a
better life for their children and for themselves. The
Committee's recommendation includes this $5,000,000 as part of
its initiative to help reduce the number of abortions in
America by alleviating the economic pressures and other real
life conditions that can sometimes cause women to decide not to
carry their pregnancies to term.
The bill continues a provision to prohibit the use of Job
Corps funding for compensation of an individual that is not a
Federal employee at a rate in excess of Executive Level I. The
Committee bill continues a provision providing that no funds
from any other appropriation shall be used to provide meal
services at or for Job Corps centers.
VETERANS EMPLOYMENT AND TRAINING
The Committee recommends $228,198,000 for veteran
employment and training activities, which is $5,009,000 above
the fiscal year 2007 level and $102,000 above the budget
request. Within this amount, $197,143,000 is to be expended
from the employment security administration account of the
Unemployment Trust Fund for the State and Federal
administration of veterans' employment and training activities,
which includes the funding of local veterans' employment
representatives and disabled veteran's outreach specialists who
provide services to meet the employment needs of eligible
veterans.
Funding for the veterans workforce investment program is
provided at the fiscal year 2007 level, which is $84,000 more
than the budget request. For the homeless veteran's
reintegration program that has shown success in getting
veterans who are homeless back into the economic mainstream,
$23,620,000 is provided, which is an increase of $1,181,000
over fiscal year 2007 and the same as the budget request. The
Committee supports the efforts within both the homeless
veterans program and the State grant program to address the
employment needs of incarcerated veterans to assure their
successful reintegration into the community.
OFFICE OF THE INSPECTOR GENERAL
The Committee recommends $78,658,000 for the Office of the
Inspector General (OIG), which is $5,892,000 above the fiscal
year 2007 level and the same as the budget request. This
includes $72,929,000 in general funds along with the authority
to transfer $5,729,000 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 no direct appropriation for the
working capital fund (WCF) for fiscal year 2008. For fiscal
year 2007, $6,168,000 was provided. The Administration
requested $12,000,000 for fiscal year 2008.
The Committee understands that the Department has completed
a cost benefit analysis of options for the new core accounting
system. The Committee requests that when a decision is made on
the most viable alternative for implementing a new financial
management solution for the Department, information on this
solution be provided to the House and Senate Committees on
Appropriations, together with a revised implementation
schedule.
In previous years, the Committee has provided direct
appropriations for the Department of Labor working capital
fund. However, other Federal departments have self-sustaining
working capital funds, and providing direct appropriations is
inconsistent with the treatment of these entities. The purpose
of a working capital fund is to generate sufficient revenue to
cover the full cost of operations, and to finance its
continuing operations without direct appropriations.
General Provisions
(INCLUDING TRANSFER OF FUNDS)
Sec. 101. The Committee modifies a prior provision to
permit transfers of up to one percent between programs,
projects or activities.
Sec. 102. The Committee repeats a prohibition on the
purchase of goods that were in any part produced by indentured
children.
Sec. 103. The Committee repeats a provision requiring the
Secretary to issue a monthly transit subsidy (of not less than
$110) to each of the Department's eligible employees in the
National Capital region.
Sec. 104. The Committee requires the Department to report
to the Committees on Appropriations on its plan for the use of
demonstration, pilot, multiservice, research and multi-State
projects under the Workforce Investment Act, including the up
to 10 percent set-aside within the dislocated workers
assistance national reserve, prior to the obligation of funds
for these activities.
Sec. 105. The Committee repeats a provision in the 2007
Continuing Appropriations Resolution that requires the
Secretary of Labor to award community-based job training
initiative grants and grants for training and employment in
high growth industries on a competitive basis.
Sec. 106. The Committee directs that grants made from funds
available to the Department under the American Competitiveness
and Workforce Improvement Act be used only for training
activities in the occupations and industries for which
employers use the visas that generate these funds, and that
related activities be limited to those necessary to support
such training. The bill does not apply this restriction to
competitive grant awards made in response to solicitations
issued prior to April 15, 2007, or to the grants that may be
made under the provisions of section 107 of this title.
Sec. 107. The Committee provides that up to $20,000,000 of
the funds available to the Department under section 414(c) the
American Competitiveness and Workforce Improvement Act of 1998
may be used for grants to States for activities that enable
trade adjustment assistance (TAA) participants and dislocated
workers awaiting TAA certification to benefit from the health
coverage tax credit authorized by the Trade Adjustment
Assistance Reform Act of 2002.
Sec. 108. The Committee modifies a prior provision
directing that the Department take no action to amend or to
modify the definition of administrative costs, or the procedure
for redesignation of local workforce investment areas until
such time as legislation reauthorizing the Act is enacted. This
provision is not intended to permit or require the Secretary of
Labor to withdraw approval for such redesignation for a State
that received approval not later than January 2, 2006.
Sec. 109. The Committee retains language included in the
2007 Continuing Appropriations Resolution that prohibits use of
funds to finalize or implement regulations under the Workforce
Investment Act of 1998, the Wagner-Peyser Act of 1933, or the
Trade Adjustment Assistance Reform Act of 2002, until such time
as legislation reauthorizing the Workforce Investment Act or
the Trade Adjustment Act is enacted. The Committee expects that
while the Congress considers the reauthorization of these Acts,
the Administration will refrain from unilateral changes to the
administration, operation, and financing of employment and
training programs.
Sec. 110. The Committee has included language requiring the
Secretary of Labor to issue a final standard on employer
payment for personal protective equipment (PPE) under the
Occupational Safety and Health Act by November 30, 2007 that is
to be no less protective than the proposed rule published on
March 31, 1999. The bill provides that, in the event this final
standard is not issued by November 30, 2007, the proposed rule
shall become effective.
Sec. 111. The Committee has included language that
prohibits the use of funds in this title to carry out
competitive sourcing activities at the Department of Labor
under OMB Circular A-76 until 60 days after the Committee
receives a report by the Government Accountability Office.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
HEALTH RESOURCES AND SERVICES
The Committee includes a program level total of
$7,080,709,000 for health resources and services programs,
which is $665,007,000 above the fiscal year 2007 funding level
for these activities and $1,259,904,000 above the budget
request. The Health Resources and Services Administration
(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
As described in the ``Increasing Access to Health Care for
the Uninsured'' initiative in the front of the report, the
Committee provides $2,188,000,000 for community health centers
(CHC), which is $199,961,000 above the fiscal year 2007 funding
level and $199,533,000 above 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 increase provided in
the bill will support the care of approximately one million
additional patients, a 5.7 percent increase over the 16 million
patients currently served in over 4,000 sites nationwide.
The Committee supports continued efforts to expand the
health centers program into those areas of the country without
current access to a health center. The Committee urges HRSA to
implement such an expansion to address the lack of access in
the neediest communities of the country, and not to limit new
funding to certain geographic areas, such as counties. The
Committee has rejected bill language requested by the
Administration setting aside $26,000,000 for high-poverty
counties. Further, the Committee urges HRSA to make funding
available to increase capacity at existing centers, and for
service expansion awards adding or expanding mental health
services, dental services, and pharmacy services at community
health centers. HRSA should also use a portion of the increased
funding to provide planning grants to help communities develop
their plans for future applications. The Committee expects HRSA
to implement any new expansion initiative using the existing,
and statutorily-required, proportionality for urban and rural
communities, as well as migrant, homeless, and public housing
health centers.
Within the amount provided, $35,000,000 is included in bill
language for base grant adjustments. These funds are intended
to graphic the rising cost of health care at existing centers
and to resolve specific financial situations beyond the control
of the local health center, such as unusual increases in the
number of uninsured patients seeking care. While the Committee
fully supports the expansion of the CHC program, it recognizes
the narrow operating margins of most health centers.
The Committee rejects the Administration's budget proposal
to cancel the funding in the health centers loan guarantee
program. This loan authority is important to give centers
access to capital for infrastructure improvements.
The Committee recognizes the importance of increasing the
use of health information technology (IT) at health centers.
Health centers have demonstrated improved access to services,
improved quality of care and improved patient outcomes by
utilizing electronic health records and other health
information technology (HIT) tools through their participation
in health center controlled network initiatives, and other
quality improvement initiatives such as the health disparities
collaboratives. Given this success, the Committee urges HRSA to
ensure that health centers have adequate resources to establish
and expand health IT systems in order to further enhance the
delivery of cost-effective, quality health care services.
The Committee recognizes the important role of CHCs in
caring for people living with or at risk for hepatitis C (HCV).
The Committee encourages the Bureau of Primary Care to increase
health centers' capacity for delivery of medical management and
treatment of HCV by implementing training and technical
assistance initiatives, so that health centers are able to
increase hepatitis C counseling, testing, medical management,
and treatment services to meet the healthcare priorities of
their respective communities.
The Committee encourages HRSA to continue its support of
the National Center for Frontier Communities.
State health access grants
As described in the ``Increasing Access to Health Care for
the Uninsured'' initiative section in the front of the report,
the Committee bill provides $75,000,000 for State health access
grants to begin to address the problems faced by the 46.6
million uninsured in our country. Grants would be awarded
competitively to States that demonstrate they have a program
design ready to implement and that they have achieved the
necessary State and local statutory or regulatory changes.
States that have already developed a comprehensive health
insurance access program would not be eligible to apply. The
types of activities that could be supported through this grant
include:
``three share'' community coverage
(employer, State or local government, and the
individual);
reinsurance plans that subsidize a certain
share of carrier losses within a certain risk corridor;
subsidized high risk insurance pools;
health insurance premium assistance;
creation of a state insurance ``connector''
authority to develop new, less expensive, portable
benefit packages for small employers and part-time and
seasonal workers;
development of statewide or automated
enrollment systems for public assistance programs; and
innovative strategies to insure low-income
childless adults
Two types of State grants would be available: target grants
($2,000,000-4,000,000 annually per State) for States that
choose to target particular populations such as uninsured
children, small business employees, or uninsured seniors; or
comprehensive grants ($7,000,000-10,000,000 annually per State)
for large States or those that are planning more extensive
coverage initiatives. The Committee intends that each grant be
awarded based on a three-year grant period, subject to the
availability of funds, with funding distributed each year based
on attaining benchmarks that would be designated in the grant
award. States shall be required to demonstrate their
seriousness of intent by matching twenty percent of the Federal
grant through non-Federal resources, which could be a
combination of State, local, and private dollars from insurers
and providers. Waiver of the matching requirement shall be
possible if financial hardship is demonstrated. States shall
also be required to demonstrate their ability to sustain the
program without Federal funding after the end of the three-year
grant period. HRSA should consider geographic diversity in the
allocation of these awards.
States shall be required to report to HRSA the impact and
results of their demonstration project at the conclusion of the
three-year grant period. HRSA is encouraged to convene grantees
periodically throughout the period of their award to share
information with each other about their program experiences and
gain ideas for refinement of their programs. The Committee
directs that HRSA submit a comprehensive report to the
Appropriations Committees of the House and Senate about the
outcomes and lessons learned from each of the State
demonstrations eighteen months after the three-year grant
period ends.
Free clinics medical malpractice
The Committee provides $40,000 for payments of claims under
the Federal Tort Claims Act to be made available for volunteer
free clinic health care professionals, which is $1,000 below
the fiscal year 2007 funding level and $60,000 below the budget
request. 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. 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, and
therefore eligible for coverage under the Federal Tort Claims
Act. To date, 65 applications from free clinics have been
approved and almost 1,700 volunteer practitioners have been
deemed.
National Hansen's disease program
The Committee provides $16,109,000 for the National
Hansen's disease program, which is $137,000 above the fiscal
year 2007 funding 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.
National Hansen's disease program--buildings and facilities
The Committee provides $100,000 for National Hansen's
disease buildings and facilities, which is $120,000 below the
fiscal year 2007 funding 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 $1,996,000 for the treatment of
persons with Hansen's disease in the State of Hawaii, which is
the same as the fiscal year 2007 funding level and $20,000 more
than the budget 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 less than 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 256 active ambulatory Hansen's disease
cases.
National Health Service Corps: Field placements
The Committee provides $40,443,000 for field placements,
which is the same as the fiscal year 2007 funding level and
$9,714,000 above 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. The Committee feels it is
important to maintain NHSC field placement strength to support
the recruitment and mentoring of clinicians and to encourage
their retention. Thus, the Committee rejects the
Administration's proposal to cut the program. The NHSC supports
4,600 clinicians across the country who provide medical and
dental services to four million people in low-income and
underserved communities.
The Committee is pleased by the increasing proportion of
NHSC assignees being placed at community, migrant, homeless,
and public housing health centers. The Committee encourages
HRSA to further expand this effort to ensure that health
centers have access to a sufficient level of health
professionals through the NHSC, especially given recent efforts
to expand the health centers program.
National Health Service Corps: Recruitment
The Committee provides $91,057,000 for recruitment
activities, which is $5,827,000 above the fiscal year 2007
funding level and 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. This
funding will support the recruitment of more than 1,700
practitioners through the loan repayment and scholarship
programs.
Health professions
The Committee provides $393,920,000 for all health
professions training programs, which is $59,495,000 above the
fiscal year 2007 funding level and $278,880,000 above the
budget request. The Committee rejects the rescission proposals
included in the budget request that would cancel unobligated
balances available at institutions of higher education with a
student loan revolving fund.
Training for diversity
As the first step in a continuing restoration and expansion
of the diversity programs, the Committee provides $104,817,000,
which is $41,031,000 or 64.3 percent above the fiscal year 2007
level and $95,084,000 above the budget request. The Committee
is acutely aware of the needs identified in the landmark
Institute of Medicine report, ``Unequal Treatment,'' which
issued recommendations to begin closing the profound gaps that
exist in health care delivery and treatment. The report
recommended increases in these diversity programs because they
are the pipeline for training minority students in the health
professions to serve in medically underserved communities.
Centers of excellence
The Committee provides $28,431,000 for centers of
excellence, which is $16,551,000 above the fiscal year 2007
funding level. The budget request does not include 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. This increase will permit
HRSA to fund the four centers of excellence at historically
black colleges and universities as well as approximately six
Hispanic, Native American, and other centers of excellence. The
Committee is pleased that HRSA has re-focused the centers of
excellence program on providing support to historically
minority health professions institutions. The Committee
recognizes the important role of this program in supporting
faculty and other academic programs at minority institutions.
Health careers opportunity program
The Committee provides $28,440,000 for the health careers
opportunity program, which is $24,480,000 above the fiscal year
2007 funding level. The budget request does not include funding
for this program. The program provides grants to eligible
schools and health educational entities with the goal of
increasing the number of disadvantaged students entering health
and allied health professions programs. The additional funds
provided will increase the size of the program six-fold,
permitting the award of as many as 24 additional grants to
operate programs that prepare disadvantaged students at the
earliest levels of the educational pipeline for careers in
health and allied health professions. The Committee urges HRSA
to give priority consideration to awarding grants to those
institutions with an historic mission of training minorities in
the health professions.
Faculty loan repayment
The Committee provides $1,289,000 for the faculty loan
repayment program, which is the same as the fiscal year 2007
funding level. The budget request does not include funding for
this program. The program provides loan repayment for
disadvantaged health professions students who serve as faculty
for a minimum of two years. Their institutions are also
required to make matching payments. The funding provided will
support approximately thirty faculty with loan repayments of up
to $20,000 per year.
Scholarships for disadvantaged students
The Committee provides $46,657,000 for scholarships for
disadvantaged students, which is the same as the fiscal year
2007 funding level and $36,924,000 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. This funding level will permit over 15,000 students to
receive scholarships.
Training in primary care and dentistry
The Committee provides $48,851,000 for training in primary
care and dentistry, which is the same as the fiscal year 2007
funding level. The budget request does not include funding for
this program. The training program is comprised of four
elements: (1) family medicine; (2) general internal medicine
and general pediatrics; (3) physician assistants; and (4)
general and pediatric dentistry. The Committee intends that the
general and pediatric dentistry programs receive the same
amount as was provided under the 2007 joint continuing funding
resolution.
Area health education centers
The Committee provides $31,200,000 for area health
education centers (AHEC) program, which is $2,519,000 above the
fiscal year 2007 funding level. The budget request does not
include funding for this program. The program provides
cooperative agreements to medical and nursing schools to
encourage the establishment and maintenance of community-based
training programs in off-campus rural and underserved areas.
Emphasis is also placed on enhancing the diversity of the
health personnel workforce and improving the practice
environment and the quality of care available in underserved
areas. This funding increase will permit the AHECs, which
operate in 46 States, to expand their networks of community-
based training programs.
Allied health and other disciplines
The Committee provides $3,960,000 for allied health and
other disciplines, which is the same as the fiscal year 2007
funding level. The budget request does not include funding for
this program. The program assists eligible entities in meeting
the costs associated with graduate psychology and chiropractic
programs.
The Committee recognizes the importance of the graduate
psychology education program, which provides interdisciplinary
training for health service psychologists to provide mental and
behavioral health care services to underserved populations,
such as older adults, children, chronically ill persons, and
victims of abuse or trauma, including returning military
personnel. The need for behavioral and mental health services
in an integrated health care system is significant and well
documented. While being trained in both rural and urban
communities, trainees also provide direct services to those who
would otherwise not receive them. Since its establishment six
years ago, trainees have worked with over thirty health
professions and medical specialties. In addition, the program
has increased the rate of students entering into and staying to
practice in underserved areas following completion. Therefore,
the Committee encourages HRSA to strengthen funding for the
existing twenty grantees.
Geriatric programs
The Committee provides $31,548,000 for geriatric programs,
which is the same as the fiscal year 2007 funding level.
Funding for these programs is not included in the fiscal year
2008 budget request. The geriatric programs are comprised of
three activities: (1) geriatric education centers; (2) the
geriatric training program for physicians, dentists, and
behavioral and mental health professionals; and (3) geriatric
academic career awards. This funding supports about fifty
geriatric education centers and training of 50,000 health care
providers.
Public health, preventive medicine, and dental public health programs
The Committee provides $7,920,000 for public health,
preventive medicine, and dental public health programs, which
is the same as the fiscal year 2007 funding level. Funding for
these programs is not included in the budget request. The
program awards grants to support the education and training of
the public health workforce to deal with new and unanticipated
problems and to place these specialists in underserved areas.
This funding will support approximately 8,000 students with
traineeships and medical residents.
Nurse training programs
The bill provides $165,624,000, which is an increase of
$15,945,000 or 10.7 percent over fiscal year 2007 and
$60,317,000 over the budget request for nursing education
programs. The Committee strongly disagrees with the President's
request to cut these programs despite America's nursing
shortage, which is projected to deepen--to over 1 million
nurses--in the next decade without significant investment to
train new nurses. This growing nursing shortage is having a
detrimental impact on the entire health care system. Numerous
studies have shown that nursing shortages contribute to medical
errors, poor patient outcomes, and increased mortality rates.
The aging of the baby boom generation increases the urgency of
addressing the nursing shortage, since the boomers will require
more nursing services as they age at the same time as many
nurses--who are themselves members of the baby boom--retire.
The increase provided in the bill provides a first step towards
alleviating the long-term nursing shortage.
Advanced education nursing
The Committee provides $57,061,000 for advanced education
nursing, which is the same as the fiscal year 2007 funding
level. The President's budget does not include funds for this
program. The program provides grant support 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 registered nurses as nurse
faculty, nurse practitioners, clinical nurse specialists, nurse
midwives, nurse anesthetists, nurse administrators, public
health nurses, and other nurse specialists for advanced
practice roles. In fiscal year 2008, almost 3,000 students and
9,000 trainees will be supported.
Nurse education, practice and retention
The Committee provides $37,291,000 for nurse education,
practice, and retention, which is the same as the fiscal year
2007 funding level and the budget request. 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. Fiscal year 2008 funding will support approximately
20 baccalaureate projects targeting expanded enrollment, 40
career ladder mobility projects, and almost 30 enhanced patient
care delivery system projects.
Nursing workforce diversity
The Committee provides $16,107,000 for nursing workforce
diversity, which is the same as the fiscal year 2007 funding
level and 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. In fiscal year 2008, almost 21,000
minority students, 3,000 nursing program students, and 3,000
college pre-entry nursing students are expected to participate
in the program. Almost 500 will receive scholarships.
Loan repayment and scholarship program
The Committee provides $44,000,000 for the nurse loan
repayment and scholarship program, which is $12,945,000 above
the fiscal year 2007 funding level and $256,000 above 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. This funding will
provide more than 1,000 loan repayment agreements and almost
300 scholarships.
Comprehensive geriatric nurse education
The Committee provides $3,392,000 for comprehensive
geriatric nurse education, which is the same as the fiscal year
2007 funding level and the budget 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.
Nineteen training projects are expected to be funded in fiscal
year 2008.
Nursing faculty loan program
The Committee provides $7,773,000 for the nursing faculty
loan program, which is $3,000,000 above the fiscal year 2007
funding level and the budget request. The nursing 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. Fiscal year
2008 funding is expected to support grants to 67 institutions
which operate loan funds.
The Committee recognizes that the growing nurse faculty
shortage is directly linked to the nationwide shortage of
registered nurses. According to the American Association of
Colleges of Nursing's 2006-2007 survey, almost three quarters
of the nursing schools offering baccalaureate and graduate
nursing programs pointed to faculty shortages as a major reason
for turning away nearly 43,000 qualified applicants. In
addition, the average ages of doctoral-prepared nurse faculty
holding the ranks of professor, associate professor, and
assistant professors are 59, 56, and 52 years, respectively. A
wave of nurse faculty retirements is projected for the next ten
years that will only worsen the crisis. The Committee urges the
Secretary of Health and Human Services to continue efforts to
address the nurse faculty shortage as well as the impending
retirements of nurse faculty.
Children's hospitals graduate medical education payment program
The Committee provides $307,009,000 for the children's
hospitals graduate medical education payment program, which is
$10,000,000 above the fiscal year 2007 funding level and
$196,991,000 above the budget request. The program provides
support for graduate medical education 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 important to restoring the
reimbursement inequity faced by pediatric hospitals, which
provide high quality care to children with difficult and
expensive conditions. This program supports 61 free-standing
children's hospitals and the training of more than 5,100
medical residents on and off-site.
National practitioner data bank
The Committee does not provide funding for the national
practitioner data bank for fiscal year 2008, which is the same
as both the fiscal year 2007 appropriation and the budget
request. The Committee recommendation and the budget request
assume that the data bank will be self-supporting, with
collections of $18,900,000 in user fees. Traditional bill
language is included to ensure that user fees are collected to
cover the full costs of the data bank operations. 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. In fiscal year 2006, the board
processed more than 3,600,000 queries.
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
2008. 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. Traditional bill
language is included to ensure that user fees are collected to
cover the full costs of the data bank operations. 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. In fiscal
year 2006, the bank processed more than 900,000 requests for
information.
The Committee supports the consolidation of these two
similar data banks into one program, the National Practitioner
Data Bank, as proposed by the Administration, to maximize
efficiencies.
Maternal and child health block grant
The Committee provides $750,000,000 for the maternal and
child health (MCH) block grant, which is $57,000,000 above the
fiscal year 2007 funding level and the budget request. States
use the block grant to improve access to care for mothers,
children, and their families; reduce infant mortality; provide
pre- and post-natal care; support screening and health
assessments for children; and provide systems of care for
children with special health care needs. By statute, 85 percent
of the first $600 million is allocated to States and 15 percent
is allocated to Special Projects of Regional and National
Significance (SPRANS). Amounts in excess of $600 million are
allocated to Community Integrated Service Systems as well as
State grants and SPRANS.
The Committee includes bill language identifying
$170,991,000 for SPRANS activities and intends that the
following amounts be provided within SPRANS for the listed
activities:
$15,000,000 for an initiative increasing public
awareness and resources for women preparing for birth;
$12,000,000 for a dental health initiative;
$5,800,000 for epilepsy services demonstrations;
$4,000,000 for sickle cell community demonstrations;
$3,800,000 for heritable disorders screening; and
$30,000,000 for autism early detection and
intervention.
Public awareness for first time parents.--$15,000,000 is
provided for new competitive grants to States to increase
public awareness of resources available to women preparing for
childbirth and new parents through advertising campaigns and
toll-free hotlines. The Committee recommends this funding as
part of its initiative to help reduce the number of abortions
in America by alleviating the economic pressures and other real
life conditions that can sometimes cause women to decide not to
carry their pregnancies to term.
Dental health.--As described in the ``Improving Access to
Dental Care'' initiative in the front of the report,
$12,000,000 is provided for up to 25 competitive State grants
to help expand access to oral health services. $2,000,000 of
this total is transferred from HRSA program management, the
former placement of the oral health workforce activities
program. States may use these grants for the purposes outlined
in the Dental Health Improvement Act, such as encouraging more
dentists to practice in shortage areas through such mechanisms
as loan forgiveness and repayment for dentists; providing
grants to establish or expand oral health services in
community-based facilities; and expanding dental residency
programs. States may also use these funds to integrate oral
health services into the medical home concept for children with
special health care needs, and for grants to ensure low-income
pregnant women and women of child-bearing age have access to
appropriate oral health services. States should develop
proposals that address the shortage of dentists and dentists'
reluctance for financial reasons to work in certain geographic
areas and to serve low-income and Medicaid patients.
In addition, as indicated in the HRSA Program Management
section, the Committee directs HRSA to strengthen its support
of the oral health infrastructure within the agency and to
appoint a chief dental officer.
The Committee is aware that dental disease
disproportionately affects our nation's most vulnerable
populations. New ways of bringing oral health care to
underserved populations are needed to address geographic and
other challenges that exist. The Committee encourages HRSA to
explore innovative programs for delivering preventive and
restorative oral health services, including State and community
proposals and programs that seek to improve access to care in
accordance with state licensing laws.
Epilepsy.--The Committee provides $5,800,000 for epilepsy
service demonstrations, which doubles the funding for this
program compared to fiscal year 2007. The epilepsy service
programs improve access to comprehensive, coordinated health
care and related services for children and youth with epilepsy
in medically underserved areas. Funds are used to support 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. Funds are
also used to support a national technical assistance support
center to reach additional States in need of technical support
and model program development.
Sickle cell disease.--The Committee provides $4,000,000 to
support the continuation of the seventeen community-based
sickle cell disease outreach and supportive service centers.
These centers coordinate followup on needs identified in sickle
cell screening, provide referrals to networks of services, and
support community education. The Committee also provides
$2,184,000 for sickle cell anemia demonstrations, as discussed
below, which are comprehensive university-based screening and
treatment centers.
Heritable disorders.--The Committee provides $3,800,000 for
heritable disorders screening, which doubles the funding for
this program compared to fiscal year 2007. This screening
program is designed to strengthen States' newborn screening
programs and improve States' ability to develop, evaluate, and
acquire innovative testing technologies, and establish and
improve programs to provide screening, counseling, testing and
special service for newborns and children at risk for heritable
disorders.
The Committee urges HRSA to prioritize Fragile X as a key
prototype in the development of cost-effective public health
screening and genetic counseling programs. The Committee
requests a report by July 1, 2008 on progress made in the
development of a screening tool for Fragile X and in working
with the National Institute of Child Health and Human
Development to create the tests necessary for the inclusion of
Fragile X in newborn screening programs.
The Committee commends HRSA for convening the Secretary's
Advisory Committee on Heritable Disorders and Genetic Diseases
in Newborns and Children to develop national recommendations
for standardizing newborn screening programs in the U.S. and
for funding the Regional Genetic Service and Newborn Screening
Collaborative to address the maldistribution of genetic
services and resources to bring services closer to local
communities. However, the Committee is aware that wide
disparities continue to exist among States in the number of
conditions for which newborns are screened and in the service
infrastructure for infants who test positive. The Committee
encourages HRSA and the Secretary's Advisory Committee to
consider developing written guidance for parents on the
availability of additional screens that may not be required
under State law.
Autism.--The Committee provides $30,000,000 for activities
authorized in the Combating Autism Act, including the promotion
of screening tools and the expansion of Leadership Education in
Neurodevelopmental and Related Disabilities (LEND) training
sites to diagnose autism spectrum disorders and related
disabilities. The Committee believes it is critical to
strengthen HRSA's activities targeting autism spectrum
disorders to respond to this emerging national epidemic.
Vision screening.--The Committee understands that States
currently conduct childhood screening programs through their
MCH block grant. The Committee recognizes that vision disorders
are the leading cause of impaired health in childhood, and that
one in four school-age children has a vision problem
significant enough to affect their learning. The Committee
urges the States to strengthen their vision screening programs
and to broaden the programs' geographic reach. In this effort,
States are encouraged to take maximum advantage of the ongoing
vision screening program conducted by the Centers for Disease
Control and Prevention, which is increased by 40.6 percent to
$3,466,000 in the bill.
Thalassemia.--The Committee reiterates its long-standing
support for the continuation of funding for comprehensive
thalassemia treatment centers under the SPRANS program. The
Committee strongly encourages HRSA to continue this program and
to coordinate closely its activities with the thalassemia
clinical research network and the related voluntary
organizations.
Hemophilia.--The Committee urges HRSA to maintain its
funding support of the network of hemophilia treatment centers,
which provide comprehensive disease management services to men
and women with bleeding and clotting disorders.
Fetal Infant Mortality Review.--HRSA has operated the
National Fetal Infant Mortality Review (NFIMR) program since
1990. 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 and are a component of many
existing Healthy Start Initiatives.
Sickle cell anemia demonstration program
The Committee provides $2,184,000 for the sickle cell
anemia demonstration program, which is the same as the budget
request and $4,000 above the fiscal year 2007 funding level.
This program was created to develop systemic mechanisms for the
prevention and treatment of sickle cell disease. It supports
four university-based networks linked to local community health
centers that provide treatment, education, continuity of care,
and provider training for sickle cell anemia patients.
Traumatic brain injury
The Committee provides $8,910,000 for the traumatic brain
injury (TBI) program. This is the same as the fiscal year 2007
funding level. The budget request does not include funding for
this program. The TBI program funds the development and
implementation of statewide systems to ensure access to care
including pre-hospital care, emergency department care,
hospital care, rehabilitation, transitional services,
rehabilitation, education and employment, and long-term
community support. Grants also go to State protection and
advocacy systems. In fiscal year 2006, 45 States received TBI
awards, and 57 State protection and advocacy systems were
funded.
Healthy Start
The Committee provides $120,000,000 for Healthy Start,
which is $18,482,000 above the fiscal year 2007 funding level
and $19,497,000 above the budget request. The Committee
recommends the $18,482,000 increase as part of its initiative
to help reduce the number of abortions in America by
alleviating the economic pressures and other real life
conditions that can sometimes cause women to decide not to
carry their pregnancies to term. Healthy Start provides
discretionary grants to communities with high rates of infant
mortality to provide ongoing sources of primary and preventive
health care to mothers and their infants. Currently, 99
communities have Healthy Start grants. The increase provided in
the bill will support approximately twenty new grants to
communities.
Universal newborn hearing screening
The Committee recommendation includes $11,000,000 for the
universal newborn hearing screening program, an increase of
$1,196,000 over the fiscal year 2007 enacted level and
$11,000,000 over the request. This 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. The Committee is concerned that
even though approximately 90 percent of babies are now screened
for hearing loss before one month of age, about one-third of
those who are referred for screening do not receive diagnostic
evaluations by three 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
six months of age.
To avoid duplication, the Committee encourages 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 $19,800,000 for the emergency
medical services for children (EMSC) program, which is the same
as the fiscal year 2007 funding level. The budget request does
not include funding for this program. Grants are provided to
States and territories to incorporate pediatric components into
existing emergency medical services systems and to schools of
medicine to develop and evaluate improved procedures and
protocols for treating children. In fiscal year 2006, 56 grants
were awarded to States and territories.
Ryan White HIV/AIDS programs
The Committee provides a program level of $2,237,086,000
for Ryan White HIV/AIDS programs, which is $99,291,000 above
the fiscal year 2007 funding level and $79,174,000 above 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.
The Committee provides the maximum authorized level for the
Ryan White Act. The bill includes language proposed by the
Administration to make funds appropriated for Parts A and B
available for three years to be consistent with the recent
reauthorization. These programs provide medical and related
support services to more than 500,000 people.
The Committee is pleased that HRSA intends to fund the
minority HIV/AIDS initiative at the full authorized level
established in the recent Ryan White CARE Act authorization of
$135,100,000. These programs 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.
The recent Ryan White CARE Act reauthorization provides up
to 25 percent of available funds under Parts A, B, and C for
``support services,'' necessary for individuals with HIV/AIDS
to achieve their medical outcomes. The Committee is aware that
food and nutrition services--which have been provided under the
Act since 1990--are essential to the comprehensive treatment of
HIV/AIDS. Among other contributions, such services facilitate
the absorption of medicine, mitigate pharmaceutical side
effects, maintain immune system function, and stem muscle and
weight loss. Accordingly, the Committee expects HRSA to make no
change in the status of such services as eligible support
services under Ryan White and work to promote access to food
and nutrition services for Ryan White-eligible individuals.
The Committee is aware that over 30 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 grantees to encourage them to proactively
address HCV care and treatment among their HIV/HCV co-infected
patient populations and provide more education and training to
medical providers treating HIV/HCV co-infected persons. The
Committee also encourages State AIDS drug assistance programs
(ADAP) to provide coverage of therapies approved by the Food
and Drug Administration for the treatment of HCV in HIV/HCV co-
infected patients.
Emergency assistance
The Committee provides $636,300,000 for the Part A,
emergency assistance program, which is $32,307,000 above the
fiscal year 2007 funding level and the budget request. These
funds provide grants to metropolitan areas with very high
numbers of HIV/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. The program will provide awards to 56 eligible
metropolitan areas and transitional areas in fiscal year 2008.
The Committee has provided funds within the part A program
to prevent substantial funding losses in both eligible
metropolitan areas and transitional grant areas. Changes in the
recent reauthorization significantly altered the method for
allocating part A funds, and additional funds are required to
create a stop loss against unanticipated cuts that threaten to
disrupt access to needed medical care and support services for
people living with HIV and AIDS. The Committee includes bill
language to cap maximum fiscal year 2007 losses at 8.4 percent
for eligible metropolitan areas and 13.4 percent for
transitional grant areas.
When allocating fiscal year 2008 supplemental funds under
part A of the Ryan White CARE Act, the Committee urges HRSA to
provide additional increases to jurisdictions that have
experienced cuts in their total awards relative to the amount
awarded in fiscal year 2006.
Comprehensive care programs
The Committee provides $1,239,500,000 for Part B,
comprehensive care programs, which is $44,000,000 above the
fiscal year 2007 funding level and $23,982,000 above the budget
request. The funds provide formula grants to States for the
operation of HIV service delivery consortia in the localities
most heavily affected, the provision of home and community-
based care, continuation of health insurance coverage for
infected persons, and purchase of therapeutic drugs. The
Committee includes bill language identifying $830,593,000 of
this total specifically to support State AIDS Drug Assistance
Programs (ADAP), which is $41,047,000 above the fiscal year
2007 funding level and $16,047,000 above the budget request.
The Part B program provides 59 grants to States and
territories, 57 of which receive ADAP funding. In fiscal year
2005, 132,000 clients were served by ADAP. The Part B program
also awards States supplemental grants for emerging
communities, 19 of which are eligible for grants this year.
The Committee is concerned about the increasing incidence
of HIV drug resistance among Americans living with HIV/AIDS.
New, active HIV therapies are being developed that treat
patients with HIV resistance. Current, national HIV treatment
guidelines require that each patient's treatment regimen be
individualized and include two or more active agents. CMS, in
developing regulations for Medicare Part D plans, recognized
the importance of making new HIV antiretrovirals available to
providers and patients as soon as possible by requiring Part D
plan pharmacy and therapeutics review committees to conduct
expedited reviews of new HIV treatments within 90 days of FDA
approval. Therefore, the Committee urges HRSA to ensure that
State AIDS Drug Assistance Programs provide immediate access to
all new antiretroviral therapies for their eligible clients.
Early intervention program
The Committee provides $216,700,000 for Part C, the early
intervention services program, which is $22,979,000 above the
fiscal year 2007 funding level and $16,879,000 above the budget
request. Funds are used for discretionary grants to community
health centers, family planning agencies, comprehensive
hemophilia diagnostic and treatment centers, Federally-
qualified health centers, county and municipal health
departments and other non-profit community-based programs that
provide comprehensive primary care services to populations with
or at risk for HIV disease. The grantees provide testing, risk
reduction counseling, transmission prevention, oral health,
nutritional and mental health services, and clinical care.
Optional services include case management, outreach, and
eligibility assistance. Currently, 363 grantees provide
comprehensive, primary care services to approximately 212,000
people in 49 States and territories.
The Committee urges HRSA to direct funding increases above
the fiscal year 2007 level to existing Part C service areas
rather than to expand the overall number of Part C programs.
The number of Part C sites has continued to expand even in the
absence of funding increases; existing programs are
experiencing significant strains. There is already strong
geographic diversity in the Part C program.
Children, youth, women, and families
The Committee provides $71,800,000 for Part D, children,
youth, women, and families programs, which is $6,000 above the
fiscal year 2007 funding level and the budget request. HIV-
infected children, youth, women, and affected family members
have multiple, complex medical, economic, and social service
needs which often require more intensive care coordination,
intensive case management, child and respite care, and direct
service delivery to engage and maintain adolescents and mothers
in care. Funds support innovative and unique strategies and
models to organize, arrange for, and deliver comprehensive
services through integration into ongoing systems of care.
Currently, 89 grants support health care and support services
for over 53,000 women, infants, children and youth living in 31
States, D.C. and Puerto Rico.
The Committee intends that at least 90 percent of part D
funding be provided to existing service areas. Technical
assistance may be provided to Part D grantees using up to 2
percent of the funds appropriated under this section. The
Committee is aware of the efforts of Part D grantees to care
for youth infected with HIV and urges HRSA to disseminate the
effective practices and models of care developed by Part D
grantees across all Ryan White CARE Act providers.
AIDS dental services
The Committee provides $13,086,000 for AIDS dental
services, which is the same as the fiscal year 2007 funding
level and the budget request. The program includes two
components: the dental reimbursement program, which reimburses
dental education programs for non-reimbursed costs incurred in
providing care to AIDS patients, and the community-based dental
partnership, which increases access to oral health services and
provider training in community settings. In fiscal year 2005,
66 dental schools and post-doctoral dental education programs
received partial reimbursement for the costs of serving 31,000
patients. In addition, 12 community-based dental partnership
grants provided training to students and residents enrolled in
dental education programs that provide care for people with HIV
under direction of dentists in the community.
Education and training centers
The Committee provides $34,700,000 for AIDS education and
training centers (AETCs), which is $1,000 less than the fiscal
year 2007 funding level and $6,000,000 above the budget
request. The program supports a network of 11 regional centers
with more than 130 associated sites that conduct targeted,
multi-disciplinary HIV education and training for health care
providers.
Organ transplantation
The Committee provides $23,049,000 for organ donation and
transplantation activities, the same as the fiscal year 2007
level and the budget request. These funds support a scientific
registry of organ transplant recipients and the National Organ
Procurement and Transplantation Network to match donors and
potential recipients of organs, through a contract with the
United Network for Organ Sharing (UNOS). In fiscal year 2005,
more than 23,200 deceased donor organs were transplanted.
The Committee applauds the efforts of the Division of
Transplantation to implement the new provision of Public Law
208-116, the Organ Donation and Recovery Improvement Act, which
provides for reimbursement of travel and subsistence expenses
of living organ donors. The Committee notes that the first
awards under this new program are expected this spring and are
anticipated to have a direct impact on increasing the rate of
successful transplantations. The Committee further notes the
successful implementation of the Organ Donation Breakthrough
Collaborative, which has helped to increase the rate of organ
donation.
The Committee commends HRSA for its leadership in promoting
increased organ and tissue donations across the nation and
encourages the Division of Transplantation to expand its
partnership with the pulmonary hypertension (PH) community in
this important area. In addition, the Committee commends UNOS
for working with the pulmonary hypertension community to
address concerns regarding the allocation of lungs for
transplantation in PH patients. The Committee encourages UNOS
to continue its dialogue to monitor any concerns regarding the
methodology used to determine transplant eligibility for PH
patients.
National cord blood inventory program
The Committee provides $3,963,000 for the national cord
blood inventory program, which is the same as the fiscal year
2007 appropriation and $1,997,000 above the Administration
request. The Committee strongly supports this program and has
appropriated $27,720,000 for this purpose since 2004. The
purpose of this program is to provide funds to cord blood banks
to build an inventory of the highest quality cord blood units
for transplantation. As of this date, approximately 300 cord
blood units have been collected.
Cell transplantation program
The Committee provides $25,168,000 for the cell
transplantation program, which is the same as the fiscal year
2007 funding level and $2,467,000 above the budget request. The
C.W. Bill Young Cell Transplantation Program is the successor
to the National Bone Marrow Donor Registry. Its purpose is to
increase the number of transplants for recipients suitably
matched to biologically unrelated donors of bone marrow and
cord blood.
Office of pharmacy affairs
The Committee provides $2,940,000 for the office of
pharmacy affairs, which is the same as the budget request. No
funding was provided in fiscal year 2007 funding level. The
340B program requires drug manufacturers to provide discounts
or rebates to certain entities that serve low-income patients.
HRSA administers the program, calculates the 340B prices, and
works with manufacturers to verify the pricing. Financial
support for the office will help resolve identified
deficiencies in the 340B drug pricing program and is intended
to make major improvements in program operations.
In January, 2007, HRSA issued proposed guidelines that
would make significant changes to the traditional definition of
the term ``patient'' under the drug discount program authorized
by Section 340B of the Public Health Service Act. The Committee
has heard concerns about numerous aspects of the proposed
guidelines, including the limitations to prescriptions
resulting from outpatient services and requirements regarding
patient health record information. The Committee urges HRSA to
consider the concerns raised by the external community as it
reviews the guidelines before publication in final form.
Poison control centers
The Committee provides $30,100,000 for poison control
centers, which is $7,100,000 above the fiscal year 2007 funding
level and $20,100,000 above the budget request. These funds
support a grant program for 61 poison control centers, which
fielded five million calls in 2006. 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.
Rural outreach grants
The Committee provides $52,962,000 for rural outreach
grants, which is $14,077,000 above the fiscal year 2007 funding
level. The Administration does not request funding for this
program. The program administers more than 200 grants to
deliver and improve rural health care services to more than
775,000 rural residents annually.
Rural health research
The Committee provides $9,500,000 for rural health
research, which is $763,000 above the fiscal year 2007 funding
level and the budget request. This activity supports eight
rural health research centers and the Secretary's rural health
advisory committee.
Rural hospital flexibility grants
The Committee provides $63,538,000 for rural hospital
flexibility grants, which is the same as the fiscal year 2007
funding level. The budget request does not include funding for
this program. 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 rural
hospital improvement grants that provide modest amounts to
hospitals to assist them in automation and compliance with
confidentiality requirements. In fiscal year 2007, 92 grants
are expected to be awarded to States for these activities.
Rural and community access to emergency devices
The Committee provides $2,000,000 for the rural access to
emergency devices and the public access defibrillation
demonstration program, which is $513,000 more than the fiscal
year 2007 funding level. The Administration does not request
funding for this program. The amount above the fiscal year 2007
level may be used for rural EMS training and equipment
assistance. 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).
An estimated 94 percent of all cardiac arrests that take
place outside a hospital are deadly. Immediate cardiopulmonary
resuscitation (CPR) and early defibrillation using an AED can
more than double a victim's chance of survival. Communities
with comprehensive AED programs, including training of
anticipated rescuers, have achieved cardiac arrest survival
rates of 40 percent or higher.
State offices of rural health
The Committee provides $9,000,000 for State offices of
rural health, which is $859,000 above the fiscal year 2007
funding level and 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.
Black lung clinics
The Committee provides $5,891,000 for black lung clinics,
which is the same as the fiscal year 2007 funding level and
$5,000 above the budget request. The program supports 15
grantees that treat about 11,000 patients who are active and
retired coal miners and others with occupation-related
respiratory and pulmonary impairments. Of the 15 grantees, six
receive health center funding as well as black lung grants.
Radiation exposure screening and education program
The Committee provides $1,917,000 for the radiation
exposure screening and education program, which is $2,000 below
the fiscal year 2007 funding level and $13,000 above the budget
request. This program provides seven grants to States, local
governments, and healthcare organizations for the education,
prevention, and early detection of radiogenic cancers and
diseases resulting from exposure to uranium during mining and
milling at nuclear test sites. 1,400 patients are served by the
program.
Denali commission
The Committee concurs with the budget request and does not
include funding for the Denali Commission. The fiscal year 2007
funding level is $39,283,000.
Family planning
The Committee provides $310,910,000 for the family planning
program, which is $27,764,000 above the fiscal year 2007
funding level and $27,807,000 above the budget request. The
Committee recommends the $27,764,000 increase as part of its
initiative to help reduce the number of abortions in America by
alleviating the economic pressures and other real life
conditions that can sometimes cause women to decide not to
carry their pregnancies to term. The program currently serves
over five million low-income women and men at 4,400 clinics
nationwide. This funding increase will allow the program to
serve 98,000 new clients. Family planning funds in the bill are
expected to prevent more than one million unintended
pregnancies.
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 is the only source of health care
for many of its clients.
Healthcare-related facilities and other programs
The Committee includes funding for construction and
renovation (including equipment) of health care and other
facilities and other health-related activities. The Committee
includes the following projects in the following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
A.O. Fox Memorial Hospital, Oneonta, NY for $250,000
facilities and equipment............................
Access Community Health Network, Chicago, IL for 225,000
facilities and equipment for Chicago sites..........
Adirondack Medical Center, Saranac Lake, NY for 250,000
facilities and equipment............................
Adrian College, Adrian, MI for nurse training 250,000
programs, including facilities and equipment........
Adventist Glen Oaks Hospital, Glendale Heights, IL 200,000
for facilities and equipment........................
Adventist Health, Roseville, CA for expansions to the 250,000
clinical information system, including purchase of
equipment...........................................
Alamo Community College System, San Antonio, TX for 300,000
facilities and equipment............................
Alaska Addictions Rehabilitation Services, Inc., 150,000
Wasilla, AK for facilities and equipment............
Alderson-Broaddus College, Philippi, WV for 100,000
facilities and equipment for the nursing program....
Alice Hyde Medical Center, Malone, NY for facilities 100,000
and equipment.......................................
Alleghany Memorial Hospital, Sparta, NC for an 150,000
electronic health records initiative, including
equipment...........................................
Alle-Kiski Medical Center, Natrona Heights, PA for 350,000
facilities and equipment............................
Alliance for NanoHealth, Houston, TX for facilities 450,000
and equipment.......................................
AltaMed Health Services Corp., Los Angeles, CA for 275,000
facilities and equipment............................
American Oncologic Hospital; Fox Chase Cancer Center, 500,000
Philadelphia, PA for facilities and equipment.......
American Samoa, Pago Pago, AQ for facilities and 400,000
equipment for the LBJ Medical Center................
Armite County Medical Services, Liberty, MS for 135,000
facilities and equipment............................
Arnold Palmer Hospital, Orlando, FL for facilities 200,000
and equipment.......................................
Ashland County Oral Health Services, Ashland, OH for 100,000
facilities and equipment............................
Asian Americans for Community Involvement, San Jose, 378,000
CA for facilities and equipment for a community
health clinic.......................................
Association for Utah Community Health, Salt Lake 300,000
City, UT for health information technology for
community health centers represented by the
Association throughout the State....................
Atlantic Health Systems, Florham Park, NJ for an 500,000
electronic disease tracking system..................
Avis Goodwin Community Health Center, Dover, NH for 375,000
facilities and equipment in Somerworth, NH..........
Avilsta Adventist Hospital, Louisville, CO for health 200,000
information systems.................................
Bad River Tribe of Lake Superior Chippewa, Odanah, WI 500,000
for facilities and equipment for a health clinic....
Ball Memorial Hospital, Muncie, IN, for facilities 100,000
and equipment.......................................
Baltimore City Health Department, Baltimore, MD for 200,000
facilities and equipment for mobile units...........
Baltimore Medical System, Baltimore, MD for 200,000
facilities and equipment for a community health care
facility............................................
Baptist Health Medical Center--Heber Springs, Heber 75,000
Springs, AR for facilities and equipment............
Banert Hospital, Paterson, NJ for facilities and 200,000
equipment...........................................
Banes-Kasson County Hospital, Susquehanna, PA for 150,000
obstetrical care....................................
Bare Family Health Center, Barre, MA for facilities 150,000
and equipment.......................................
Bay Area Medical Clinic, Marinette, WI for facilities 200,000
and equipment.......................................
BayCare Health System, Clearwater, FL for upgrades to 200,000
medical information systems.........................
Baylor Research Institute, Dallas, TX for facilities 100,000
and equipment.......................................
Bayonne Medical Center, Bayonne, NJ for health 300,000
information technology..............................
Baystate Health Systems, Springfield, MA for 200,000
facilities and equipment............................
Beaumont Hospital, Royal Oak, MI for a Core Molecular 500,000
Laboratory, including facilities and equipment......
Belmont University, Nashville, TN for facilities and 100,000
equipment for the Health Science Center.............
Bemidji State University, Bemidji, MN for a nurse 200,000
training program....................................
Benedictine Hospital, Kingston, NY for health 175,000
information systems.................................
Benefis Healthcare, Great Falls, MT for facilities 300,000
and equipment.......................................
Berea Health Ministry Rural Health Clinic, Inc., 50,000
Berea, KY for facilities and equipment for a rural
diabetes clinic.....................................
Bloomington Hospital Foundation, Bloomington, IN for 200,000
for health information systems......................
Bloomsburg Hospital, Bloomburg, PA for facilities and 200,000
equipment...........................................
Blount Memorial Hospital, Maryville, TN for purchase 100,000
of equipment........................................
Boone Hospital Center, Columbia, MO for facilities 200,000
and equipment.......................................
Boriken Neighborhood Health Center, New York, NY for 150,000
facilities and equipment............................
Boscobel Area Health Care, Boscobel, WI for 300,000
facilities and equipment............................
Boston Medical Center, Boston, MA for facilities and 500,000
equipment...........................................
Boston University Medical School, Boston, MA for 250,000
facilities and equipment for biomedical research....
Bridge Community Health Clinic, Wausau, WI for 500,000
facilities and equipment............................
Bridgeport Hospital, Bridgeport, CT for facilities 100,000
and equipment.......................................
Brockton Neighborhood Health Center, Brockton, MA for 200,000
facilities and equipment............................
Brookside Community Health Center, San Pablo, CA for 350,000
facilities and equipment............................
Brunswick County, Bolivia, NC for facilities and 150,000
equipment for a senior center.......................
Bryan W. Whitfield Hospital, Demopolis, AL for 100,000
facilities and equipment............................
Bureau County Health Clinic, Princeton, IL to expand 150,000
rural health services, including purchase of
equipment...........................................
Cactus Health Services, Inc., Sanderson, TX for 175,000
primary health care services in rural communities in
Terrell and Pecos Counties..........................
California Hospital Medical Center, Los Angeles, CA 400,000
for facilities and equipment........................
California State University, Bakersfield, CA for 200,000
nurse training programs, including purchase of
equipment...........................................
Camillus House, Inc., Miami, FL for facilities and 60,000
equipment...........................................
Canonsburg General Hospital, Canonsburg, PA for 150,000
purchase of equipment...............................
Cape Cod Free Clinic and Community Health Center, 150,000
Mashpee, MA for facilities and equipment............
Capital Park Family Health Center, Columbus, OH for 200,000
facilities and equipment............................
Cardinal Stritch University, Milwaukee, WI for a 100,000
nursing training program............................
Carolinas HealthCare System, Charlotte, NC for 100,000
facilities and equipment............................
Carroll County Regional Medical Center, Carrollton, 200,000
KY for facilities and equipment.....................
Carroll County Youth Service Bureau, Westminster, MD 350,000
for facilities and equipment for the Outpatient
Mental Health Clinic................................
Center for Health Equity, Louisville, KY for a mobile 225,000
health unit.........................................
Central Wyoming College, Riverton, WY for facilities 200,000
and equipment at the Virtual Medical Skills.........
Center for Training Nurses in Rural Health Care......
CentroMed, San Antonio, TX for facilities and 300,000
equipment...........................................
Champlain Valley Physician's Hospital, Plattsburgh, 250,000
NY for facilities and equipment.....................
Charles A. Dean Memorial Hospital, Greenville, ME for 200,000
facilities and equipment............................
Chatham County Safety Net Collaborative, Savannah, GA 200,000
for purchase of equipment...........................
Cherry Street Health Services, Grand Rapids, MI for 200,000
an electronic health records initiative, including
equipment...........................................
Children's Friend and Family Services, Salem, MA for 200,000
facilities and equipment............................
Children's Home of Pittsburgh, Pittsburgh, PA for 200,000
facilities and equipment............................
Children's Hospital and Clinics of Minnesota, 15,000
Minneapolis, MN for facilities and equipment........
Children's Hospital and Health System, Milwaukee, WI 350,000
for purchase of equipment...........................
Children's Hospital at Albany Medical Center, Albany, 200,000
NY for facilities and equipment.....................
Children's Hospital Medical Center of Akron, Akron, 300,000
OH for facilities and equipment.....................
Children's Hospital of Orange County, Mission Viejo, 150,000
CA for purchase of equipment........................
Children's Hospital of The King's Daughters, Norfolk, 550,000
VA for pediatric facilities and equipment...........
Children's Hospital, Denver, CO for facilities and 200,000
equipment...........................................
Children's Hospitals and Clinics of Minnesota, 100,000
Minneapolis, MN for facilities and equipment for the
Mobile Pediatric Health Simulation Center...........
Children's Medical Center, Dayton, OH for CARE House, 100,000
including facilities and equipment..................
Children's Memorial Hospital Chicago, IL for 525,000
facilities and equipment............................
Children's National Medical Center, Washington, DC 500,000
for facilities and equipment for emergency
preparedness........................................
Children's Specialized Hospital, Mountainside, NJ for 300,000
facilities and equipment............................
Chippewa Valley Hospital, Durand, WI for facilities 125,000
and equipment.......................................
Chiricahua Community Health Centers, Inc., Elfrida, 400,000
AZ for facilities and equipment for the Bisbee/Naco
Chiricahua community health center in Bisbee, AZ and
the Douglas/El Frida Medical and Dental Border
Healthcare Clinic in Douglas, AZ....................
Christian Health Care Center of New Jersey, Wyckoff, 200,000
NJ for facilities and equipment.....................
Christian Sarkine Autism Treatment Center, 200,000
Indianapolis, IN for facilities and equipment.......
Christus Santa Rosa's Children's Hospital, San 200,000
Antonio, TX for facilities and equipment............
Cincinnati Children's Hospital Medical Center, 300,000
Cincinnati, OH for purchase of equipment............
Citrus County Board of County Commissioners, 150,000
Inverness, FL for facilities and equipment..........
City of Austin, TX for facilities and equipment for 250,000
the Travis County Hospital District.................
City of Chesapeake, VA for infant mortality and 100,000
chronic disease prevention program, including
equipment...........................................
City of Hueytown, AL for the Senior Citizens' Center, 200,000
including facilities and equipment..................
City of Oakland, CA for facilities and equipment for 500,000
a new youth center to house health services programs
City of Stockton, CA for facilities and equipment for 300,000
a health care facility..............................
City of Stonewall, OK for facilities and equipment... 260,000
Clarion Health Center, Clarion, PA for purchase of 100,000
equipment...........................................
Cleveland Clinic Huron Hospital, East Cleveland, OH 250,000
for facilities and equipment........................
Cobb County Government, Marietta, GA for a senior 325,000
health center, including facilities and equipment...
Coffeyville Regional Medical Center, Coffeyville, KS 250,000
for facilities and equipment........................
Coles County Council on Aging, Mattoon, IL for 200,000
facilities and equipment............................
College Misericordia, Dallas, PA for facilities and 275,000
equipment for the NEPA Assistive Technology Research
Institute...........................................
Collier County, Naples, FL to develop a health care 342,000
access network for the under- and uninsured,
including information technology upgrades...........
Colorado State University, Fort Collins, CO for 300,000
purchase of equipment...............................
Columbia Memorial Hospital, Hudson, NY for health 150,000
information systems.................................
Columbus Children's Hospital, Columbus, OH for a 100,000
telehealth project..................................
Columbus Children's Hospital, Columbus, OH for 300,000
purchase of equipment...............................
Communi Care, Inc., Columbia, SC for health 285,000
information systems, facilities, and equipment......
Community College of Aurora, Aurora, CO for 350,000
facilities and equipment............................
Community Dental Services, Albuquerque, NM for 300,000
facilities and equipment............................
Community Health Care, Tacoma, WA for facilities and 400,000
equipment...........................................
Community Health Center of Franklin County, Turners 150,000
Falls, MA for health information systems............
Community Health Works, Forsyth, GA for rural health 50,000
care outreach.......................................
Community Hospital of Bremen, Bremen, IN for 125,000
facilities and equipment............................
Community Hospital TeleHealth Consortium, Lake 200,000
Charles, LA for a telehealth initiative.............
Community Medical Centers, Stockton, CA for 200,000
facilities and equipment for Gleason House..........
Comprehensive Community Action Program (CCAP), 100,000
Cranston, RI for facilities and equipment for dental
care................................................
Connecticut Hospice, Inc., Branford, CT for health 300,000
information systems.................................
Cook Children's Medical Center, Fort Worth, TX for 600,000
facilities and equipment............................
Cooperative Education Service Agency 11 Rural Health 225,000
Dental Clinic, Turtle Lake, WI for dental services..
County of Modoc Medical Center, Alturas, CA for 150,000
purchase of equipment...............................
County of Peoria, Peoria, IL or facilities and 200,000
equipment...........................................
County of San Diego, CA for Public Health Services 286,000
for the purchase of equipment.......................
Crousee Hospital, Syracuse, NY for purchase of 300,000
equipment and improvement of electronic medical
information.........................................
Crowder College-Nevada Campus, Nevada, MO for 200,000
facilities and equipment for the Moss Higher
Education Center....................................
Crozer-Chester Medical Center, Upland, PA for 300,000
facilities and equipment............................
Cumberland Medical Center, Crossville, TN for 150,000
facilities and equipment............................
Dartmouth-Hitchcock Medical Center, Lebanon, NH for 275,000
facilities and equipment............................
Delaware Technical and Community College, Dover, DE 150,000
for purchase of equipment...........................
Denver Health and Hospital Authority, Denver, CO for 300,000
facilities and equipment............................
Des Moines University and Broadlawns Medical Center, 200,000
Des Moines, IA for a mobile clinic..................
Detroit Primary Care Access, Detroit, MI for health 300,000
care information technology.........................
Dixie County, Cross City, FL for facilities and 75,000
equipment for the primary care facility.............
Dodge County Hospital, Eastman, GA for facilities and 100,000
equipment...........................................
Drew County Memorial Hospital, Monticello, AR for 200,000
facilities and equipment............................
DuBois Regional Medical Center, DuBois, PA for 200,000
purchase of equipment and electronic medical records
upgrades............................................
East Carolina University, Greenville, NC for the 350,000
Metabolic Institute, including facilities and
equipment...........................................
East Tennessee Children's Hospital, Knoxville, TN for 180,000
facilities and equipment............................
East Tennessee State University College of Pharmacy, 250,000
Johnson City, TN for facilities and equipment.......
Easter Seals of Mahoning, Trumbull, and Columbiana 200,000
Counties, Youngstown, OH for facilities and
equipment...........................................
Eddy County, NM, for a regional substance abuse 150,000
rehabilitation center, including facilities and
equipment...........................................
Edgemoor Hospital, Santee, A for purchase of 150,000
equipment...........................................
Eisenhower Medical Center, Rancho Mirage, CA for 150,000
facilities and equipment............................
El Proyecto del Barrio, Arleta, ICA for facilities 250,000
and equipment at the Azusa Health Center, Azusa, CA.
El Proyecto del Barrio, Winnetka, CA for health 150,000
information systems.................................
Elizabeth City State University, Elizabeth City, NC 200,000
for facilities and equipment for a science education
building............................................
Emerson Hospital, Concord, MA for facilities and 200,000
equipment...........................................
Englewood Hospital and Medical Center, Englewood, NJ 150,000
for facilities and equipment........................
Excela Health, Mt. Pleasant, MA for facilities and 350,000
equipment...........................................
Fairfield Medical Center, Lancaster, OH for 200,000
facilities and equipment............................
Fairview Southdale Hospital, Edina, MN for purchase 150,000
of equipment........................................
Family and Children's Aid, Danbury, CT for facilities 250,000
and equipment for the Harmony Center................
Family Behavioral Resource, Greensburg, PA for 100,000
community health outreach activities................
Family Center of the Northern, Neck, Inc., White 200,000
Stone, VA for obstetric care services, including
facilities and equipment............................
Family Health Center of Southern Oklahoma, 100,000
Tishomingo, OK for facilities and equipment.........
Family HealthCare Network, Visalia, CA for electronic 200,000
medical records upgrades............................
Family Medicine Spokane, Spokane, WA for rural 150,000
training assistance.................................
Florida Hospital College of Health Sciences, Orlando, 150,000
FL for facilities and equipment.....................
Florida Institute of Technology, Melbourne, FL for 2,000,000
facilities and equipment for the Autism Research and
Treatment Center....................................
Florida Southern College, Lakeland, FL for purchase 300,000
of equipment to support nursing programs............
Floyd Valley Hospital, Le Mars, IA for facilities and 100,000
equipment...........................................
Freeman Health System, Joplin, MO for purchase of 255,000
equipment...........................................
Fulton County Medical Center, McConnelsburg, PA for 250,000
facilities and equipment............................
Gardner Family Health Network, Inc., San Jose, CA for 300,000
facilities and equipment............................
Gaston College, Health Education Institute, Dallas, 150,000
NC for nurse training programs, including facilities
and equipment.......................................
Gateway to Care, Houston, TX for health information 200,000
technology..........................................
Gertrude A. Barber Center, Erie, PA for the Autism 150,000
Early Identification Diagnostic and Treatment
Center, including purchase of equipment.............
Glen Rose Medical Center, Glen Rose, TX for 330,000
facilities and equipment............................
Glendale Adventist Medical Center, Glendale, CA for 350,000
facilities and equipment............................
Glens Falls Hospital, Glens Falls, NY for facilities 375,000
and equipment.......................................
Grady Health Systems, Atlanta, GA for electronic 150,000
medical records upgrades............................
Grandview Hospital, Dayton, OH for facilities and 150,000
equipment...........................................
Greater Hudson Valley Family Health Center,Inc., 75,000
Newburgh, NY for facilities and equipment...........
Greater New Bedford Community Health Center, New 300,000
Bedford, MA for health information systems..........
Griffin Hospital, Derby, CT for facilities and 400,000
equipment...........................................
Gritman Medical Center, Moscow, ID for facilities and 100,000
equipment...........................................
Gundersen Lutheran Health System, West Union, IA for 250,000
a mobile health unit................................
Gunderson Lutheran, Decorah, IA for a Remote Fetal 250,000
Monitoring Program, including purchase, of equipment
Halifax Regional Health System, South Boston, VA for 300,000
an electronic health records initiative, including
equipment...........................................
Hamilton Community Health Network, Flint, MI for 200,000
health care information technology..................
Hampton University, Hampton, VA for health 250,000
professions training................................
Harris County Hospital District, Houston, TX for 300,000
facilities and equipment............................
Harris County Hospital District, Houston, TX for 200,000
facilities and equipment............................
Harris County Hospital District, Houston, TX for 150,000
facilities and equipment for an outpatient physical
and occupational therapy center.....................
Harris County Hospital District, Houston, TX for 200,000
facilities and equipment for the diabetes program...
Harris Methodist Erath County Hospital, Stephenville, 140,000
TX for facilities and equipment.....................
Hatzoloh EMS, Inc., Monsey, INY for purchase of 125,000
ambulances..........................................
Hawkeye Community College, Waterloo, IA for 350,000
facilities and equipment for a health center........
Healing Tree Addiction Treatment Solutions, Inc., 150,000
Sterling, CO for facilities and equipment...........
HEALS Dental Clinic, Huntsville, AL for facilities 75,000
and equipment.......................................
HealthCare Connection, Cincinnati, OH for an 150,000
electronic health records initiative, including
equipment...........................................
HealthEast Care System, St. Paul, MN for health 500,000
information systems.................................
Heartland Community HealthlClinic, Peoria, IL for 300,000
facilities and equipment............................
Hektoen Institute for Medical Research Beloved 250,000
Community Wellness Program, Chicago, IL for
facilities and equipment............................
Helen DeVos Children's Hospital, Grand Rapids, MI for 100,000
facilities and equipment............................
Henry Mayo Newhall Memorial Hospital, Valencia, CA 200,000
for facilities and equipment........................
Highland Community Hospital, Picayune, MS for health 200,000
information systems.................................
Highlands County, Sebring, FL for facilities and 400,000
equipment for the veterans service office...........
Holy Name Hospital, Teaneck, NJ for facilities and 150,000
equipment...........................................
Home Nursing Agency, Altoona, PA, for telehealth 100,000
services, including purchase of equipment...........
I Hormel Foundation, Austin, MN for facilities and 400,000
equipment for the cancer research center............
Hospice of Northwest Ohio Toledo Center, Toledo, OH 100,000
for health information systems......................
Hospice of the Western Reserve, Cleveland, OH for a 150,000
pediatric care program..............................
Houston County Hospital District, Crockett, TX for 200,000
facilities and equipment............................
Howard Community College,Columbia, MD for facilities 150,000
and equipment for radiologic technology.............
Hudson Alpha Institute for Biotechnology, Huntsville, 275,000
AL for facilities and equipment.....................
Hudson Headwaters Health Network, Inc., Glens Falls, 100,000
NY for health information systems...................
Humility of Mary Health Partners, Youngstown, OH for 200,000
health information technology.......................
Humphreys County Memorial Hospital, Belzoni, MS for 175,000
facilities and equipment............................
Hunterdon Medical Center, Flemington, NJ for 500,000
facilities and equipment............................
Hunter's Hope Foundation, Orchard Park, NY, including 200,000
purchase of equipment...............................
Huntsville Hospital, Huntsville, AL for facilities 175,000
and equipment.......................................
Hurley Medical Center, Flint, MI for health 200,000
information systems.................................
Idaho Caring Foundation, Inc., Boise, ID for oral 300,000
health services for low-income children.............
Idaho State University, Pocatello, ID for the 200,000
Advanced Clinical Simulation Laboratory, including
facilities and equipment............................
Illinois Masonic Medical Center, Chicago, IL for 250,000
facilities and equipment............................
Illinois Primary Health Care Association, 225,000
Springfield, IL for health information systems for
clinic sites across the State.......................
India Community Center, Militias, CA for facilities 300,000
and equipment for the medical clinic................
Indiana University Bloomington, IN for facilities and 75,000
equipment for the School of Nursing.................
Indiana University School of Medicine, Gary, IN for 400,000
facilities and equipment for the Northwest Indiana
Health Research Institute...........................
Indiana University School of Medicine, Indianapolis, 150,000
IN for facilities and equipment.....................
Indiana University Southeast New Albany, IN for 75,000
facilities and equipment for the School of Nursing..
Inland Behavioral Health Services, Inc., San 500,000
Bernardino, CA for facilities and equipment.........
Institute for Family Health, New Paltz, NY for health 100,000
information systems across all eight academic health
centers.............................................
Institute for Research and Rehabilitation, Houston, 200,000
TX for purchase of equipment........................
INTEGRIS Health, Oklahoma City, OK for a telemedicine 200,000
demonstration.......................................
Intermountain Healthcare, Salt Lake City, UT for an 170,000
electronic health records initiative, including
equipment...........................................
Jameson Hospital, New Castle, PA for facilities and 250,000
equipment...........................................
Jasper Memorial Hospital, Monticello, GA for 40,000
facilities and equipment............................
Jefferson Regional Medical Center Nursing School, 200,000
Pine Bluff, AR for facilities and equipment.........
Jenkins County GA Hospital, Millen, GA for facilities 250,000
and equipment.......................................
John Wesley Community Health Institute, Bell Gardens, 150,000
CA for facilities and equipment for the Bell Gardens
Health Center.......................................
Johnson Memorial Hospital, Stafford Springs, CT for 250,000
facilities and equipment............................
Johnston Memorial Hospital, Smithfield, NC for 200,000
facilities and equipment............................
Kalamazoo Valley Community College, Kalamazoo, MI for 350,000
purchase of equipment...............................
Kennedy Krieger Institute, Baltimore, MD for 450,000
facilities and equipment for the International
Center for Spinal Cord Injury facility..............
Kent State University Stark Campus, North Canton, OH 500,000
for facilities and equipment........................
Kent State University, Ashtabula, OH for facilities 200,000
and equipment.......................................
Kilmichael Hospital, Kilmichael, MS for facilities 175,000
and equipment.......................................
Kirkwood Community College, Cedar Rapids, IA for 200,000
facilities, equipment and curriculum for an advanced
medical simulation instruction center...............
Knox Community Hospital, Mount Vernon, OH for 275,000
facilities and equipment............................
La Clinica de la Raza, Oakland, CA for facilities and 250,000
equipment for the San Antonio Neighborhood Health
Center..............................................
La Rabida Children's Hospital, Chicago, IL for 225,000
facilities and equipment............................
Lake Erie College of Osteopathic Medicine, Erie, PA 200,000
for the Drug Information Center.....................
Lakeland Community College, Kirtland, OH for a health 100,000
information training program, including facilities
and equipment.......................................
Lamar University, Beaumont, TX for the Community and 150,000
University Partnership Service, including facilities
and equipment.......................................
Lanai Women's Center, Lani City, HI for facilities 100,000
and equipment.......................................
Laurens County Health Care System, Clinton, SC for an 100,000
electronic health records initiative, including
equipment...........................................
Lawrence Hospital Center, Bronxville, NY for 225,000
facilities and equipment............................
League Against Cancer, Miami, FL for purchase of 200,000
equipment...........................................
Liberty County, FL, Bristol, FL for facilities and 300,000
equipment for a medical facility....................
Liberty Regional Medical Center, Hinesville, GA for 100,000
facilities and equipment............................
Limestone Community Care, Inc. Medical Clinic, 75,000
Elkmont, AL for facilities and equipment............
Lincoln Community Health Center, Durham, NC for 200,000
facilities and equipment............................
Lincoln Medical and Mental Health Center, Bronx, NY 200,000
for facilities and equipment........................
Lodi Memorial Hospital, Lodi, CA for a telehealth 175,000
project.............................................
Loretto, Syracuse, NY for facilities and equipment 250,000
for elderly health care and skilled nursing programs
Los Angeles Orthopaedic Hospital, Los Angeles, CA for 275,000
facilities and equipment in the Lowman Center.......
Louisville Metro Department of Public Works, 250,000
Louisville, KY for facilities and equipment for a
mobile health unit..................................
Lourdes Medical Center of Burlington County, 150,000
Willingboro, NJ for purchase of equipment...........
Loyola University Health System, Maywood, IL for 250,000
facilities and equipment............................
Lucile Packard Children's Hospital, Palo Alto, CA for 200,000
facilities and equipment............................
Madison Center, South Bend, IN for facilities and 150,000
equipment for a clinic for attention deficit
hyperactivity disorder..............................
Madison County Memorial Hospital, Rexburg, ID for 200,000
facilities and equipment............................
Madison County, Virginia City, MT for facilities and 200,000
equipment...........................................
Madison St. Joseph Health Center, Madisonville, TX 120,000
for facilities and equipment........................
Maine Center for Marine Biotechnology, Gulf of Maine 100,000
Research Institute, Portland, ME for facilities and
equipment...........................................
Maine Primary Care Association, Augusta, ME for 50,000
health information systems in community health
centers across the State............................
Manchester Memorial Hospital, Manchester, CT for 300,000
facilities and equipment............................
Marana Health Center, Marana, AZ for facilities and 125,000
equipment...........................................
Marias Medical Center, Shelby, MT for purchase of 200,000
equipment...........................................
Marquette General Hospital, Marquette, MI for 300,000
facilities and equipment............................
Marshalltown Medical and Surgical Center, 300,000
Marshalltown, IA for high resolution medical
imaging, including purchase of equipment............
Mary Scott Nursing Center, Dayton, OH for facilities 200,000
and equipment.......................................
Maryland State Dental Association, Columbia, MD for 150,000
facilities and equipment for mobile dental care
units...............................................
Maryville University, St. Louis, MO for facilities 200,000
and equipment at the Center for Science and Health
Professions.........................................
Mason County Board of Health, Maysville, KY for 300,000
facilities and equipment............................
Massachusetts College of Pharmacy and Health 200,000
Sciences, Worcester, MA for health information
technology systems..................................
Maury Regional Hospital, Columbia, TN for facilities 250,000
and equipment.......................................
Meharry Medical College, Nashville, TN for facilities 300,000
and equipment.......................................
Memorial Hermann Baptist Beaumont Hospital, Beaumont, 200,000
TX for facilities and equipment.....................
Memorial Hermann Healthcare System, Houston, TX for 200,000
facilities and equipment............................
Memorial Hermann Southwest Hospital, Houston, TX for 100,000
facilities and equipment............................
Mendocino Coast District Hospital, Fort Bragg, CA for 300,000
facilities and equipment............................
Menominee Indian Tribe of Wisconsin, Keshena, WI for 375,000
facilities and equipment for the Family Wellness
Center..............................................
Mercy College of Northwest Ohio, Toledo, OH for 200,000
facilities and equipment for the continuing
professional education division.....................
Mercy Health Foundation, Durango, CO for facilities 200,000
and equipment for a community health clinic.........
Mercy Hospital Grayling, Grayling, MI for facilities 125,000
and equipment.......................................
Mercy Hospital, Buffalo, NY for facilities and 100,000
equipment...........................................
Mercy Medical Center, Redding, CA for facilities and 200,000
equipment...........................................
Mercy Medical Center-House of Mercy, Des Moines, IA 275,000
for facilities and equipment related to substance
abuse...............................................
Mercy Memorial Hospital, Monroe, MI for facilities 200,000
and equipment.......................................
Mercy Ministries Health Center, Laredo, TX for a 100,000
mobile health unit..................................
Mercy Suburban Hospital, Norristown, PA for 300,000
facilities and equipment............................
Methodist Hospital of Southern California, Arcadia, 550,000
CA for facilities and equipment.....................
Methodist Hospital, Houston, TX for purchase of 200,000
equipment...........................................
Metropolitan Hospital, New York, NY for facilities 100,000
and equipment.......................................
MetroWest Medical Center Framingham Union Hospital, 75,000
Framingham, MA for facilities and equipment for
interpreting services...............................
Miami Beach Community Health Center, Miami Beach, FL 150,000
for facilities and equipment........................
Middle Tennessee State University, Murfreesboro, TN 200,000
for facilities and equipment for the school of
nursing.............................................
Middlesex Community College, Lowell, MA for 200,000
facilities and equipment for the health education
programs............................................
Middletown Regional Hospital, Middletown, OH for 100,000
facilities and equipment for the Greentree Science
Academy in Franklin, OH.............................
Mid-Ohio FoodBank, Columbus, OH for facilities and 200,000
equipment...........................................
Miles Community College, Miles City, MT for the 200,000
Pathways to Careers in Healthcare initiative........
Mission Hospitals, Asheville, NC for facilities and 200,000
equipment...........................................
Missouri Delta Medical Center, Sikeston, MO for 200,000
purchase of equipment...............................
Monroe Clinic, Monroe, WI for health care information 250,000
technology..........................................
Monroe County Hospital, Forsyth, GA for facilities 45,000
and equipment.......................................
Montefiore Medical Center, Bronx, NY for health 75,000
information systems.................................
Montgomery Area Nontraditional Equestrians, Pike 100,000
Road, AL for facilities and equipment to serve the
disabled............................................
Morehead State University, Morehead, KY to improve 300,000
rural health........................................
Morris Heights Health Center, Inc., Bronx, NY for 100,000
facilities and equipment............................
Morton Hospital and Medical Center, Taunton, MA for 300,000
facilities and equipment............................
Mount Nittany Medical Center, State College, PA for 200,000
facilities and equipment............................
Mount Vernon Hospital, Mount Vernon, NY for 200,000
facilities and equipment............................
Mount Wachusett Community College, Gardner, MA for 325,000
facilities and equipment............................
Muhlenberg Community Hospital, Greenville, KY for 150,000
facilities and equipment............................
Naugatuck Valley Community College, Waterbury, CT for 100,000
facilities and equipment for the nursing program....
Nebraska Hospital Association Research and Education 250,000
Foundation, Lincoln, NE for a telehealth
demonstration, including purchase of equipment......
New York College of Osteopathic Medicine, Old 300,000
Westbury, NY for disease management and patient
advocacy programs, including purchase of equipment..
New York Presbyterian Hospital, New York, NY for 500,000
facilities and equipment............................
Newark Beth Israel Medical Center, Newark, NJ for 200,000
facilities and equipment............................
Newark-Wayne Community Hospital, Newark, NY for 500,000
facilities improvements and digital health care
equipment...........................................
Newport Hospital, Newport, RI for facilities and 300,000
equipment...........................................
Newton Memorial Hospital, Newton, NJ for purchase of 150,000
equipment...........................................
Niagara Falls Memorial Medical Center, Niagara Falls, 400,000
NY for facilities and equipment.....................
Norman Regional Health System, Norman, OK for 200,000
telehealth and electronic medical records
initiatives.........................................
NorthEast Ohio Neighborhood Health Services, Inc., 250,000
Cleveland, OH for facilities and equipment..........
Northeast Wisconsin Technical College, Green Bay, WI 175,000
for a mobile health clinic..........................
Northern Dutchess Hospital, Rhinebeck, NY for health 200,000
information technology systems......................
Northern Westchester Hospital, Mount Kisco, NY for 100,000
facilities and equipment............................
Northland Medical Center, Princeton, MN for purchase 250,000
of equipment........................................
Northwest Community Health Care, Pascoag, RI for 300,000
facilities and equipment............................
Northwest Hospital Intermediate Care Unit, 100,000
Randallstown, MD for facilities and equipment.......
Northwest Kidney Centers, Seattle, WA for facilities 100,000
and equipment.......................................
Northwest Nazarene University, Nampa, ID for 100,000
facilities and equipment............................
Northwestern Memorial Hospital, Chicago, IL for 375,000
facilities and equipment for Prentice Women's
Hospital............................................
Oakland University School of Nursing, Rochester, MI 250,000
for facilities and equipment........................
Oaklawn Adult Group Home, Goshen, IN for facilities 150,000
and equipment.......................................
Oakwood Healthcare System Foundation, Dearborn, MI 200,000
for facilities and equipment for the Western Wayne
Family Health Center................................
Ocean Beach Hospital, Ilwaco, WA for a telepharmacy 350,000
program.............................................
Ohio State University Comprehensive Cancer Center, 150,000
Columbus, OH for James Cancer Survivorship Center
for construction of facilities......................
Ohio State University Medical Center, Columbus, OH 200,000
for facilities and equipment........................
Oklahoma University College of Medicine--Tulsa, 150,000
Tulsa, OK for facilities and equipment..............
Olympic Community Action Program, Port Angeles, WA 50,000
for facilities and equipment for the OlyCAP Oral
Health Center.......................................
Oregon Coast Community College, Newport, OR for 75,000
facilities and equipment for health professions
education...........................................
Osceola County Health Department, Poinciana, FL for 150,000
facilities and equipment............................
Osceola Medical Center, Osceola, WI for facilities 150,000
and equipment.......................................
Our Lady of Lourdes Memorial Hospital, Binghamton, NY 325,000
for facilities and equipment........................
Palisades Medical Center, North Bergen, NJ for 250,000
facilities and equipment............................
Palmetto Health Foundation, Columbia, SC for 1,000,000
facilities and equipment............................
Parkland Health Center, Farmington, MO for facilities 200,000
and equipment.......................................
Passavant Area Hospital, Jacksonville, IL for 200,000
facilities and equipment............................
Pattie A. Clay Regional Medical Center, Richmond, KY 225,000
for facilities and equipment........................
Pee Dee Healthy Start, Florence, SC for programs to 88,000
improve maternal and child health...................
Peninsula Hospital Center, New York, NY for health 200,000
information systems.................................
People, Inc., Williamsville, NY for electronic health 200,000
records upgrades....................................
Peralta Community College, 0akland, CA for facilities 200,000
and equipment for the nursing program at Highland
Hospital............................................
Person Memorial Hospital, Roxboro, NC for facilities 200,000
and equipment.......................................
Phoenix Children's Hospital, Phoenix, AZ for health 250,000
information systems.................................
Placer County, Auburn, CA for construction of the 250,000
Children's Health Center/Emergency Shelter..........
Pointe Coupee Better Access Community Health, New 100,000
Roads, LA for facilities and equipment..............
Ponce Center of Autism, Municipality of Ponce, PR for 225,000
facilities and equipment at the Autism Center.......
Powell County Medical Center, Deer Lodge, MT for 100,000
facilities and equipment............................
Powell Valley Health Care, Powell, WY for electronic 300,000
information technology..............................
Prairie Star Health Center, Hutchinson, KS for 200,000
facilities and equipment............................
Preston Memorial Hospital, Kingwood, WV for 275,000
facilities and equipment............................
Project Access Spokane, Spokane, WA for healthcare 200,000
delivery to low income residents....................
ProMedica Continuing Care Service Corporation, 150,000
Adrian, MI for a telemedicine initiative............
Provena Saint Joseph Hospital, Elgin, IL for 300,000
facilities and equipment............................
Providence Health System, Anchorage, AK to improve 200,000
services in underserved regions.....................
Putnam Hospital Center, Carmel, NY for facilities and 200,000
equipment...........................................
Quebrada Health Center, Municipality of Camuy, PR for 125,000
purchase of equipment...............................
Quincy Valley Medical Center, Quincy, WA for 150,000
facilities and equipment............................
Rancho Santiago Community College District, Santa 150,000
Ana, CA for facilities and equipment for a medical
education complex...................................
Reading Hospital School of Nursing, West Reading, PA 100,000
for nurse training programs including facilities and
equipment...........................................
Reformed Presbyterian Woman's Association, 200,000
Pittsburgh, PA for facilities and equipment for a
skilled nursing facility............................
Regional Children's Hospital, Johnson City, TN for 100,000
facilities and equipment............................
Rhode Island Quality Institute, Providence, RI for 250,000
health information technology in conjunction with
Rhode Island mental health organizations............
Rio Arriba County, Espanola, NM for facilities and 750,000
equipment for the Health Commons....................
Riverside County Regional Medical Center, Moreno 225,000
Valley, CA for facilities and equipment.............
Riverside County Regional Medical Center, Moreno 140,000
Valley, CA for facilities and equipment.............
Riverside Health System, Newport News, VA for the 150,000
Patient Navigator Program...........................
Roosevelt Hospital, New York, NY for facilities and 200,000
equipment...........................................
Rosebud Sioux Tribe, Rosebud, SD for facilities and 100,000
equipment...........................................
Roswell Park Cancer Institute, Buffalo, NY for 300,000
facilities and equipment............................
Rural Health Technology Consortium for facilities and 200,000
equipment...........................................
Rush University Medical Center, Chicago, IL for 225,000
facilities and equipment for the Center for Advanced
Medical Response....................................
Saginaw Valley State University, University Center, 350,000
MI for purchase of equipment........................
Saint Mary's Health Care, Grand Rapids, MI for an 150,000
electronic health records initiative, including
equipment...........................................
Sam Rogers Health Clinic, Kansas City, MO for 200,000
facilities and equipment............................
San Antonio Hospital Foundation, Upland, CA for 450,000
facilities and equipment............................
San Francisco Medical Center Outpatient Improvement 450,000
Programs, Inc., San Francisco, CA for facilities and
equipment...........................................
San Mateo County, Redwood City, CA for facilities and 400,000
equipment for the San Mateo Medical Center Emergency
Department..........................................
San Ysidro Health Center, San Ysidro, CA for 100,000
facilities and equipment............................
Sandoval County, Bernalillo, NM for a telemedicine 200,000
initiative, including purchase of equipment.........
Santa Rosa Memorial Hospital, Orange, CA for 150,000
facilities and equipment............................
Schneck Medical Center, Semour, IN for facilities and 375,000
equipment...........................................
Scotland Memorial Hospital, Laurinberg, NC for 200,000
facilities and equipment............................
Seattle Cancer Care Alliance Seattle, WA for 100,000
facilities and equipment............................
Sharp Rehabilitation Services, San Diego, CA for 150,000
facilities and equipment............................
Shasta Community Health Center, Redding, CA for 150,000
facilities and equipment............................
Shawano County Rural Health Initiative, Shawano, WI 75,000
for rural health care...............................
Sidney Health Center, Sidney, MT for purchase of 200,000
equipment...........................................
Sierra Nevada Memorial Foundation, Grass Valley, CA 250,000
for an electronic health records initiative.........
Sistersville General Hospital, Sisterville, WV for 225,000
facilities and equipment............................
Skagit Valley Hospital Cancer Care Center, Mount 275,000
Vernon, WA for facilities and equipment.............
Soldiers and Sailors Memorial Hospital, Wellsboro, PA 200,000
for purchase of equipment...........................
Somerset Medical Center, Somerville, NJ for 350,000
electronic health records upgrades..................
South Broward Hospital District, Hollywood, FL for 250,000
facilities and equipment............................
South Carolina HIV/AIDS Council, Columbia, SC for 185,000
health outreach.....................................
South Nassau Communities Hospital, Oceanside, NY for 200,000
facilities and equipment............................
South Shore Hospital, South Weymouth, MA for 300,000
facilities and equipment............................
Southampton Hospital, Southampton, NY for facilities 300,000
and equipment.......................................
Southeast Alabama Medical Center, Dothan, AL for 350,000
facilities and equipment for the Southeast Regional
Cancer Screening Program............................
Southeast Community College, Cumberland, KY for 100,000
facilities and equipment for an allied health
training center.....................................
Southeast Missouri State University, Cape Girardeau, 0
MO for facilities and equipment.....................
Southern Methodist University, Dallas, TX for 150,000
purchase of equipment...............................
Southern Vermont Recreation Center Foundation, 100,000
Springfield, VT for facilities and equipment for a
medical rehabilitation unit.........................
Southwest Tennessee Community College, Memphis, TN 200,000
for facilities and equipment........................
St. James Hospital and Health Centers, Chicago 225,000
Heights, IL for facilities and equipment for the
Olympia Fields campus...............................
St. Agnes Hospital, Fresno, CA for purchase of 160,000
equipment...........................................
St. Ambrose University, Davenport, IA for facilities 150,000
and equipment.......................................
St. Anthony Community Hospital, Warwick, NY for 100,000
facilities and equipment............................
St. Anthony Hospital, Chicago, IL for facilities and 200,000
equipment...........................................
St. Anthony Memorial Health Centers, Hammond, IN for 275,000
facilities and equipment............................
St. Bernard Health Center, Inc., Chalmette, LA for 200,000
facilities and equipment............................
St. Bernardine Medical Center, San Bernardino, CA for 200,000
facilities and equipment............................
St. Camillus Health and Rehabilitation Center, 300,000
Syracuse, NY for the brain injury program, including
facilities and equipment............................
St. Catharine College, St. Catharine, KY for the 175,000
allied health science program, including facilities
and equipment.......................................
St. Charles Parish, LaPlace, LA for purchase of 150,000
equipment...........................................
St. Clair Hospital, Pittsburgh, PA for facilities and 200,000
equipment...........................................
St. Claire Regional Medical Center, Morehead, KY for 200,000
facilities construction.............................
St. Elizabeth Medical Center, Utica, NY for 400,000
facilities and equipment............................
St. Francis Hospital, Escanaba, MI for facilities and 125,000
equipment...........................................
St. Francis Medical Center, Trenton, NJ for 250,000
facilities and equipment............................
St. James Parish Hospital, Lutcher, LA for facilities 200,000
and equipment.......................................
St. John's North Shore Hospital, Harrison Township, 200,000
MI for facilities and equipment.....................
St. Joseph of the Pines, Southern Pines, NC for an 100,000
electronic health records system....................
St. Joseph Regional Medical Center, South Bend, IN 275,000
for health care information technology..............
St. Joseph's Hospital Mercy Care Services, Atlanta, 300,000
GA for health information technology................
St. Joseph's Hospital, Buckhannon, WV for facilities 100,000
and equipment.......................................
St. Joseph's Hospital, Savannah GA for facilities and 275,000
equipment...........................................
St. Joseph's Regional Medical Center, Paterson, NJ 200,000
for health information technology...................
St. Joseph's/Candler Health System, Savannah, GA for 200,000
purchase of equipment...............................
St. Luke's Quakertown Hospital, Quakertown, PA for 400,000
facilities and equipment............................
St. Luke's Regional Medical Center, Ltd., Boise, ID 200,000
for purchase of equipment...........................
St. Mary Medical Center Foundation, Langhorne, PA for 100,000
facilities and equipment............................
St. Mary Medical Center, Apple Valley, CA for the 500,000
electronic intensive care unit......................
St. Mary's Hospital Foundation, Grand Junction, CO 200,000
for facilities and equipment for the Saccomanno
Education Center....................................
St. Mary's Hospital, Madison, WI for facilities and 150,000
equipment...........................................
St. Mary's Medical Center, Huntington, WV for 400,000
facilities and equipment for the Center for
Education...........................................
St. Mary's Regional Medical Center, Reno, NV for 250,000
facilities and equipment............................
St. Patrick Hospital and Health Sciences Center, 300,000
Missoula, MT for an electronic medical records
system..............................................
St. Peter's Hospital Foundation, Albany, NY for 200,000
facilities and equipment for the St. Peter's Breast
Center..............................................
St. Petersburg College, St. Petersburg, FL for 250,000
facilities and equipment............................
St. Vincent Hospital, Billings, MT for facilities and 300,000
equipment...........................................
St. Vincent's Charity Hospital, Cleveland, OH for 450,000
facilities and equipment............................
St. Vincent's Medical Center, Bridgeport, CT for 200,000
facilities and equipment............................
St. Xavier University, Chicago, IL for facilities and 200,000
equipment...........................................
Stamford Hospital, Stamford, CT for facilities and 200,000
equipment...........................................
Stark Prescription Assistance Network, Canton, OH for 150,000
facilities and equipment............................
State Fair Community College, Sedalia, MO for 300,000
facilities and equipment............................
Stewart-Marchman Center, Inc., Daytona Beach, FL for 150,000
facilities and equipment............................
Stony Point Ambulance Corps, Stony Point, NY for 375,000
facilities and equipment............................
Summers County Commission, Hinton, WV for facilities 230,000
and equipment for the Appalachian Regional
Healthcare Hospital.................................
Swedish Covenant Hospital, Chicago, IL for facilities 250,000
and equipment.......................................
Sylvan Grove Hospital, Jackson, MS for facilities and 50,000
equipment...........................................
Tangipahoa Parish, Loranger, LA for facilities and 100,000
equipment...........................................
Tarleton State University, Stephenville, TX for the 200,000
Rural Nursing Education Program, including purchase
of equipment........................................
Tarrant County Infant Mortality Task Force, Ft. 100,000
Worth, TX for education and outreach programs.......
Taylor Regional Hospital, Hawkinsville, GA for 55,000
facilities and equipment............................
Temple Health and Bioscience Economic Development 250,000
District, Temple, TX for facilities and equipment...
Teton Valley Hospital and Surgicenter, Driggs, ID for 200,000
purchase of equipment...............................
Texas A&M; University--Kingsville, Kingsville, TX for 150,000
facilities and equipment for a research facility....
Texas Institute for Genomic Medicine, College 125,000
Station, TX for facilities and equipment............
Texas Tech University Health Sciences Center, El Paso 550,000
and Lubbock, TX for facilities and equipment for the
West Texas Center for Influenza Research, Education
and Treatment.......................................
Texas Tech University Health Sciences Center, 100,000
Lubbock, TX for health professionals training,
including facilities and equipment..................
Thomas Jefferson University Breast Cancer Center, 400,000
Philadelphia, PA for facilities and equipment.......
Thomason General Hospital, EI Paso, TX for facilities 350,000
and equipment.......................................
Thundermist Health Center, Woonsocket, RI for health 500,000
information technology..............................
Tohono O'odham Nation, sells, AZ for facilities and 100,000
equipment for its diabetes and dialysis program.....
Toledo Children's Hospital, Toledo, OH for facilities 75,000
and equipment for a palliative care program.........
Tomorrow's Child/Michigan SIDS, Lansing, MI for 200,000
facilities and equipment............................
Town of Argo, AL for facilities and equipment for the 100,000
Senior Citizens' Center for Health and Wellness.....
Translational Genomics Research Institute, Phoenix, 500,000
AZ for facilities and equipment.....................
Transylvania Community Hospital, Inc., Brevard, NC 275,000
for facilities and equipment........................
Tulare District Hospital, Tulare, CA for an 150,000
electronic medical record system....................
Tuomey Healthcare System, Sumter, SC for health 200,000
information systems.................................
Twin City Hospital, Dennison, OH for facilities and 300,000
equipment...........................................
Union Hospital, Terre Haute, IIN for health 200,000
information technology..............................
Uniontown Hospital, Uniontown, PA for facilities and 300,000
equipment for the chest pain center.................
Unity Health Care, Washington, DC for health 200,000
information systems.................................
University Community Hospital/Pepin Heart Hospital, 200,000
Tampa, FL for purchase of equipment.................
University Health System, San Antonio, TX for 175,000
facilities and equipment............................
University of Alabama, Tuscaloosa, AL for a 100,000
telehealth initiative...............................
University of Arizona Medical Center, Tucson, AZ for 400,000
facilities and equipment............................
University of Arkansas for Medical Sciences, Little 200,000
Rock, AR for facilities and equipment...............
University of Arkansas for Medical Sciences, Little 180,000
Rock, AR for facilities and equipment at the
Antenatal and Neonatal Guidelines, Education, and
Learning System (ANGELS)............................
University of Arkansas Medical School Cancer Research 325,000
Center, Little Rock, AR for facilities and equipment
University of California, Davis Health System, 420,000
Sacramento, CA for facilities and equipment for the
Center for Education................................
University of Chicago Hospitals, Chicago, IL for 225,000
facilities and equipment............................
University of Illinois College of Medicine, Peoria, 200,000
IL for facilities and equipment.....................
University of Iowa, Iowa City, IA for facilities and 100,000
equipment for a public health research and education
building............................................
University of Iowa, Iowa City, IA for facilities and 100,000
equipment for an advanced biomedical research
institute...........................................
University of Kansas Research Center, Lawrence, KS 425,000
for facilities and equipment........................
University of Massachusetts Memorial Medical Center, 350,000
Worcester, MA for health information technology.....
University of Memphis, Memphis, TN for facilities and 200,000
equipment for the community health building.........
University of Miami, Miami, FL for equipment at the 150,000
Center for Research in Medical Education............
I University of Michigan Health System, Ann Arbor, MI 350,000
for facilities and equipment for the C.S. Mott
Children's and Women's Hospitals....................
University of North Alabama, Florence, AL for 225,000
facilities and equipment for a science building.....
University of North Texas, Denton, TX for the center 350,000
for Computational Epidemiology, including facilities
and equipment.......................................
University of Northern Colorado, Greeley, CO to 350,000
develop the National Center for Nursing Education,
including facilities and equipment..................
University of South Florida, Tampa, FL for the 400,000
Florida Cancer Clinical Trials Project..............
University of Tennessee of Chattanooga, Chattanooga, 400,000
TN for a low birth weight study.....................
University of Texas Southwestern Medical Center, 300,000
Dallas, TX for facilities and equipment for the
sickle cell program.................................
University of Texas Southwestern Medical Center, 200,000
Dallas, TX for purchase of equipment................
University of Virginia Health System, 150,000
Charlottesville, VA for a telehealth project for
southwest VA........................................
University of Wisconsin-Oshkosh, Oshkosh, WI for 165,000
facilities and equipment............................
Utah Navajo Health System, Inc., Montezuma Creek, UT 100,000
for telehealth systems..............................
Valley Cooperative Health Care, Hudson, WI for health 75,000
information systems.................................
Vanguard University Nursing Center, Costa Mesa, CA 200,000
for facilities and equipment........................
Village Network Boys' Village Campus, Wooster, OH for 250,000
facilities and equipment............................
Virtua Memorial Hospital Burlington County, Mount 200,000
Holly, NJ for purchase of equipment.................
Visiting Nurse Association Healthcare Partners of 400,000
Ohio, Cleveland, OH for telehealth..................
Wadsworth Rittman Hospital Foundation, Wadsworth, OH 400,000
for facilities and equipment........................
Wake County, Raleigh, NC for facilities and equipment 300,000
for Holly Hill Hospital.............................
Washington County, GA Regional Medical Center, 250,000
Sandersville, GA for facilities and equipment.......
Washington Hospital Center, Washington, DC for 200,000
facilities and equipment............................
Washington Parish, Bogalusa, LA for health care 100,000
centers, including facilities and equipment.........
Wayne Memorial Hospital, Jesup, GA for facilities and 300,000
equipment...........................................
West Jefferson Medical Center, Marrero, LA for 200,000
facilities and equipment............................
West Shore Medical Center, Manistee, MI for 150,000
facilities and equipment............................
West Side Community Health Services, St. Paul, MN for 150,000
facilities and equipment............................
West Virginia University Hospital, Morgantown, WV for 175,000
facilities and equipment............................
Western North Carolina Health System, Asheville, NC 300,000
for health information technology...................
Whidden Memorial Hospital, Everett, MA for facilities 275,000
and equipment.......................................
White County Memorial Hospital, Monticello, IN for 210,000
facilities and equipment............................
White Memorial Medical Center, Los Angeles, CA for 400,000
facilities and equipment............................
White Plains Hospital Center, White Plains, NY for 225,000
facilities and equipment............................
Whiteside County Department of Health, Rock Falls, IL 200,000
for facilities and equipment........................
Whittemore Peterson Institute for Neuro-Immune 200,000
Disease, Sparks, NV for facilities and equipment....
Wind River Community Health Center, Riverton, WY for 250,000
facilities and equipment............................
Wing Memorial Hospital, Palmer, MA for facilities and 200,000
equipment...........................................
Winneshiek Medical Center, Decorah, IA for purchase 230,000
of medical equipment................................
Wolfson Children's Hospital, Jacksonville, FL for 300,000
purchase of equipment...............................
Woodhull Medical and Mental Health Center, Brooklyn, 230,000
NY for equipment for a hospital-based radiologic
technology school...................................
Woodruff County Nursing Home, McCrory, AR for 200,000
facilities and equipment............................
Wyoming County Community Hospital, Warsaw, NY for 100,000
facilities and equipment............................
YMCA of Central Stark County, Canton, OH for 500,000
facilities and equipment............................
York Memorial Hospital, York, PA for facilities and 92,000
equipment...........................................
Youth Crisis Center, Jacksonville, FL for facilities 200,000
and equipment.......................................
Zucker Hillside Hospital, Glen Oaks, NY for 250,000
facilities and equipment............................
------------------------------------------------------------------------
Bioterrorism hospital grants to states
The Committee provides funding for this activity in the
Office of the Secretary, Assistant Secretary for Preparedness
and Response, as requested in the President's request and
provided in the Continuing Appropriations Resolution, 2007.
Telehealth
The Committee provides $7,000,000 for telehealth, which is
$181,000 above the fiscal year 2007 funding level and 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 isolated populations and health-related education
to the practitioners who serve them. The program supports 16
grants for networks along with five regional resource centers.
Program management
The Committee provides $142,191,000 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 $4,103,000 below the fiscal year 2007
funding level and $2,000,000 below the budget request. The
Committee reduces funding for this account by $2,000,000
because it intends to support the dental shortages
demonstration currently funded in program management in the MCH
SPRANS dental health initiative.
The Committee is concerned that there is a widespread lack
of awareness among health care providers that cardiovascular
disease is the leading killer of women in the United States.
The Committee encourages HRSA to conduct an education and
awareness campaign for physicians and other health care
professionals relating to the prevention, diagnosis, and
treatment of heart disease, stroke and other cardiovascular
diseases in women.
The unfortunate death earlier this year of a 12-year old
Maryland boy from a brain infection stemming from an abscessed
tooth has focused the Committee's attention on the issue of
access to oral health care for underserved populations. As the
agency that supports programs that provide services to
disadvantaged, medically underserved and special populations,
the Committee believes that HRSA should be actively involved in
addressing this problem. The Committee was disturbed to learn
that the lack of administrative support for oral health
infrastructure within HRSA and collaborative oral health
initiatives among HRSA bureaus and with other Federal agencies
has made it nearly impossible for HRSA staff to respond to
States' needs. The Committee believes that HRSA must appoint a
chief dental officer who can coordinate the agency's oral
health activities, focus on rebuilding the HRSA dental corps
and provide direction for HRSA field officers. The Committee
directs HRSA to report to the Committee no later than October
30, 2007 on its activities to name a chief dental officer.
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT
The Health Education Assistance Loans (HEAL) program
insures 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 $1,000,000 to liquidate obligations
from loans guaranteed prior to 1992, which is $3,000,000 below
the fiscal year 2007 funding level and the same as budget
request.
The Committee provides $2,906,000 for HEAL program
management, which is $8,000 above the fiscal year 2007 funding
level and the same as the budget request.
VACCINE INJURY COMPENSATION TRUST FUND
The Committee makes available the release of $57,547,000
from the Vaccine Injury Compensation Trust Fund in fiscal year
2008, which is $1,676,000 above the fiscal year 2007 funding
level and the same as 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 $3,528,000 in costs incurred
by the agency in the operation of the program, which is
$454,000 less than the fiscal year 2007 funding level and the
same as the budget request.
Centers for Disease Control and Prevention
DISEASE CONTROL, RESEARCH, AND TRAINING
The Committee provides a program level total of
$6,457,832,000 for the Centers for Disease Control and
Prevention (CDC), which is $255,160,000 above the fiscal year
2007 funding level and $475,181,000 above the budget request.
Of the funds provided, $316,079,000 shall be derived from
evaluation set-aside funds available under section 241 of the
Public Health Service Act, which is $50,979,000 above the
fiscal year 2007 set-aside and $50,079,000 above the requested
set-aside. The Committee includes an undistributed reduction of
$2,000,000 within this account.
With the exception of the public health and health services
block grant, which has a statutorily-determined formula
distribution, all funds provided in this appropriation are
awarded via competitive grant/cooperative agreement or
contract, administratively-determined formula, or are awarded
on a sole-source basis where only one eligible partner is
determined. Funding is typically awarded to States, localities,
public health departments, higher education institutions,
private industry, or nonprofit voluntary groups or associations
and is reviewed by outside peer reviewers.
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. The activities of CDC focus on several major
priorities, including providing core public health functions,
responding to urgent public health threats, monitoring the
nation's health using scientific methods, building the nation's
public health infrastructure, 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.
Infectious diseases
The Committee provides a program level of $1,913,302,000
for infectious diseases, which is $109,071,000 above the fiscal
year 2007 funding level and $118,934,000 above the budget
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 budget
request.
Immunization and respiratory diseases
The Committee provides a program level of $636,159,000 for
immunization and respiratory diseases, which is $68,155,000
over the fiscal year 2007 funding level and $91,182,000 above
the budget request. Of the amount provided, $12,794,000 is to
be derived from section 241 evaluation set-aside funds, as
provided in fiscal year 2007 and as proposed in the request. In
addition, the current vaccines for children program is expected
to provide $2,761,957,000 in vaccine purchases and distribution
support in fiscal year 2008, for a total of $3,398,116,000 for
immunization and respiratory diseases activities in fiscal year
2008.
In fiscal year 2007, CDC reorganized within the
coordinating center for infectious diseases to combine
activities related to respiratory diseases with immunization
activities. In addition, a new influenza division was created
within this new national center for immunization and
respiratory diseases.
Immunization project grants are awarded to States and local
agencies for planning, developing, and conducting childhood and
adult 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.
The Committee recommends $516,273,000 for the immunization
program authorized by section 317 of the Public Health Service
Act, which is $58,750,000 above the fiscal year 2007 funding
level and $91,150,000 above the budget request. The Committee
is aware that prior to 2000 and the introduction of new
vaccines, such as the recent human papillomavirus vaccine, the
317 immunization program was adequately providing vaccines to
children and adolescents traditionally dependent on the public
sector for support, but who were not eligible for the vaccines
for children program.
Currently, the 317 immunization program is falling far
short of the need. The current estimate of the cost to fully
immunize a female through age 18 is over $1,240 and for a male
it is over $936--this compares with a total cost of $186 for
females and males in 1999. As a result of these increased
vaccine costs, the number of children receiving vaccines under
the 317 program has fallen from 747,000 in 1999 to an estimated
279,000 in 2006. The Committee recommendation is the first step
toward the goal of fully immunizing all eligible individuals.
The additional funding included above the fiscal year 2007
appropriation will allow approximately 42,000 additional
children and adolescents to receive the full vaccine schedule
compared to the estimated number of those who will be served in
2007.
The Committee is concerned that immunization levels for
vaccines routinely recommended for many adolescents and adults
lag far behind coverage levels for vaccines for children. The
Committee understands that CDC led a process during the early
1990s that resulted in the development of immunization action
plans (IAPs) in all 50 States and in many major urban areas to
achieve 90 percent immunization coverage for vaccines
recommended for young children. These IAPs were the result of
community planning efforts led by State and local health
departments and included detailed actions thought to be needed
to achieve coverage goals, activities that could be undertaken
with available resources and estimates of the resources
required for such efforts. The Committee believes that while
maintaining the commitment to and the coverage levels for
children, a similar process may be useful for reaching
adolescent and adult immunization goals, and encourages CDC to
provide funding to States or local organizations that receive
section 317 immunization grant funds to develop community
adolescent and adult immunization planning demonstrations to
achieve 90 percent immunization coverage for vaccines routinely
recommended for adolescents and adults. These models should
include existing and new efforts planned within existing
resources; new activities needed and estimates for those needs.
The Committee is pleased with the report on the section 317
immunization program that CDC provided and requests that the
report be updated and promptly submitted by February 1, 2008,
to reflect fiscal year 2009 cost estimates. The updated report
also should include an estimate of optimum State and local
operations funding as well as CDC operations funding needed
relative to current levels to conduct and support childhood,
adolescent, and adult programs. This estimate should include
the cost of vaccine administration; surveillance and assessment
of changes in immunization rates; vaccine storage, handling and
quality assurance; implementation of centralized vaccine
distribution and other vaccine business improvement practices;
needs to support provider and public outreach and education on
new vaccines; identification of barriers to immunization and
strategies to address such barriers; maintenance, utilization,
and enhancement of immunization information systems, including
integration with public health preparedness and other public
health information technology systems; innovative strategies to
increase coverage rates in hard-to-reach populations and
geographic pockets of need; vaccine safety; and other non-
vaccine resource needs of a comprehensive immunization program.
Each of these activities is critical to ensuring the delivery
of life-saving vaccines to our nation and has been under-funded
in recent years.
The Committee recommends $82,575,000 for immunization and
respiratory diseases program operations, which is $19,759,000
above the fiscal year 2007 funding level and $32,000 above the
budget request. This funding supports vaccine tracking, vaccine
safety, and prevention activities. Included within the total is
$19,800,000 to provide funds to States to increase demand for
influenza vaccine with the intention that by doing so, U.S.
vaccine production capacity also will be stimulated.
The Committee recommends $37,311,000 for activities related
to preparing for and responding to a pandemic influenza, which
is $10,354,000 below the fiscal year 2007 funding level and the
same as the budget request. Included within this total is
$19,800,000 to develop a repository of pandemic virus reference
strains for manufacturing and $14,850,000 to increase the stock
of diagnostic reagents for influenza.
Vaccine safety datalink.--In fiscal year 2006, the
Committee requested that the National Institute of
Environmental Health Sciences (NIEHS) convene a panel of
expert, independent researchers for the purpose of exploring
the possibility of using the CDC's vaccine safety datalink
(VSD) to conduct a study that could ``identify or rule out any
association between thimerosal exposure in pediatric vaccines
and increased rates of autism.'' The expert panel convened in
May 2006 and issued a report, which recommended that gaps and
uncertainties in the VSD be addressed prior to the
consideration of further studies of autism and thimerosal using
the VSD. Given that the VSD ten-year contract totals more than
$120,000,000, the Committee urges CDC to report to the House
Committee on Appropriations no later than March 1, 2008 on its
response to the NIEHS recommendations. This report should
include information about current and ongoing CDC studies that
address the potential association between thimerosal exposure
in pediatric vaccines and neurodevelopmental disorders
including autism.
HIV/AIDS, viral hepatitis, STD and TB prevention
The Committee provides $1,042,303,000 for HIV/AIDS, viral
hepatitis, sexually transmitted diseases (STD), and
tuberculosis (TB) prevention, which is $32,112,000 above the
fiscal year 2007 funding level and $14,495,000 below the
request.
Within the total, $715,463,000 is for domestic HIV/AIDS
prevention and research, which is $17,413,000 above the fiscal
year 2007 funding level and $29,644,000 below the budget
request. This funding level supports 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 Committee supports the domestic
HIV/AIDS initiative and provides $63,000,000 for the testing
component of the initiative within CDC, which is $18,000,000
more than the fiscal year 2007 funding level and $30,000,000
less than the budget request. The Committee does not provide a
set-aside within this funding for the early diagnosis grant
program and notes that currently no States have adopted the HIV
testing policies designated for eligibility to receive funding
under this new authorization.
Within the total, $18,615,000 is for the viral hepatitis
program, which is $1,000,000 more than the fiscal year 2007
funding level and $1,025,000 more than the budget request. The
division of viral hepatitis provides the scientific and
programmatic foundation for the prevention, control, and
elimination of hepatitis virus infections in the U.S.
Within the total, $157,537,000 is for the sexually
transmitted diseases (STD) prevention program, which is the
same as the fiscal year 2007 funding level and $227,000 more
than the budget request. The division of STD prevention
provides national leadership through research, policy
development, and support of effective services to prevent
sexually transmitted diseases and their complications such as
infertility, adverse outcomes of pregnancy, and reproductive
tract cancer. CDC assists health departments, health-care
providers, and non-governmental organizations and collaborates
with other governmental entities through the development,
syntheses, translation, and dissemination of timely, science-
based information; the development of national goals and
science-based policy; and the development and support of
science-based programs that meet the needs of communities.
Within the total, $150,688,000 is for the tuberculosis
program, which is $13,699,000 more than the fiscal year 2007
funding level and $13,897,000 more than the budget request. The
TB 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.
HIV/AIDS in minority communities.--Funds are provided
within the total for domestic HIV/AIDS prevention and research
programs to support 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.
Hepatitis B.--The Committee applauds CDC's efforts to
develop and implement a new strategy to screen individuals at
risk for chronic hepatitis B. As only approximately one-third
of individuals with hepatitis B are aware of their condition,
the Committee urges CDC to continue to collaborate with the
National Institute of Diabetes and Digestive and Kidney
Diseases in the development of a public health strategy to
expand the screening of individuals at risk for chronic
hepatitis B. In addition, the Committee notes that accurate
national statistics are lacking as to the number of Americans
infected with hepatitis B, as existing population-based surveys
have not included Asian/Pacific islander groups in whom
hepatitis B is by far the most common. The Committee is aware
that there are now six pharmaceutical products available for
the treatment of hepatitis B and that three of them have become
available in the last two years. The significant improvement in
treatment options increases the timeliness of an aggressive
screening program for hepatitis B.
Hepatitis C.--The Committee is concerned that more than 75
percent of the 4 million people with hepatitis C are unaware of
their condition because the condition is often asymptomatic
until advanced liver damage develops. Therefore, the Committee
urges CDC to implement an aggressive screening program. In
addition to targeting at-risk populations, the Committee urges
the consideration of age-based screening policies to more
effectively reach infected populations. The Committee also
urges CDC to support a campaign of public announcements that
will highlight the need for appropriate screening and medical
follow-up for target populations.
The Committee also recognizes the alarming rate of
individuals co-infected with hepatitis C and HIV, and that end-
stage liver disease secondary to hepatitis C is now the leading
cause of death for individuals with HIV disease. The Committee
urges that funding be focused on expanding the capability of
State health departments, particularly to enhance resources
available to the hepatitis C State coordinators and for
increased screening initiatives. The Committee also encourages
the division of viral hepatitis to collaborate with the Health
Resources and Services Administration (HRSA) to implement
improved HCV screening programs for HIV-infected individuals
served by HRSA programs.
Global tuberculosis.--TB is an enormous public health
crisis in the developing world, killing millions of people in
the prime of their lives every year. Despite the development of
effective treatments against TB fifty years ago, there have
never been more people infected with the disease in the history
of the world. Approximately 2 billion people (approximately 30
percent of the world's population) have been infected with
mycobacterium tuberculosis, the causative agent of TB. TB is a
leading cause of death in HIV-infected individuals and in women
of childbearing age. Each year, TB takes the lives 2 million
people and there are 8 million new cases; another million die
of the combination of HIV and TB. To help stem this growing
pandemic, the Committee provides funding to enhance and expand
the existing CDC cooperative agreement on TB vaccine research.
Intensified support and activities to accelerate control
(ISAAC).--The Committee applauds CDC for implementing the ISAAC
initiative for targeting TB in African Americans and along the
U.S.-Mexico border, universal genotyping of all culture
positive TB cases, and expanding clinical trials and
development of new tools for the diagnosis and treatment of TB.
The Committee notes with concern, however, reports of
extensively drug resistant tuberculosis strains in Africa that
demonstrate extremely high mortality rates. The Committee urges
CDC to continue to provide leadership and technical expertise
to other nations experiencing outbreaks of extensively drug
resistant tuberculosis and to coordinate activities with other
Federal and international health agencies.
Multi-drug resistant (MDR) tuberculosis and extensively
drug resistant tuberculosis (XDR-TB).--The Committee is
extremely concerned about MDR TB and XDR-TB. The Committee
urges CDC to expand resources for global TB control to enhance,
maximize, and target resources for surveillance, including
laboratory testing, and control of TB in the U.S. and around
the world, while ensuring preparedness and response capacity
for both MDR TB and XDR-TB.
Tuberculosis elimination and laboratory cooperative
agreements.--The Committee is concerned that CDC is not meeting
its commitment to fully implement the new funding formula under
the TB elimination and laboratory cooperative agreements. The
Committee supports the CDC distribution formula that would
award funds in proportion to the number and complexity of TB
cases in a jurisdiction and urges CDC to accelerate and
complete the implementation of this new formula as soon as
possible to ensure Federal TB funds are awarded to reflect the
actual number and complexity of TB cases in each jurisdiction.
Zoonotic, vector-borne, and enteric diseases
The Committee provides $70,342,000 for zoonotic, vector-
borne, and enteric diseases, which is $272,000 more than the
fiscal year 2007 funding level and $7,390,000 more than the
budget request. Within this total, no less than the level
allocated in fiscal year 2007 for the West Nile virus program
is recommended for fiscal year 2008.
The new national center for zoonotic, vector-borne, and
enteric diseases was created in 2007 through a reorganization
of the infectious disease program. This center provides
national and international scientific and programmatic
leadership addressing zoonotic, vector-borne, foodborne,
waterborne, mycotic, and related infections to identify,
investigate, diagnose, treat, and prevent these diseases. The
programs focus on the continuing challenge of emerging and re-
emerging zoonoses and the ecologies from which these diseases
have emerged, while recognizing the importance of working
collaboratively, not just across CDC and the traditional public
health community, but also with agricultural, wildlife,
companion animal, and environmental agencies and organizations.
Preparedness, detection, and control of infectious diseases
The Committee provides $164,498,000 for preparedness,
detection, and control of infectious diseases, which is
$8,532,000 more than the fiscal year 2007 funding level and
$34,857,000 more than the budget request. Within the total,
$19,228,000 is to address the growing problem of antimicrobrial
resistance, which is $1,748,000 more than the fiscal year 2007
funding level and $1,776,000 more than the budget request.
The new national center for preparedness, detection, and
control of infectious diseases will provide greater focus on
preparedness and response capacity for new and complex
infectious disease outbreaks, and will manage and coordinate
emerging infectious diseases, integrate laboratory groups, and
facilitate increased quality and capacity in clinical
laboratories. The center will serve as a focal point for
engaging outside agencies and partners in quality laboratory
systems and improved healthcare settings.
Community-associated Methicillin-resistant Staphylococcus
aureus (CA-MRSA).--The Committee is concerned about the
explosion in virulence and prevalence of MRSA strains in the
U.S. Compounding this problem is a fundamental shift from
primarily hospital-based transmission to community-based
transmission of MRSA. The spread of CA-MRSA through perfectly
healthy community members with no hospital contact concerns the
Committee. Within the funds provided, the Committee encourages
CDC to conduct a strong, extramural research program in MRSA
epidemiology and pathophysiology. The Committee encourages CDC
to maximize this MRSA research through continued support for
entities with established MRSA research programs.
Health promotion
The Committee provides $1,002,212,000 for health promotion,
which is $42,550,000 above the fiscal year 2007 funding level
and $43,480,000 above the budget request.
Chronic disease prevention, health promotion, and genomics
The Committee provides $869,479,000 for chronic disease
prevention, health promotion, and genomics, which is
$34,481,000 more than the fiscal year 2007 funding level and
$35,284,000 more than the budget request. Chronic diseases have
had a profound human and economic toll on our nation. More than
1.7 million Americans die of a chronic disease each year,
accounting for approximately 70 percent of all deaths in the
U.S. The programs funded through this budget activity provide
support for State and community programs, surveillance,
prevention research, evaluation, and health promotion.
Within the total provided, the Committee includes the
following amounts for chronic disease prevention, health
promotion, and genomics activities:
$48,744,000 for heart disease and stroke programs,
which is $4,431,000 above the fiscal year 2007 funding
level and $4,475,000 above the budget request;
$69,157,000 for diabetes programs, which is
$6,287,000 above the fiscal year 2007 funding level and
$6,351,000 above the budget request;
$326,100,000 for cancer prevention and control
programs, which is $19,379,000 more than the fiscal
year 2007 funding level and $19,691,000 more than the
budget request (included within this total is
$19,605,000 for the WISEWOMAN program, $9,000,000 to
carry out activities authorized by Johanna's Law, and
$6,505,000 for activities related to ovarian cancer);
$22,797,000 for arthritis and other chronic diseases
programs, which is $764,000 more than the fiscal year
2007 funding level and $787,000 more than the budget
request (included within this total is $8,402,000 for
the epilepsy program);
$104,347,000 for tobacco programs, which is the same
as the fiscal year 2007 funding level and $106,000
above the budget request;
$42,250,000 for nutrition, physical activity and
obesity programs, which is $899,000 more than the
fiscal year 2007 funding level and $941,000 more than
the budget request (included within this total is
$2,300,000 for the fruit and vegetable program formerly
known as the 5-a-day program);
$27,544,000 for health promotion, which is $224,000
more than the fiscal year 2007 funding level and
$254,000 more than the budget request (within the
total, $3,466,000 is provided for the visual screening
education program and $1,000,000 is provided within
community health promotion for activities related to
sleep disorders);
$56,449,000 for school health programs, which is
$500,000 more than the fiscal year 2007 funding level
and $556,000 more than the budget request (within the
amount provided, $500,000 shall be used to develop and
policy to manage the risk of food allergies and
anaphylaxis in schools and to provide parents with
enhanced information on these conditions via the
Internet);
$48,530,000 for the safe motherhood/infant health
programs, which is $4,412,000 more than the fiscal year
2007 funding level and $4,456,000 more than the budget
request;
$10,000,000 for new demonstration grant program to
prevent teen pregnancy, which was not requested by the
Administration;
$13,140,000 for oral health programs, which is
$1,500,000 more than the fiscal year 2007 funding level
and $1,511,000 more than the budget request;
$29,556,000 for prevention centers, which is $30,000
less than the fiscal year 2007 funding level and the
same as the budget request;
$26,386,000 for steps to a healthier U.S., which is
$17,299,000 less than the fiscal year 2007 funding
level and the same as the budget request;
$37,553,000 for REACH, which is $3,414,000 more than
the fiscal year 2007 funding level and $3,449,000 more
than the budget request; and,
$6,926,000 for genomics, which is the same as the
fiscal year 2007 funding level and $7,000 more than the
budget request.
Alzheimer's disease and healthy aging.--There is growing
scientific evidence that many of the same strategies that
preserve overall health may also help prevent or delay the
onset of cognitive impairment and dementia. For example,
statins used for heart disease may hold promise in the fight
against Alzheimer's disease and epidemiological studies show
that individuals taking anti-inflammatory drugs to treat
conditions such as arthritis have a lower occurrence of
Alzheimer's; others appear to link known risk factors for
diabetes and heart disease with those for Alzheimer's disease.
In light of this evidence, three years ago Congress launched a
CDC brain health initiative to promote greater public awareness
and communication, better surveillance on the burden of the
disease in communities, public health interventions and greater
prevention research.
Blindness prevention.--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. The Committee strongly supports CDC's
vision health initiative.
Cancer survivorship.--The Committee supports the CDC's
efforts to address the needs of the approximately 10 million
cancer survivors living with, through, and beyond cancer. The
Committee is especially supportive of efforts to provide
comprehensive services to cancer patients and survivors through
multiple partnerships, which in turn provide individuals with
one-stop resources.
Chronic kidney disease.--The Committee previously has
expressed concern regarding the need to expand public health
strategies to combat chronic kidney disease (CKD) given that
many individuals are diagnosed too late to initiate treatment
regimens that could reduce morbidity and mortality. There are
20 million Americans who have CKD, and another 20 million who
are at risk of developing the disease. Individuals with
diabetes or hypertension have especially high vulnerability.
Kidney disease is the ninth leading cause of death in the U.S.,
and death by cardiovascular disease is 10 to 30 times higher in
kidney dialysis patients than in the general population. The
Committee encourages CDC to continue development of a public
health strategy for chronic kidney disease.
Colorectal cancer.--Colorectal cancer is the third most
commonly diagnosed cancer among both men and women in the U.S.
and the second leading cause of cancer-related deaths. When
colorectal cancer is detected and treated early, survival is
greatly enhanced. 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 CDC
to continue to expand its partnerships with State health
departments, professional and patient organizations, and
private industry to combat this devastating disease.
Community-based approaches to address obesity.--The
Committee recognizes the importance of community-based
approaches to address our national obesity epidemic which
results from poor nutrition and lack of physical activity.
These innovative and cost-effective programs establish
sustainable policy and environmental change in the area of
healthy eating and active living to address the chronic disease
and obesity crisis.
Diabetes.--Diabetes is the sixth leading cause of death in
the U.S., and costs the nation an estimated $132,000,000,000 in
direct and indirect costs. Approximately 14.6 million Americans
are diagnosed with diabetes, and an estimated 6.2 million
people are undiagnosed and remain untreated. The incidence of
the disease in America has increased approximately 14 percent
in the last two years alone, and over 1.5 million new cases of
diabetes are diagnosed each year. CDC estimates that one in
three children born today will develop diabetes in their
lifetime.
The collateral health effects of diabetes can be
devastating, often causing heart disease, stroke, blindness,
kidney failure, pregnancy complications, amputations of the
leg, foot, and toe, as well as contributing to deaths related
to influenza and pneumonia. Known preventive measures can
reduce the devastating consequences of diabetes, but these
preventions are not currently practiced universally. The
Committee believes that public awareness campaigns must be
promoted to reach the general population so that individuals
with diabetes are encouraged to take appropriate measures to
check their blood glucose levels and to take action to prevent
or slow the progression of their disease. A goal of the CDC is
to increase the percentage of individuals with diabetes who
receive annual eye and foot exams, and at least two A1C
measures per year.
It is estimated that maintaining a certain blood glucose
level (A1C target of less than seven) would reduce the health
complications of diabetes and achieve direct and indirect
medical cost savings. The Committee encourages CDC to establish
additional national public-private partnerships to leverage
Federal resources with private-sector contributions to expand
the national diabetes education program. These new efforts
could augment public awareness campaigns encouraging
individuals with diabetes to be tested and know their A1C
levels so that they and their healthcare professionals can take
appropriate action to control their condition.
Epilepsy.--The Committee supports the CDC epilepsy program,
which has made considerable progress over the past decade in
establishing and advancing a public health agenda to meet the
needs of Americans with epilepsy. The Committee applauds CDC's
activities to train first-responders, educators, school nurses,
employers, family caregivers, and other health care
professionals in the recognition, diagnosis and treatment of
seizures.
Food allergies.--The Committee is concerned with the sharp
increase in the incidence of food allergies among children, and
requests CDC produce a report to the Committee by April 15,
2008 detailing the national incidence of children with reported
food allergies, possible causes of the reported increased
incidence, and steps the CDC recommends to address this growing
national threat to children's health.
Genetics of diabetic kidney disease.--The Committee
acknowledges CDC for its collaboration with the National
Institute of Diabetes and Digestive and Kidney Diseases to
implement the Genetics of Kidneys in Diabetes (GoKinD) Study, a
large scale effort to identify the genetic determinants of
diabetic kidney disease. The Committee urges CDC to take steps
to ensure that GoKinD biosamples are made available to the
research community in a sustainable and long-term manner, such
as through a central biorepository, so that this valuable
genetic collection can be efficiently mined for knowledge that
could lead to the development of new therapies to treat
diabetic kidney disease.
Gynecologic cancer education and awareness program.--The
Committee is encouraged by the progress that has been made by
CDC, in coordination with the Office of Women's Health, to
initiate a national education campaign on gynecologic cancers.
In the absence of an available screening test, the Committee
understands that the best way for gynecologic cancers to be
detected early is for women and health professionals to
recognize its signs and symptoms. The Committee is pleased that
these efforts were authorized in statute with the passage of
Johanna's Law: The Gynecologic Cancer Education and Awareness
Act. The Committee provides funding for activities authorized
by Johanna's Law to support the continuation and expansion of
this program. Within the total, a portion is to be allocated
toward the completion of a report to Congress providing a
description of past and present activities of the Department of
Health and Human Services to increase awareness and knowledge
of the public with respect to different types of cancer,
including gynecologic cancers as well as past efforts to
increase awareness and knowledge of health care providers with
respect to different types of cancer, including gynecologic
cancers.
Heart disease and stroke.--The Committee remains strongly
supportive of CDC's new division for heart disease and stroke
prevention. Heart disease, stroke, and other cardiovascular
diseases continue to be the leading cause of death in every
State; however, effective prevention efforts are not practiced
universally. Additionally, the current surveillance systems in
the U.S. cannot directly track progress towards achieving the
goal of Healthy People 2010, which is to reduce the epidemic
burden of heart disease and stroke. The Committee continues to
support the goal of providing funding for basic implementation
of CDC's heart disease and stroke prevention program in each
State. The Committee is aware that many States still need this
program and understands that CDC's national competition allowed
non-funded States to apply for this program for the first time
since 2002, but required all 33 funded States to re-compete for
support.
Inflammatory bowel disease.--It is estimated that up to 1.4
million people in the U.S. suffer from Crohn's disease or
ulcerative colitis, collectively known as inflammatory bowel
disease (IBD). The Committee has included funding to continue
this important initiative.
Interstitial cystitis.--The Committee is pleased by the
progress made by CDC on educating the public and professional
communities about interstitial cystitis (IC). In addition to
generating public attention to IC, the Committee encourages CDC
to develop and implement a comprehensive structured outreach
plan for the provider community.
National school lunch and breakfast program.--The Committee
is aware that the disparity of national standards is having a
negative effect on national school lunch and breakfast
programs. Therefore, the Committee encourages CDC to work with
the Secretary of the U.S. Department of Agriculture to
establish uniform national nutrition standards for all schools
participating in the national school lunch and breakfast
programs and to define what it means to implement the dietary
guidelines for Americans.
Oral health.--The Committee recognizes that to reduce
disparities in oral diseases will require additional and more
effective efforts at the State and local levels. The Committee
has provided funding to strengthen State capacities to assess
the prevalence of oral diseases and the associated health
burden, to target resources and interventions, such as
additional water fluoridation and school-linked sealant
programs, and resources to the underserved, to assess trends in
oral diseases, and to evaluate changes in policies and
programs. The Committee encourages CDC to advance efforts to
reduce the disparities and burden from oral diseases, including
those that are closely linked to chronic diseases such as
diabetes and heart disease.
Primary immunodeficiency diseases.--Within funds available,
the Committee encourages CDC to support the national physician
education and public awareness campaign for primary
immunodeficiency syndrome. The campaign has featured public
service announcements, physician symposia, publications, and
the development of website and educational materials, as well
as mailings to physicians, school nurses, daycare centers, and
others. Together with the private investments in this activity,
the campaign has directly resulted in a three-fold increase in
diagnosis, testing, and treatment since the campaign began.
Psoriasis.--As many as 7.5 million Americans are affected
by psoriasis and/or psoriatic arthritis--chronic, inflammatory,
painful and disfiguring diseases for which there are limited
treatment options and no cure. The Committee understands that
there are very few efforts to collect epidemiologic and other
related data on individuals with psoriasis and psoriatic
arthritis, and as such, researchers and clinicians are limited
in their longitudinal understanding of these diseases and their
effects on individual patients. The Committee encourages CDC to
support longitudinal studies to learn about key attributes such
as response to treatment, substantiating the waxing and waning
of psoriasis, understanding associated manifestations like nail
disease and arthritis, the relationship of psoriasis to other
public health concerns such as the high rate of smoking and
obesity among those with the disease as well as the association
of psoriasis with other serious medical conditions such as
diabetes and heart attack. The Committee believes a national
registry that collects longitudinal psoriasis and psoriatic
arthritis patient data will help improve the care and outcomes
for people with these diseases by increasing the understanding
of: psoriasis incidence/prevalence, the distribution of disease
severity, risk factors, and the incidence/prevalence of co-
morbidities.
Pulmonary hypertension.--The Committee continues to
encourage CDC to foster greater awareness of pulmonary
hypertension, a rare blood vessel disorder of the lung in which
the pressure in the pulmonary artery rises above normal levels
and may become life threatening. When pulmonary hypertension
occurs in the absence of a known cause, it is referred to as
primary pulmonary hypertension. Secondary pulmonary
hypertension (SPH) means the cause is known. Emphysema and
bronchitis are common causes of SPH. Other less frequent causes
are the inflammatory or collagen vascular diseases such as
scleroderma, CREST syndrome, or systemic lupus erythematosus.
Congenital heart diseases that cause shunting of extra blood
through the lungs like ventricular and atrial septal defects,
chronic pulmonary thromboembolism, HIV infection, liver disease
and diet drugs like fenfluramine and dexfenfluramine also are
causes of pulmonary hypertension.
Sleep disorders.--The Committee is aware that sleep
disorders are critically under-addressed contributors to many
chronic diseases and has provided $1,000,000 for CDC's
participation in the national sleep awareness roundtable, a
partnership with other Federal agencies and the health
community, and to integrate messages about sleep into the
national public health network. The Committee also urges CDC to
incorporate sleep and sleep related disturbances into
established CDC surveillance systems.
Teen pregnancy prevention demonstration grants.--A new
$10,000,000 initiative is recommended for grants to State and
local public health departments, school districts, and
nonprofit organizations to support factually and medically
accurate, age-appropriate approaches to preventing teen
pregnancies, including information about both abstinence and
contraception, and dissemination of science-based tools and
strategies to prevent HIV, STD, and teen pregnancy. The
Secretary of Health and Human Services shall require each
applicant for financial assistance under this program to
certify that all materials proposed in the application and
funded during the project period of the grant are medically
accurate. The Secretary of Health and Human Services shall
require a panel of medical experts to review all grant
applications and assess whether the materials proposed are
medically accurate. These demonstration projects shall be
evaluated based on their success in reducing the rate of teen
pregnancies in their respective communities. The Committee's
recommendation for this activity is part of its initiative to
reduce the number of abortions in America by alleviating the
economic pressures and other real life conditions that can
sometimes cause women to decide not to carry their pregnancies
to term.
Underage drinking.--The Committee recognizes the importance
of monitoring risk factors that science has demonstrated
contribute to youth drinking, and urges CDC to develop and
continue its work to monitor and report on the level of risk
faced by youth from exposure to alcohol advertising.
Birth defects, developmental disabilities, disability and
health
The Committee provides $132,733,000 for birth defects,
developmental disabilities, disability and health, which is
$8,069,000 more than the fiscal year 2007 funding level and
$8,196,000 more than the budget 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:
$38,750,000 for birth defects and developmental
disabilities, which is $227,000 above the fiscal year
2007 funding level and $266,000 above the budget
request (included within this total is $2,496,000 for
the folic acid program);
$72,987,000 for human development and disability,
which is $6,976,000 above the fiscal year 2007 funding
level and $7,043,000 above the budget request (included
within this total is $16,500,000 for autism activities
and $10,500,000 for early hearing detection and
intervention activities); and,
$20,996,000 for blood disorders, which is $866,000
more than the fiscal year 2007 funding level and
$887,000 more than the budget request (included within
this total is $18,187,000 for the hemophilia program).
Amputee population.--There are currently more than 1.9
million Americans living with limb loss due to diabetes,
trauma, cancer, and cardiovascular disease. 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
efforts to address these challenges through the work of the
disability and health team and strongly supports CDC's resource
and information center, which assists 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.
Attention deficit/hyperactivity disorder (AD/HD).--Current
estimates indicate that AD/HD affects almost 4.5 million
school-age children and can last into adulthood. Only half of
all children with AD/HD receive necessary treatment, with lower
diagnostic and treatment rates among girls, minorities and
children in foster care. The Surgeon General has reported a
severe lack of professionals trained to diagnose and treat the
condition effectively. The Committee continues to support the
AD/HD activities of the National Center on Birth Defects and
Developmental Disabilities as it responds to the overwhelming
demand for information and support services, reaches special
populations in need, and educates health and education
professionals on AD/HD.
Cerebral palsy.--The Committee is pleased with CDC's
progress in autism and developmental disabilities surveillance
and is encouraged to learn of the launch of the largest ever
epidemiologic study of potential causes of autism spectrum
disorders. The Committee encourages CDC to build upon these
successes and to also focus on the development of surveillance
and research activities focused on cerebral palsy, another
priority public health concern.
Cooley's anemia.--The Committee remains 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. CDC
maintains an archive of tested and analyzed blood samples, as
well as monitoring for other complicating factors.
Down syndrome.--The Committee commends CDC for initiating a
study to document the onset and course of secondary and related
developmental and mental disorders in individuals with Down
syndrome. The Committee encourages further research relating to
these areas of dual diagnosis.
Duchenne and Becker muscular dystrophy (DBMD).--The
Committee is aware of recent efforts by CDC to develop a
Duchenne and Becker muscular dystrophy patient registry that
will provide a virtual web interface that identifies and
characterizes the patient population, provides, as examples,
common data elements and clinical endpoints for clinical
trials, and accelerates translational research through broader
clinical trial networks. This patient registry will serve as a
model for rare disease. The Committee encourages the agency to
work directly with the patient and scientific communities to
accelerate this project with a goal for its launch of March 1,
2008, and to the extent possible and practicable, to align
these efforts with any cross-agency initiative to coordinate
focus and investments in rare disease patient registries. The
Committee also urges CDC to work with the Agency for Healthcare
Research and Quality to finalize the DBMD care considerations
and integrate the care considerations as part of the DBMD
international patient registry.
Early hearing detection and intervention.--Within the total
provided, $10,500,000 is designated for the early hearing
detection and intervention (EHDI) program for newborns,
infants, and young children with hearing loss. This funding
will allow States to continue to invest in developing
appropriate surveillance and tracking systems to provide timely
and appropriate diagnostic and intervention services to infants
and toddlers. Funding also may 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. The Committee urges CDC to
coordinate its efforts with the Health Resources and 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 syndrome (FAS).--The Committee is concerned
about the prevalence of FAS in the U.S. and notes that drinking
during pregnancy continues to be the nation's leading known
preventable cause of mental retardation and birth defects. The
Committee encourages CDC to continue and enhance efforts to
prevent, reduce, and diagnose FAS disorders. The Committee
requests that CDC submit a progress report within six months on
the contributions made to preventing and reducing FAS
disorders, and for CDC's future plans, including programmatic
and funding priorities.
Folic acid education campaign.--The Committee is aware of a
recent analysis conducted by CDC that showed folate
concentrations among non-pregnant women of child bearing age
have decreased by 16 percent from 1999-2000 through 2003-2004.
These findings are troubling and the Committee is concerned
that women are not receiving an adequate level of folic acid to
prevent neural tube defects. Within the funds provided, the
Committee has included sufficient resources for CDC to expand
the folic acid education campaign and inform more women and
healthcare providers about the benefits of folic acid,
particularly the Hispanic population.
Fragile X.--The Committee supports the CDC's continuation
of public health activities in the areas of fragile X, fragile
X-associated tremor/ataxia syndrome, and fragile X-associated
premature ovarian failure. The Committee encourages CDC to
focus its efforts primarily on increasing epidemiological
research, surveillance, and screening efforts, with particular
attention towards collecting epidemiological data on the
incidence and prevalence of fragile X and related conditions,
including autism. The Committee urges CDC to support the
development of a national registry to track patients living
with fragile X. The Committee also encourages CDC to distribute
existing educational materials to the health care professional
community and the public and not to create new, duplicative
educational materials. The Committee requests that CDC report
to the House and Senate Committees on Appropriations, no later
than April 15, 2008 with a progress update on CDC's efforts and
spending priorities as they relate to fragile X.
Hemophilia.--The Committee recognizes the many
accomplishments of the blood disorders division and the network
of hemophilia treatment centers. The Committee expects CDC to
continue its efforts to support and expand access to
comprehensive chronic disease management for people with
bleeding and clotting disorders and to improve outreach to the
growing numbers of women with bleeding disorders.
Hereditary hemorrhagic telangiectasia (HHT).--The Committee
encourages CDC to establish a hereditary hemorrhagic
telangiectasia resource center to increase identification of
people affected with HHT, and increase knowledge, education and
outreach of this largely preventable life-threatening
condition. The Committee encourages CDC to provide information
on effective evidence-based interventions and treatments to
prevent premature death in the HHT population, improve outcomes
and the quality of life for people living with HHT by creating
a database to collect and analyze data, support epidemiology
studies, provide surveillance, and train health care
professionals.
Marfan syndrome.--The Committee continues to be interested
in Marfan syndrome, a heritable condition that affects the
connective tissue. In the Marfan syndrome, the connective
tissue is defective and does not act as it should--it
degenerates. Because connective tissue is found throughout the
body, the Marfan snydrome can affect many body systems,
including the skeleton, eyes, heart and blood vessels, nervous
system, skin, and lungs. The problems that occur in the heart
and blood vessels are the most life-threatening aspects of the
Marfan syndrome. Many individuals with Marfan syndrome are
undiagnosed or misdiagnosed until they experience a cardiac
complication, frequently due to valvular prolapse or aortic
aneurysms. The Committee encourages CDC to increase awareness
of the condition and requests a report on these outreach
activities as part of CDC's fiscal year 2009 budget
justification.
National Birth Defects Prevention Study.--The Committee
supports CDC's efforts in the area of birth defects
surveillance, research, and prevention and encourages CDC to
continue the promising research being conducted by the regional
centers for birth defects research and prevention and to
increase assistance to States to implement community-based
birth defects tracking systems, programs to prevent birth
defects, and activities to improve access to health services
for children with birth defects. The Committee encourages the
CDC to expand the birth defects studied in the National Birth
Defects Prevention Study to include single gene disorders, like
fragile X.
Paralysis.--To meet the growing demand for information,
resources, and public health services by individuals with
paralysis, the Committee supports efforts to expand a paralysis
resource center.
Preterm birth.--Preterm birth is a serious and growing
public health problem that occurs in 12.5 percent of all births
in the U.S. The Committee strongly encourages CDC to conduct
additional epidemiological studies on preterm birth, including
the relationship between pre-maturity, birth defects, and
developmental disabilities. The Committee also encourages the
establishment of systems for the collection of maternal-infant
clinical and biomedical information to link with the pregnancy
risk assessment monitoring system (PRAMS) and other
epidemiological studies of pre-maturity in order to track
pregnancy outcomes and prevent preterm birth.
Spina bifida.--The Committee recognizes that spina bifida
is the leading permanently disabling birth defect in the U.S.
While spina bifida and related neural tube defects are highly
preventable through adequate daily folic acid consumption, and
its secondary effects can be mitigated through appropriate and
proactive medical care and management, such efforts have not
been adequately supported to result in significant reductions
in these costly conditions. The Committee encourages CDC to use
resources for quality of life activities related to improving
medical and psychosocial treatment. The Committee continues to
strongly support CDC's collaboration with the Agency for
Healthcare Research and Quality to develop a patient registry.
Tourette syndrome.--The Committee commends CDC for its
continued work on developing a public health education and
research program for Tourette syndrome. This program educates
parents, physicians, educators, and other health care workers
about the disorder and expands on the scientific knowledge base
on prevalence, risk factors, and co-morbidities of Tourette
syndrome.
Tuberous sclerosis complex (TSC).--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
encourages CDC to develop an initiative 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.
Health information and service
The Committee provides a program level total of
$254,028,000 for health information and service, which is
$31,375,000 more than the fiscal year 2007 program level and
$10,532,000 more than the budget request. Of the funds
provided, $183,924,000 shall be derived from evaluation set-
aside funds available under section 241 of the Public Health
Service Act. The evaluation set-aside is $49,689,000 more than
the fiscal year 2007 funding level and $48,789,000 more than
the budget request.
Health statistics
The Committee provides $120,000,000 for health statistics,
which is $10,979,000 more than the fiscal year 2007 funding
level and $10,079,000 more than the budget 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 Health Interview Survey, the National Health and
Nutrition Examination Survey (NHANES), the National Health Care
Survey, the National Vital Statistics System, and the National
Survey of Family Growth.
The Committee commends the national center for health
statistics (NCHS) for fulfilling its mission as the nation's
premiere health statistics agency and for ensuring the
credibility and integrity of the data it produces. In
particular, the Committee congratulates NCHS for its timely
release of critical data and encourages it to continue making
information, including data from NHANES and the National Health
Interview Study, accessible to the public as soon as possible.
Additionally, the Committee is interested in the National
Survey of Family Growth (NSFG) and includes an additional
$200,000 over fiscal year 2007 for NCHS to make necessary
improvements to the survey to increase sample size in order to
produce annual statistics and to strengthen the statistics for
teenagers and minority and low-income groups. The Committee's
recommendation for the NSFG is part of its initiative to help
reduce the number of abortions in America by alleviating the
economic pressures and other real life conditions that can
sometimes cause women to decide not to carry their pregnancies
to term.
Food allergies.--Life-threatening food allergies severely
impair the quality of life for allergic children and their
parents. For reasons that scientists can not yet explain, food
allergies appear to be afflicting more and more children each
year. The Committee is disappointed that CDC does not currently
track the incidence of food allergies as it does for other
conditions. The Committee strongly urges CDC to include the
incidence of food allergies in the National Health Interview
Survey, or a comparable annual tracking mechanism.
Genomics.--The National Health and Nutrition Examination
Survey (NHANES) is a continuous survey representative of the
U.S. population that assesses health and nutrition status. With
the success and continual improvement of genomic technologies,
the Committee believes that the next improvement in this survey
will be to genotype participants of past and future NHANES
surveys using large-scale genotyping platforms (with
appropriate consideration for consent, privacy, and
confidentiality), as part of CDC's beyond gene discovery
initiative, and assess the impact of genetic variation on
public health, along with nutrition and environmental factors.
Nontuberculous mycobacteria (NTM).--The Committee is
concerned that NTM incidence continues to rise. Mycobacteria
are environmental organisms found in both water and soil that
cause substantial respiratory damage. The Committee continues
to encourage the national center for health statistics to
include questions regarding NTM testing in ongoing surveys to
gain a better understanding of the epidemiology of this
emergent disease.
Nutrition monitoring.--The Committee affirms America's
commitment to nutrition for all and encourages NCHS and the
Agricultural Research Service at the U.S. Department of
Agriculture to develop a national nutrition monitoring system.
Such system should support both management decision-making and
research needed to address and improve the crisis of obesity,
nutrition-related diseases, physical inactivity, food
insecurity, and the poor nutritional quality of the American
diet, as well as provide the data needed to protect the public
against environmental pathogens and contaminants.
Vital statistics.--The Committee values NCHS and its
critical role in monitoring our nation's health. The Committee
is troubled that NCHS lacks the support it needs to collect a
full year's worth of data on births, deaths, and other vital
information. CDC should ensure that NCHS has sufficient funds
to contract with the vital records jurisdictions for the
purchase of 12 months of vital statistics data under the agreed
upon terms of the vital statistics cooperative program. In
addition, CDC should develop a plan on how to directly support
jurisdictions as they implement electronic systems that will
improve the timeliness, quality, and security of birth and
death data.
Public health informatics
The Committee provides $94,855,000 for public health
informatics, which is $24,214,000 more than the fiscal year
2007 funding level and $453,000 more than the budget request.
Information systems and information technology extend the
traditional reach of public health professionals. Activities
funded through public health informatics include on-going
collaborative efforts to build a national network of public
health information systems to enhance detection and monitoring,
surveillance, data analysis and interpretation, preparedness,
communications, and response.
Pandemic influenza.--The Committee provides $24,545,000 for
pandemic influenza activities as requested by the
Administration. Within this total, $14,645,000 is to develop a
vaccine registry to monitor vaccine use and distribution that
will supplement already existing State registries to include
adults and $9,900,000 is for real-time assessment and
evaluation of influenza interventions.
Physician reqistry.--The Committee directs the national
center for public health informatics to continue to fund at a
level of $325,000 from existing appropriations the
establishment of a nationwide database of contact information
for practicing physicians that can be used by Federal agencies
and State and local health departments in the event of a
terrorist attack, natural disaster, pandemic, or other severe
public health emergency. The Committee expects this effort to
be coordinated with the Office of the Assistant Secretary for
Preparedness and Response to avoid any programmatic
duplication.
Health marketing
The Committee provides a program level of $39,173,000 for
health marketing, which is $3,818,000 less than the fiscal year
2007 funding level and the same as the budget request. Health
marketing uses commercial, non-profit, and public service
marketing, and communication science practices to better
understand people's health-related needs and preferences, to
motivate changes in individuals and organizations to protect
and improve health, and to develop and enhance partnerships
with public and private organizations.
Environmental health and injury prevention
The Committee provides $305,151,000 for environmental
health and injury prevention, which is $17,047,000 more than
the fiscal year 2007 funding level and $17,477,000 more than
the budget request.
Environmental health
The Committee provides $165,005,000 for environmental
health, which is $15,518,000 more than the fiscal year 2007
funding level and $15,741,000 more than the budget request. The
environmental health program focuses on preventing disability,
disease, and death caused by environmental factors through
laboratory and field research.
Within the total, the Committee provides the following
amounts for environmental health activities:
$40,473,000 for the environmental health laboratory,
which is $13,491,000 above the fiscal year 2007 funding
level and $13,531,000 above the budget request;
$56,731,000 for general environmental health
activities, which is $2,027,000 above the fiscal year
2007 funding level and $2,108,000 above the budget
request (included within this total is $26,533,000 for
the environmental health outcome tracking network;
funding is not provided for arctic health or volcanic
emissions activities);
$31,898,000 for asthma programs, which is the same as
the fiscal year 2007 funding level and $48,000 more
than the budget request; and,
$35,903,000 for childhood lead poisoning prevention
programs, which is the same as the fiscal year 2007
funding level and $54,000 more than the budget request.
Asthma.--The Committee is pleased with the work that CDC
has done to address the increasing prevalence of asthma.
However, the increase in asthma among children remains
alarming. The Committee encourages CDC to continue 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 support community-based
interventions that apply effective approaches demonstrated in
research projects within the scientific and public health
community.
Biomonitoring.--The Committee applauds CDC's biomonitoring
efforts and encourages CDC to continue this program and to
continue to improve its efforts to communicate these results in
context. In particular, the CDC's National Report on Human
Exposure to Environmental Chemicals is a significant new
information database 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 by conducting biomonitoring for
environmental chemicals. The Committee urges CDC to devote a
greater proportion of program resources to implement the
recommendations of the National Academies' National Research
Council, particularly with regard to the development of
necessary methods to interpret human biomonitoring
concentrations in the context of potential health risk and the
enhancement of efforts to communicate results in context. CDC
is encouraged to collaborate with toxicologists, health
scientists, laboratory analytical chemists, and Environmental
Protection Agency scientists in this effort.
Childhood lead poisoning prevention.--The Committee
commends 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. Further development of this device
will help ensure its application in community health settings.
Climate change.--Additional scientific research is needed
to further understand the potential health effects of global
climate change and to identify tools to educate health
professionals about adaptation strategies. The Committee
encourages CDC to begin to develop public health research,
technical assistance, and surveillance programs to understand
the impacts of climate change on health.
Landmine survivors.--The Committee commends CDC for its
effective response to the public health threat posed by
landmines and improvised explosive devices. Within the funds
provided, the Committee urges CDC to support programmatic and
geographic expansion to include those injured by civil strife
and terrorism, including, but not limited to, landmines.
Mercury and arsenic exposure.--The Committee recognizes the
extraordinary services of the environmental health laboratory
to develop new and improved biomonitoring methods to accurately
and rapidly assess human exposure to mercury and arsenic,
including exposure to the form of mercury in thimerosal, and to
improve health risk assessment by expanding studies of the
relationship between biomonitoring exposure levels and disease.
National Report on Dietary and Nutritional Indicators in
the U.S. Population.--The Committee supports the efforts of the
environmental health laboratory and its commitment to improving
the measurement of dietary and nutritional indicators in the
American people. The Committee is aware that many Americans are
confused about which foods to eat to improve and maintain their
health. The Committee is also aware that there is a wide gap
between recommended dietary intake and what people eat.
Consequently, without knowledge of what levels of most dietary
or nutritional indicators actually are in people's bodies, it
is difficult for public health officials and others to improve
the diet and nutritional status of Americans. The Committee
recognizes that future reports will provide this essential
information, which is not available in any other document in
either the private or public sector. A publicly funded program
that monitors human levels of vitamins, trans fats and omega-3
fatty acids, and other indicators of nutritional and dietary
status is needed to provide the hard scientific data needed to
make critical decisions about nutritional health for the
nation.
Newborn screening quality assurance program.--Within the
funds provided for the environmental health laboratory, the
Committee provides $7,000,000 for the newborn screening quality
assurance program. Funds also are included for the
biomonitoring program to enhance State public health laboratory
biomonitoring capabilities, including upgrading facilities and
equipment and bolstering workforce capacity, and to provide
adequate technical assistance and training to States in
biomonitoring. Increased funds for newborn screening are
provided for additional technical assistance to State newborn
screening labs, new screening tools, and methods to increase
accuracy and expand the number of disorders screened, and
population-based pilot testing to ensure the effectiveness of
new screening tools.
Trans fat.--The Committee is supportive of the division of
laboratory sciences and its commitment to improving the
measurement of risk factors associated with heart disease,
stroke, and other cardiovascular disease. Dietary fat profiles
have a significant impact on health. The Committee is aware
that experimental evidence shows an increasing risk of heart
disease associated with trans fat intake, and that many State
and local governments are proposing bans in restaurants and
schools. A publicly funded surveillance system to monitor trans
fat levels and other fatty acids, such as omega-3 fatty acids,
in humans is needed to assess the impact of public health
interventions to reduce the intake of trans fat. In addition,
the lipid standardization program currently offers
standardization services for lipids to Federally-funded and
other public health research labs and also is well-equipped to
standardize trans fat measurement.
Injury prevention and control
The Committee provides $140,146,000 for the injury
prevention and control program, which is $1,529,000 more than
the fiscal year 2007 funding level and $1,736,000 more than the
budget request. Within the total, $5,816,000 is provided for
the traumatic brain injury program, which is $529,000 more than
the fiscal year 2007 funding level and $537,000 more than the
budget request.
Injuries are the leading cause of death among children and
adults under 44 years of age in the U.S. In 2004, more than
167,000 people died from injuries and violence and over 29
million people sustained injuries serious enough to require
treatment in an emergency department. 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 to prevent
premature death and disability and to reduce human suffering
and medical costs caused by injury and violence.
Child maltreatment.--The Committee applauds CDC's
activities in the area of child maltreatment. A growing body of
research indicates that childhood abuse and neglect may
contribute significantly to the development of both acute and
chronic health conditions throughout the lifespan, including
obesity and heart disease. The Committee encourages CDC to
develop a network of consortia that will address research and
training, as well as the dissemination of best practices and
prevention efforts, on the health harms of child abuse and
neglect.
Children and adolescents.--Within the total, the Committee
includes sufficient funds for CDC to support an additional
injury control research center that will conduct research on
injury and injury prevention related to children and
adolescents. The Committee believes that children and
adolescent populations have special and underserved needs in
injury control. Injury is the leading cause of death and
disability among children and teenagers in the U.S. Currently,
there is no center that focuses exclusively on childhood and
adolescent injuries even though children and adolescents are
affected by injury more than any other segment of the
population.
Gun control advocacy.--The Committee maintains bill
language prohibiting funds in this bill 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 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.
National violent death reporting system.--The Committee is
supportive of the national violent death reporting system
(NVDRS) and has included funds to continue implementation of
the NVDRS in fiscal year 2008. The Committee urges CDC to
continue to work with private health and education agencies as
well as State agencies in the development and implementation of
this injury reporting system.
Occupational safety and health
The Committee provides a program level total of
$310,937,000 for occupational safety and health, which is
$56,838,000 above the fiscal year 2007 funding level and
$57,939,000 above the budget request. Of the amount provided,
$88,361,000 is to be derived from section 241 evaluation set-
aside funds, rather than $87,071,000 as provided in fiscal year
2007 and proposed in the budget request.
The National Institute for Occupational Safety and Health
(NIOSH) 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.
Within the total, the Committee provides the following
program levels for occupational safety and health research
activities:
$21,806,000 for education and research centers, which
is $1,982,000 above the fiscal year 2007 funding level
and $2,112,000 above the budget request;
$12,732,000 for personal protective technology
development activities, which is the same as the fiscal
year 2007 funding level and $84,000 above the budget
request;
$112,834,000 for the national occupational research
agenda, which is $13,648,000 more than the fiscal year
2007 funding level and $13,728,000 more than the budget
request;
$50,000,000 for the World Trade Center treatment and
monitoring program for 9/11 responders and recovery
personnel, which is double the amount requested by the
Administration in the Public Health and Social Services
Emergency Fund;
$25,200,000 for mining research, which is $13,000,000
less than the fiscal year 2007 funding level and
$12,748,000 less than the budget request; and,
$88,365,000 for other occupational safety and health
research, which is $4,208,000 more than the fiscal year
2007 funding level and $4,763,000 more than the budget
request.
Cancer incidence and mortality study.--The Committee
continues to be pleased with the progress of research and the
translation of that research into practice under the national
occupational research agenda. Within the funding provided, the
Committee encourages NIOSH to continue its study of former
manufacturing workers through the initiation of a cancer
incidence and mortality study within this population.
Mining research.--The Committee notes that an additional
$13,000,000 for research to develop mine safety technology and
to make improvements to leased facilities has been provided to
NIOSH within the fiscal year 2007 supplemental appropriations
bill (P.L. 110-28). The period of availability for the
supplemental funding extends through fiscal year 2008.
World Trade Center.--The Committee includes report language
under the Public Health and Social Services Emergency Fund
section requesting that the Secretary of Health and Human
Services, together with the Director of NIOSH, submit a
comprehensive long-term plan, including cost estimates,
regarding a program of medical monitoring and treatment of all
individuals exposed to toxins at the World Trade Center site
following the terrorist attacks of September 11, 2001.
The Committee notes that an additional $50,000,000 for the
treatment and monitoring program has been provided to NIOSH
within the fiscal year 2007 supplemental appropriations bill
(P.L. 110-28). The supplemental funding is available until
expended.
Global health
The Committee provides $381,337,000 for global health,
which is $47,299,000 above the fiscal year 2007 funding level
and $1,618,000 above the budget 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.
Within the total, the following amounts are included for
global health activities:
$122,769,000 for the global AIDS program, which is
the same as the fiscal year 2007 funding level and
$1,546,000 more than the budget request;
$144,438,000 for the global immunization program,
which is the same as the fiscal year 2007 funding level
and $55,000 more than the budget request;
$32,479,000 for global disease detection, which is
the same as the fiscal year 2007 funding level and
$13,000 more than the budget request;
$8,985,000 for the global malaria program, which is
the same as the fiscal year 2007 funding level and
$4,000 more than the budget request, and;
$72,666,000 for other global health activities, which
is $47,299,000 more than the fiscal year 2007 funding
level and the same as the budget request.
Pandemic influenza.--The Committee provides $69,300,000 for
pandemic influenza activities as requested by the
Administration. Within this total, $17,820,000 is for rapid
outbreak response for high-priority countries, $3,960,000 is
for human-animal interface studies, and $47,520,000 is for
international surveillance, diagnosis, and epidemic
investigations.
Malaria.--The Committee recognizes that malaria is a global
emergency affecting mostly poor women and children. While
malaria is treatable and preventable, tragically it remains one
of the leading causes of death and disease worldwide. The
Committee appreciates the integral and unique role that the CDC
malaria program plays in national and global efforts to prevent
and control malaria. The Committee urges CDC to expand malaria-
related research, program implementation, and evaluation.
Insecticide resistance and drug resistance have the real
potential to compromise global malaria efforts and point to the
need for the development and testing of new technologies and
materials for insecticide-treated nets and new anti-malarial
therapies. The Committee is concerned that failure to support
these efforts could seriously impair future control efforts.
Additionally, the Committee encourages CDC to provide technical
assistance and support program research in non-African malaria-
affected countries, which, in turn, can then be used to
strengthen control efforts in African countries.
Terrorism preparedness and response
The Committee provides $1,598,751,000 for terrorism
preparedness and response, which is $57,451,000 above the
fiscal year 2007 funding level and $94,376,000 above the budget
request. CDC distributes grants to State, local, and
territorial public health agencies; centers for public health
preparedness; and other to support infrastructure upgrades to
respond to all potential hazards, including acts of terrorism
or infectious disease outbreaks. Funds are used for needs
assessments, terrorism response planning, training,
strengthening epidemiology and surveillance, and upgrading
laboratory capacity and communications systems. Activities
support the establishment of procedures and response systems,
and build the infrastructure necessary to respond to a variety
of disaster scenarios.
Within the total, the Committee provides the following
amounts for terrorism preparedness and response activities:
$789,948,000 is for upgrading State and local
capacity, which is $5,606,000 more than the fiscal year
2007 funding level and $91,681,000 more than the budget
request (included within the total is $734,536,000 for
the bioterrorism cooperative agreement program);
$136,815,000 is for upgrading CDC capacity, which is
the same as the fiscal year 2007 funding level and
$223,000 more than the budget request;
$9,500,000 is for the anthrax research study, which
is $4,383,000 less than the fiscal year 2007 funding
level--the Administration's budget request did not
include funding for this activity;
$81,153,000 is for the biosurveillance activities,
which is $2,593,000, more than fiscal year 2007 funding
level and $7,028,000 less than the budget request
(included within this total is $50,000,000 for BioSense
and $21,028,000 for quarantine stations); and,
$581,335,000 is for the strategic national stockpile,
which is $56,635,000 above the fiscal year 2007 funding
level and the same as the budget request.
BioSense.--The Committee has not provided the full budget
request for the BioSense program due to concerns that this and
other similar syndromic and event detection systems across the
Federal government may not be the most efficient and effective
way to detect the presence of pathogens. State and local health
departments have principal responsibility for protecting the
public's health and therefore take the lead in conducting
disease surveillance and supporting response efforts. According
to a June 2005 Government Accountability Office (GAO) report,
many State, local, and private networks are not being utilized
to collect data and State and local health departments do not
find the data collected to be useful. The Committee has
invested $189,100,000 in the BioSense program since fiscal year
2003, but does not have a comprehensive plan for its
development and full scale implementation.
The Committee requests, that not later than April 1, 2008,
GAO submit a report to the House and Senate Committees on
Appropriations that evaluates BioSense. This report should
include an analysis of the ability of hospitals and Federal,
State, and local public health officials to respond to
emergencies based on the information received from BioSense
versus local surveillance data; comparisons of the costs and
benefits of operating BioSense with State, local, and private
surveillance systems; annual and long-term cost and timeline
estimates for the development and implementation of BioSense;
and recommended benchmarks and performance indicators that
should be developed as part of a comprehensive plan.
Leased aircraft.--The Committee is concerned about recent
reports that the three leased aircraft that are available to
CDC for public health emergency situations are rarely used. The
fiscal year 2006 cost for maintaining access to these jets was
approximately $8,500,000. The Committee requests that CDC
prepare a report to the House and Senate Committees on
Appropriations by no later than 30 days after enactment of this
Act and then provide semiannual updates thereafter on the cost
of the aircraft, purpose of each trip, and passengers on the
aircraft for each trip. The report also should provide a
justification for maintaining leases for three aircraft.
Public health research
The Committee provides $31,000,000 for public health
research, which is the same as the fiscal year 2007 funding
level and the budget request. The Committee provides these
funds through the section 241 evaluation set-aside funds as
provided in fiscal year 2007 and as proposed in the budget
request.
Through the public health research funding, 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 $199,237,000 for public health
improvement and leadership, which is $9,429,000 above the
fiscal year 2007 funding level and $8,825,000 above the budget
request. Within this total, the Committee provides $6,000,000
for the CDC Director's discretionary fund.
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 funding also supports the
CDC's public health workforce and career development efforts,
and the director's discretionary fund.
Public health professionals.--The Committee is concerned
about documented shortages in State health departments of
applied epidemiologists and laboratory scientists--core public
health professionals. The Committee urges CDC to provide a
stable, dedicated source of funding for existing fellowship
training programs designed to alleviate these shortages.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Adler Aphasia Center, Maywood, NJ for a program to $100,000
improve communication and other life skills for
people with aphasia.................................
Advocate Good Shepard Hospital, Barrington, IL for 30,000
the expansion of an ongoing pilot project to address
the growing problem of childhood obesity among
elementary schools in Lake County, IL...............
Alameda County Public Health Department, Office of 250,000
AIDS Administration, Oakland, CA for an HIV/AIDS
prevention and testing initiative...................
Baylor College of Medicine, Houston, TX for 200,000
epidemiological research and educational outreach
related to childhood cancer in cooperation with the
Vannie E. Cook Jr. Cancer Foundation in McAllen, TX.
Bayside Community Center, San Diego, CA for its STEPS 150,000
health education and outreach program for senior
citizens............................................
Berean Community & Family Life Center, Brooklyn, NY 200,000
for obesity prevention programs and community health
and wellness education..............................
Bienestar Human Services, Inc., Los Angeles, CA to 125,000
expand a mobile HIV rapid testing program in East
Los Angeles.........................................
Boys and Girls Club of Delaware County, Jay, OK for 300,000
equipment and operating expenses for programs to
improve diet, physical activity, and emotional
health..............................................
California State University-Fullerton, Fullerton, CA 250,000
for programs aimed at preventing obesity and
promoting health in children........................
Charles R. Drew Wellness Center, Columbia, SC for an 235,000
obesity focused wellness program....................
Charter County of Wayne, Michigan, Detroit, MI for 200,000
Infant Mortality Prevention services................
Chez Panisse Foundation, Berkeley, CA for the school 250,000
lunch initiative to integrate lessons about
wellness, sustainability and nutrition into the
academic curriculum.................................
Children's Hunger Alliance, Columbus, OH for programs 200,000
to prevent childhood obesity........................
Columbus Children's Research Institute, Columbus, OH 200,000
for the Center for Injury Research and Policy.......
County of Marin, San Rafael, CA for research and 250,000
analysis related to breast cancer incidence and
mortality in the county.............................
CREATE Foundation, Tupelo, MS for childhood obesity 300,000
prevention programs.................................
Dupage County, Wheaton, IL for a county-wide physical 150,000
fitness assessment pilot project....................
East Carolina University, Brody School of Medicine, 200,000
Greenville, NC for a project to study the problem of
racial disparities in cardiovascular diseases.......
El Puente, Brooklyn, NY for an obesity, diabetes, 220,000
STD, and HIV/AIDS prevention program for adolescents
and their families as well as control and management
of asthma and other environmentally connected
diseases............................................
Friends of the Congressional Glaucoma Caucus 75,000
Foundation, Lake Success, NY to provide glaucoma
screenings and follow-up in the Phoenix, AZ area....
Friends of the Congressional Glaucoma Caucus 350,000
Foundation, Lake Success, NY to provide glaucoma
screenings and follow-up in the Virgin Islands......
Georgia Chapter of the American Lung Association, 350,000
Smyrna, GA to study the relationship between
residential floor coverings and distributive
patterns of airborne particulates...................
Haitian American Association Against Cancer, Inc., 240,000
Miami, FL for cancer education, outreach, screening
and related programs................................
Healthy Eating Lifestyle Principles, Monterey, CA for 175,000
a program to improve nutrition by promoting the
accessibility and consumption of fresh fruits and
vegetables in schools...............................
Home Instruction Program for Preschool Youngsters- 150,000
Florida, Coral Gables, FL to create a preventative
health care model...................................
Ingalls Development Foundation, Harvey, IL for a 225,000
comprehensive cancer prevention and early detection
program, focusing on minority populations...........
International Rett Syndrome Association, Clinton, MD 150,000
for education and awareness programs regarding Rett
syndrome............................................
Kips Bay Boys and Girls Club, Bronx, NY for a 300,000
nutrition and anti-obesity demonstration program for
6- to 12-year-old children..........................
Long Island University, Brooklyn, NY for asthma 200,000
education, counseling, and prevention programs......
Louisville Department of Public Health and Wellness, 100,000
Louisville, KY for improving and providing
preventative healthcare to men to address disease
and obesity prevention, oral health, and stress
management..........................................
Middle Tennessee State University, Murfreesboro, TN 300,000
for research and education regarding ways of
increasing physical activity and fitness among
children and adolescents............................
Myositis Association, Washington, DC to develop a 75,000
national patient registry for individuals afflicted
with myositis.......................................
Natividad Medical Center, Salinas, CA for a diabetes 125,000
care management program.............................
Nevada Cancer Institute, Las Vegas, NV for a 200,000
comprehensive program to reduce cancer incidence and
mortality rates and address cancer health
disparities.........................................
North Shore Health Project, Gloucester, MA for 100,000
outreach and education on hepatitis C...............
Plymouth State University, Plymouth, NH for the 150,000
Partners Enabling Active Rural Living Institute to
develop an evidence-based model for promoting and
enabling appropriate daily physical activity in
rural communities...................................
Providence Cancer Center, Portland, OR for the rural 75,000
and underserved cancer outreach project.............
Pulmonary Hypertension Association, Silver Spring, MD 200,000
for public education and outreach...................
San Antonio Metropolitan Health District, San 200,000
Antonio, TX for further studies and public health
outreach regarding environmental health concerns at
and near the former Kelly Air Force Base............
SHAREing and CAREing, Astoria, NY to provide 100,000
culturally sensitive breast health education,
referrals for screenings/diagnostic and support
services for medically underserved and uninsured
minority women......................................
Silent Spring Institute, Newton, MA for studies of 100,000
the impact of environmental pollutants on breast
cancer and women's health...........................
Southeastern Center for Emerging Biologic Threats, 100,000
Atlanta, GA for programs related to bioterrorism and
emerging biological threats.........................
St. Elizabeth's Medical Center, Wabasha, MN to 100,000
support a disease prevention pilot program to reduce
the incidence of heart disease......................
St. Francis Medical Center Foundation, Lynwood, CA 100,000
for health education and outreach...................
St. John's Regional Medical Center, Oxnard, CA for 200,000
diabetes prevention and management programs.........
St. John's Well Child and Family Center, Los Angeles, 100,000
CA for a patient education program to address
obesity, diabetes, and hypertension.................
University of Arizona College of Medicine, Tucson, AZ 170,000
for diabetes educational outreach programs..........
University of Findlay Center for Public Health 300,000
Preparedness, Findlay, OH for training programs on
school safety and workplace violence avoidance......
University of North Texas Health Science Center, Fort 300,000
Worth, TX for the Center for Minority Health,
Education, Research and Outreach....................
University of South Florida, Tampa, FL to create, 375,000
implement, and evaluate programs to assist school-
aged children in becoming physically active and
healthy.............................................
University of Texas Pan American, Edinburg, TX for 200,000
the South Texas Border Health Disparities Center's
program on preventing obesity in minority
populations.........................................
University of Texas, Brownsville, TX for studies 250,000
regarding the health of the Hispanic population in
the Rio Grande Valley...............................
Virgin Islands Perinatal Inc., Christiansted, VI for 150,000
implementation of chronic disease management and
prevention modalities to minimize adverse outcomes
related to diabetes and hypertension................
Voorhees College, Denmark, SC for a demonstration 135,000
program on reversing diabetes in minority
communities.........................................
Wayne County Department of Public Health, Detroit, MI 275,000
for a lead poisoning assessment, prevention, and
intervention program................................
WestCare Foundation, Las Vegas, NV, for the Batterers 500,000
Intervention Program in Needles, CA and surrounding
communities.........................................
Yale New Haven Hospital, New Haven, CT to develop a 300,000
comprehensive ovarian cancer prevention and early
detection program...................................
YBH Project, Inc., Albany, GA for nutrition, fitness, 100,000
and education programs for middle school students
and their families..................................
------------------------------------------------------------------------
Preventive health and health services block grant
The Committee provides $109,000,000 for the preventive
health and health services block grant, which is $10,000,000
above the fiscal year 2007 funding level. The budget request
does not include funding for this program. 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 $10,500,000 for buildings and
facilities, which is $123,900,000 below the fiscal year 2007
funding level and $9,500,000 below the budget request. These
funds support efficient maintenance and operations of existing
facilities to protect the interest and investment of the
government so that deterioration of CDC facilities does not
occur again.
Business services and support
The Committee provides $344,377,000 for business services
and support, which is the same as the fiscal year 2007 funding
level and $24,500,000 above the budget request. Some of the
activities that are supported through this funding are
administrative services and programs, the human resources
center, capital planning and investment control, financial
management, security and emergency preparedness, and
information technology services.
It is the Committee's intention that funds provided in
business services and support are sufficient to carry out CDC's
business functions. The Committee will not support programmatic
``tapping'' to achieve additional funding in this area and
appreciates that CDC has made efforts to curtail this practice.
If additional funding is required for activities within this or
any other budget line, the Committee expects CDC to work with
the Department of Health and Human Services to prepare
reprogramming requests to be submitted to the House and Senate
Committees on Appropriations.
National Institutes of Health
The Committee recommends an appropriation of
$29,649,887,000 for the National Institutes of Health (NIH),
which is $750,000,000 above the fiscal year 2007 appropriation
and $1,028,646,000 above the request.
As described in the ``Advancing Biomedical Research''
initiative in the front of the report, the Committee has made
difficult choices in order to provide a $750,000,000 increase
for biomedical research supported by NIH. The Committee hopes
to stop the funding rollercoaster NIH has experienced during
the past decade and provide a substantial and sustainable
growth path for the future.
The funding level recommended by the Committee would
provide 10,666 new and competing grants, an increase of 545
over fiscal year 2007. The number of total grants would rise to
39,003. The recommendation would also reverse the two-year
freeze in the inflationary adjustment of grants, with an
average two percent increase for new grants. The recommendation
is attentive to the pipeline issue, providing funding for three
programs to support young investigators as well as a two
percent average increase in research training stipends. The
Committee fully funds the Administration's request of
$300,000,000 for transfer to the global fund for AIDS, malaria
and tuberculosis and continues the National Children's Study
with an appropriation of $110,900,000. The Common Fund is
supported as a set-aside within the Office of the Director at
the statutory minimum of $495,153,000 rather than through an
assessment of institute and center budgets. The Committee also
preserves the taxpayer's investment in the research labs on the
NIH campus by increasing the buildings and facilities account
by $40,000,000.
The following chart displays the funding provided to each
of the 27 appropriations that comprise the total NIH
appropriation. The full name of each institute and center is
included in the table along with its acronym. These acronyms
will be used throughout the report rather than repeating the
full name of the institute or center. Funding levels are also
shown in the detailed table at the back of the report.
NATIONAL INSTITUTES OF HEALTH
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
2008 Committee compared to--
Institutes/Centers Fiscal year 2008 -------------------------------------
Committee Fiscal year 2007 2008 Budget
----------------------------------------------------------------------------------------------------------------
National Cancer Institute (NCI)........................ 4,870,382 +72,743 +88,268
National Heart, Lung, and Blood Institute (NHLBI)...... 2,965,775 +42,846 +40,362
National Institute of Dental & Craniofacial Research 395,753 +6,050 +6,031
(NIDCR)...............................................
Nat. Inst. of Diabetes & Digestive & Kidney Diseases 1,731,893 +26,025 +23,848
(NIDDKD)..............................................
National Institute of Neurological Disorders and Stroke 1,559,106 +23,561 +22,087
(NINDS)...............................................
National Institute of Allergy and Infectious Diseases 4,632,019 +264,311 +39,537
(NIAID)...............................................
National Institute of General Medical Sciences (NIGMS). 1,966,019 +30,211 +24,557
Nat. Inst. of Child Health and Human Development 1,273,863 +19,156 +8,917
(NICHD)...............................................
National Eye Institute (NEI)........................... 677,039 +9,923 +9,219
National Institute of Environmental Health Sciences 652,303 +10,301 +14,897
(NIEHS)...............................................
National Institute on Aging (NIA)...................... 1,062,833 +15,573 +15,685
Nat. Inst. Arthritis & Musculoskeletal & Skin Diseases 516,044 +7,804 +7,962
(NIAMS)...............................................
Nat. Inst. on Deafness & Other Communication Disorders 400,305 +6,637 +6,623
(NIDCD)...............................................
National Institute of Nursing Research (NINR).......... 139,527 +2,123 +1,727
National Institute on Alcohol Abuse and Alcoholism 442,870 +6,611 +6,365
(NIAAA)...............................................
National Institute on Drug Abuse (NIDA)................ 1,015,559 +14,938 +15,194
National Institute of Mental Health (NIMH)............. 1,425,531 +21,037 +20,110
National Human Genome Research Institute (NHGRI)....... 493,996 +7,505 +9,560
National Institute of Biomedical Imaging and 303,318 +6,431 +2,855
Bioengineering (NIBIB)................................
National Center for Research Resources (NCRR).......... 1,171,095 +37,855 +58,597
National Center for Complementary and Alternative 123,380 +1,804 +1,681
Medicine (NCCAM)......................................
National Center on Minority Health and Health 202,691 +3,247 +8,196
Disparities (NCMHHD)..................................
John E. Fogarty International Center (FIC)............. 67,599 +1,153 +1,005
National Library of Medicine (NLM)..................... 325,484 +4,634 +12,922
Office of the Director (OD)............................ 1,114,422 +67,521 +597,360
Buildings and Facilities............................... 121,081 +40,000 -14,919
========================================================
Total.............................................. 29,649,887 +750,000 +1,028,646
----------------------------------------------------------------------------------------------------------------
National Cancer Institute
Mission.--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.
Unprecedented gains.--The Committee is pleased to note the
important gains returned by the nation's investment in cancer
research. These investments are proving to be important steps
toward advances in diagnosis, treatment and prevention for many
cancers. For example, the Cancer Biomedical Informatics Grid
(caBIG) will allow investigators to manage and share clinical
data in real time in a move toward ``digital biology''. The
Cancer Genetic Markers of Susceptibility initiative will scan
the entire human genome and identify genetic changes associated
with either increased or decreased risk for breast and prostate
cancer. The Cancer Genome Atlas, done in conjunction with
NHGRI, will test the complex science and technology framework
needed to systematically identify and characterize genomic
changes associated with cancer. The repository named REMBRANDT
developed by NCI and NINDS is a publicly available
bionformatics knowledge base of primary brain tumor data. The
new Clinical Proteomics Program is developing the standards
needed to characterize patterns of protein markers in human
serum for very early detection of cancer. The Nanotechnology
Alliance for Cancer began harnessing nanotechnologies for
cancer diagnostics, targeted imaging, and drug delivery.
Cancer metastasis to bone.--A frequent complication of
cancer is its spread to bone (bone metastasis) that occurs in
up to 80 percent of patients with myeloma and 70 percent of
patients with either breast or prostate cancer--causing severe
bone pain and pathologic fractures. Only 20 percent of breast
cancer patients and five percent of lung cancer patients
survive more than five years after discovery of bone
metastasis. The Committee understands that immune response
plays a role in cancer metastasis and encourages NCI to focus
research in the emerging area of osteoimmunology. The Committee
encourages NCI, as well as NIAMS, NIA, and NIDDK, to support
research to determine mechanisms to identify, block and treat
cancer metastasis to bone. Furthermore, the Committee
encourages NCI to expand research on osteosarcoma to improve
survival and quality of life and to prevent metastatic
osteosarcoma in children and teenagers who develop this cancer.
In addition, NCI is encouraged to strengthen research on tumor
dormancy as it relates to bone metastasis.
Gynecologic cancers.--Today, in the United States, one
woman will be diagnosed with a gynecologic cancer every seven
minutes. That is almost 200 per day and 80,000 in a given year.
Furthermore, almost 30,000 women die from a gynecologic cancer
each year. Existing NCI funding for specialized programs of
research excellence (SPOREs), program projects, the early
detection network, and investigator initiated grants has
accelerated basic, molecular-based research discoveries for
gynecologic cancers. The Committee encourages NCI to give
priority to gynecologic cancers under its nanotechnology plan,
its oncology biomarker qualifications initiative, and its
cancer genomics atlas project, jointly conducted with NHGRI.
This will allow laboratory discoveries to be translated into
clinical applications at the bedside causing a decrease in the
mortality rates for women with gynecologic cancer.
Gynecologic oncology clinical trials.--The Committee
recognizes NCI's longstanding commitment to improving the
health of women through gynecologic oncology clinical trials.
These trials have led to the identification of new therapeutic
agents and techniques for treating gynecologic cancers. This
effort has directly produced improved outcomes for ovarian
cancer patients as a result of changes in the way ovarian
cancer is treated and the development of a vaccine for
preventing the virus that causes cervical cancer. The Committee
encourages NCI to continue its support of gynecologic oncology
clinical trials through public-private partnerships with the
pharmaceutical and biotechnology industries and the NCI-
sponsored cancer centers and cooperative groups.
HPV Vaccine and cervical cancer.--The Committee encourages
NCI to study if there are clinical and cost benefits of
prospectively tracking pap test results and outcomes in women
who have been vaccinated for human papillomavirus (HPV). The
Committee encourages NCI to support research that will identify
the most cost-effective management strategy for cervical cancer
screening in the era of HPV vaccines and to identify the
circumstances where pap test/HPV screening fails in vaccinated
women.
Liver cancer.--The Committee notes that the incidence of
primary liver cancer continues to increase. Liver cancer is one
of the few cancers experiencing continuing increases in
mortality, and treatment options remain very limited. The
Committee encourages NCI to work closely with NIDDK to develop
a basic, clinical and translational research program designed
to reverse these trends and enhance survivability.
Pancreatic cancer.--The Committee recognizes that
pancreatic cancer is the country's fourth leading cause of
cancer death among men and women. While NCI support for
pancreatic cancer research has increased during the past
several years, unfunded opportunities remain. The Committee
strongly encourages the Institute to continue to support the
existing pancreatic cancer SPORES and to consider using
separate pay lines for each cancer within the SPORE program.
Lymphoma.--The incidence rates for non-Hodgkin lymphoma in
the general population have doubled since the 1970s. The
reasons for its increased incidence are not clear. The
Committee recommends an enhanced commitment to research
focusing on the possible environmental links to lymphoma. The
Committee suggests that NCI direct funds to: (1) studies on the
identification of environmental-genetic interactions which may
influence the development of lymphoma; (2) studies of adequate
scope to assure the identification of environmental risk
factors for specific subtypes of lymphoma; (3) small studies
designed to improve detection and quantification of
historically difficult-to-measure environmental factors; (4)
studies that are directed toward enhancing the understanding of
the role of the immune system in the initiation and progression
of lymphoma; and, (5) studies that examine the simultaneous
presence of a wide profile of infectious agents among
individuals with lymphoma. Lymphoma is often diagnosed in young
adulthood and middle age, and survivors may experience
immediate, but also late and long-term effects of the disease
and treatment. Although there are effective treatments for
Hodgkin lymphoma, survivors of this form of lymphoma may have a
wide range of side effects from the disease and will require
long-term monitoring and follow-up care to address the long-
term effects. The Committee encourages NCI to dedicate some of
its survivorship research to problems confronted by lymphoma
survivors.
Lymphatic research and lymphatic diseases.--The Committee
recommends that NCI support research on lymphedema, a chronic,
progressive and historically neglected complication that must
be endured by many cancer survivors. The Committee also
encourages the Institute to support the study of
lymphangiogenesis and lymphatic imaging, which are critical to
a greater understanding of cancer metastasis and lymphedema.
Ovarian cancer.--Today, in the United States, there is no
widely available screening test for ovarian cancer. More than
22,000 women will be diagnosed with ovarian cancer this year
and 16,000 women are expected to die from it. Ovarian cancer
has a high mortality rate, 55 percent over five years, mainly
because there is no proven effective method for early
detection. Research is being conducted on glycomic profiling
which may identify unique patterns of glycosylation that may be
more sensitive and specific than CA-125, an existing blood
marker, in identification of early stage ovarian cancer.
Circulating plasma proteins, another blood marker, could also
possibly serve as biomarkers to differentiate women with
ovarian cancer from healthy women. The Committee encourages NCI
to make randomized, prospective studies that would lead to the
validation and acceptance of these and other biomarkers for the
early detection of ovarian cancer a priority.
Clinical trial participation.--Despite efforts to improve
participation in cancer clinical trials, only three percent of
adult cancer patients participate in trials, and the
participation by senior citizens is even more limited. The
Committee strongly encourages NCI to support research to
investigate decision-making by patients, particularly with
respect to barriers to, and decisions on, participation in
clinical trials. This research effort should be undertaken to
inform strategies to enhance accrual in cancer clinical trials.
Current low levels of accrual are often rate-limiting in the
development of novel treatment approaches, and solving this
problem would ultimately improve outcomes for cancer patients.
Cancer centers.--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 consider 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.
Tissue repositories.--Cancer biorepositories, because they
centralize and standardize molecular annotation of tissues,
have the potential to accelerate the understanding of cancer
and the discovery and development of new biomarkers, new
diagnostics and new therapeutic approaches. The Committee
encourages NCI to continue to support efforts to centralize the
collection and distribution of tissue and pursue programs to
make them available to researchers.
Neuroblastoma.--The Committee notes with concern the
incidence of neuroblastoma, an aggressive pediatric cancer with
poor survival rates among Stage III and Stage IV patients. The
Committee encourages NCI to accelerate support for
neuroblastoma research with a focus on clinical trials for
high-risk patients. The Committee requests a comprehensive
report on NCI's research in this area, including planned
clinical and translational research initiatives, as part of
NCI's fiscal year 2009 budget justification.
Radioisotope research.--The Committee encourages NCI to
continue and enhance its support for radioisotope-targeted
therapy and research. This research ultimately benefits cancer
patients worldwide by developing new, productive avenues for
the use of nuclear stockpile materials previously earmarked for
weapons development.
National Heart, Lung, and Blood Institute
Mission.--NHLBI 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 commends the
Institute for its leadership in undertaking an inclusive
strategic planning process, which included a national
conference on heart disease. The Committee looks forward to
receiving the heart disease action plan from the meeting as
well as updates on progress made to implement its goals. The
Committee continues to regard research on heart disease, stroke
and other cardiovascular diseases as a top health priority. The
Committee strongly believes that as the baby boomers age, more
research on cardiovascular diseases is critically needed to
better prevent, diagnose, treat, and cure cardiovascular
diseases.
Congenital heart disease.--The Committee recognizes that
congenital heart disease is a chronic disease affecting
approximately 1.8 million Americans. It commends NHLBI for
convening a working group to address this issue, and supports
its recommendation that action be taken to prevent needless
disability and premature mortality in this rapidly-growing
population. The Committee urges NHLBI to work with patient
associations and other appropriate public health organizations
to develop education and research initiatives targeted to the
life-long needs of congenital heart disease survivors.
Cardiovascular disease and women.--The Committee remains
concerned that as the population ages women will continue to be
affected by cardiovascular disease at high rates. The Committee
encourages the Institute to place a high priority on heart
disease, stroke and other cardiovascular diseases in women by
intensifying its investment in basic, clinical, translational,
and trans-institute cardiovascular disease research. Despite
new therapies, the Committee continues to believe that research
is needed to better understand the causes of these diseases in
women, develop more effective treatments and cures, and prevent
cardiovascular diseases, which remain a major cause of
permanent disability and the number one killer of women.
Gender differences in health and disease are well
established. For example, while cardiovascular disease is the
number one killer of both women and men, women die of
cardiovascular disease an average of ten to twenty years later
than men. Numerous primary and secondary randomized controlled
prevention trials have been conducted in men showing the
benefit of lowering total and LDL cholesterol. Women have been
included in many of these studies but not in sufficient numbers
to permit a meaningful analysis of the benefits for women
alone. As a result, women are currently treated according to
the data from studies where there is a preponderance of men--
namely, the treatment is designed to lower total and LDL
cholesterol. This is done on the assumption that this treatment
regime is the best approach to primary prevention in women.
However, there are some significant indications that high HDL-
cholesterol and low triglycerides are more important for
women's cardiovascular health. The Women's Health Initiative
did not substantiate the expectations from observational
studies that postmenopausal hormone therapy reduces the risk of
coronary heart disease in spite of lowering total cholesterol
and LDL-cholesterol. New research is needed to answer the
question of the optimal lipid profile in primary prevention of
cardiovascular morbidity and mortality in women and to define
gender differences. The Committee encourages NHLBI to undertake
this type of research.
Heart disease and diabetes.--Heart disease is the leading
cause of death in diabetic patients, and individuals with type
1 diabetes have a 10-fold increased risk of heart disease
compared to others of the same age. Research has shown that
heart disease begins as early as childhood or adolescence in
type 1 diabetes patients. NHLBI is encouraged to promote
research to identify early biomarkers of cardiovascular disease
in young diabetic patients to learn who might benefit from
therapeutic agents that are currently used in adults. Delaying
heart disease by even a few years could make a significant
difference in the lives and health of young diabetic patients.
Pulmonary hypertension (PH).--The Committee commends NHLBI
for its leadership in advancing research on PH, a rare,
progressive, and fatal disease that predominantly affects
women. The Committee continues to view research on pulmonary
hypertension as a high priority. It encourages the Institute to
consider expanding its specialized centers of clinically
oriented research program in this area and to establish a PH
research network to facilitate collaboration and data sharing
among leading PH investigators.
Thalassemia.--The Committee remains strongly supportive of
the focused research effort that is being undertaken by the
thalassemia clinical research network, which is comprised of
the leading research institutions in the field of thalassemia,
or Cooley's anemia. In addition, the Committee commends NHLBI
for its commitment to pursue gene therapy and urges the
Institute to move aggressively in pursuing a research agenda
that will lead to a cure.
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 supports both intramural and extramural means of
expanding research on LAM and urges NHLBI 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. The Committee understands that recent
scientific findings have presented new treatment approaches for
clinical testing, and that experimental trials with the drug
sirolimus have begun. The Committee commends NHLBI for
supporting the multicenter international
lymphangioleiomyomatosis efficacy of sirolimus trial (MILES)
trial, and further encourages the support of other phase I and
phase II clinical treatment trials to capitalize on the LAM
patient population that NHLBI has assembled who do not qualify
for the MILES trial. The Committee is also aware of the
potential benefit of establishing LAM centers, and suggests
NHLBI consider supporting these activities.
Sleep disorders.--The Committee encourages the National
Center on Sleep Disorders Research to partner with CDC to
implement a sleep education and public awareness initiative
using the roundtable model that has been successful for NIH
institutes and public health service agencies.
Alpha-1 antitrypsin deficiency.--The Committee is aware
that Alpha-1 antitrypsin deficiency (or Alpha-1) is the major
known genetic risk factor for chronic obstructive pulmonary
disease (COPD), the fourth leading cause of death in the U.S.
and the only one of the four leading causes of death with a
rising mortality over the past decade. As many as three percent
of individuals with COPD have undetected Alpha-1. In addition,
individuals with Alpha-1 can exhibit symptoms of advanced
emphysema, even in the absence of tobacco use. Alpha-1 is an
indication for lung transplantation. Alpha-1 is also a factor
in the development of liver disease in children and adults. The
Committee commends NHLBI for its plans to focus additional
research efforts in the area of COPD. As there is a growing
appreciation of the role of genetic influences on the
development of COPD and as Alpha-1 is the major identified
genetic risk factor in this condition, the additional focus on
research leading to a better understanding of Alpha-1,
including improved management and therapeutic approaches, is
important. The Committee further recommends cooperation between
NHLBI, NIDDK, NHGRI, and other institutes to enhance the NIH
research portfolio, and to provide appropriate information to
health professionals. The Committee suggests achieving these
goals through use of the NHLBI rare lung diseases consortium
and the COPD clinical research network.
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 NTM pulmonary infections in women,
particularly involving rapidly growing mycobacteria. The
Committee commends NHLBI for its planning meetings regarding
NTM; and recommends further collaboration with NIAID, the
advocacy community, and other Federal agencies to provide a
better understanding of NTM, enhance diagnostic and treatment
options, and promote education of health care providers.
Bleeding and clotting disorders.--The Committee commends
NHLBI for its commitment to research in bleeding and clotting
disorders. The Committee encourages the Institute to continue
these efforts focusing on improved and novel therapies for
these disorders and maintaining its collaborative relationship
with the scientific and medical research community and
voluntary organizations.
Marfan syndrome.--The Committee commends NHLBI for its
strong leadership on Marfan syndrome research, particularly its
sponsorship of a landmark pediatric heart network clinical
trial focused on the drug losartan. The Committee encourages
NHLBI to continue to partner with the Marfan syndrome community
on this research, and explore ways to support promising
ancillary studies to the clinical trial. The Committee also
applauds the Institute for establishing a working group on
Marfan syndrome and looks forward to reviewing the group's
recommendations for future research.
Bone marrow failure diseases.--The Committee applauds NHLBI
for funding research that has led to a greater understanding of
bone marrow failure diseases. The Committee encourages NHLBI to
collaborate with NCI to fund new research efforts that seek new
treatments and cures for aplastic anemia, myelodysplastic
syndromes (MDS), and paroxysmal nocturnal hemoglobinuria (PNH).
Lymphatic research and lymphatic diseases.--The Committee
recognizes the leadership role NHLBI has played in advancing
lymphatic research within its Institute and strongly encourages
continuation of these efforts in concert with NSE /ORWH AND
OTHER RELEVANT/CI, NIAID, NIDDK, NIAMS, and other relevant ICs.
The Committee urges NHLBI's lung division to engage in
lymphatic research initiatives, with particular attention to
congenital lymphatic malformation-induced pulmonary
dysfunction.
National Institute of Dental and Craniofacial Research
Mission.--The mission of NIDCR is to improve the Nation's
oral, dental and craniofacial health through research, research
training, and the dissemination of health information. NIDCR
accomplishes its mission by performing and supporting basic and
clinical research; conducting and funding research training and
career development programs to ensure an adequate number of
talented, well-prepared, and diverse investigators;
coordinating and assisting relevant research and research-
related activities among all sectors of the research community;
and promoting the timely transfer of knowledge gained from
research and its implications for health to the public, health
professionals, researchers, and policy-makers.
Dental disease.--Dental disease is the most common chronic
childhood illness and one of the most prevalent unmet needs in
poor children. Research indicates that dental disease has a
serious impact on learning and overall health of children, and
recent data indicates an increase in early childhood cases. The
Committee commends NIDCR for its current efforts in this area
and encourages NIDCR to support additional research to
determine the most effective methods for preventing,
controlling, and treating early childhood carries.
National Institute of Diabetes and Digestive and Kidney Diseases
Mission.--NIDDK supports research in three major disease
categories: diabetes, endocrinology, and metabolic diseases;
digestive diseases and nutrition; and kidney, urologic, and
hematologic diseases. 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.
Cooley's anemia.--The Committee continues to support the
high quality research being conducted by NIDDK on such issues
as iron chelation and non-invasive iron measurement. 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 measuring iron that accumulates in the heart
and liver.
Polycystic kidney disease (PKD).--The Committee is pleased
that NIH-supported PKD research has rapidly led to the
development of multiple human clinical trials and
interdisciplinary studies focused on slowing PKD disease
progression or even reversing the progression of PKD. Given the
momentum in PKD research, the Committee encourages NIDDK to
promote additional PKD clinical trials and multidisciplinary
research, and expand knowledge-based studies of pathophysiology
and molecular biology. The Committee encourages NIDDK to
conduct a comprehensive review of its structure to ensure that
funding is directed to areas of research (such as PKD) that
show the best return on investment in terms of ameliorating
and/or curing diseases.
Management of pediatric kidney disease.--The complexity and
variety of causes unique to childhood kidney diseases require
multiple detailed treatment regimens for chronic kidney
disease, dialysis and kidney transplantation. When these life-
saving medication and treatment plans are not followed,
patients experience life-threatening complications and costly
hospitalizations. The Committee urges NIDDK to conduct trans-
institute trials to study methods to improve adherence with
treatment regimens for children and adolescents throughout the
spectrum of chronic kidney disease, particularly in the areas
of dialysis and post-kidney transplantation. Additionally, the
Committee urges NIDDK to support collaborating networks of
health care providers to collect data and plan trials to
improve therapy for the spectrum childhood kidney diseases and
the transition of children with kidney disease into adulthood.
Glomerular disease.--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
a glomerular disease workshop and encourages the Institute to
support research related to the findings of the workshop. The
Committee is also aware of the potential for progress in the
understanding of glomerular diseases through the establishment
of a patient registry.
Mucopolysaccharidosis (MPS).--The Committee is gratified by
NIDDK's continuing commitment to support research on MPS
disorders and appreciates NIDDK's involvement and collaboration
with NINDS and the Office of Rare Diseases (ORD) on a recent
scientific conference to identify and address impediments to
effective therapies and to develop a strategy to determine the
minimum standard protocol for clinical application of effective
therapies for MPS. The Committee recognizes the efforts of
NIDDK to address glycosaminoglycans accumulation issues and its
effects on bones and joints; additionally the Committee is
pleased with the continuing focus on addressing the challenges
of the blood-brain barrier. The Committee recognizes the
implementation of NIDDK's molecular therapy core centers
(MTTCs) to support research on gene and other molecular therapy
research for a variety of genetic diseases; two of the four
centers study MPS. The objective of bringing together
investigators from relevant disciplines to enhance and extend
the effectiveness of their research and cultivate collaboration
between scientists is a positive development. MTCCs that
include new technologies, such as homologous recombination and
RNA-interference, gene therapy and novel approaches to human
therapies, are supported by the Committee.
Bowel incontinence.--This condition affects people of all
ages and is associated with a wide variety of causes. The
Committee is pleased that NIDDK is collaborating with NICHD on
an incontinence state-of-the-science conference and encourages
the Institute to prioritize implementation of this conference.
Irritable bowel syndrome.--The Committee is pleased that
NIDDK is formulating an action plan for digestive diseases
through the National Commission on Digestive Diseases and that
irritable bowel syndrome (IBS) will be included.
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 a major cause of morbidity from intestinal
illness. The Committee commends NIDDK for its strong leadership
in this area and continues to encourage the Institute to
strengthen research focused on: (1) the cellular, molecular and
genetic structure of IBD, (2) identification of the genes that
determine susceptibility or resistance to IBD in various
patient subgroups, and (3) 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.''
Drug-induced liver injury.--The Committee is aware of the
good work of the five centers which comprise the drug-induced
liver injury network (DILIN). This network represents an
important database to record, examine, and research the liver
toxicity of various pharmaceutical and over the counter
products. In view of the increasing incidence of liver injury
from prescription and nonprescription drugs, the Committee
encourages NIDDK to strengthen the DILIN network and requests a
review of progress made in the use of the NILIN network data in
developing findings or recommendations to reverse the incidence
of liver injury.
Hepatitis B.--The Committee is pleased with the NIH
commitment to conduct a consensus conference in 2008 on best
treatment practices for individuals with hepatitis B,
especially with the growing number of treatment options. As
most people who are infected with hepatitis B are unaware of
their infection, the Committee encourages NIDDK to continue to
collaborate with CDC in the development of a public health
strategy to expand the screening of individuals at risk for
chronic hepatitis B.
Hepatitis C.--The Committee notes that several new
antiviral agents are in development against hepatitis C.
However the problem of antiviral drug resistance has emerged as
a stumbling block. The Committee encourages implementation of
clinical studies aimed at overcoming antiviral drug resistance,
possibly by utilizing novel agents in combination.
Obesity-related 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. The Committee encourages
NIDDK to continue to support fatty liver disease clinical
trials that includes both adult and pediatric populations.
Beta cell research.--The Committee commends NIDDK for its
support of the beta cell biology consortium (BCBC) which has
developed excellent resources, research reagents, and databases
that add value to the entire beta cell biology research
community. NIDDK is encouraged to support research focused on
translating the fundamental discoveries made by the BCBC into
clinical applications that may directly benefit type 1 diabetes
patients.
Digestive diseases.--Diseases of the digestive system may
affect up to 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 that result in tremendous human suffering
and economic cost. The Committee encourages NIDDK to strengthen
this important program with an increased emphasis on irritable
bowel syndrome.
Acute liver failure.--The Committee is concerned that over
one-third of acute liver failure cases, resulting from over the
counter drug interactions and other causes, are fatal due
largely to the continuing shortage of livers available for
transplantation. The Committee is aware that there is no
effective and approved medical procedure such as dialysis,
cellular transplants, or other techniques to maintain liver
function after acute failure for a period of time until a liver
becomes available for transplantation or the liver repairs
itself naturally. The Committee encourages research in this
area, consistent with the liver disease research action plan,
to reduce the mortality rate for those who suffer from acute
liver failure.
Glucose monitoring.--Recent advances in continuous glucose
monitoring technology have the potential to revolutionize the
way diabetes is managed on a daily basis, but more research is
needed to validate this technology in a variety of patient
populations under ``real world'' conditions. Moreover,
biomedical research progress is enabling increasing numbers of
type 1 diabetes patients to live with this disease for more
than fifty years. The NIDDK is urged to support clinical
research on the potential benefits of continuous glucose
monitoring in type 1 diabetes patients over the age of 65 to
assess the potential of this technology to produce better
health outcomes in these individuals and to obtain evidence to
support healthcare coverage for continuous monitoring devices
in elderly diabetic patients.
Prostatitis.--The Committee supports the efforts of the
NIDDK chronic prostatitis collaborative research network
(CPCRN) to find the cause and a cure for prostatitis. The past
ten years of research by the CPCRN have produced important
progress. The Committee encourages NIDDK to maintain the
momentum of this research to prevent the loss of previous work,
which would have to be duplicated at a later date if this
silent epidemic is to be controlled.
Hemophilia and hepatitis C.--The Committee understands that
hepatitis C continues to have a devastating impact on the
hemophilia population, with as many as 75 percent of all
persons with hemophilia having contracted HCV and many of these
individuals co-infected with HIV. The Committee encourages
NIDDK to pursue research initiatives on co-infection and the
progression of liver disease in this population.
Interstitial cystitis/painful bladder syndrome IC/PBS.--The
Committee is concerned about the lack of clarity surrounding
the definition of IC and suggests that NIDDK host a meeting of
international IC experts that specifically addresses these
issues to update its research criteria and clarify its
investigative questions on IC.
The Committee encourages NIDDK to support research in areas
that examine predisposition/risk factors, underlying cellular
and molecular pathology of IC/PBS and the association/cross-
sensitization of IC/PBS with other disorders/diseases. The
Committee also suggests that NIDDK fund translational research
in IC/PBS that would include pilot therapy testing and early
intervention of lifestyle/behavioral changes to prevent/lessen
symptoms. The Committee encourages NIDDK to take an active role
in ongoing studies of the epidemiology of IC in order to
address design issues and to ensure the consultation of outside
experts.
Cellular therapies.--The Committee is encouraged by recent
clinical trial results, in which 14 patients recently diagnosed
with type 1 diabetes remained insulin-free for up to 34 months,
post treatment with an immunosuppressive regimen followed by
the infusion of autologous hematopoietic stem cells. Given
these positive results, the Committee recommends NIH continue
to support clinical trials in the U.S. using cellular therapies
to treat type 1 diabetes, including therapies such as the
lymphoablative hematopoietic stem cell treatment used in this
trial as well as alternative therapies using cell sources such
as dendritic cells, T-regulatory cells, or umbilical cord blood
cells.
National Institute of Neurological Disorders and Stroke
Mission.--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 commends the Institute for its
leadership in initiating a strategic planning process for
stroke research. Stroke is this nation's third leading cause of
death and the Committee regards stroke research as a top health
priority. The Committee encourages the Institute to enhance its
investment in basic, clinical, translational, and trans-
institute stroke research using all available mechanisms. As
the baby boomers age, additional stroke research is critically
needed to identify innovative methods to better diagnose,
treat, rehabilitate, and prevent stroke.
The Committee is encouraged that the Institute convened
experts in the field of stroke to conduct a midpoint review of
the ten-year plan outlined in the stroke progress review group
(SPRG) report. The Committee supports the full and timely
implementation of the SPRG report and expects an update on
implementation of the report in hearings on the fiscal year
2009 budget request.
Duchenne translational conference.--The Committee is aware
that NIH will be convening a conference focused on
translational research opportunities for Duchenne and Becker
Muscular Dystrophy (DBMD) this June. The Committee applauds NIH
for taking this concrete step forward and requests that a
comprehensive report summarizing the conference's findings,
identifying the most promising opportunities for a DBMD
translational research initiative and establishing clear next
steps to establish this initiative, be published within five
months of the conclusion of the conference. The Committee
requests the Muscular Dystrophy Coordinating Committee (MDCC)
develop a clear action plan that includes, among all the
identified goals, tracking of NIH funded grants against the
identified scientific opportunities for DBMD translational
research, and mapping areas of investment and areas of unmet
opportunity, by February 1, 2008.
Dystonia.--The Committee continues to support research
regarding the neurological movement disorder dystonia. The
Committee is pleased with progress made in broadening the
dystonia research portfolio resulting from the joint dystonia
research program announcement and understands that eleven new
grants have been funded as a result of this initiative. The
Committee commends NINDS on its sponsorship of the June 2006
scientific workshop on dystonia and looks forward to
initiatives based on this activity.
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.
Charcot-Marie-Tooth (CMT).--CMT is one of the most common
inherited neurological disorders. It is characterized by a
slowly progressive degeneration of the peripheral muscles in
the foot, lower leg, hand, and forearm. In severe forms it
debilitates children so that they require wheelchairs and may
even result in premature death. The Committee recognizes the
NINDS workshop on peripheral neuropathies held in the fall of
2006 that focused on developing research opportunities to
address CMT. The workshop concluded that there were a number of
specific research directions that were particularly relevant
including (1) the development of high throughput screening to
identify candidate treatments that may be currently available
for patients, (2) research into novel mechanisms to repair
genetic abnormalities in patients with CMT, (3) research into
interactions between neurons and glial cells that are disrupted
and cause disability in many CMT patients, and (4) research
into the biological role of inflammatory cells that may
exacerbate disability in CMT patients. The Committee encourages
NINDS to capitalize on these recommendations through mechanisms
such as a relevant program announcement or request for
applications.
Down syndrome.--The Committee notes the recent publication
of a number of breakthrough studies concerning the structure
and function of synapses in cognitive circuits in mouse models
of Down syndrome. These findings suggest that important
advances are possible that could enhance cognitive function in
both children and adults with this disorder. The Committee
notes that these advances were suggested by the Down syndrome
workshop sponsored by NINDS, the goal of which was to address
research priorities for optimizing the structure and function
in neuronal circuits important for cognition. The Committee
commends NINDS for its leadership in organizing the workshop
and encourages it to build upon the important findings from the
meeting. In particular, the Committee encourages NINDS to
identify opportunities for investigating the genetic and
cellular basis for abnormalities in the structure and function
of cognitive circuits in both the developing and mature nervous
systems of people with Down syndrome. 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.
Hydrocephalus.--Hydrocephalus is a serious neurological
condition, characterized by the abnormal buildup of
cerebrospinal fluids in the ventricles of the brain. It is a
condition, not a disease, which affects an estimated one
million Americans. It can be congenital, or acquired for no
known cause or secondary to many conditions, illnesses, or
injuries. Normal pressure hydrocephalus (NPH) is an acquired
condition that generally affects people over the age of 50 and
often goes undetected or misdiagnosed for many years as
dementia, Alzheimer's disease, or Parkinson's disease. Some
estimates suggest that over 375,000 older Americans have NPH.
There is no known cure for hydrocephalus. The standard
treatment was developed in 1952, and carries multiple risks
including shunt failure, infection and over-drainage. The
Committee commends NINDS for taking lead sponsorship of the
2005 workshop to set national research priorities for
hydrocephalus. The Committee encourages the institute to
significantly strengthen funding for hydrocephalus research
along with actively soliciting grant applications based on the
findings from the workshop. The Committee also encourages NINDS
to seek opportunities to collaborate with other institutes and
offices at NIH, including NIA, NICHD, NEI, NIBIB and ORD, to
support research collaboratively in epidemiology,
pathophysiology, disease burden and improved treatment for
hydrocephalus.
Mucolipidosis Type IV (ML4).--Now that NIMH has created and
can make available to researchers a strain of mice that
replicates the genetic mutation which causes ML4 in humans, the
Committee encourages NINDS to sponsor targeted research to
develop therapies which might alleviate some of the effects of
ML4 and similar genetic disorders, or even lead to their cure.
Spinal muscular atrophy (SMA).--The Committee commends
NINDS for the advancement of the SMA therapeutics development
program and encourages NINDS to continue to commit the full
range of resources to identifying and completing preclinical
research and development (R&D;) of SMA drug candidates. The
Committee urges NINDS to plan clinical trials and
infrastructure including site support, patient registries,
biomarker development and natural history studies.
Opsoclonus myoclonus syndrome (OMS).--OMS is a rare, auto-
immune, disorder that targets the brain. In childhood, it is
associated with neuroblastoma of the chest, abdomen, or pelvis.
Besides the hallmark features of involuntary eye movements,
muscle jerks, and gait disorder, the children have rages,
inability to sleep, and may become mute and unable to sit or
stand. Permanent problems in motor control, language
development, behavior and cognition, even mental retardation,
are common. The available treatment options for OMS are
extremely limited. The Committee encourages the Institute to
accelerate research efforts to identify OMS susceptibility
genes and biomarkers, and to develop innovative
immunotherapeutic strategies.
Torval cysts.--The Committee encourages NINDS to collect
and analyze data on torval cysts, their causes, their
diagnosis, and their treatment.
Vulvodynia.--NIH-supported research indicates that millions
of women suffer from chronic pelvic and genitourinary pain
conditions such as vulvodynia. The Committee encourages NINDS,
in coordination with the NICHD, Office of Research on Women's
Health (ORWH), the NIH pain consortium and other institutes, to
strengthen its support of research in this area, with a focus
on etiology and multi-center therapeutic trials. The Committee
also encourages NINDS to work with ORWH and other relevant
institutes and government agencies, as well as patients and
professional organizations, to implement an education outreach
campaign on vulvodynia.
Mucopolysaccharidosis (MPS).--The Committee applauds NINDS
for its collaboration efforts with NIDDK, ORD and MPS patient
advocates by taking the leading role in a landmark MPS
scientific conference, whose objective was to identify and
address impediments to effective therapies.
Traumatic brain injury (TBI).--The Committee is pleased
with the work being done at NINDS on TBI translational basic
science research and rehabilitation and encourages the
Institute to continue such work, specifically bench science
research into the cellular and molecular mechanisms of TBI and
into neuroprotection/regeneration and repair of the injured
brain.
Dandy-Walker and hydrocephalus research.--The Committee
encourages NINDS to establish a coordinating committee for
Dandy-Walker and hydrocephalus research. This coordinating
committee is encouraged to report its findings to the public on
the progress in the epidemiology, pathophysiology, disease
burden, treatment improvements, diagnoses and awareness for
Dandy-Walker and hydrocephalus.
Hereditary hemorrhagic telangiectasia (HHT).--HHT is a
multi-system vascular genetic disorder that affects 75,000
Americans, producing arterioveneous malformations in the brain
and lung. The Committee recognizes that while HHT is largely
preventable with proper intervention, twenty percent of
children and adults with HHT die or become disabled due to lack
of recognition by the medical community. The Committee
encourages NINDS to support research that would improve the
quality of life for people living with HHT.
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. The Committee applauds the leadership
undertaken at NINDS to coordinate research through the trans-
NIH tuberous sclerosis coordinating committee. The Committee
recommends that the scope of the coordinating committee be
broadened to include planning of international conferences and
annual targeted workshops on specific areas of TSC research as
identified by the coordinating committee and the TSC research
community. The Committee also suggests that NINDS human
genetics resource center develop a TSC DNA Repository that
would serve as a research resource for the TSC research
community. Finally, the Committee encourages NINDS to stimulate
and support research on the role of early onset seizures in TSC
and subsequent cognitive development.
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 NINDS for hosting the second ``Curing Epilepsy 2007''
Conference in March 2007 and encourages NINDS to issue a report
and develop plans and goals based on the latest research
developments--as highlighted at the conference. Additionally,
the Committee recognizes that trials and longitudinal studies
are needed to test findings and further develop exciting
research directions in epilepsy.
National Institute of Allergy and Infectious Diseases
Mission.--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 AIDS, asthma and
allergies, tuberculosis, sexually transmitted diseases,
tropical diseases, and emerging microbes. The goals of NIAID
research are to understand disease pathogenesis better, 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.
The Committee includes bill language requested by the
Administration allowing NIH to transfer the funds appropriated
for the construction of extramural biodefense research
facilities to accounts that would remain available until
expended. This would permit the grantees additional time to
complete the construction of these complex projects and comply
with the requirements of the National Environmental Protection
Act.
Antiviral drug resistance.--The committee recognizes that
several new drugs to treat hepatitis B have become available
recently and several more are being developed, both against
hepatitis B and hepatitis C. One of the major challenges in
implementing these therapies is the development of antiviral
drug resistance. The Committee encourages the development of
standardized terminology to describe this resistance and
studies of the mechanism of resistance and methods to overcome
resistance.
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 actively
with voluntary health organizations to support asthma
prevention, treatment, and research activities.
Drug-resistant tuberculosis (TB).--The Committee
understands that NIAID is working on a response plan to drug
resistant tuberculosis, including extremely drug resistant TB
(XDR-TB), and applauds these efforts. The Committee encourages
the appropriate allocation of resources to effectively address
this global health emergency.
Liver transplantation.--The Committee applauds the
significant progress in developing successful techniques for
liver transplantation, but notes that the next medical frontier
is to focus on improving the long-term quality of life of
individuals who receive liver transplants. The Committee
encourages additional research focused on these long-term
quality of life issues, as well as research to improve patient
and graft survival, pre-transplant graft evaluation and
preservation, with a particular focus on research to reduce and
eventually eliminate a transplant recipient's dependence on
immunosuppressive drugs.
Malaria vaccine.--The Committee commends NIAID for its
malaria research and, specifically, its effort to create a
malaria vaccine. The Committee encourages NIAID to target
resources to support malaria vaccine development, drug
development, diagnostics, vector control, infrastructure and
research capability, and to strengthen components of the
implementation plan for global research on malaria. The
Committee encourages NIAID to strengthen its efforts related to
developing improved diagnostic tools which will help in the
early identification of malaria and support the provision of
rapid treatment. The Committee is concerned that drug-resistant
malaria increasingly is being reported around the world, making
the development of new drugs to treat malaria essential. Of
further concern is that reports of insecticide-resistant
mosquitoes are on the rise. To that end, the Committee
encourages NIAID to undertake additional research on the basic
biology and ecology of mosquitoes, as well as work in genomics
to develop new insecticides or render mosquitoes incapable of
transmitting malaria.
Antibiotic resistance.--The Committee is concerned about
the alarming rates of antibiotic resistance and the related
increase in morbidity, mortality and health care costs. Little
research has been devoted to defining optimal dosing regimens,
particularly in defining the minimal duration of therapy
necessary to cure many types of infections. The Committee
recognizes that studies of this type require a long-term
commitment and are not likely to be funded by pharmaceutical
manufacturers since the products are already approved by the
FDA. The consensus of many experts is that infections may be
treated for longer periods of time than are necessary,
needlessly increasing the antimicrobial resistance. Therefore,
the Committee encourages NIAID to support randomized controlled
trials to define the necessary length of therapy.
Primary immunodeficiency diseases (PI).--NIAID is the lead
agency for research into bone marrow transplantation (BMT),
which can cure some primary immunodeficiencies. The Institute
has made significant progress in reducing graft versus host
disease (GVHD) and improving therapies when GVHD develops. With
newborn screening of certain PI diseases being piloted, the
Committee urges the Institute to redouble its efforts to ensure
that identified patients have the best possible chance for
survival.
Clinical islet transplantation.--The Committee acknowledges
the productive collaboration of the NIDDK and NIAID in
overseeing the Clinical Islet Transplantation Consortium (CIT).
The development of seven clinical trial protocols of islet
transplantation marks a significant step toward validating this
procedure as a viable treatment for type 1 diabetes patients
suffering from extremely ``brittle'' or difficult-to-control
blood sugar levels. NIDDK and NIAID are urged to take steps to
ensure the efficient launch of these trials and to expedite
patient recruitment and enrollment.
Anaphylaxis.--The issue of food allergies is an area of
particular concern to this Committee. As many as 30,000
individuals, many of whom are children, require emergency room
admission for food allergies every year, and several hundred
die. The Committee supports intensive NIAID research in
anaphylaxis and food allergy research to develop a cure for
anaphylaxis, or severe allergic reactions to food or
medications.
National Institute of General Medical Sciences
Mission.--NIGMS supports research and research training in
the basic biomedical sciences. Institute grantees, working in
such fields as cell biology, biophysics, genetics,
developmental biology, pharmacology, physiology, biological
chemistry, bioinformatics, and computational biology 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 provide the
scientists needed by industry and academia. NIGMS also has
programs to increase the diversity of the biomedical workforce.
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 career opportunity programs for
high school and undergraduate college students in conjunction
with historically black health professions schools. The
Committee urges continued, long-term support of this program.
National Institute of Child Health and Human Development
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.
Demographic research.--The Committee applauds NICHD for
supporting demographic research. As a result of this support,
important strides have been made in our understanding of family
dynamics--especially how these factors influence marriage and
the health and development of children. In addition,
interdisciplinary demographic research has uncovered clues
regarding the causes of health disparities across racial,
ethnic, educational, and income groups. The Committee
encourages NICHD to maintain its levels of investment in
demographic training and infrastructure support and to support
opportunities for interdisciplinary research into the complex
environmental and biological mechanisms that produce health
disparities.
Pulmonary rehabilitation.--Pulmonary rehabilitation has
been increasingly recognized as an important treatment option
for the many patients with disabling chronic lung diseases,
like chronic obstructive pulmonary disease (COPD). The
Committee encourages the National Center for Medical
Rehabilitation Research (NCMRR) to expand research
opportunities in this area.
Newborn screening.--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 which, if left untreated, can cause
death, disability, mental retardation and other serious
illnesses. The Committee encourages NICHD to continue to
prioritize fragile X as a key prototype in the development of
cost-effective newborn screening programs.
Premature ovarian failure (POF).--POF is a condition in
which the ovaries stop functioning normally in a woman younger
than age 40. Studies show that women who have POF of unknown
cause have a one in fifty chance of being a premutation carrier
of the FMR1 gene, the same gene that causes fragile X syndrome.
Women with POF and a family history of female relatives with
POF have a one in fifteen chance in carrying this premutation.
The Committee acknowledges the importance of furthering
research into the FMR1 premutation to inform the research
community about the genetic causes of infertility and disorders
of altered ovarian function. The Committee supports further
research efforts focused on collecting DNA and other genetic
information from women who possess a mutation of the FMR1 gene
as well as women who have POF. To accomplish this goal, the
Committee encourages NICHD to include the collection of genetic
and DNA data on women who are relatives of people living with
fragile X in the development of a national fragile X patient
registry. Additionally, NICHD is encouraged to take steps to
develop a comprehensive research strategy on POF as it relates
to the FMR1 gene.
Traumatic brain injury (TBI).--Congress is pleased with the
work being done on TBI translational science research and
rehabilitation at the NCMRR and encourages NCMRR to continue
such work; especially the cooperative multi-center traumatic
brain injury clinical trials network.
Spinal muscular atrophy (SMA).--SMA is the leading single
gene cause of death in infants and toddlers and the most
prevalent genetic motor disease. The severity of the disease,
its relatively high incidence, and the possibility of imminent
treatments led the NINDS to initiate the innovative SMA
Project. The Committee is concerned that the NICHD has not
dedicated resources specifically to initiate work and sustain
ongoing resources for SMA. The Committee is aware, for
instance, that despite multiple submissions last year, little
funding was dedicated by NICHD to SMA-related research. The
Committee encourages NICHD to support specific basic,
translational, and clinical research initiatives on SMA. The
Committee also encourages NICHD to coordinate funding with
NINDS to ensure increased participation of investigators in SMA
and developmental neurobiology relevant to SMA and to establish
a cross-institute working group comprised of NICHD, NINDS, and
NIGMS.
Liver wellness in children.--The National Children's Study
(NCS) provides a unique opportunity to study the prevalence of
obesity-related chronic liver disease, also known as fatty
liver, from birth to early adulthood. The Committee understands
that fatty liver is the most common liver abnormality in
children age 2 to 19 years old, and disproportionately affects
Hispanic-Americans. The Committee encourages NICHD to analyze
the prevalence of fatty liver under the NCS to better
understand obesity-related chronic illnesses in children and to
work with other agencies in the screening and prevention of
these diseases.
Primary immunodeficiency (PI) diseases.--The Committee
continues to be impressed with the dedication of financial and
personnel resources by NICHD to physician education and public
awareness programs to reach early diagnosis of this class of
140 diseases. In addition, the Institute's focus on newborn
screening research is critical as States begin to implement
pilot newborn screening programs for severe combined
immunodeficiency disease (SCID), one of the most severe forms
of PI. NICHD is urged to coordinate its efforts with CDC and
the States in this critical implementation period.
Pre-term births.--A recent national study showed that the
rate of pre-term births among first pregnancies has increased
50 percent over the past decade. The data also revealed that
women in their first pregnancy are at highest risk for
developing preeclampsia, which puts them at risk for
devastating maternal complications and fetal death. In
addition, the study also showed a racial disparity with black
women at a two-fold higher risk than white women. The Committee
understands that the prediction and prevention of these first
pregnancy complications is problematic and that there is a
shortage of research on the etiology and prevention
interventions for this cohort of women. The Committee requests
that NICHD conduct research on women in their first pregnancy
in order to fill the gap in knowledge for the prevention of
these complications.
Assisted reproductive technology (ART).--ART over the past
two decades has allowed thousands of infertile couples to have
children, accounting for 1.1 percent of total U.S. births and
17.1 percent of U.S. multiple births. There is recent evidence
of higher rates of adverse pregnancy outcomes even in single
birth pregnancies associated with ART including increased low
birth weight, fetal growth restrictions, genetic disorders and
congenital disorders. The Committee encourages NICHD to support
an initiative for a multi-site cohort study on ART that would
emphasize pregnancy outcomes, and short and long term effects
on children to determine if the adverse outcomes are
specifically related to ART procedures.
Stillbirth.--The Committee applauds NICHD's efforts in
addressing stillbirth, a major public health issue with
morbidity equal to that of all infant deaths. The Committee
understands that the NICHD cooperative network has an ongoing
study using a standard protocol at five clinical sites and
encourages NICHD to continue supporting this effort.
Vulvodynia.--As a result of efforts funded by the NICHD,
the number of highly qualified scientists interested in
researching vulvodynia has greatly increased. The Committee
commends NICHD for reissuing its program announcement in this
area and suggests that a request for applications be
considered. The Committee encourages NICHD to strengthen its
support of vulvodynia studies in 2006, with a particular
emphasis on etiology and multi-center therapeutic trials. The
Committee commends NICHD for working with ORWH to implement an
educational outreach campaign on vulvodynia and calls upon the
Institute to continue these efforts.
Pre-term birth.--The Committee recognizes that prematurity
is the leading cause of newborn death and an estimated twenty
percent of infants who survive suffer long term consequences,
including cerebral palsy, mental retardation, and developmental
delays that affect the child's ability to do well in school.
The Committee encourages NICHD to strengthen research on the
underlying causes of pre-term delivery and the development of
treatments for the prevention of premature birth. Furthermore,
the Committee is aware that a 2006 Institute of Medicine report
found that a multidisciplinary research approach is needed to
better understand premature birth, and therefore encourages NIH
to use this strategy to fund research on pre-term birth.
Mental retardation.--The Committee recognizes the
outstanding contributions of the Mental Retardation/
Developmental Disabilities Research Centers (MRDDRC) toward
understanding why child development goes awry, discovering ways
to prevent developmental disabilities, and discovering
treatments and interventions to improve the lives of people
with developmental disabilities and their families. The
Committee is particularly pleased with the MRDDRC contributions
in the areas of autism, fragile X syndrome, Down syndrome and
other genetic and environmentally induced disorders. These
centers have greatly improved our understanding of the causes
of developmental disabilities. However, the Committee is
concerned that the centers have not been given sufficient
resources to sustain the progress made in this critical area,
even though they received outstanding scientific evaluations.
The Committee urges NICHD to provide additional resources to
the MRDDRCs so that they can conduct translational research to
develop effective prevention and intervention strategies for
children and adults with developmental disabilities.
National Eye Institute
Mission.--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, NEI is responsible for the dissemination of
information, specifically public and professional education
programs aimed at the prevention of blindness.
Age-related macular degeneration (AMD).--The Committee
commends NEI for its trans-Institute research into the cause,
prevention, and treatment of AMD, the nation's leading cause of
blindness, including identification of gene variants associated
with an increased risk for AMD, which presents an opportunity
to predict and preempt the disease. The Committee encourages
further research into diagnostics for early detection and
appropriate therapies. The Committee also applauds NEI for
initiating the second phase of its age-related eye disease
study, in which additional dietary supplements are being
studied to determine if they can demonstrate or enhance their
protective effects against progression to the advanced form of
AMD, as shown with dietary zinc and antioxidant vitamins in the
study's first phase. This research is a potentially cost-
effective means by which to decrease the progression of this
disease.
Diabetic eye disease.--The Committee applauds NEI for the
collaborative efforts of the diabetic retinopathy clinical
research network to test innovative treatments for diabetic eye
disease. The Institute is encouraged to consider expanding and
extending the network by increasing the number of clinical
trials with new drugs and therapeutics that can treat and
prevent diabetic retinopathy.
National ophthalmic disease genotyping network.--The
Committee congratulates NEI on its progress in identifying many
of the genes involved in some of the most devastating eye
diseases, including age-related macular degeneration (AMD),
retinitis pigmentosa (RP), and glaucoma, and the progress that
has been made in understanding the underlying disease
mechanisms and in developing appropriate treatments. NEI's new
national ophthalmic disease genotyping network (eyeGENE) will
help accelerate application of these new approaches to
medicine. By encouraging the participation of patients and
their families who need highly-specialized genetic testing
services and coordinating the efforts of many vision research
laboratories, vital information is being collected
confidentially and maintained securely. This information will
help preempt eye disease by enabling qualified investigators to
develop targeted treatments and to identify those individuals
who are appropriate candidates for these treatments.
National Institute of Environmental Health Sciences
Mission.--The mission of NIEHS is to prevent disease and
improve human health by using environmental sciences to
understand human biology and disease. This mission is achieved
through conducting and supporting disease-oriented biomedical
research (basic, integrative, clinical, and epidemiologic),
enhancing research capacity in environmental health sciences,
prevention and intervention strategies, and communication with
researchers, public health and health care providers, and the
public.
Validation of alternative methods.--The Committee commends
the interagency coordinating committee on the validation of
alternative methods (ICCVAM) for beginning to develop a five-
year plan to research, develop, translate and validate new and
revised non-animal and other alternative assays for integration
of reliable methods into Federal agency testing programs. The
plan will prioritize areas which have the potential to most
significantly and rapidly reduce, refine or replace laboratory
animal methods. The Committee requests that the plan be
submitted to the Committee by January 1, 2008.
Alpha-1 antitrypsin deficiency (Alpha 1).--The Committee is
aware that Alpha-1 is the major genetic risk factor for chronic
obstructive pulmonary disease (COPD), the fourth leading cause
of death in the U.S. and the only leading cause of death with a
rising mortality. As many as three percent of individuals with
COPD have undetected Alpha-1. Given the link between
environmental factors and the onset of Alpha-1-related COPD,
the Committee encourages NIEHS to develop research initiatives
to explore gene-environment interaction research and to support
public-private partnerships.
Bone marrow failure diseases.--Aplastic anemia,
myelodysplastic syndromes (MDS) and paroxysmal nocturnal
hemoglobinuria (PNH) are life threatening, non-contagious
diseases. While there are no known causes of bone marrow
failure diseases, they have been linked to environmental
factors. The Committee encourages NIEHS to work with NHLBI and
NCI to fund research that explores these links to determine
what, if any, environmental factors may cause bone marrow
failure diseases.
Mercury.--In order to properly research gaps in the area of
mercury exposure and brain chemistry, the Committee encourages
NIEHS 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. The Committee requests NIEHS to evaluate the
feasibility of conducting several studies outlined in the 2006
NIEHS report to the Committee entitled: ``Thimerosal Exposure
and Childhood Vaccines'' and report back to the Committee on
its plan by the end of February 2008.
NIH is encouraged to continue its work on the long-term
effects of the exposure of pregnant women to methyl mercury,
including higher than average levels of exposure, and to report
to the Committee by April 1, 2008 the results of these studies.
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 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 may 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.
Parkinson's disease.--The Committee commends NIEHS for
funding the collaborative centers for neurodegenerative disease
environmental research (CCNDER) to foster multidisciplinary
research approaches to elucidate gene-environment interactions
in neurodegenerative diseases. The Committee encourages NIEHS
to ensure that the CCNDER program continues to pursue promising
Parkinson's research resulting from the work of the
collaborative centers for Parkinson's disease environmental
research (CCPDER) program. The Committee requests NIEHS to
report to Congress on the outcomes and results of Parkinson's
disease research conducted under CCPDER and plans for ensuring
that promising Parkinson's research continues under the new
CCNDER program.
Food allergies.--The Committee recognizes the potential
relationship between environmental conditions and food
allergies, and encourages NIEHS to fund research in cooperation
with NIAID to understand the causes and potential therapies for
the growing danger of anaphylaxis resulting from food
allergies.
National Institute on Aging
Mission.--NIA supports and conducts biomedical, social and
behavioral research, training, and health information
dissemination with respect to the aging process and the
diseases and other special problems and needs of older
Americans.
Demographic and economic research.--The Committee
encourages NIA to sustain its commitment to the demography of
aging centers program. These centers coordinate key data
collection and dissemination activities that benefit the entire
field of population aging research and inform public policy
issues, such as reform of federal entitlement and health care
programs. The Committee also congratulates NIA for elevating
the dialogue surrounding global aging issues by hosting with
the Department of State the Summit on Global Aging.
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
collaborate with other institutes to address the issues that
face elderly adults with Down Syndrome.
Gerontology centers.--The Committee expresses its full
support for the Edward R. Roybal Research Centers on Applied
Gerontology. The centers are designed to move promising social
and behavioral basic research findings out of the laboratory
and into programs, practices, and policies that will improve
the lives of older people and the capacity of society to adapt
to societal aging. The Committee suggests that NIA consider
expanding the numbers of centers, developing new topics for
research especially in the area of diversity and ethnic and
minority communities, and providing opportunities for
collaborative, interdisciplinary research between the Roybal
centers and other program initiatives such as the resource
centers for minority aging research (RCMAR) and the demographic
centers.
Bone strength.--The Committee has learned that although
bone mineral density has been a useful predictor of
susceptibility to fracture, other properties of the skeleton
contribute to bone strength, such as geometry and composition.
At this time, little is understood as to how these properties
influence bone strength. The Committee encourages NIA to work
with NIAMS, NIBIB, NICHD, NIDDK, NCRR and NHLBI to support
research, including research on bone structure and periosteal
biology, which will achieve identification of the parameters
that influence bone strength and lead to better prediction for
prevention and treatment of bone diseases.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Mission.--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.
Burden of skin diseases.--The Committee continues to urge
NIAMS to strengthen the research portfolio on skin disease and
develop partnerships with the skin disease research community
to address recognized challenges and future research questions.
The Committee is especially concerned about epidermolysis
bullosa (EB), a rare, genetic skin disease characterized by
severe blistering and sores on the skin and, in some cases, on
mucous membranes, the external surface of the eye, as well as
the respiratory, gastrointestinal and genitourinary tracts. The
Committee also notes the importance of autoimmune diseases,
such as scleroderma, in the overall burden of skin diseases.
Psoriasis.--The Committee encourages NIAMS to expand and
coordinate genetic, clinical, and basic psoriasis and psoriatic
arthritis research, with emphasis on the cellular and molecular
mechanisms of disease; understanding the genetics that lead to
psoriasis susceptibility; the role of inflammation in psoriasis
co-morbidities such as obesity, depression and heart disease;
and studies to ascertain if aggressive early treatment of
psoriasis can prevent or mitigate psoriatic arthritis, which
often appears as much as a decade after psoriasis.
Mucopolysaccharidosis (MPS).--In previous years, the
Committee has encouraged NIAMS to support and work
collaboratively with NIDDK in an effort to achieve a greater
understanding of bone and joint lesions 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
interest to the Committee. In its congressional justification,
the Institute noted that it would welcome applications for
musculoskeletal-related research related to MPS. It also noted
its meetings with NIDDK, NINDS and MPS patient advocates to
examine opportunities for collaboration. The Committee is
interested in further information on the outcome of these
efforts and the steps that are being taken to encourage
progress in this area of study.
Lupus.--The Committee is aware that despite numerous
important research advances, few new therapies are available to
patients with lupus. Treatment with steroids, anti-inflammatory
agents and immunosuppressive medications may be palliative, but
these medications have numerous side effects and may become
less effective over time. Advances in the identification of
lupus susceptibility genes and biomarkers make it important to
translate these research advances into clinically relevant
treatments. The Committee encourages the Institute to develop
focused programs designed to move research advances from the
laboratory to the patient's bedside so that the complications
of lupus and the underlying disease can be treated more
effectively.
Musculoskeletal trauma and skeletal pain.--The Committee
recognizes that of the 29.7 million Americans who are treated
for injuries at U.S. hospital emergency departments, more than
40 percent have injuries to the musculoskeletal system. In the
U.S., back pain is a major reason listed for lost time from
work. The Committee encourages NIAMS, NIA, NIDCR, and NCCAM to
study ways to better understand the epidemiology of back pain,
improve existing diagnostic techniques, as well as develop new
ones. The Committee also encourages NIAMS, NIBIB, NICHD, NIDCR,
NIDDK and NIA to expand research to improve diagnostic and
therapeutic approaches to lower the impact of musculoskeletal
traumas, as well as research on accelerated fracture healing--
including the use of biochemical or physical bone stimulation,
the role of hematopoietic niches to preserve bone stem cells,
the use of mesenchymal bone stem cells, and biomaterials and
biologicals in bone repair and regeneration--and research into
repair of nonunion fractures in osteogenesis imperfecta.
National Institute on Deafness and Other Communication Disorders
Mission.--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, 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.
Tinnitus.--The Committee recognizes that tinnitus,
characterized by loud ringing in the ears, can be a severely
debilitating medical condition. While tinnitus
disproportionately impacts military personnel exposed to
explosive devices or loud noise, it also affects people of all
ages, including children and the elderly. In 2005, the NIDCD
held a workshop to explore areas of needed research for the
treatment and cure of tinnitus. The Committee encourages NIDCD
to follow up on the workshop's recommendations, including
increasing collaboration between NIH, the Department of
Defense, and the Department of Veterans Affairs to support a
multi-disciplinary research approach that promotes accurate
diagnosis and treatment to cure tinnitus.
National Institute of Nursing Research
Mission.--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.
End-of-life science.--Improving the care of terminally ill
patients at the end of life continues to be an urgent public
health need, along with the need to improve the end-of-life
experience for the patient's loved ones. Additional research is
needed into improving palliative care, reducing caregiver
burden, and improving the interactions between patients, loved
ones, and clinicians. The Committee recognizes NINR's continued
leadership in end-of-life sciences and encourages the
Institute's continued focus in this area.
Nursing shortage.--The shortage of nurses in the U.S. is a
great concern for the field of healthcare. The nursing shortage
threatens our nation's healthcare delivery systems, and
shortages of nursing faculty impair the ability of schools of
nursing to train new nurses. The Committee is concerned about
the potential impact of the nursing shortage on nursing
research and encourages NINR to explore innovative strategies
for recruiting and developing additional nurse scientists. The
Committee encourages NINR to support training programs that
will develop the next generation of nurse scientists,
especially those with multidisciplinary research skills and
those from underserved populations.
Health disparities.--The Committee continues to encourage
NINR to support research into the causes of health disparities
and into the development of innovative methods for overcoming
such disparities. In addition, NINR is encouraged to develop
new nurse scientists from underserved populations as a way to
encourage new health disparities research.
National Institute on Alcohol Abuse and Alcoholism
Mission.--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 abuse and
associated damage, especially in the underage population; 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.
Underage drinking.--The Committee commends NIAAA for its
inter-disciplinary approach to understanding and addressing
underage drinking within the context of overall physical
development. The Committee is aware that this framework formed
the scientific foundation of the ``Surgeon General's Call to
Action to Prevent and Reduce Underage Drinking.'' The Committee
further commends NIAAA for spearheading research to address key
aspects of underage drinking. This includes research projects
to engage health care systems in identifying and addressing
underage drinking, particularly in rural areas. NIAAA is also
supporting projects to address fundamental questions about the
impact of child and adolescent alcohol consumption on the
developing brain including: (1) what are the effects (both long
and shorter-term) of alcohol exposure on the developing brain;
(2) what is the effect of timing, dose and duration of alcohol
exposure on brain development; and (3) to what extent do these
effects resolve or persist.
National Institute on Drug Abuse
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
policymakers, practitioners, and the public.
Drug abuse and crime.--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
significantly decreases future drug use and criminal behavior,
while improving social functioning. The Committee strongly
supports NIDA's efforts in this area, particularly the criminal
justice drug abuse treatment studies (CJ-DATS).
HIV/AIDS and drug abuse.--The Committee understands that
drug abuse and addiction continue to fuel the spread of HIV/
AIDS in the United States and abroad, and that drug abuse
prevention and treatment interventions can be very effective in
reducing HIV risk. Research should continue to examine every
aspect of HIV/AIDS, drug abuse, and addiction, including risk
behaviors associated with both injection and non-injection drug
abuse, how drugs of abuse alter brain function and impair
decision making, and HIV prevention and treatment strategies
for diverse groups. The Committee applauds the Institute for
holding a spring 2007 conference titled ``Drug Abuse and Risky
Behaviors: The Evolving Dynamics of HIV/AIDS,'' and urges the
Institute to continue supporting research that focuses on
developing and testing drug abuse-related interventions
designed to reduce the spread of HIV/AIDS.
Research translation.--The Committee commends NIDA for its
outreach and work with State substance abuse authorities to
reduce the current fifteen to twenty-year lag between the
discovery of an effective treatment intervention and its
availability at the community level. In particular, the
Committee applauds NIDA for continuing its work with the
Substance Abuse and Mental Health Services Administration to
strengthen State agencies' capacity to support and engage in
research that will foster statewide adoption of meritorious
science-based policies and practices. The Committee encourages
NIDA to continue collaborative work with States to ensure that
research findings are relevant and adaptable by State substance
abuse systems.
Drug abuse and brain development.--The Committee notes
neuroimaging research by NIDA and others showing that the human
brain does not fully develop until about age 25. The Committee
encourages NIDA to continue its emphasis on adolescent brain
development to better understand how developmental processes
and outcomes are affected by drug exposure, the environment,
and genetics.
Centers of excellence for physician information.--The
Committee is pleased that NIDA has created centers of
excellence for physician information, and understands that
these centers will serve as national models to support the
advancement of addiction awareness, prevention, and treatment
in primary care practices. The NIDA centers of excellence will
target physicians-in-training, including medical students and
resident physicians in primary care specialties. The Committee
urges the Institute to continue its focus on activities to
provide physicians and other medical professionals with the
tools and skills needed to incorporate NIDA-funded research
findings into their clinical practices.
Minority populations.--The Committee notes that the
consequences of drug abuse disproportionately impact
minorities, especially African American populations. The
Committee is pleased to learn that NIDA continues to encourage
researchers 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.
AAPI behavioral research.--The Committee recognizes that
there is a need for additional research to develop a body of
knowledge addressing the bio-psycho-social aspects of substance
abuse as well as co-occurring disorders among Asian American
and Pacific Islander (AAPI) populations. The Committee urges
NIDA, NIAAA, and NIMH to address the behavioral health research
needs for AAPI populations, including studies focused on AAPI
incidence and prevalence data for substance abuse and co-
occurring disorders; research addressing the biological
differences that may exist within AAPI populations; nature of
substance abuse among AAPI populations; effective prevention
and treatment strategies; and culturally appropriate ways to
evaluate AAPI substance services; and the etiology, causes and
impact on AAPI populations as a result of substance use and
abuse.
National Institute of Mental Health
Mission.--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; 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.
Adolescent depression and suicide.--Suicide is the third
leading cause of death among teenagers; for the first time in
sixteen years, teen suicide rates have increased in the U.S.
Depressive disorders, one of the major risk factors for
suicide, continue to be very common in adolescence. The
Committee therefore strongly encourages NIMH to strengthen its
investment in finding ways to better identify the risk factors
for suicide in adolescents, improving the criteria for
identifying those at risk, and examining the outcomes of
actions taken to assist those found to be at risk.
Geriatric mental health.--By the year 2010, there will be
approximately 40 million people in the United States over the
age of 65, and 20 percent of them will experience mental health
problems. A national crisis in geriatric mental health care is
emerging, and action must be taken to avert serious problems in
the future. For the past five years, this Committee has urged
NIMH to strengthen research devoted to older adults; however,
the geriatric mental health research portfolio supported by
NIMH continues to be dramatically disproportionate to the
increasing number of older Americans. The Committee requests
that NIMH provide data on funding targeted toward geriatric
mental health research in 2002-2006 and the amount of funding
provided to new investigators in late-life mental health
research. In addition, the Committee urges NIMH to place a
stronger emphasis on research on adults over age 65 to reflect
the growth in numbers of this population.
Suicide prevention research.--Suicide is a major,
preventable public health problem. In 2004, it was the eleventh
leading cause of death in the U.S., accounting for 32,000
deaths. An estimated eight to 25 attempted suicides occur per
every suicide death. The Committee is pleased to note that NIMH
is supporting three developing centers for interventions to
prevent suicide and encourages NIMH to strengthen its
investment in suicide prevention research.
Down syndrome.--The Committee encourages NIMH to develop
new strategies for cataloging, diagnosing and treating
behavioral disorders that are common in people with Down
syndrome, including autism, pervasive developmental disorder,
obsessive compulsive disorder, depression, and psychosis. The
Committee encourages NIMH to coordinate its research on Down
syndrome with NICHD, NINDS, NIA and other institutes.
National Human Genome Research Institute
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.
Spinal muscular atrophy (SMA).--The Committee is supportive
of the development of a carrier screening program for SMA and
the trans-institute collaborative effort initiated by NHGRI to
develop a strategic plan addressing research-related needs to
improve carrier screening technology. The Committee encourages
NHGRI to work collaboratively and cooperatively with the
advocacy community in this effort.
National Institute of Biomedical Imaging and Bioengineering
Mission.--The NIBIB mission is to improve human health by
leading the development and accelerating the application of
biomedical technologies. The Institute is committed to
integrating the engineering and physical sciences with the life
sciences to advance basic research and medical care.
National Center for Research Resources
Mission.--NCRR provides laboratory scientists and clinical
researchers with environments and tools that they can use to
prevent, detect, and treat a wide range of diseases. This
support enables discoveries that begin at the molecular and
cellular level, move to animal-based studies, and then are
translated to patient-oriented clinical research, resulting in
cures and treatments for both common and rare diseases. NCRR
connects researchers with each other and with patients and
communities across the nation to bring the power of shared
resources and research to improve human health.
Image guided therapy.--The Committee applauds NCRR for its
development and support of a national image guided therapy
center (IGT) for research, training, and services related to
novel imaging tools for disease diagnosis and therapy. NCRR is
encouraged to work with NIDDK and NIBIB to ensure that this
unique resource center engages with the diabetes research
community to accelerate the development of new methods for the
non-invasive imaging of pancreatic islets for applications in
type 1 diabetes research and treatment.
Rare diseases.--The Committee commends NCRR for the
development of the rare disease consortium, including rare lung
diseases such as LAM, and urges the continuation of the
program.
Research Centers in Minority Institutions Program (RCMI).--
The Committee continues to recognize the critical role of
minority institutions in addressing the ongoing racial and
ethnic health disparities in the United States. The Committee
encourages NIH to expand its direct participation with minority
institutions and increase the resources available to these
institutions. The Committee also recognizes the importance of
the RCMI program in building research capacity at minority
institutions. The RCMI program assists minority institutions in
competing for NIH grants and other funding by helping to
recruit promising researchers, equip and modify existing
laboratories, and fund core research facilities and other
research support at minority institutions. The Committee
further expresses support for the proposed RCMI translational
research network (RTRN) and its focus on strengthening ties
between minority institutions, and encourages NIH to designate
specific resources for the RTRN apart from the existing RCMI
program.
National Center for Complementary and Alternative Medicine
Mission.--NCCAM 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 (CAM) practices and to
train individuals to apply the tools of exacting science to CAM
systems and modalities in order to provide health care
professionals and the American public with reliable information
about these practices.
Improving liver disease outcomes.--The Committee is pleased
with the progress made in studying the benefit of active
ingredients in milk thistle and SAM-e, a naturally occurring
compound, in ameliorating and improving the outcome of
individuals with non-alcoholic steatohepatitis.
National Center on Minority Health and Health Disparities
Mission.--NCMHD 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 disease.--The Committee understands that a type
of glomerular disease, focal and segmental glomerulosclerosis,
which is a group of diseases affecting the filtering mechanisms
of the kidneys, is more common in African Americans than the
general population. The Committee encourages NCMHD to include
glomerular disease in its research portfolio.
Research endowment.--The Committee commends NCMHD for its
leadership in addressing the longstanding problem of health
status disparities in minority and medically underserved
populations. For fiscal year 2008, the Committee continues to
encourage NCMHD to implement its successful research endowment
program as an ongoing initiative in a manner consistent with
the authorizing legislation. The Committee also commends NCMHD
for its successful Project EXPORT initiative and urges
continued support for this important program.
Health disparities among Hispanic-Americans.--The Committee
is aware of promising research on health disparities among
Hispanic-Americans. The Committee encourages NCMHD to continue
to conduct such research, in close coordination with Hispanic
researchers, with the goal of identifying the most promising
avenues for disease-specific research to address health
disparities among Hispanic-Americans.
John E. Fogarty International Center
Mission.--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.
Malaria and tuberculosis (TB).--The Committee appreciates
the important and unique role that FIC plays in addressing
global health challenges. The Committee commends the Center for
the success of its programs to strengthen science and public
health research institutions in low-income countries,
specifically in malaria, TB, and neglected tropical diseases.
The Committee urges FIC to continue supporting research
training focused in these areas to enable developing country
scientists to develop effective, evidence-based strategies to
prevent, treat, and diagnose these debilitating diseases. While
major investments in biomedical research by NIAID and others
are resulting in new tools and medical advances, the Committee
realizes that improvements in health outcomes will be delayed
without local scientific expertise to translate research
findings into practice. The Committee encourages FIC to promote
applied health research in developing countries to speed the
implementation of new health interventions for malaria, TB, and
neglected tropical diseases.
Chronic obstructive pulmonary disease (COPD).--The
Committee notes that COPD is the fourth leading cause of death
worldwide, and encourages FIC to enhance its COPD research and
training activities.
Tuberculosis training.--The Committee is pleased with the
FIC's efforts to supplement grants in the AIDS international
training and research program (AITRP) and the international
training and research program in emerging infectious diseases
(ERID), which train tuberculosis experts in the developing
world.
National Library of Medicine
Mission.--NLM collects, organizes, and disseminates
information important to biomedicine; serves as a national
information resource for medical education, research, and
health service activities; enhances access to biomedical
literature through electronic services; serves the public by
providing electronic access to reliable health information for
consumers; supports and directs the national network of
libraries of medicine; provides grants for research in
biomedical communications, medical library development, and
training health information specialists; conducts and supports
research in biomedical informatics and computational biology;
and creates information resources for genomics, molecular
biology, toxicology, medical images, environmental health,
emergency preparedness and response, and health services
research.
Health information technology.--The Committee encourages
NLM to conduct outreach activities to all public and private
sector organizations which have demonstrated capabilities in
health information technology. The Committee is particularly
interested in disease management technology as it relates to
saving health care dollars, and improving care for chronically
ill individuals and the workforce.
Outreach.--The Committee encourages NLM to continue its
outreach activities aimed at educating health care
professionals and the general public about the Library's
products and services, in coordination with medical librarians
and other health information specialists.
PubMed Central.--The Committee commends NLM for its
leadership in developing PubMed Central, an electronic online
repository for life science articles. Because of the high level
of expertise health information specialists have in the
organization, collection, and dissemination of medical
information, the Committee believes that health sciences
librarians have a role to play in the further development of
PubMed Central. The Committee encourages NLM to work with the
medical library community regarding issues related to
copyright, fair use, and classification of information on
PubMed Central.
Registry of liver toxicities.--The Committee applauds NLM's
plan to create an accessible, on-line registry of the liver
toxicity of medications and sees this as an important step to
help physicians and patients avoid the devastating consequences
of liver failure. The registry will include information
regarding the liver toxicity of over four hundred drugs to
assist physicians to better understand the potential of drugs
to interfere with the normal functions of the liver. The
Committee encourages the inclusion in the registry of
information from databases that catalog information on the
interrelationship between environmental toxins and genes.
NIEHS journal management.--The Committee understands that
NLM has been assigned the management of the recompetition of
the publication of the NIEHS journal, Environmental Health
Perspectives. The Committee is aware of earlier problems
resulting from efforts to privatize this publication and to
dramatically reduce its budget. The Committee expects NLM to
take the necessary steps to ensure that the quality and
comprehensiveness of the journal is maintained.
Office of the Director
Mission.--OD provides leadership to the NIH research
enterprise and coordinates and directs initiatives that cross-
cut NIH. 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
the operations of NIH.
The Committee includes bill language identifying
$495,153,000 for the total support of the Common Fund. The
Committee believes this funding approach is preferable to
assessing the institutes and centers and using the director's
discretionary fund.
The Committee includes bill language within the Office of
the Director account allocating $110,900,000 to continue the
National Children's Study. The Committee would not normally
identify funding in bill language for a specific research
effort, but feels an exception is necessary in this case
because the Administration has resisted supporting the study.
The Committee repeats bill language from the fiscal year
2007 bill identifying $14,000,000 for flexible research
authority modeled on the Department of Defense Advanced
Research Projects Agency (DARPA).
The Committee includes bill language providing not more
than $500,000 to be used for the Foundation on NIH.
Seven general provisions are included in the bill
pertaining to NIH:
The Committee rejects the Administration
proposal to limit salaries of researchers through an
NIH grant to not more than the rate of Executive Level
II and continues the language (sec. 203) setting the
limit at Executive Level I.
The Committee continues traditional language
(sec. 208) 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 research funding. The Committee
also continues a provision (sec. 209) to make NIH funds
available for human immunodeficiency virus research
available to the Office of AIDS Research.
The Committee continues a provision (sec.
214) granting authority to the OD to support research
under the flexible research authority.
The Committee includes language (sec. 216)
similar to that carried in the House-reported version
of the fiscal year 2007 bill requiring NIH-funded
authors to deposit final, peer-reviewed manuscripts in
the National Library of Medicine's PubMed Central
database within twelve months of the official date of
publication.
The Committee includes language (sec. 217)
requested by the Administration permitting institutes
and centers to use their appropriation for renovation
and improvement of facilities, up to $2,500,000 per
project and up to a total of $35,000,000 across NIH.
The Committee shares NIH's concern about the pipeline for
new investigators and the prospect of researchers becoming so
discouraged by repeated rejection of their applications that
they leave the field. The Committee provides funding for the
following programs to begin to address this problem:
$91,500,000 within the Office of the
Director for the Director's one-year Bridge awards for
investigators who either are being considered for their
first award renewal or have just missed the funding
payline with no other sources of support;
$31,000,000 funded through all the
institutes and centers for the Pathways to Independence
program to provide new investigators with mentored
grants that convert into independent research project
grants; and
$40,000,000 through the Common Fund for the
New Innovator awards that provide first-time
independent award funding for a five-year period based
more on ideas than experimental data.
The Committee believes the Director's Pioneer Awards are an
effective tool to encourage high risk, transformative research
and has provided $27,000,000 within the Common Fund for this
purpose.
As requested by the Administration, included within funding
for the Office of the Director is $95,310,000 for radiological,
nuclear and chemical countermeasures and up to $10,000,000 for
the Director's discretionary fund.
The Committee understands that the National Institutes of
Health Reform Act of 2006 signed into law on January 15, 2007
contains significant organizational and reporting requirements.
The Committee requests that the agency provide a report
detailing the timeline for planned implementation of each of
these requirements, particularly the establishment of the
Division of Program Coordination, Planning, and Strategic
Initiatives, the appointment of the Council of Councils and the
Scientific Management Review Board, the electronic coding
system for research grants, and the biennial report to
Congress. The report to the Committee should also include the
personnel appointed to lead these efforts; the authorities
delegated to these new entities; and organizational tables
displaying how the new entities link to the existing NIH
structure. The Committee requests the first report by September
1, 2007, followed by semi-annual reports thereafter through
2009.
The Committee expects NIH to notify the House and Senate
Committees on Appropriations each time the Director uses the
one percent transfer authority provided in the NIH
reauthorization.
The Committee is concerned about numerous incidents at the
National Institute of Environmental Health Sciences that call
into question the administrative and scientific management of
the Institute. The Committee understands that the HHS Inspector
General and Congressional committees are investigating a range
of troubling circumstances in areas as diverse as management of
scientific journals, employee complaints about performance
appraisal systems, alleged conflict of interest by outside
contractors hired to operate peer review systems, and improper
use of Federal funds in office renovation and support staff
assignments. The Committee believes it is necessary for the
Office of the Director to take a leadership role in conducting
a comprehensive management review of the entire Institute. The
Committee directs the NIH Director to task the Office of
Management Assessment with conducting an on-site review of
scientific and administrative operations at NIEHS. This review
should encompass personnel practices, including communication
with employee unions; contracting procedures; financial
management and accounting practices; and enforcement of
financial disclosure and conflict of interest by NIEHS
employees and contractor staff. The Committee understands this
review will require a substantial level of effort, but would
like to receive a report on the review findings by January 1,
2008.
The Committee understands that although NIH has established
a detailed policy for its Federal employees on conflict of
interest and financial disclosure, there is no similar policy
in place for the 6,830 staff NIH hires through contract. These
staff support NIH in both administrative and research
functions. Having learned of some of the flagrant conflict of
interest situations identified among the NIH Federal staff, the
Committee is concerned that there is great potential for
similar problems among the NIH contract staff. The Committee
directs the NIH Director, after consultation with the U.S.
Office of Government Ethics, to develop a conflict of interest
policy that is appropriate for contract staff. The Committee
expects a report from the NIH Director by October 1, 2007 on
the plans and timeline for implementation of a conflict of
interest and financial disclosure policy for contract staff.
The Committee is deeply troubled by the recent allegations
of religious discrimination occurring in the NIH spiritual
ministry department. The Committee was alarmed to learn that,
since 2004, three chaplains who voiced concerns against these
discriminatory practices were subsequently terminated from
their duties. The Committee notes the January, 2006 findings of
the Equal Employment Opportunity Commission that one of these
chaplains who complained about the intolerent environment in
the department was the target of ``discriminatory and
retaliatory animus''.
The Committee directs that the HHS Inspector General to
review the overall operation of the spiritual ministry
department at NIH's clinical research center, with a specific
emphasis on the adequacy of policies and procedures addressing
any problems of religious intolerance. The review should also
address the performance of the current staff of the spiritual
ministry and make personnel recommendations to the director of
the clinical center. The Committee requests a report on the
Inspector General's findings and recommendations by January 1,
2008. The Committee urges NIH to develop a plan to ensure that
they are providing adequate chaplain services to people of all
faiths.
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.
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. ORWH 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.
Irritable bowel syndrome (IBS).--The Committee is pleased
with the increased focus on IBS at ORWH and encourages the
office to continue strengthening research on this prevalent
functional gastrointestinal disorder. 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. 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, OAR allocates an
emergency AIDS discretionary fund to support research that was
not anticipated when budget allocations were made.
The bill includes continues language permitting the OAR to
use up to $4,000,000 for construction or renovation of
facilities, as authorized in title XXIII of the Public Health
Service Act.
Microbicides.--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 basic research efforts, the best
possibilities may be found within pharmaceutical companies
where there are dozens of potential compounds already developed
as therapeutics that could move into clinical development as
microbicides if made available. In recent years, nonprofit
groups have entered into innovative agreements with leading
pharmaceutical companies to jointly test and develop leading
AIDS drugs as microbicides. The Committee believes that more
partnerships like these between the pharmaceutical industry and
the nonprofit community will be critical and should receive the
active support of NIH leadership.
Microbicide research branch.--Women and girls are the new
face of HIV/AIDS and are increasingly affected by the disease
in every region of the world. The Committee has long advocated
that NIH accelerate and better coordinate its microbicide
research and notes with approval that NIH has stated its intent
to establish a dedicated microbicide branch at NIH with clearly
identified leadership, funding and staffing. The Committee
strongly supports establishment of this branch and requests
that NIH prepare within six months of passage of this bill a
report detailing progress made in establishing a microbicide
branch, including detailed information on staff and funding
dedicated to this effort.
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 to 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.
Mucopolysaccharidosis (MPS).--The Committee commends ORD
for its collaborative efforts with NINDS and NIDDK in
supporting a landmark scientific conference with the objective
of identifying and addressing impediments to effective
therapies. The Committee notes ORD's accessibility to MPS
patient advocates and other rare disease organizations with
similar goals and is gratified that ORD has used its resources
to support enhanced activity in MPS research.
Multi-institute research issues
National Children's Study.--The Committee strongly supports
full and timely implementation of the National Children's Study
that aims to quantify the impacts of a broad range of
environmental influences, including physical, chemical,
biological, and social influences, on child health and
development. The Committee urges NIH to coordinate the
involvement of the Department, the lead Federal partners, and
other interested non-Federal partners conducting research on
children's environmental health and development.
Clinical and Translational Science Awards (CTSA).--The
Committee is pleased with the extensive planning and
consultation that NIH has conducted in the development of the
CTSA program, and it will be very interested in the progress
report due July 1, 2007 that was requested in the fiscal year
2007 House Appropriations Committee report. The Committee
understands that a national CTSA evaluation is being developed,
along with evaluations of each CTSA site. The Committee
believes it is important that the national evaluation include
the expertise of external reviewers not affiliated with the
CTSA grants or NIH. These reviewers would provide credibility
grounded in independent experience with the challenges of
clinical and translational research. Such viewpoints would
contribute to a candid assessment of the successes and
shortcomings of the CTSA research model and its impact on the
clinical research enterprise. The Committee recommends that NIH
include such reviewers in the evaluation of CTSA's impact. The
Committee suggests that participants in the Institute of
Medicine's Clinical Research Roundtable who are not affiliated
with the CTSA program would be useful additions to the
program's evaluation.
Research training stipends.--The Committee is concerned
about NIH's response to the finding in the 2000 National
Academy of Sciences needs assessment that NRSA stipends are
unduly low in view of the high level of education and
professional skills involved in biomedical research. Plans to
increase awards to $25,000 for graduate and $45,000 for entry-
level postdoctoral stipends, and to maintain that value with
annual cost-of-living adjustments, have not been realized. The
Committee has provided funding to permit an average two percent
increase in stipends and urges NIH to prioritize further
increases for NRSA stipends in future years. NIH should also be
prepared to discuss comparability of stipends to levels of
income available to students and postdoctorates from other
sources during hearings on the fiscal year 2009 budget. The
Committee requests that NIH provide a report by March 1, 2008
estimating the funding increase that would be needed to
increase the minimum stipend award to $45,000 for entry-level
postdoctoral students. The Committee is aware of the higher
cost of living that individuals pursuing NIH funded post-
doctoral research in urban areas experience. The Committee
urges NIH to consider making adjustments to fellowship awards
to reflect geographic differences in living expenses and
requests that NIH include in the report mentioned above
information on the budgetary impact of such adjustments.
Minority research training programs.--The Committee
supports the recommendations put forward in the 2005 National
Academy of Sciences (NAS) report on NIH minority research
training programs. The Committee believes that the training of
research scientists is a critical component of the NIH mission,
and the Committee urges NIH to improve its data systems so that
more complete information about NIH-supported graduate and
post-doctoral research assistants and trainees is available.
Without adequate data, the NIH programs cannot be properly
evaluated or monitored. As proposed by the NAS, the Committee
recommends the NIH develop an integrated NIH-wide trainee and
research assistant data tracking system. The Committee further
encourages NIH to engage trainees and research assistants in
the data tracking process to document outcomes such as future
funding awards, including those programs that are targeted to
underrepresented minorities.
Fragile X syndrome.-- This syndrome has many
characteristics and features that make it important to the
research portfolios of multiple NIH institutes and centers. The
Committee places most of the report language pertaining to
fragile X in the NIH Office of the Director to emphasize the
cross-disciplinary nature of many of the disease's research
questions. For example, the symptoms of fragile X syndrome
include digestive difficulties. Some affected individuals also
show hyperphagia and obesity. Understanding this disorder may
permit the development of treatments to relieve these fragile X
symptoms and may also help understanding disorders with similar
symptoms. The Committee encourages NIDDK to coordinate its
efforts with other Institutes working on related activities,
including NIMH, NINDS, NICHD, NHGRI and FIC.
More generally, the Committee encourages the institutes to
support clinical drug trials of pharmaceuticals indicated for
treatment for fragile X, as well as basic and translational
fragile X research, including efforts to analyze the linkages
among fragile X, autism, and autism spectrum disorders. The
institutes are encouraged to convene a scientific session in
2008 to develop a `Blueprint' of coordinated fragile X research
strategies and public-private partnership opportunities for
fragile X research. The Committee believes it is important in
these efforts to collaborate with the Federally-funded fragile
X centers of excellence and the fragile X clinics consortium.
The Committee requests a report by September 2008 on progress
in achieving these goals.
In the research field of aging, the Committee encourages
NIA to expand its existing dialogue with NINDS to fund research
on fragile X-associated tremor/ataxia syndrome (FXTAS). NIA is
encouraged to strengthen its existing research portfolio into
this newly identified neurological disorder, which involves
progressively severe tremors and difficulty with walking and
balance that specifically affect some older premutation
carriers, generally grandfathers of children with fragile X
syndrome. The Committee suggests that NIA include FXTAS among
its priorities in the area of adult-onset disorders. Given the
link, FXTAS may serve as a gateway to understanding other aging
disorders including parkinsonism and dementia.
In addition, the Committee encourages NIMH to 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.
Finally, there are important aspects of Fragile X to be
studied in genomic research. FMRP, the protein whose absence
results in fragile X syndrome, is a regulator of translation of
many genes, including those involved in learning and memory. A
genomic approach to understanding the diverse pathways
regulated by FMRP would aid in the understanding of human
cognition and identify potential targets for drug design to
alleviate the symptoms of fragile X and related disorders. The
Committee encourages NHGRI to strengthen its research
activities on fragile X and to coordinate these efforts with
other Institutes working on related activities, including NIMH,
NINDS, NIDDK, NICHD and FIC.
Autism.--The Committee recognizes the growing public health
crisis represented by the dramatic rise in autism, which
according to CDC now strikes one in 150 of our nation's
children. Autism causes serious hardships to families of
children with autism, as well as to the children themselves,
and also creates an extreme financial burden to families and
our nation. The care of a child diagnosed with autism is
estimated to cost $3,200,000 in direct and indirect costs over
his/her lifetime; all individuals diagnosed with autism are
projected to cost the nation an estimated $35,000,000,000
annually. In response to this crisis, the Combating Autism Act
was signed into law last year, which expanded autism activities
at CDC and HRSA, authorized increased funding for autism,
created centers of excellence and called for the establishment
of an inter-agency autism coordinating committee (IACC),
charged with the preparation of a strategic research plan for
autism. The Committee encourages HHS's prompt appointment of
the IACC and looks forward to its completion of an autism
strategic research plan. In addition, the Committee encourages
NIH to use its research funds to implement the recommendations
of that strategic plan.
Alzheimer's disease.--Alzheimer's disease is reaching
epidemic levels in the United States. Nearly half of people
over age 85, and more than one in 8 over age 65 have the
disease. Currently, more than 5 million Americans suffer from
Alzheimer's, including up to half a million people under age
65. Unless science finds ways to prevent, cure or more
effectively treat Alzheimer's soon, by mid-century as many as
16 millionpersons will be living with this disease, placing an
even greater strain on families as well as Medicare, Medicaid
and State healthcare programs. To prevent this will require a
stepped-up investment in a comprehensive Alzheimer's research
strategy that includes: basic investigator-initiated research
to isolate the best targets for drug development; cost-
effective interdisciplinary research across multiple
institutions that shares data and biological materials; multi-
site clinical trials to test potential therapies; and larger-
scale clinical studies, inclding neuron-imaging techniques, to
find early biomarkers of disease so as to speed drug discovery
and to identify those at risk so treatment can start soon
enough to make a difference. To those ends the Committee
encourages the National Institute on Aging, the National
Institute of Neurological Disorders and Stroke and the National
Institute of Mental Health to continue to assign a high
priority to their respective Alzheimer research portfolios, and
to continue to work collaboratively whenever appropriate.
Congenital and genetic disease of bone.--The Committee is
aware that thousands of children and adolescents nationwide
suffer from musculoskeletal disorders and malformations, many
of which have devastating effects on mortality and disability.
Diseases such as osteogenesis imperfecta, fibrous dysplasia,
osteoporosis, and Paget's disease are caused by poorly
understood genetic mutations. In Paget's disease, underlying
genetic defects can also be exacerbated by environmental
factors. The Committee understands that the science of genetics
has led to tremendous advances in our understanding of numerous
systems that affect bone health, but little of this technology
is being applied to bone research. The Committee encourages
NIAMS and NICHD to support research focusing on mechanisms of
preventing fractures and improving bone quality and correcting
malformations, on innovations in surgical and non-surgical
approaches to treatment, on physical factors that affect
growth, and on genetic defects that cause bone disease.
Furthermore, the Committee urges NIAMS, NICHD, NIDCR, and NIDDK
to expand research on skeletal stem cell biology and the
genetics and pathophysiology of rare disorders such as fibrous
dysplasia, melhoreostosis, XLinked hypophosphatemic rickets,
and fibrodysplasia ossificans progressiva.
Duchenne and Becker muscular dystrophy (DBMD).--The
Committee is encouraged by the progress made in the area of
DBMD, particularly through support of the six MD centers of
excellence and advancement of a conference focusing on
translational research opportunities. The Committee urges NIH
to continue to provide sufficient funding to advance the work
of the centers, encourage greater collaboration and resource
sharing between centers, and to further additional DBMD
research opportunities. Given increasing concerns about cardiac
complication in both DBDM patients and carriers, the Committee
suggests that the muscular dystrophy coordinating committee be
broadened to include the Director of NHLBI.
Musculoskeletal trauma and skeletal pain.--The Committee
recognizes that of the 60 million Americans injured annually,
more than one-half incur injuries to the musculoskeletal
system. In the U.S., back pain is a major reason listed for
lost time from work. The Committee encourages NIAMS, NIA,
NIDCR, and NCCAM to study ways to better understand the
epidemiology of back pain and improve existing diagnostic
techniques, as well as develop new ones. The Committee also
encourages NIAMS, NIBIB, NICHD, NIDCR, NIDDK and NIA to conduct
research to improve diagnostic and therapeutic approaches to
lower the impact of musculoskeletal traumas, as well as
research on accelerated fracture healing and research into
repair of nonunion fractures in osteogenesis imperfecta.
Psoriasis.--In addition to the research priorities the
Committee has identified for psoriasis in NIAMS, the disease
has relevance to the research portfolios of several other
institutes. The Committee encourages NHLBI to undertake
research on the link between severe psoriasis and increased
risk of heart attack, as this may help advance the
understanding of both heart disease and psoriasis. Secondly,
since the Committee understands that while psoriasis manifests
itself on the skin, it may be an auto-immune disease. The
Committee encourages NIAID to identify and study immune cells
and inflammatory processes involved in psoriasis. Lastly,
because it is a disease involving both genetic and
environmental/lifestyle components, the Committee encourages
NIEHS to identify environmental and lifestyle triggers
associated with psoriasis onset, flares, and disease state
which will help in the development of appropriate therapies and
interventions. The Committee encourages NIEHS to expand its
biomarker work to include efforts to identify psoriasis and
psoriatic arthritis genetic susceptibility.
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 vaccine and a
subset of autism termed autistic entercolitis. There have been
presentations at medical meetings by researchers presenting
data showing the presence of measles RNA in inflamed intestines
of children with autism. 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 expedite this research.
Down syndrome.--The Committee encourages the Director of
NIH to note recent advances in the neurobiology of Down
syndrome, especially regarding the structure and function of
neural circuits that mediate cognition. These advances point to
Down syndrome as a fertile area for research investments that
could lead to effective treatments for cognitive difficulties
in both adults and children with this disorder. Studies of
cognition in Down syndrome could be a useful trans-NIH
initiative that would accelerate progress toward understanding
and treating cognitive problems in both children and adults.
The Committee requests the Director of NIH to report to the
Committee by April 2008, regarding his views as to whether this
research would be an appropriate use of Common Fund resources.
Amyloidosis.--The Committee encourages NIH to continue to
intensify its research efforts into amyloidosis, 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 some patients, and not a cure. The Committee
understands that NIH has held a U.S. seminar on amyloidosis and
participated in an international conference on the disease. The
Committee urges NIH to pursue the recommendations from these
meetings and identify steps that need to be taken to increase
the understanding, prevention and treatment of this devastating
group of diseases.
Neurofibromatosis (NF).--NF is an important research area
for multiple NIH institutes. The Committee highlights NF
research in the following specific areas and encourages further
work by the institutes involved:
Recognizing NF's connection to many of the most common
forms of human cancer, the Committee encourages NCI to enhance
its NF research portfolio in such areas as further development
of animal models, natural history studies, genetic and drug
screening, therapeutic experimentation, and pre-clinical and
clinical trials. The Committee further encourages NCI to apply
existing cancer drugs to NF patients in clinical trials and to
develop new drugs for NF, which might then apply to the general
population because of NF's connection to most forms of human
cancer. The Committee applauds work being done analyzing the
DNA of NF tumor samples, which not only will help find a
treatment for NF by determining its functioning, its connection
to modifier genes and to an individual's personal genetic make-
up, but also connect it to other forms of cancers and other
diseases.
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 encourages NHLBI to continue to enhance its NF
research portfolio in light of the significant implications for
the general population.
Learning disabilities occur with high frequency in children
with NF. Great advances have been made in the past few years in
the successful treatment of learning disabilities in pre-
clinical NF animal models. The Committee encourages NICHD to
support clinical trials for NF patients in this area.
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 mice with NF through gene therapy, with important
implications for gene therapy in general and for patients
suffering from meningiomas and other tumors in particular. The
Committee encourages NIDCD to strengthen its NF research
portfolio through all suitable mechanisms, including requests
for applications and clinical trials.
Vulvodynia.--In the last decade, NIH has supported three
important research conferences on vulvodynia, as well as the
first prevalence study and clinical trial of the disorder.
These efforts demonstrated the need for additional research and
served to heighten the research community's interest in
studying vulvodynia. The Committee recommends that the Director
build upon these initial successes by coordinating through ORWH
collaborative extramural and intramural research into the
causes of, and treatments for, vulvodynia. This effort should
involve ORWH, NICHD, NINDS, and other relevant ICs, as well as
the NIH pain consortium. The Committee also commends ORWH for
working to plan an educational outreach campaign on vulvodynia.
The Committee encourages the Director to work with the Center
for Scientific Review and the institutes and centers to ensure
that experts in vulvodynia, and related chronic pain and female
reproductive system conditions, are adequately represented on
peer review panels.
Parkinson's disease.--The Committee remains very interested
in NIH-funded research that aims to expedite discovery of
better treatments and a cure for Parkinson's disease. The
Committee continues to be aware that Parkinson's disease
research would benefit from targeted and measured investment of
resources by NIH which would result in significant dividends in
terms of reduction in human suffering and economic costs to
society. The Committee encourages NIH to use a Parkinson's
disease planning process with an outcomes-oriented approach
that makes disease eradication and treatment a top priority.
The Committee requests NIH to report to the Committee by June
2008 on a strategic plan for future investments in Parkinson's
research that outlines progress already made and specific
results of investments. The Committee urges NIH to intensify
its support to pursue promising translational and clinical
research that may result in scientific breakthroughs for people
living with Parkinson's disease. The Committee continues to
support the innovative multidisciplinary Parkinson's disease
research and training provided by the Morris K. Udall
Parkinson's Disease Research Centers of Excellence. The
Committee applauds the creation of an additional coordinating
center to further focus and manage the interdisciplinary
efforts of the Udall centers. The Committee further encourages
NIH to require that the Udall centers include a clinical
component, in addition to their ongoing basic and translational
research.
Brain tumors.--Brain tumors are the most common solid tumor
type for children, and the leading cause of pediatric cancer
death. Because current treatments are invasive, toxic, and
cause debilitating side effects and impairments, the Committee
encourages the Directors of NIH, NCI, NINDS, NIBIB, and ORD to
develop a comprehensive research plan to focus on children's
brain tumors with the goal of identifying alternative, safer
and more effective treatments, as well as a cure. The Committee
further encourages the NIH to achieve this objective by
targeting basic and clinical research, accelerating the
enhancement of the institutes' cancer research portfolios,
creating research priorities with a sequential agenda and
timeline, and facilitating the coordination and collaboration
of public and private organizations already funding related
research initiatives. This comprehensive research plan should
provide specific time frames for the implementation of goals.
The Committee requests submission of the plan by the end of
fiscal year 2008.
Spina bifida.--The Committee encourages the institutes to
study the causes and care of the neurogenic bladder in order to
improve the quality of life of children and adults with spina
bifida; to support research to address issues related to the
prevention and treatment of spina bifida and associated
secondary conditions such as hydrocephalus; and to invest in
understanding the myriad co-morbid conditions experienced by
children with spina bifida, including those associated with
both paralysis and developmental delay.
Spinal muscular atrophy (SMA).--The Committee encourages
the Director of NIH to monitor the progress of the SMA Project
at NINDS. The Committee notes that the SMA Project is an
excellent example of high risk, high reward research that was a
focus of the recent reauthorization of the NIH by Congress. The
current SMA project is scheduled to reach its near-term
milestones in 2007 and thus it is important that the OD
participate in planning for the successive stages of the
project, including clinical trials and the infrastructure that
will be needed to support drug development. Specific attention
by the OD is necessary to ensure that the results of this
innovative project are maximized, as well as to ensure that it
serves as a model for other diseases as an innovative program
to accelerate actual treatments for disease.
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.
Mitochondrial disease.--The Committee encourages NIH to
intensify its research efforts into primary mitochondrial
disease. Mitochondria are specialized compartments within
almost every cell and are responsible for producing energy.
Mitochondrial diseases result when there is a genetic defect
that reduces the ability of the mitochondria to produce energy.
As the mitochondria fail to produce energy, the cell will not
function properly. If the energy production falls to a critical
level, cell death will follow. Approximately 1 in 2000 children
born in the U.S. each year develop a mitochondrial disease.
Most of these affected children will not survive beyond their
teenage years. There is currently no cure or effective
treatment for those suffering from primary mitochondrial
disease. Mitochondrial dysfunction is also implicated in
numerous disease states and degenerative disorders such as
Parkinson's disease, Alzheimer's dementia, heart disease,
diabetes and cancer. Intensified research into primary
mitochondrial disease will help further understanding into
these other conditions.
Gene therapy research.--The Committee is encouraged by
promising research being undertaken in gene therapy, especially
regarding thalassemia, or Cooley's anemia. NIH has indicated
that human clinical trials could begin between 2008 and 2010.
The Committee encourages that every step be taken to assure
that this research moves forward without delay at the earliest
possible date, consistent with safety.
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. The
Committee recognizes the important work of NICHD to implement
this legislation. NICHD should continue to act as coordinator
for all other Institutes within NIH for which pediatric
pharmacological drug research may have therapeutic relevance,
and, in consultation with the Food and Drug Administration,
develop study requests. The Committee requests NICHD to provide
an annual report on the implementation process instituted,
including the process of prioritizing a list of needs in
pediatric therapeutics; the number of pediatric studies
supported to date through the research fund; the contributions
of the individual Institutes of the NIH to the studies; the
estimated cost of each ongoing or proposed study; the nature
and type of studies proposed or undertaken including whether
any studies are comparative; the estimated completion date of
all proposed or ongoing studies; the patent status of the drugs
studied; the number of drugs remaining on the priority list;
and the key ethical, scientific, intellectual property, and
operational issues that have arisen in the implementation of
the program.
Interdisciplinary genetic research.--Approximately one out
of every 200 babies born has chromosomal abnormalities which by
definition are multisystemic in that they are caused by changes
in multiple genes and result in alterations to dozens of
contiguous genes. The frequency and complexity of these
conditions have a major impact on childhood morbidity and
mortality. The Committee commends NIH for supporting
independent investigators studying chromosome abnormalities and
for partnering to sponsor meetings on many conditions. However,
the Committee encourages NIH to sponsor mechanisms to support
multidisciplinary, multi-institute research focused on devising
treatments for the 20,000 babies born every year with a
chromosome abnormality, especially those involving chromosome
18.
Peer review.--The Committee is concerned that individuals
with surgical expertise are sometimes not assigned to surgical
research grant application review. The Committee urges the
Center for Scientific Review to ensure that there is an
adequate number of specialty-specific peer reviewers,
especially cardio-thoracic surgeons, in organ-specific or
system-specific study sections reviewing surgical research
applications.
Study of gender differences.--The Committee notes that, in
2001, the Institute of Medicine released a report that stressed
the importance of biological gender as a basic variable that
needs to be considered in all areas of biomedical research.
Recent findings have demonstrated that significant differences
between men and women exist in health and disease. One of the
fields where such differences are most pronounced is
neuroscience. The Committee strongly encourages each of the 15
institutes involved in the NIH Neuroscience Blueprint to
carefully analyze its NIH Neuroscience Blueprint research
portfolio to ensure gender is included as a variable, when
appropriate, and to require that all reported results include
gender specific analysis. The Committee requests a written
report from the Director that includes information on the
progress of these efforts at each of the NIH Neuroscience
Blueprint institutes prior to the fiscal year 2009 budget
hearings.
Basic behavioral research.--The Committee is aware that
basic behavioral research focused on such areas as cognition,
perception, emotion, social interaction, and learning have led
to important advances and improved treatments for depression,
bipolar and other affective disorders, diabetes, compliance on
behavior change related to diabetes, heart disease, cancer,
obesity, and more effective public health announcements and
interventions. In view of the fact that eight out of the ten
leading causes of death have a significant behavioral component
and that basic research is the underpinning of advances in
behavioral research, the Committee is concerned with the
continued lack of focus of scientific leadership at NIH for
this important field of science. However, the Committee views
the new Office of Portfolio Analysis and Strategic Initiatives
(OPASI) within the Office of the Director as a potentially
important source of leadership in encouraging NIH investment in
behavioral science research. The recent NIH reauthorization
placed OBSSR within OPASI. As OPASI begins to perform its
function of analyzing balance and content in all NIH areas of
research, it would be appropriate for OPASI to set as an
initial task a review of the NIH basic behavioral research
portfolio. The Committee requests that the Director of NIH
instruct OPASI, using OBSSR expertise, to prepare a strategic
plan for basic behavioral research. This plan should include
the amount spent in fiscal years 2006 and 2007, by institute
and center, on basic behavioral research, and a plan for NIH's
investment in basic behavioral research for fiscal year 2008
and beyond. This strategic plan should also identify any gaps
in the NIH basic behavioral research portfolio. The Committee
expects to receive the strategic research plan no later than
May 1, 2008.
Disparities in clinical trials.--The Committee commends NIH
for prioritizing increases in the number of participants from
populations that suffer from health disparities in clinical
trials as part of the NIH health disparity research plan.
Unfortunately, data from NIH-funded trials continually show
that participation numbers from certain groups, including
racial and ethnic minorities and the elderly, remain low. The
Committee encourages NIH to revisit the issue of health
disparities in clinical trials with a goal of increasing
participation from under-represented populations.
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 and skin. Because of the effects of TSC on multiple
organ systems, the Committee urges NIH to continue coordinating
TSC research activities through the trans-NIH tuberous
sclerosis coordinating committee. The Committee also encourages
the various institutes that fund TSC research to place
increased emphasis on this important research, and to increase
coordination with the TSC community as future research plans
are developed and executed.
Minority training.--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. The Committee encourages NIH to strengthen
participation from minority institutions with a track record of
producing minority scholars in science and technology.
Bridging the sciences.--The Committee believes the
``Bridging the Sciences'' demonstration program fulfills a need
not met elsewhere in the Federal government by supporting
research at the interface between the biological, behavioral,
and social sciences with the physical, chemical, mathematical,
and computational sciences. The Committee encourages the
Director to give high priority to developing a demonstration
program and to collaborate with the Department of Energy, the
National Science Foundation, and other agencies. The Committee
notes the importance of compliance with the statutory
provisions dealing with appropriate, multidisciplinary peer
review panels and the unique type of research envisioned.
BUILDINGS AND FACILITIES
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 $3,393,841,000
for the Substance Abuse and Mental Health Services
Administration (SAMHSA), which is $66,820,000 above the fiscal
year 2007 funding level and $226,252,000 above the budget
request. Within the total, $120,913,000 is provided through the
evaluation set-aside, which is the same as the fiscal year 2007
level and $250,000 less than the request. The Committee does
not include requested bill language that would authorize SAMHSA
to withhold 5 percent of State block grant allotments if a
State does not report on national outcome measures and to
redistribute those remaining to funds to States that do report.
The majority of funding administered by SAMHSA, 70 percent,
is distributed by statutory formula to States and territories.
The rest of the programs administered by SAMHSA are competitive
grants or contracts to State or private organizations or are
competitive cooperative agreements to States, territories or
tribal organizations that use an outside peer review process
for evaluation.
SAMHSA is responsible for supporting mental health and
alcohol and drug abuse prevention and treatment services
nationwide through discretionary capacity expansion and science
to service activities, 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 provides $128,514,000 for activities
throughout SAMHSA programs of regional and national
significance 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. This is
$16,993,000 more than the fiscal year 2007 funding level and
$16,717,000 more than the budget request. These funds provide
grants to organizations with a history of providing culturally
competent, community-specific, and linguistically appropriate
services in hard to reach and high-risk communities of color to
expand service infrastructure and capacity.
The Committee includes within the total provided for
programs of regional and national significance across SAMHSA,
$57,123,000 for homeless programs, which is $11,508,000 more
than the fiscal year 2007 funding level and $20,105,000 more
than the budget request. The Committee is hopeful that programs
that provide supportive services to individuals in permanent
housing settings will help to end long-term homelessness in
this country and directs SAMHSA to develop supportive services
programs within the authority of the programs of regional and
national significance.
The Committee recognizes that substance abuse is at
critically high levels among American Indians and Alaska
Natives and is deeply concerned about the epidemic of mental
health and substance abuse problems on reservations and among
urban Indian populations. According to CDC, rates of substance
abuse and dependency are the highest among the American Indian
and Alaska Native population at 14.1 percent. The Committee is
deeply troubled by recent reports, which state that 30 percent
of American Indian youths have experimented with
methamphetamines. The Committee encourages SAMHSA to strengthen
outreach to tribal organizations, particularly with respect to
the access to recovery and targeted capacity expansion-general
programs, in order to increase tribal participation in these
programs. Furthermore, the Committee requests SAMHSA to submit
a report to the House Committee on Appropriations not later
than six months after the enactment of this Act on its past
outreach efforts to tribal organizations, the current
participation rates of eligible tribal organizations, and
barriers to access facing tribal organizations. Additionally,
the Committee includes adequate funding to ensure that no less
than $4,070,000 shall be made available to tribes and tribal
organizations for treatment programs for mental illness and
substance abuse.
Health disparities need to be addressed as the demographics
of our society are changing dramatically. The Committee notes
that minorities represent 30 percent of the population and are
projected to increase to 40 percent by 2025. Yet, only 23
percent of recent doctorates in psychology, social work and
nursing were awarded to minorities. For fiscal year 2008, the
Committee has provided no less than the level allocated in
fiscal year 2007 for the minority fellowship program in order
to train culturally competent mental health, and substance
abuse treatment and prevention professionals. The
Administration did not request funding for this program.
Center for mental health services
The Committee provides a program level total of
$910,625,000 for the center for mental health services (CMHS),
which is $26,767,000 above the fiscal year 2007 funding level
and $103,397,000 above the budget request. Within the total,
$21,413,000 is provided through the evaluation set-aside as
requested.
Research shows that more than 90 percent of those who
suffer from eating disorders are women between the ages of 12
and 25. Data indicate that eating disorders are almost as
prevalent as alcohol or drug problems among middle and high
school female students, but that far less time is spent on
preventing eating disorders than on substance abuse prevention
programs. Therefore, the Committee urges SAMHSA to integrate
eating disorder education and prevention programs into its core
mental health programs, particularly those that serve middle
and high school students.
Programs of regional and national significance
The Committee provides $277,030,000 for mental health
programs of regional and national significance, which is
$13,767,000 above the fiscal year 2007 funding level and
$90,397,000 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 $96,156,000 to continue and expand
violence prevention programs in schools, including elementary,
secondary, and postsecondary educational institutions. This is
$3,000,000 more than the fiscal year 2007 funding level and
$20,446,0000 more than the budget request. Funds are used by
schools to establish an emergency/crisis management response
plan; to provide mental health and substance abuse treatment
services to those in need; to educate students on mental health
promotion, suicide, and violence prevention; to prepare
educational materials on mental health for students and
families of students to increase awareness of mental health and
substance abuse issues in young adults; to train students and
school personnel to respond effectively to students with mental
and behavioral health problems that could lead to school
failure, substance abuse, and/or violent behaviors; and, as
needed, to develop a network/infrastructure to link the school
with health care providers who can treat mental and behavioral
problems. Of this amount, the Committee intends that not less
than $80,868,000 be used to collaborate with the Department of
Education for the safe schools/healthy students initiative and
not less than $3,000,000 shall be used for a jointly funded
initiative administered by the Department of Education and
SAMHSA to support competitive grants to institutions of higher
education to develop and implement emergency management plans
for preventing campus violence (including assessing and
addressing the mental health needs of students) and for
responding to threats and incidents of violence or natural
disaster in a manner that ensures the safety of the campus
community.
Within funds provided, the Committee recommends $32,360,000
for the national child traumatic stress initiative, which is
$2,942,000 more than the fiscal year 2007 funding level and
$4,292,000 more than the budget request. This program has
established 54 treatment development and community service
centers to treat children who have experienced trauma and also
supports the national center for traumatic stress. It is
estimated that more than 34,000 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 2007 be
allocated for the older adults program. The Administration did
not request funding for this program. Additionally, SAMHSA is
urged to study, or to commission a study, examining the mental
health workforce needed to address the healthcare needs of
older adults.
The Committee recognizes that veterans returning from Iraq
and Afghanistan have enhanced needs for mental health care and
other supportive services that they may want to access through
the community. To improve veterans' access to mental health and
related services, the Committee encourages SAMHSA to fund a
pilot internet-based veterans' portal within the network of
care. The portal should include a comprehensive service
directory; a veteran-specific library; links to advocacy and
support groups; and state-of-the-art, interactive technology
for personal recordkeeping, and information-sharing. Such a
resource will enable veterans and their families to identify
and access available services, educate themselves about mental
illnesses, facilitate communications with providers and others,
and overcome the stigma that often prevents veterans from
seeking care.
According to CDC, teen suicide rates in the U.S. increased
by 18 percent between 2003 and 2004. The Committee is deeply
concerned by this disturbing development and urges SAMHSA to
strengthen its efforts to assist local educational systems and
non-profit entities to implement mental health screening and
suicide prevention programs and to identify evidence-based
practices for facilitating treatment for youth at risk. As
evidence-based programs are developed and identified, the
Committee urges SAMHSA to support activities in fiscal year
2008 to determine how these practices can be best implemented
at the community level.
The Committee requests that SAMHSA provide not less than
the fiscal year 2007 funding level for statewide family network
grants, consumer and consumer supported technical assistance
centers, the national training and technical assistance center,
the statewide consumer network program, and the anti-stigma
campaign.
The Committee includes the following projects in the
following amounts:
Mental health block grant
The Committee provides a program level total of
$441,256,000 for the mental health block grant, which is
$13,000,000 above the fiscal year 2007 funding 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, $21,413,000 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.
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Access Community Health Center, Bloomingdale, IL for $250,000
mental health services..............................
Advocate Health Care, Oak Brook, IL for specialized 275,000
and comprehensive psychotherapy and support to
abused and neglected children and their families....
Alfred University, Alfred, NY for a graduate school 100,000
psychologist training program.......................
American Red Cross, Lower Bucks County Chapter, 100,000
Levittown, PA to provide mental health counseling
and case management services, along with related
services............................................
City and County of San Francisco Department of Public 1,000,000
Health, San Francisco, CA for mental health and
substance abuse services for homeless persons in
supportive housing..................................
City of Los Angeles, CA for supportive housing 250,000
services............................................
Community Rehabilitation Center, Inc., Jacksonville, 200,000
FL for substance abuse and mental health programs...
Family Services of Greater Waterbury, Waterbury, CT 125,000
for the outpatient counseling/psychiatric program...
Family Support Systems Unlimited, Inc., Bronx, NY for 150,000
mental health services..............................
Fulton County Department of Mental Health, Atlanta, 100,000
GA for a jail diversion program.....................
Heartland Health Outreach, Inc., Chicago, IL for 150,000
mental health services to refugee children..........
Helen Wheeler Center for Community Mental Health, 200,000
Kankakee, IL for mental health services.............
Holy Spirit Hospital, Camp Hill, PA for the Teenline 100,000
suicide prevention program..........................
Indiana Wesleyan University, Marion, IN for the 150,000
Institute of Training in Addiction Studies..........
Jewish Association for Residential Care, Farmington 200,000
Hills, MI for the Lifelines project.................
Kids Hope United, Waukegan, IL for the multi-systemic 270,000
therapy program for youth...........................
New Image Homeless Shelter, Los Angeles, CA for 50,000
mental health case management.......................
Pacific Clinics, Arcadia, CA for mental health and 250,000
suicide prevention programs for Latina youth........
Prime Time House, Inc., Torrington, CT for mental 125,000
health services.....................................
Ruth Rales Jewish Family Service, Boca Raton, FL to 100,000
provide preventive youth mental health services and
clinical outreach to at risk students...............
Ventura County Probation Office, Ventura, CA for 200,000
treatment and related services for juvenile
offenders with mental health and chemical dependency
problems............................................
Ventura County Sheriff's Department, Thousand Oaks, 200,000
CA for training programs related to the mentally ill
Youthville, Wichita, KS for an adoption and trauma 300,000
resource center.....................................
------------------------------------------------------------------------
Children's mental health
The Committee provides $104,078,000 for the grant program
for comprehensive community mental health services for children
with serious emotional disorders, which is the same as the
fiscal year 2007 funding level and 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 $54,261,000 for the grants to States
for the homeless (PATH) program, which is the same as the
fiscal year 2007 funding 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 $34,000,000 for the protection and
advocacy program, which is the same as the fiscal year 2007
funding level and the budget request. 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
$2,195,993,000 for the center for substance abuse treatment
(CSAT), which is $38,453,000 above the fiscal year 2007 funding
level and $85,312,000 above the budget request. Within the
total, $83,500,000 is provided through the evaluation set-aside
as requested.
The Committee recognizes that the Asian American and
Pacific Islander (AAPI) populations are one of the fastest
growing groups in the U.S., and the need for substance abuse
services continues to outpace the availability and access to
culturally competent services. The Committee encourages SAMHSA
to work with appropriate 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 U.S.
Programs of regional and national significance
The Committee provides a program level total of
$402,402,000 for substance abuse treatment programs of regional
and national significance, which is $3,453,000 above the fiscal
year 2007 funding level and $50,312,000 above 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 capacity expansion
initiatives to help communities respond to serious, emerging
and unmet treatment needs and science into services initiatives
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.
Within the funding provided, the Committee recommends
$98,000,000 for the access to recovery treatment voucher
program. This is $703,000 less than the fiscal year 2007
funding level and the same as the budget request. The fiscal
year 2008 funding will provide the second year of funding for
State and tribal grantees that will be competing for funding in
fiscal year 2007. Within this amount, $25,000,000 is dedicated
to finance treatment services for methamphetamine abuse.
Within the funding provided, the Committee recommends
$37,823,000 for criminal justice activities, which is
$13,709,000 more than the fiscal year 2007 funding level and
the same as the budget request. The Committee provides an
increase for treatment drug court grants, but also maintains
the fiscal year 2007 funding level for other criminal justice
programs. The Committee urges SAMHSA to ensure, through the
grant application process, that successful applicants for the
treatment drug court program demonstrate evidence of direct and
extensive consultation and collaboration with the corresponding
State substance abuse agency in the planning, implementation
and evaluation of the grant.
The Committee recommends no less than the fiscal year 2007
funding level for the addiction technology transfer centers
(ATTCs). The ATTC network operates 14 regional centers and one
national office to translate the latest science of addiction,
including evidence-based addiction treatment. The ATTCs also
are an important component of the blending initiative that
seeks to improve the manner in which research findings are
moved into every day practice.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
City of Las Vegas, NV for the EVOLVE program......... $200,000
City of Oxford, Oxford, MS for a substance abuse 250,000
treatment program...................................
Fulton County, Atlanta, GA for Project Excell, an 100,000
intensive outpatient treatment program serving
homeless males with co-occurring substance abuse and
mental health disorders.............................
Gavin Foundation, South Boston, MA for substance 250,000
abuse treatment services at its Cushing House
facility for adolescents............................
Glide Foundation, San Francisco, CA for substance 250,000
abuse services......................................
Metro Homeless Youth Services of Los Angeles, Los 100,000
Angeles, CA to expand services for homeless youth
with substance abuse problems.......................
Minnesota Indian Women's Resource Center, 100,000
Minneapolis, MN for a dual diagnosis outpatient
treatment program...................................
Nassau University Medical Center, East Meadow, NY for 200,000
substance abuse treatment services..................
Sandhills Teen Challenge, Carthage, NC for substance 100,000
abuse treatment services............................
Sheriffs Youth Program of Minnesota, Inver Grove 125,000
Heights, MN for chemical dependency treatment
services............................................
Talbert House, Cincinnati, OH for a substance abuse 300,000
treatment program...................................
Trumbull County Lifelines, Warren, OH for behavioral 200,000
health services.....................................
Union Station Foundation, Pasadena, CA for services 150,000
to homeless families................................
United Way of Treasure Valley, Boise, ID for a 400,000
substance abuse treatment program...................
Wayne County Academy, Alpha, KY for a substance abuse 200,000
counseling program..................................
WestCare Kentuckv, Ashcamp, KY for a substance abuse 200,000
treatment proqram...................................
------------------------------------------------------------------------
Substance abuse prevention and treatment block grant
The Committee provides a program level total of
$1,793,591,000 for the substance abuse prevention and treatment
(SAPT) block grant, which is $35,000,000 more than the fiscal
year 2007 funding level and the budget request. Within the
total, $79,200,000 is provided through the evaluation set-aside
as requested. The SAPT 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 is aware that the SAPT block grant is an
effective and efficient program. Data collected from States
demonstrate that SAPT block grant funded programs help people
remain abstinent from alcohol and other drug use; find or
regain employment; find stable housing; stay away from criminal
activity; reunite with their families; and live productively in
communities across the country. The Committee is aware, for
example, that certain SAPT block grant funded programs report
that approximately 70 to 80 percent of persons completing
treatment are abstinent at discharge. The Committee is also
aware that States employ a broad range of accountability
strategies to ensure that SAPT block grant funded services
achieve results. Overall, the SAPT block grant funds over
10,500 community-based organizations to help serve the nation's
most vulnerable citizens--including those with HIV/AIDS. The
Committee applauds States for supporting family treatment
services through the SAPT block grant given the impact of
addiction on children, women, and families.
The Committee recognizes the important role played by the
20 percent prevention services set-aside within the SAPT block
grant. This effective substance abuse prevention program helped
contribute to a 23 percent decrease in youth drug use over the
last five years. The Committee urges SAMHSA to promote maximum
flexibility in the use of prevention set-aside funds in order
to allow each State to employ prevention strategies that match
State and local circumstances.
Center for substance abuse prevention
Programs of regional and national significance
The Committee provides $194,502,000 for the substance abuse
prevention programs of regional and national significance,
which is $1,600,000 more than the fiscal year 2007 funding
level and $38,041,000 more than the budget request. The program
identifies and disseminates evidence-based substance abuse
prevention approaches.
Within the total, the Committee recommends $7,000,000 to
carry out programs authorized by the Sober Truth on Preventing
(STOP) Underage Drinking Act: $5,000,000 for community-based
coalition enhancement grants; $1,000,000 for the
Intergovernmental Coordinating Committee on the Prevention of
Underage Drinking (ICCPUD); and, $1,000,000 to continue and
enhance the national adult-oriented media public service
campaign to prevent underage drinking. The Committee intends
that the funding provided to ICCPUD will be used to provide a
report to the House and Senate Committees on Appropriations on
State underage drinking prevention and enforcement activities
consistent with the STOP Underage Drinking Act, including a
comprehensive summary of the actions taken to accomplish the
recommendations in the Surgeon General's call to action.
The Committee commends the Surgeon General's ``Call to
Action'' on underage drinking, and shares the Surgeon General's
concern about new research indicating that the developing
adolescent brain may be particularly susceptible to long term
harms from alcohol use, including neurocognitive impairment.
The Committee urges ICCPUD to develop and pursue efforts to
carry out the Surgeon General's Call to Action, including
supporting and assisting State and local efforts. The Committee
encourages the Surgeon General and the administrator of SAMHSA
to continue speaking out on the issue.
The strategic prevention framework state incentive grant
(SPF SIG) program is designed to promote, bolster, and sustain
prevention infrastructure in every State in the country. The
Committee recognizes that the lynchpin of the SPF SIG program
is State flexibility. Therefore, the Committee urges SAMHSA to
promote flexibility in the use of SPF SIG funds in order to
allow each State to tailor prevention strategies that are most
appropriate for the populations in their own jurisdiction.
The Committee recommends funding at no less than the level
provided in fiscal year 2007 for the centers for the
application of prevention technologies (CAPTs). The
Administration did not request funding for this program. The
purpose of the CAPTs is to translate the latest substance abuse
prevention science and improve the practices of prevention
professionals and community coalition members. The CAPTs are
SAMHSA's only regional network system that provides substance
abuse prevention workforce training through regional
conferences, workshops, customized technical assistance,
curriculum development, online courses, and trainer events.
The Committee supports the continuation and enhancement of
SAMHSA's fetal alcohol spectrum disorders (FASD) center for
excellence, and requests that SAMHSA submit a progress report
within six months of enactment of this bill on the center's
accomplishments and lessons learned in preventing and reducing
FASD. The report should outline future plans for the center,
including programmatic and funding priorities.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Community Foundation for Greater New Haven, New $500,000
Haven, CT to support innovative multi-disciplinary
intervention programs serving children and families
exposed to violence and trauma......................
Fighting Back Partnership, Vallejo, CA for an 250,000
intervention program targeting elementary and high
school students who are at risk for substance abuse
and misuse..........................................
Institute for the Advanced Study of Black Families, 150,000
Oakland, CA for integrated HIV/AIDS and substance
abuse prevention with African American women and
teenagers...........................................
Operation SafeHouse, Riverside, CA for a substance 100,000
abuse prevention program............................
Partnership for a Drug-Free America, New York, NY for 250,000
educational awareness programs on prescription and
over-the-counter drug abuse.........................
Shiloh Economic Development Center, Bryan, TX for a 150,000
substance abuse prevention program..................
South Boston Community Health Center, South Boston, 100,000
MA for substance abuse prevention services..........
YMCA of the East Bay, Richmond, CA for substance 100,000
abuse orevention activities.........................
------------------------------------------------------------------------
Program management
The Committee provides a program level total of $92,721,000
for program management, of which $16,000,000 is provided
through the evaluation set-aside. The fiscal year 2008 program
level is the same as the fiscal year 2007 funding level and
$498,000 less than 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 $329,564,000 for the
Agency for Healthcare Research and Quality (AHRQ), which is
$10,578,000 more than the fiscal year 2007 funding level and
the same as the budget request.
The mission of AHRQ is to improve the quality, safety,
efficiency, effectiveness, and cost-effectiveness of health
care for all Americans. The agency fulfills its mission by
conducting and supporting health services research that focuses
on answering questions on such topics as clinical practice,
outcomes of care and effectiveness, evidenced-based medicine,
health care quality, patient safety and medical errors, health
care costs and financing, and health information technology.
AHRQ research findings are used by providers, health care
administrators, and others to improve health care quality,
accessibility, and outcomes of care.
The Committee provides $271,564,000 for research on health
costs, quality, and outcomes, which is $10,578,000 more than
the fiscal year 2007 funding level and the same as 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 available, the Committee does not provide
funding requested by the Administration for the new ``network
of networks'' under the personalized health care initiative.
The Committee is concerned that HHS has yet to develop a
detailed, integrated, and coherent implementation plan for
achieving health information technology strategic goals, as
recommended by the General Accounting Office. The Committee
includes report language within the Office of the National
Coordinator for Health Information Technology that requests a
report that identifies specific program objectives; details the
timelines and performance benchmarks to achieve these
objectives; and links specific initiatives and resources to
these program objectives. The report also should include
information on health information technology activities funded
through AHRQ.
Within the total for research on health costs, quality, and
outcomes, $30,000,000 is provided for the comparative
effectiveness health care research program, which is
$15,000,000 more than the fiscal year 2007 funding level and
the budget request. This program provides current, unbiased
evidence about the comparative effectiveness of different
health care interventions. The objective of the program is to
help consumers, health care providers, and others make informed
choices among treatment alternatives, including drugs.
Safe patient handling and movement.--The Committee is
concerned about the consequences of manual patient lifting,
transferring and movement in hospitals, nursing homes and other
patient care settings that can be a detriment to quality
patient care, including increased risk of injury to patients
from being lifted and moved without assistive equipment and
patient injuries including skin tears, skin ulceration, falls
and shoulder dislocations. The Committee is further concerned
by findings that a nurse on a typical shift lifts 1.8 tons and
that work-related injuries to nurses frequently result in loss
of work time and can be debilitating, career-ending events, and
that injury and fear of injury are listed as top reasons why
nurses leave the profession thereby exacerbating the already
critical nursing shortage. The Committee urges AHRQ to
undertake or commission a study to determine the impact of
utilizing assistive devices and patient-lifting equipment on
patient injuries and outcomes, the health and safety of nurses,
and the financial implications of using available technology.
Spina bifida.--The Committee supports the expansion and
development of the national spina bifida patient registry and
encourages AHRQ to lead the effort to validate quality patient
treatment data measures for the registry being developed with
CDC. The Committee requests that AHRQ report to Congress on the
status of this effort as part of the fiscal year 2009 budget
justification.
The Committee provides $55,300,000 for the Medical
Expenditures Panel Surveys (MEPS), which is the same as the
fiscal year 2007 funding 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 2007 funding 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 $141,630,056,000 for the Federal
share of current law state Medicaid costs, which is
$36,159,099,000 above the fiscal year 2007 funding level and
$2,000,000 above the budget request. This amount does not
include $65,257,617,000 which was advance funded in the fiscal
year 2007 appropriation for the first quarter of fiscal year
2008. In addition, the Committee provides an advance
appropriation of $67,292,669,000 for program costs in the first
quarter of fiscal year 2009. The Committee has also included
indefinite budget authority for unanticipated costs in fiscal
year 2008.
Medicaid is projected to provide health care to 50.0
million people in fiscal year 2008, an increase of 1.9 percent.
This represents 16.9 percent of the U.S. population. Medicaid
will provide coverage to more than one out of every five
children in the nation. Non-disabled adults under age 65 and
children will represent 72 percent of the Medicaid population,
but account for 32 percent of Medicaid benefit outlays. In
contrast, the elderly and disabled populations are estimated to
make up 28 percent of the Medicaid population, yet account for
approximately 68 percent of Medicaid benefit outlays. Medicaid
is the largest payer for long-term care for all Americans.
PAYMENTS TO HEALTH CARE TRUST FUNDS
The Committee provides $188,828,000,000 for the payments to
the health care trust funds account, which supports Part B and
prescription drug benefits for 44.6 million Medicare
beneficiaries. This amount is $12,529,520,000 above the fiscal
year 2007 funding level and $200,000,000 above the budget
request. 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. The Committee continues
to include 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 $3,230,163,000 in trust funds
for Federal administration of the Medicare and Medicaid
programs, which is $89,056,000 above the fiscal year 2007
funding level and $43,863,000 below the budget request.
Research, demonstration, and evaluation.--The Committee
provides $23,070,000 for research, demonstration and
evaluation, which is $34,350,000 below the fiscal year 2007
funding level and $10,630,000 below 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. The Committee includes the full
request of $14,400,000 for the Medicare Current Beneficiary
Survey. Funding requested by the Administration for Real Choice
Systems Change grants not included in the bill.
The Committee encourages CMS to conduct a demonstration
project to identify effective therapy management program models
for low-income Medicare Part D enrollees living with HIV/AIDS.
The demonstration project would emphasize evidence-based
prospective medication management, technological innovation,
and outcome reporting. Recent medical studies show that
patients receiving medication therapy management services for
HIV dramatically improve their clinical status and demonstrate
significant cost reductions in their overall health care.
The Committee commends CMS on its work to implement the
low-vision rehabilitation services demonstration. The Committee
encourages CMS to update the design and consider expanding the
number of sites in the five-year demonstration.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Access Health, Inc., Muskegon, MI, for a small $200,000
business health coverage program....................
Bedford Ride, Bedford, VA for a program to assist 70,000
seniors.............................................
Bi-State Primary Care Association, Concord, NH to 300,000
treat uninsured patients............................
City and County of San Francisco Department of Public 1,000,000
Health, San Francisco, CA for enhancements to the
HIV/AIDS service delivery system in San Francisco...
City of Detroit, MI for the Detroit Primary Care 300,000
Access Project......................................
City of Waterbury, CT for a health access program.... 200,000
Gadsden County, FL, Quincy, FL for a prescription 100,000
assistance medical services program.................
Jefferson Area Board for Aging, Charlottesville, VA 100,000
to address nursing assistant shortages in long-term
care settings.......................................
Orange County's Primary Care Access Network, Orlando, 200,000
FL for a health care access network.................
Piedmont Hospital, Atlanta, GA for a project 150,000
regarding the transition of older patients from
hospital to home....................................
Thurston-Mason County Medical Society, Olympia, WA 200,000
for Project Access for the uninsured................
Valley Hospice, Inc., Steubenville, OH to develop 250,000
best practices for hospices across the State........
------------------------------------------------------------------------
Medicare operations.--The Committee provides $2,221,215,000
to support Medicare claims processing contracts, which is
$61,973,000 above the fiscal year 2007 funding level and
$82,400,000 below the budget request. This activity supports
the two largest Federal health care programs, Medicare and
Medicaid, along with the State Children's Health Insurance
Program (SCHIP) and the Medicare prescription drug program. CMS
is the largest purchaser of health care in the U.S., serving
about 92 million Medicare and Medicaid beneficiaries, including
those covered under SCHIP.
The Committee includes bill language that extends the
availability of $163,800,000 until September 30, 2009 for
Medicare contracting reform activities. Bill language requested
by the Administration directing CMS to ensure that no fewer
than fifteen Medicare administrative contractors begin
operations by December 15, 2008 is not included in the bill.
The amount provided for contracting reform activities is
sufficient to support the fiscal year 2008 activities of the
first phase of contracts to be awarded in fiscal year 2007. The
Committee also includes bill language requested by the
Administration providing $49,869,000 for the Healthcare
Integrated General Ledger Accounting System, to remain
available until September 30, 2009. The Committee does not
include language from the fiscal year 2007 bill identifying a
particular funding level for the CMS revitalization plan with
extended funding availability because the revitalization plan
is concluding and funding for the remainder of the project is
provided within the account without extended availability.
Within this total, the Committee provides $45,000,000 for
the State Health Insurance Program (SHIP), which is $10,800,000
above the fiscal year 2007 level and $10,600,000 above the
Administration request. The Committee believes SHIP is an
important vehicle to help the nearly 45 million Medicare
beneficiaries grapple with changes in coverage and prescription
drug plans. SHIP provides one-on-one counseling to those who
have trouble accessing the internet or the toll-free hotlines.
The Committee is concerned that many seniors do not have a
good understanding of the benefits covered, and not covered,
under the Medicare program. In particular, studies have
indicated that a majority of adults who are 45 or older
overestimate Medicare coverage for long-term care. The
Committee commends CMS for stating its intention to inform all
target households through its initial mailings that ``Medicare
generally does not pay'' for long term care. The Committee also
encourages the Department to use other efficient communication
methods, in addition to the Internet and direct mail, to
clarify widely held misperceptions about Medicare and long term
care. This policy would allow individuals to better prepare for
their potential long-term care needs without impoverishing
themselves to qualify for Medicaid where they have limited
choices beyond institutional care.
The Committee commends CMS for its initial community-based
activities for a Medicare education and outreach campaign
directed towards dual eligible persons. The Committee is aware,
however, that there is considerable evidence that low-income
dual eligible persons with mental disabilities continue to need
direct help with Part D enrollment. The Committee urges CMS to
increase the share of funds for one-on-one pharmaceutical
benefits counseling that are provided for counseling of dual
eligible persons through community-based organizations and
safety net community mental health centers.
Biomedical research progress is enabling increasing numbers
of type I diabetes patients to live with this disease for more
than fifty years. Recent advances in continuous glucose
monitoring technology have the potential to revolutionize the
way diabetes is managed on a daily basis, and the Committee is
aware that more research is underway to validate this
technology in a variety of patient populations under ``real
world'' conditions. While research is underway, the Committee
urges CMS not to make premature coverage decisions for this
durable medical equipment or take actions that would delay the
adoption of these technologies. The Committee commends CMS's
current efforts to stimulate the exploration of emerging
technologies in the device area and believes the potential of
continuous monitoring devices is worthy of further exploration.
State survey and certification.--The Committee provides
$293,524,000 for state inspections of facilities serving
Medicare and Medicaid beneficiaries, which is $35,396,000 above
the fiscal year 2007 funding level and the same as the budget
request. The Committee does not include bill language requested
by the Administration which authorizes the Secretary of Health
and Human Services to charge fees associated with conducting
revisit surveys at health care facilities.
This program supports the certification and periodic
inspection of more than 52,000 facilities receiving Medicare
funding, such as nursing homes, hospitals, hospices, and
rehabilitation centers. In 2008, more than 70,000 surveys are
expected to be conducted. The number of facilities requiring
certification has increased dramatically in recent years--16
percent since 2002.
State high risk insurance pools.--The Committee provides
$50,000,000 to support the State high risk insurance pools
program. This program was not funded in fiscal year 2007. The
Administration did not request funding for fiscal year 2008.
33 States currently operate high-risk pools that are the
health insurers of last resort for almost 200,000 individuals
who have lost or are ineligible for group insurance coverage,
and who are medically high-risk and unable to purchase
individual health insurance in the commercial market. High-risk
pools represent a successful public/private partnership. All
risk pool participants pay a monthly premium, capped at 125 to
200 percent of the average market premium. Insurers and health
care providers support the program through assessments, and
some States contribute to their pools.
Federal administration.--The Committee provides
$642,354,000 to support Federal administrative activities
related to the Medicare and Medicaid programs, which is the
same as the fiscal year 2007 funding level and $833,000 below
the budget request. As requested by the Administration, the
Committee repeats language from last year's bill authorizing
CMS to use funds for the Healthy Start, Grow Smart program for
parents of children enrolled in the Medicaid program.
The Committee believes that the growing gap between the
size of the nation's aging baby boom population and the number
of pulmonary/critical care physicians poses challenges to the
future delivery of high quality, efficient care under Medicare
and Medicaid. The Committee urges CMS to review HRSA's May 2006
Report to Congress, ``The Critical Care Workforce: A Study of
Supply and Demand for Critical Care Physicians'', and to
consult with relevant critical care societies to develop
recommendations and pulmonary/critical care-based models to be
tested to alleviate the impact of the critical care workforce
shortage on Medicare and Medicaid beneficiaries.
The Committee notes ongoing concern regarding Medicare
beneficiary access to the lifesaving biologic therapy
intravenous immune globulin (IVIG). The Committee encourages
CMS to continue to work with members of the IVIG community to
address these challenges, and commends CMS for establishing
separate Medicare codes for each brand of IVIG introduced in
the market after October 1, 2003.
HEALTH CARE FRAUD AND ABUSE CONTROL
The Committee provides $383,000,000 to be transferred from
the Medicare trust funds for health care fraud and abuse
control activities conducted by CMS, the HHS Inspector General,
and the Department of Justice, which is $200,000,000 above the
Administration request. This activity has not been funded in
prior years. This funding is in addition to $1,131,031,000 that
is provided as mandatory funding through authorizing bills.
These funds provide resources for expanded efforts for Medicaid
program integrity activities, for safeguarding the Medicare
prescription drug benefit and the Medicare Advantage program,
and for program integrity efforts carried out by the Department
of Justice.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
The Committee recommends $2,949,713,000 for the child
support enforcement and family support programs, and
$1,000,000,000 in advance funding for the first quarter of
fiscal year 2009 to ensure timely payments for the child
support enforcement program. This amount is the same as the
budget request. The Committee recommends estimated funding of
$38,000,000 for payments to territories, the same as the fiscal
year 2007 funding level and the budget request. The Committee
notes that the authorized funding level for the repatriation
program is set at $1,000,000 under section 1113(d) of the
Social Security Act even though approximately $1,300,000 is
needed to support the current repatriation program. The
Committee urges the authorizing committee of jurisdiction to
adjust the ceiling to accommodate the current nonemergency
needs of the program as well as to permit rapid response to
emergency repatriation of U.S. citizens due to war, threat of
war, invasion, natural disaster, or similar crises.
LOW INCOME HOME ENERGY ASSISTANCE
The Committee recommends $2,662,000,000 for the low income
home energy assistance program (LIHEAP). This amount is
$500,830,000 more than the fiscal year 2007 funding level and
$880,000,000 more than the budget request. The Committee
recommends $1,980,000,000 for the State formula grants, which
is $480,000,000 more than the budget request and the same as
the fiscal year 2007 funding level. The Committee recommends
$682,000,000 for the contingent emergency reserve. This is
$500,830,000 more than the fiscal year 2007 funding level and
$400,000,000 more than the budget request.
LIHEAP provides assistance to low-income households to help
pay the costs of home energy. This program serves the most
vulnerable in the country--94 percent of households receiving
LIHEAP grants have at least one family member who is elderly,
disabled, a child under 18, or have a single adult living with
one or more children. More than three quarters of such
households reported an annual income at or below $20,000.
Currently only 16 percent of eligible households based on
Federal guidelines receive LIHEAP assistance. The amount
recommended by the Committee could provide energy assistance to
1,252,075 more families than in fiscal year 2007.
REFUGEE AND ENTRANT ASSISTANCE
The Committee recommends $650,630,000 for refugee
assistance programs. This is $62,783,000 more than the fiscal
year 2007 funding level and $5,000,000 less than the budget
request.
In addition, the Committee recommends that the Office of
Refugee Resettlement (ORR) again be granted authority to carry
over unexpended funds from fiscal year 2008 to reimburse the
costs of services provided through September 30, 2010, for all
programs within the jurisdiction of ORR.
Transitional and medical services
The Committee recommends $294,021,000 for transitional and
medical services. This is $28,475,000 more than the fiscal year
2007 funding 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 recommends up to $9,814,000 for the victims
of trafficking program. This is $9,000 less than the fiscal
year 2007 funding level and $5,002,000 less than the budget
request. The Committee strongly supports the continued
administration of a national network for identification,
tracking, and certification of trafficking victims. The
Committee's recommendation does not include funds for an
unauthorizied grant program for domestic victims of
trafficking. Many of the domestic victims are eligible for
Federal benefits in addition to all trafficking benefits,
except those reserved for refugees.
The Committee supports efforts to ensure that child
trafficking victims do not remain trapped in life-threatening
situations out of fear of being interrogated by law enforcement
authorities. The Committee requests the Department to expedite
letters of eligibility so that minor victims may be connected
to benefits without delay. Furthermore, the Committee is
concerned about the low number of child trafficking victims
being identified and recommends that the Department expand its
practices on the identification of human trafficking victims.
Social services
The Committee recommends $154,005,000 for social services.
This is the same as the fiscal year 2007 funding level and
$4,395,000 more than the budget request. Funds are distributed
by formula as well as through the discretionary grant-making
process for special projects.
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.
The Committee continues to request that the Administration
for Children and Families adequately fund refugee school impact
grants.
Preventive health
The Committee recommends $4,748,000 for preventive health
services. This amount is the same as the fiscal year 2007
funding level and $48,000 more than the budget request. These
funds are awarded to States to ensure adequate health
assessment activities for refugees.
Targeted assistance
The Committee recommends $48,590,000 for the targeted
assistance program. This amount is the same as the fiscal year
2007 funding level and $486,000 more than the budget request.
These grants provide assistance to areas with high
concentrations of refugees.
Unaccompanied minors
The Committee recommends $129,635,000 for the unaccompanied
minors program. This is $34,317,000 more than the fiscal year
2007 funding level and $5,027,000 below the budget request.
The Committee recognizes the complexity of detention for
unaccompanied children (UAC) awaiting removal proceedings and
urges the Administration for Children and Families to ensure
that the safety and humane treatment of these children are key
priorities of the agencies that detain them. The Committee has
included additional funds for the care and placement of an
increasing number of UAC through foster care, shelter care,
staff secure or secure detention centers, and for additional
field staff in areas of high apprehensions. The Committee
supports the Department's efforts to prioritize care for UACs
in child-centered, age-appropriate, small group and foster-care
settings. The Committee requests the Department to brief the
Committee on the allegations of abuse by shelter staff and what
steps the Department is taking to prevent such abuse in the
future. The Committee does not recommend that funds be included
for expanded background checks before placement of UAC. Most of
the funds requested for this activity would pay for additional
shelter costs as new background checks would lengthen the
average shelter stay of a UAC by one to three weeks. The
Committee believes this additional cost is excessive because
ORR currently performs, and the Committee expects it to
continue to perform, a rigorous background check on each adult
to whom a child is released and conducts a home assessment as
circumstances warrant.
The Committee supports the Department's efforts to provide
medical service that meet quality standards for the children
under its care. The Committee directs the Department to provide
the Committee a report on expenses incurred in fiscal years
2007 and 2008 and what it expects to incur in fiscal year 2009
delivering routine, emergent, and emergency mental and physical
medical services to UAC.
The Committee recognizes the legal representation crisis
and need for guardians for UAC and is pleased with the progress
ORR has made in implementing pro bono pilot programs. The
Committee's recommendation includes funds to expand the pilot
program as a national pro bono legal services program to ensure
representation of all UAC in adversarial immigration removal
proceedings and affirmative asylum proceedings. The Committee
expects these funds to be matched with non-Federal funds
through a public-private partnership. The Committee intends
that pro bono attorneys participating in this program shall be
trained by experts in immigration law and provided with mentors
to ensure effective representation. Additionally, in light of
the time attorneys will be expected to spend with their UAC
clients, the Committee intends these funds to be used to train
the attorneys to detect abuse, mistreatment, labor
exploitation, and trafficking. Finally, the Committee intends
these funds to be used to train the attorneys in methods to
ensure the appearance of UAC at immigration court hearings. In
fiscal year 2006 approximately 93 percent of children released
from custody appeared at their hearings when represented by
counsel. Furthermore, according to the U.S. Commission for
International Religious Freedom, asylum-seekers represented by
counsel are more than eight times as likely to be granted
asylum as those unrepresented by counsel.
Victims of torture
The Committee recommends $9,817,000 to provide a
comprehensive program of support for domestic centers and
programs for victims of torture. This is the same as the fiscal
year 2007 funding level and $100,000 more than the budget
request.
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT
The Committee recommends $2,137,081,000 for the
discretionary portion of the child care and development block
grant program, which provides child care services for low-
income families. The Committee recommendation provides an
$75,000,000 increase over the fiscal year 2007 funding level
and the budget request. The recommendation is part of its
initiative to help reduce the number of abortions in America by
alleviating the economic pressures and other real life
conditions that can sometimes cause women to decide not to
carry their pregnancies to term.
The discretionary portion of this block grant has remained
essentially frozen since fiscal year 2002, resulting in a
severe drop in the number of children served. The Committee's
recommendation takes a step toward reversing this trend.
The Committee believes that child care is an important
investment for two reasons. First, child care assistance is key
if low-income parents are to be able to work and become self-
sufficient. Single mothers who receive child care assistance
are 40 percent more likely to remain employed after two years
than those who do not receive assistance in paying for child
care. Second, studies have shown that high-quality child care
helps ensure that children enter school ready to succeed. By
second grade, children who had received high-quality care
demonstrated greater mathematical ability, greater thinking and
attention skills, and fewer behavioral problems than the
children who had received lower-quality care.
SOCIAL SERVICES BLOCK GRANT
The Committee recommends $1,700,000,000 for the social
services block grant (SSBG). This amount is the same as the
fiscal year 2007 level. The Committee rejects the
Administration's proposal to cut SSBG by $500,000,000. The
Committee continues to provide this flexible source of funding
to help local communities provide a variety of social services
to needy individuals and their families, including services
that help prevent dependency, inappropriate institutional care,
and neglect and abuse of children and adults.
CHILDREN AND FAMILIES SERVICES PROGRAMS
The Committee recommends a program level total of
$9,127,110,000 for children and families services programs.
This is $178,140,000 more than the fiscal year 2007 funding
level and $877,021,000 more than the budget request. Within the
total provided, $10,500,000 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 recommends $6,963,571,000 for the Head Start
program, which is $75,000,000 more than the fiscal year 2007
funding level and $175,000,000 more than the budget request. Of
this total, the Committee recommends advancing $1,388,800,000
of this account for fiscal year 2008.
The Continuing Appropriations Resolution, 2007, granted
Head Start its first increase since fiscal year 2002. After
five years of level funding, centers across the country were
forced to cut hours, transportation, and educational
instruction, which have threatened the quality of the programs.
In this recommendation, the Committee takes another step to
restore a portion of those deep cuts in real terms and permit
communities to enhance the quality of comprehensive child
development services to economically disadvantaged children and
their families. The Committee continues its strong support for
this program that promotes school readiness by enhancing the
social and cognitive development of children through
educational, health, nutritional, social, and other services.
The Committee's $75,000,000 increase over fiscal year 2007 is
part of its initiative to help reduce the number of abortions
in America by alleviating the economic pressures and other real
life conditions that can sometimes cause women to decide not to
carry their pregnancies to term.
The Committee recognizes that a recent study showed that
children who participated in early Head Start had a higher
cognitive development score, demonstrated a higher level of
social-emotional development, a higher vocabulary, and higher
rates of immunization than children not enrolled in early Head
Start. The Committee further recognizes that only 2 percent of
children eligible for early Head Start are currently served by
this program. Therefore, the Committee urges the Office of Head
Start to consider its value to children, families, and our
communities and increase the level of funding available for
grants for early Head Start programs.
Consolidated runaway and homeless youth programs
The Committee recommends $97,837,000 for runaway and
homeless youth activities (RHYA). This is an increase of
$10,000,000 over the fiscal year 2007 funding level and the
budget request. Funds for this program are distributed between
the basic center program and the transitional living program
under a statutory formula.
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.
The Committee supports the Department's efforts to place
greater emphasis on runaway prevention activities under the
RHYA program. The Committee encourages the Secretary to explore
additional methods to promote and expand these prevention
efforts.
The Committee's recommendation includes a $10,000,000
increase as part of its initiative to help reduce the number of
abortions in America by alleviating the economic pressures and
other real life conditions that can sometimes cause women to
decide not to carry their pregnancies to term. The increase
will fund approximately 70 new shelters that will provide youth
essential life-skills, connect youth to education, workforce
and other supports, and expand services to pregnant/parenting
youth.
Prevention grants to reduce abuse of runaway youth
The Committee recommends $15,027,000 for prevention grants
to reduce abuse of runaway youth. This is the same as the
fiscal year 2007 funding level and the budget request. This
program provides 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. 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, including
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 recommends $63,840,000. This is $11,053,000 more
than the fiscal year 2007 funding level and $695,000 more than
the budget request. Within this total, the recommendation
includes $27,007,000 for State grants and $36,833,000 for child
abuse discretionary activities.
The Committee's recommendation includes the $10,000,000
increase as part of its initiative to help reduce the number of
abortions in America by alleviating the economic pressures and
other real life conditions that can sometimes cause women to
decide not to carry their pregnancies to term. The Committee
intends the increased funding to be dedicated to support State
use of research- and evidence-based home visitation models that
use professionals, nurses, paraprofessionals, and trained
volunteers from the community to improve parenting and family
health. The Committee has funded the Administration's request
for this activity after reviewing the research supporting the
value of a range of early childhood home visitation models and
their positive affect on prenatal health, preventing child
maltreatment, and improvement in other important outcomes for
these young families
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Children Uniting Nations, Los Angeles, CA for a $100,000
foster child mentoring program in Los Angeles.......
Crisis Nursery of the Ozarks, Springfield, MO for a 245,000
child abuse prevention program......................
Jefferson County, Golden, CO for child abuse 100,000
prevention and treatment programs...................
New York Center for Children, New York, NY for 150,000
comprehensive support and services to abused
children and their families.........................
Shelter for Abused Women, Winchester, VA to enhance 100,000
community efforts to address domestic violence......
------------------------------------------------------------------------
Community-based child abuse prevention
The Committee recommends $42,430,000 for community-based
child abuse prevention. This amount is the same as the fiscal
year 2007 funding level and the budget request. Funds are
provided to State agencies and are used to develop, operate,
expand, and enhance community-based efforts to strengthen and
support families in an effort to prevent child abuse and
neglect.
Abandoned infants assistance
The Committee recommends $11,835,000 for the abandoned
infants assistance program. This amount is the same as the
fiscal year 2007 funding 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 recommends $286,754,000 for child welfare
services. This amount is the same as the fiscal year 2007
funding level and the budget request. This program 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 recommends $7,335,000 for child welfare
training. This amount is the same as the fiscal year 2007
funding 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 recommends $26,848,000 for adoption
opportunities. This amount is the same as the fiscal year 2007
funding level and the budget request. This 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 recommends $9,500,000 for the adoption
incentives program. This is $4,500,000 more than the fiscal
year 2007 funding level and $4,000,000 less than the budget
request. This program 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 recommends $14,674,000 for the adoption
awareness program. This is a $2,000,000 increase above the
fiscal year 2007 funding level and the budget request. The
Committee's recommended increase is part of its initiative to
help reduce the number of abortions in America. The increase
for adoption awareness will expand training activities for
adoption agency staff, resulting in enhanced information to and
counseling of young pregnant women about adoption as one of
their options, as well as expanded referrals to adoption
agencies. Funds will also be used to develop best practice
guidelines in adoption counseling.
Compassion capital fund
The Committee recommends $64,350,000 for the compassion
capital fund. This is the same as the fiscal year 2007 funding
level and $10,650,000 less than the budget request. This
program provides grants to intermediary organizations that in
turn provide training and technical assistance to faith-and-
community-based organizations. The program also provides
capacity-building grants directly to the latter organizations,
which include organizations that foster supportive
relationships with youth.
Social services and income maintenance research
The Committee recommends $8,635,000 for social services and
income maintenance research, $6,000,000 of which is through the
evaluation set-aside. This is the same as the President's
request. 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.
In 2006, Congress reauthorized the temporary assistance for
needy families program, imposing new administrative mandates on
States with regard to tracking and verifying work participation
rates. As a result, each State must now design and implement
new systems and procedures for tracking work-eligible
participants or risk financial penalties. ACF is currently
working collaboratively with States to pilot-test the most
cost-efficient ways to meet new monitoring and verification
requirements. The Committee encourages ACF to continue to work
with the States to ensure that needy families receive
assistance in a timely manner. Similarly, new administrative
requirements contained in the Deficit Reduction Act of 2005
call upon States to broaden their child support collection
efforts, including seeking medical insurance coverage for
children from non-custodial parents, and mandatory review and
adjustment of support orders. ACF is currently working to
increase the exchange of critical case information among State
child support agencies, their courts, and the Federal
government. The Committee encourages ACF to continue to augment
the ability of States to collect and distribute child support
payments.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Arrowhead Economic Opportunity Agency, Virginia, MN $250,000
for the Family-to-Family community based mentoring
program to assist low-income families...............
Augusta Levy Learning Center, Wheeling, WV for 75,000
services to children with Autism....................
Beth EI House, Alexandria, VA for social services and 75,000
transitional housing for formerly homeless women and
their children......................................
Children's Home Society of South Dakota, Sioux Falls, 250,000
SD for services related to domestic violence, child
abuse, and neglect..................................
Christian Outreach of Lutherans, Waukegan, IL for 125,000
Latino leadership development in underserved areas..
City of Detroit, MI for an Individual Development 350,000
Account initiative..................................
City of Fort Worth, TX for programming at 200,000
neighborhood-based early childhood resource centers.
City of San Jose, CA for its Services for New 200,000
Americans program, including assistance with job
seeking skills, citizenship, family safety and
resettlement........................................
Cliff Hagan Boys and Girls Club - Mike Horn Unit, 175,000
Owensboro, KY for purchase of equipment.............
Communities In Schools, Bell-Coryell Counties, Inc., 260,000
Killeen, TX for youth counseling services...........
Covenant House Florida, Ft. Lauderdale, FL for a 200,000
program for pregnant and parenting teens and young
adults..............................................
Eisner Pediatric and Family Medical Center, Los 125,000
Angeles, CA for the Parent-Child Home Program.......
Every Citizen Has Opportunities, Inc., Leesburg, VA 100,000
for services to disabled individuals................
Family Center of Washington County, Montpelier, VT 200,000
for childcare and related services..................
First 5 Alameda County, San Leandro, CA for 175,000
development and support of postsecondary early
childhood education and training programs, which may
include student scholarships........................
Friendship Circle of the South Bay, Redondo Beach, CA 275,000
for services for children with developmental
disabilities........................................
Greater New Britain Teen Pregnancy Prevention, Inc., 125,000
New Britain, CT for the Pathways/Senderos Center for
education and outreach..............................
Hamilton-Madison House, New York, NY for services and 100,000
equipment for a social services program.............
Healthy Learners Dillon, Columbia, SC for social 200,000
services for economically disadvantaged children....
Helping Children Worldwide, Herndon, VA to assist 250,000
students and families...............................
Hennepin County Human Services and Public Health 285,000
Department, Minneapolis, MN for the Family Healing
and Restoration Network Project.....................
Hillside Family of Agencies, Rochester, NY for the 100,000
Hillside Children's Center for adoption services....
Hope Village for Children, Meridian, MS for a program 215,000
to assist foster children...........................
Horizons for Homeless Children, Boston, MA for 50,000
Playspace Programs for homeless children............
Kingsborough Community College, Brooklyn, NY for the 100,000
New American's Center...............................
L.I.F.T. Women's Resource Center, Detroit, MI for 100,000
services to improve self-sufficiency and life skills
of women transitioning from substance abuse,
domestic violence, or homelessness..................
Lawrence County Social Services, New Castle, PA for 125,000
early childhood, parental training, and life skills
programs............................................
Lutheran Social Services, Duluth, MN for services to 350,000
runaway, homeless, and other at-risk youth and their
families............................................
Marcus Institute, Atlanta, GA for services for 400,000
children and adolescents with developmental
disabilities and severe and challenging behaviors...
Mary's Family, Orlean, VA to develop a respite 100,000
program for Winchester-area special needs families..
Mecklenburg County, Charlotte, NC, for a program to 200,000
combat domestic violence............................
Missouri Bootheel Regional Consortium, Portageville, 250,000
MO for the Fatherhood First program.................
Monterey County Probation Department, Salinas, CA for 350,000
the Silver Star gang prevention and intervention
program.............................................
Nashua Adult Learning Center, Nashua, NH for a Family 100,000
Resource Center.....................................
National Energy Assistance Directors' Association, 200,000
Washington, DC for research and information
dissemination related to the Low-Income Home Energy
Assistance Program..................................
Network for Instructional TV, Inc., Reston, VA for a 50,000
training program for child care providers...........
Nurses for Newborns Foundation, St. Louis, MO for 300,000
nurse home visiting program.........................
Organization of the NorthEast, Chicago, IL for 50,000
development of a local homeless services continuum..
Pediatric Interim Care Center, Kent, WA for the Drug- 150,000
Exposed Infants Outreach and Education program......
Public Health Department, Solano County, Fairfield, 100,000
CA for a program to support pregnant women and new
mothers.............................................
Sephardic Bikur Holim of Monmouth County, Deal, NJ 100,000
for social services programs........................
Services, Immigrant Rights and Education Network, San 100,000
Jose, CA for assistance to immigrants seeking
citizenship.........................................
Southern Illinois University, Carbondale, IL for the 150,000
Center for Autism Spectrum Disorders................
Stephen F. Austin State University, Nacogdoches, TX 150,000
for coordination of family and child services.......
Susan Wesley Family Learning Center, East Prairie, MO 100,000
for programs to assist at-risk youth and their
families............................................
TLC for Children and Families, Inc., Olathe, KS for a 200,000
transitional living program for at-risk and homeless
youth...............................................
United Way Southeastern Michigan, Detroit, MI for the 200,000
Communities of Early Learning initiative............
University of Central Missouri, Warrensburg, MO for 250,000
the treatment of autism spectrum disorders..........
Visitation Home, Inc., Yardville, NJ for programs to 100,000
assist developmentally disabled residents...........
------------------------------------------------------------------------
Developmental disabilities
For programs authorized by the Developmental Disabilities
Assistance and Bill of Rights Act and the Help America Vote
Act, the Committee recommends $175,836,000. This is $5,001,000
more than the fiscal year 2007 level and $5,000,000 more than
the budget request.
The account total includes $76,771,000 for allotments to
States to fund State councils, which is $5,000,000 more than
the budget request and the fiscal year 2007 funding level.
These councils develop, improve, and expand the system of
services and supports for people with developmental
disabilities. Through their activities, Councils on
Developmental Disabilities provide for the inclusion and
integration of individuals with developmental disabilities in
the economic, political, social, cultural, religious and
educational mainstream of our nation.
Within the total, $38,718,000 will be available to States
for operating a protection and advocacy system to protect the
legal and human rights of the developmentally disabled. This
amount is the same as the budget request and the fiscal year
2007 funding level.
The Committee recommends $15,720,000 for voting access for
individuals with disabilities programs. This amount is the same
as the fiscal year 2007 funding level and the budget request.
Within the funds provided, $10,890,000 is for payments to
States to promote access for voters with disabilities and
$4,830,000 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 recommends $11,414,000 for developmental
disabilities projects of national significance. This amount is
the same as the fiscal year 2007 funding level and the budget
request.
The Committee recommends $33,213,000 for the university
centers for excellence in developmental disabilities. This is
$1,000 more than the fiscal year 2007 level and the same as 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.
Native American programs
The Committee recommends $47,332,000 for Native American
programs. This is $3,000,000 more than the budget request and
the fiscal year 2007 funding 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 program provides financial assistance
through direct grants for individual projects, training and
technical assistance, and research and demonstration programs.
The Committee intends that the $3,000,000 increase be
available to fund the activities authorized under section
803C(b)(7)(A)-(C) of the Native American Programs Act (as added
by the Esther Martinez Native American Languages Preservation
Act of 2006).
Community services
The Committee recommends $730,959,000 for community
services activities. This is $706,507,000 more than the budget
request and $36,385,000 more than the fiscal year 2007 funding
level.
Community services block grants
For the community services block grants, the Committee
recommends $660,425,000. This is $30,000,000 more than the
fiscal year 2007 funding level. No funds were requested for
this program. This program provides grants to over 1,000
counties, territories, and Indian tribes for services such as
employment, housing, nutrition, energy, emergency services,
child care, job training and job placement, parenting
education, adult literacy classes, domestic violence
prevention, emergency food assistance, and health needs of low-
income people.
The Committee's recommended 4.8 percent increase is part of
its initiative to help reduce the number of abortions in
America by alleviating the economic pressures and other real
life conditions that can sometimes cause women to decide not to
carry their pregnancies to term. Increased services will help
struggling, low-income families raise their children.
Community economic development
The Committee recommends $32,700,000 for community economic
development. This is $5,678,000 more than the fiscal year 2007
funding level. No funds were requested for this program. This
program provides assistance to private, locally initiated
community development corporations (CDCs) that sponsor
enterprises providing employment, training, and business
development opportunities for low-income residents in poor
communities.
The Committee's recommendation reflects its commitment to
helping CDCs continue their good work in transforming the low
income communities in which they serve. CDCs help capitalize
nearly 60,000 small businesses a year and provide approximately
$2,000,000,000 in loan assistance to entrepreneurs and
residents in low income communities a year. The increase over
fiscal year 2007 will fund approximately 9 new grants, totally
45.
Job opportunities for low-income individuals
The Committee recommends $5,382,000, the same as the fiscal
year 2007 funding level, for job opportunities for low-income
individuals (JOLI). No funds were requested for this program.
This program provides competitive grants to non-profit
organizations to create new employment and business
opportunities for TANF recipients and other low-income
individuals.
Individual development accounts
The Committee recommends $24,452,000 for individual
development accounts. This amount is the same as the fiscal
year 2007 funding level and 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. Section 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 recommends $8,000,000 for the rural community
facilities program. This amount is $707,000 more than the
fiscal year 2007 funding level. 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.
Violent crime reduction programs
The Committee recommends $134,731,000 for family violence
prevention and services and battered women's shelters. This is
$10,000,000 more than the fiscal year 2007 funding level and
the budget request. 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.
The Committee also includes $2,970,000 to fund a domestic
violence hotline. This amount is the same as the fiscal year
2007 funding level and the budget request.
The Committee's recommended 8 percent increase is part of
its initiative to help reduce the number of abortions in
America by alleviating the economic pressures and other real
life conditions that can sometimes cause women to decide not to
carry their pregnancies to term. Increased funding will permit
States to expand domestic violence prevention services to more
at-risk women.
Mentoring children of prisoners
The Committee recommends $49,493,000 for the mentoring
children of prisoners program. This is the same as the fiscal
year 2007 funding level and $507,000 less than 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 recommends $46,157,000 for independent living
training vouchers. This amount is the same as the fiscal year
2007 funding level and 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 recommends a program level total of
$141,164,000 for the community-based abstinence education
program, which is the same as the budget request and
$27,764,000 above the fiscal year 2007 level. As requested,
$4,500,000 is provided within the total through the evaluation
set-aside. 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 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 5 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's recommended increase is part of its
initiative to help reduce the number of abortions in America by
alleviating the economic pressures and other real life
conditions that can sometimes cause women to decide not to
carry their pregnancies to term. The increase will provide
support for an additional 63 grants over fiscal year 2007. The
$27,764,000 increase for the community-based abstinence
education program is identical to that recommended for the family
planning program.
The Committee urges the Administration for Children and
Families (ACF) to 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 requests ACF to issue a
report to the Committees on Appropriation of the House and
Senate no later than 90 days after enactment of this Act on the
use of the 5 percent set-aside and the intended use of the
fiscal year 2008 funds. The Committee also requests ACF to
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 Secretary of Health and Human Services shall require
each applicant for financial assistance under the abstinence
education program funded under this heading to certify that all
materials proposed in the application and funded during the
project period of the grant are medically accurate; and a panel
of medical experts shall review such grant applications and
assess whether the materials proposed are medically accurate.
Faith-based center
The Committee recommends $1,386,000 for the faith-based
center. This amount is the same as the budget request and the
fiscal year 2007 funding level. The center will support
implementation of faith-based and community initiatives in
accordance with the President's executive order.
Program direction
The Committee recommends $187,776,000 for program direction
expenses for ACF. This is the same as the fiscal year 2007
funding level and $9,449,000 less than the budget request.
Promoting safe and stable families
The Committee recommends $345,000,000 in mandatory funds
for the promoting safe and stable families program, which is
the same as the fiscal year 2007 funding level and the budget
request. The Committee recommends $89,100,000 in discretionary
funds for this program, which is the same as the fiscal year
2007 funding level and the budget request.
Payments to States for foster care and assistance
The Committee recommends $5,082,000,000 for payments to
States for foster care and adoption assistance. This is
$170,000,000 more than the fiscal year 2007 funding level and
the same as the budget request. The Committee also includes an
advance appropriation of $1,776,000,000 for the first quarter
of fiscal year 2009 to ensure timely completion of first
quarter grant awards.
Within the total appropriation, including the advance
appropriation from the prior year, the Committee recommends
$4,593,000,000 for the foster care program to provide
maintenance payments to States on behalf of children who must
live outside their homes. This amount is the same as the budget
request and $118,000,000 more than the fiscal year 2007 funding
level.
Within the total appropriation, the Committee recommends
$2,159,000,000 for adoption assistance. This is $132,000,000
more than the fiscal year 2007 funding 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
Committee recommends $140,000,000 for the independent living
program. This amount is the same as the fiscal year 2007
funding 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
(AoA), the Committee recommends a total of $1,417,189,000. This
is $34,182,000 more than the fiscal year 2007 funding level and
$82,043,000 more than the budget request. This agency
administers the programs under the Older Americans Act except
for the Community Services Employment Program, which is
administered by the Department of Labor.
The majority of the funding appropriated to AoA is
distributed via statutory formula to States or tribal
organizations, including programs for nutrition and family
caregiver services. Virtually all other programs award funding
as grants using an outside peer review process.
Supportive services and centers
The Committee recommends $357,595,000 for supportive
services and centers. This is $7,000,000 above both the fiscal
year 2007 funding 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 recommends $21,400,000 for preventive health
services. This is the same as the fiscal year 2007 funding
level. No funds were requested for this program. 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.
The Committee supports strengthening the capacity of
community-based organizations dedicated to promoting preventive
healthcare services and minimizing health disparities for Asian
American and Pacific Islander elders and encourages AoA to
continue to work with national organizations to that end.
Protection of vulnerable older Americans
The Committee recommends $20,156,000 for the protection of
vulnerable older Americans. This is the same as the fiscal year
2007 funding level and $990,000 more than the budget request.
This amount includes funding for both the long-term care
ombudsman program and the prevention of elder abuse, neglect,
and exploitation program. The former program protects the
rights and interests of residents in nursing homes, board and
care homes, assisted living facilities, and similar adult care
facilities. The latter program trains law enforcement and
medical professionals in recognition of and response to elder
abuse.
National family caregiver support program
The Committee recommends $156,167,000 for the family
caregivers program. This is the same as the fiscal year 2007
funding level and $1,980,000 more than 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 as follows: 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.
The Committee recognizes the efforts of AoA in supporting
caregivers of older individuals and older relative caregivers
through the national family caregiver support program. Based on
recommendations from the 2005 White House conference on aging,
the Older Americans Act Amendments of 2006 expanded the
national family caregiver support program to include older
relative caregivers of adults with disabilities. There are
approximately 711,000 caregivers over 60 years of age who are
providing care to their adult relatives with life-long
developmental disabilities at home. These caregivers include
parents, siblings, and other older relatives. Congress intended
to include this broad population of older relative caregivers
and not limit the program to grandparent caregivers in the case
of adult relatives with disabilities. The Committee urges AoA
to provide sufficient funds to serve this population of older
relative caregivers of adults with disabilities within the
national family caregiver support program.
Native American caregiver support program
The Committee recommends $6,428,000 for the Native American
caregiver support program. This is $187,000 more than the
fiscal year 2007 funding 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 recommends
$758,599,000. This is $23,529,000 more than the fiscal year
2007 funding level and $47,090,000 more than the budget
request. The funding distribution for these programs is
included in the detailed table accompanying this report. 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.
The increase provided for congregate and home-delivered
nutrition programs, and for the nutrition services incentive
program is intended to be a significant first step in properly
investing in the care of the nation's frail elderly. Over the
past several years the funding for aging nutrition programs has
remained flat despite the fact that the fastest growing
population of Americans is those aged 85 and older. The level
provided will pay for approximately 3 million additional meals
compared to fiscal year 2007 estimates.
Grants for Native Americans
The Committee recommends $26,918,000 for grants for Native
Americans. This is $784,000 more than the fiscal year 2007
funding 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.
The increase provided for congregate and home-delivered
nutrition programs, and for the nutrition services incentive
program is intended to be a significant first step in properly
investing in the care of the nation's frail elderly. Over the
past several years the funding for aging nutrition programs has
remained flat despite the fact that the fastest growing
population of Americans is those aged 85 and older.
Program innovations
The Committee recommends $10,240,000 for program
innovations. This is $13,818,000 less than the fiscal year 2007
funding level and $25,245,000 less than the budget request.
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.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Allied Jewish Federation of Colorado, Denver, CO for $100,000
a naturally occurring retirement communities
demonstration project...............................
Amalgamated Warbasse Houses, Inc., Brooklyn, NY for a 200,000
demonstration project focusing on supportive service
programs in naturally occurring retirement
communities.........................................
California Senior Legal Hotline, Sacramento, CA for a 80,000
demonstration project to increase services to non-
English-speaking seniors............................
Durham-Chapel Hill Jewish Federation, Durham, NC for 75,000
a demonstration program to improve assistance to
family caregivers...................................
Howard Brown Health Center, Chicago, IL for the 200,000
Chicago Elder Project...............................
Jewish Community Services of South Florida, North 100,000
Miami, FL for a naturally occurring retirement
communities demonstration project...................
Jewish Family and Children's Service of Minneapolis, 200,000
Minnetonka, MI for a naturally occurring retirement
community demonstration project.....................
Jewish Family Service of New Mexico, Albuquerque, NM 100,000
for a naturally occurring retirement community
demonstration project...............................
Jewish Family Service, Los Angeles, CA for a 300,000
naturally occurring retirement communities
demonstration project in Park La Brea and the San
Fernando Valley.....................................
Jewish Family Services of Delaware, Inc., Wilmington, 100,000
DE for a naturally occurring retirement community
demonstration project...............................
Jewish Federation of Central New Jersey, Scotch 200,000
Plains, NJ for the naturally occurring retirement
community demonstration project.....................
Jewish Federation of Greater Monmouth County, NJ for 200,000
a naturally occurring retirement communities
demonstration project...............................
Jewish Federation of Greater New Haven, Woodbridge, 150,000
CT to develop, test, evaluate, and disseminate an
innovative community-based approach to caregiver
support services....................................
Jewish Federation of Middlesex County, South River, 100,000
NJ for a naturally occurring retirement communities
demonstration project...............................
Jewish Social Service Agency, Fairfax, VA for a 150,000
naturally occurring retirement community
demonstration project...............................
Shenandoah Area Agency on Aging, Front Royal, VA for 150,000
a model group respite center for persons with
Alzheimer's disease and dementia....................
United Jewish Communities of MetroWest, NJ, 250,000
Parsippany, NJ for the Lifelong Involvement for
Vital Elders Aging in Place initiative..............
University of Florida, Gainesville, FL for a 100,000
technology demonstration project to assist seniors..
------------------------------------------------------------------------
Aging network support activities
The Committee recommends $29,633,000 for aging network
support activities. This is $16,500,000 more than both the
fiscal year 2007 funding level and the budget request. Included
within this funding are five ongoing programs: the national
eldercare locator, pension counseling, senior Medicare patrols,
the national long-term care ombudsman resource center, and the
national center on elder abuse. The Committee is funding the
components of the choices for independence initiative within
aging network support activities rather than program
innovations. These established programs, which began as
demonstration projects, provide critical support for the
national aging services network.
Within this total, the Committee provides $16,500,000 to
implement the newly authorized provisions of the Older
Americans Act related to aging and disability resource centers,
evidence-based prevention programs, and consumer-directed
services targeted at individuals who are at high risk of
nursing home placement and spend-down to Medicaid. This is the
same as the fiscal year 2007 funding level. The funding
included in the budget request for the choices for independence
demonstration is for these same activities. This effort builds
on and expands support for these successful program innovations
administered by AoA over the last four years. The Committee
requests that AoA report to the House Committee on
Appropriations on the establishment of national standards that
will be used to evaluate these three programs, including the
performance measures and indicators States must use to track
and report on the outcomes and outputs they achieve. AoA should
include in future Congressional budget submissions, the number
of people served by these programs, funding breakdowns for each
program, and on the progress States are making in implementing
these activities.
Aging and disability resource centers are currently
operating in 43 States and evidence-based disease prevention
programs are being implemented in 24 States. The funding
provided is intended to sustain and expand these efforts
through a coordinated approach that will provide States with
enhanced tools for redirecting their long-term care systems to
make them more responsive to the needs and preferences of older
people and their caregivers. In implementing these activities,
the Committee encourages AoA to continue its close partnership
efforts with the Centers for Medicare and Medicaid Services,
the National Institute on Aging, the Centers for Disease
Control and Prevention, and other agencies.
Alzheimer's disease demonstration grants
The Committee recommends $11,668,000 for Alzheimer's
disease demonstration grants. This is the same as the fiscal
year 2007 funding level. No funds were requested for this
program. 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. An estimated 70
percent of Americans with Alzheimer's disease live at home,
where family members provide the preponderance of care. The
Alzheimer's disease demonstration grant program currently
supports matching grants to 36 States to help stimulate and
coordinate services to assist families caring for Alzheimer
patients, particularly those living in underserved rural
communities and minorities. Unlike other AoA general service
activities, this program is designed to address the unique
demands Alzheimer's disease places on families and emphasizes
systems change to meet those demands.
Program administration
The Committee recommends $18,385,000 for program
administration expenses. This is the same as the fiscal year
2007 funding level and $311,000 less than the budget request.
This activity provides administrative and management support
for all programs administered by AoA.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
The Committee provides $369,075,000 for general
departmental management, which is $12,837,000 above the fiscal
year 2007 level and $23,481,000 below the budget request.
Included in this amount is authority to spend $5,851,000 from
the Medicare trust funds, which is the same as the
Administration's request. In addition, the Office of the
Secretary has access to $46,756,000 for policy evaluation
funding activities under section 241 of the Public Health
Service Act.
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 the Office of the
Surgeon General and several small health promotion and disease
prevention activities that are centrally administered.
The Committee includes the following projects in the
following amounts:
------------------------------------------------------------------------
Committee
Project recommendation
------------------------------------------------------------------------
Alma Family Services, Monterey Park, CA to increase $75,000
access to culturally competent health information to
minority populations, which may include the purchase
of a fully equipped mobile computer lab/resource
unit................................................
Bronx-Lebanon Hospital, New York, NY for 350,000
demonstration project to increase access to health
care for low-income minority men in South and
Central Bronx.......................................
Community-Health Partnership, Santa Clara, CA for its 200,000
Healthy Women, Healthy Choices project to provide
comprehensive health education to underserved women.
Hunterdon Medical Center, Flemington, NJ for its 50,000
Latino Healthcare Initiative........................
Louisiana State University Health Sciences Center, 250,000
Shreveport, LA for a health literacy program........
Marymount University, Arlington, VA for a project to 70,000
provide health screenings, referrals and health
education at a nurse managed health center for
minority populations................................
Nassau University Medical Centers, East Meadow, NY 200,000
for a minority health institute.....................
National Hispanic Medical Association, Washington, DC 250,000
for a Hispanic health portal to provide online
health education materials..........................
Prince George's County, Upper Marlboro, MD for a 100,000
media campaign for pregnant women about health
insurance for prenatal care.........................
St. Luke's Community Free Clinic, Front Royal, VA for 300,000
activities focused on adult hypertension and dental
care................................................
Thurston-Mason County Medical Society, Olympia, WA 50,000
for a demonstration project to increase care for non-
English-speaking patients...........................
------------------------------------------------------------------------
The Committee recommendation includes $19,157,000 for
transformation, readiness and training of the Commissioned
Corps, which is $15,000,000 above the fiscal year 2007 level.
These additional funds will be used to create and equip
dedicated health and medical response teams, and support
training, information technology and other transformation
activities that will enable the Corps to better respond to
public health emergencies.
Area poverty research centers.--The conferees are aware
that the area poverty research center grants will expire on
September 30, 2008, and expect the Secretary to award new
grants on a competitive basis. The bill includes sufficient
funds to continue the support of multiple area poverty centers
at no less than the fiscal year 2007 level.
Healthcare access for special populations.--The Committee
is aware that culturally and linguistically appropriate models
of care are critical to reducing health disparities and
improving access to healthcare. Furthermore, the Committee
understands that Federal agencies are expected to ensure
language access in all programs. The Committee requests the
Secretary of Health and Human Services (HSS) to submit a report
to the House and Senate Committees on Appropriations not later
than one year after the enactment of this Act that includes a
description and evaluation of the activities carried out across
HHS to ensure that every sector of society has knowledge of and
access to health and human services programs; a description and
analysis of best practices, model programs, guidelines, and
other effective strategies to improve cultural and linguistic
access; a description of the effect of providing language
services on quality of healthcare and access to care; and a
description of the costs associated with and savings related to
the provision of language services.
Interagency autism coordinating committee.--The Committee
recommendation includes funds to support the Interagency Autism
Coordinating Committee (IACC) that will coordinate all efforts
with the Department of Health and Human Services concerning
autism spectrum disorders, as authorized under the Combating
Autism Act of 2006 (P.L. 109-416). The IACC will be responsible
for developing a strategic plan for autism spectrum disorder
research. The Committee looks forward to reviewing this
strategic plan after it is developed.
Food allergy.--The Committee notes that approximately three
million children under the age of eighteen suffer from food
allergies. There are no federal guidelines concerning the
management of life-threatening food allergies in a school
setting. The Committee encourages the Secretary, working with
the Secretary of Education, to develop a policy to be used on a
voluntary basis to manage the risk of food allergy and
anaphylaxis in schools within six months of the enactment of
this law. These guidelines should include but not be limited to
detailing emergency treatment procedures in the event of
anaphylaxis or other food allergy reaction, strategies to
reduce the risk of exposure to anaphylactic causative agents in
classrooms and common school areas such as the cafeteria, and
the authorization of school personnel to administer epinephrine
when the school nurse is not immediately available. Funding is
provided under the Centers for Disease Control and Prevention
to support these activities.
Preterm birth.--The Committee encourages the Surgeon
General to convene a conference on preterm birth and produce a
report establishing a public-private agenda to expedite the
identification of and treatments for the causes and risk
factors for preterm labor and delivery as authorized by the
PREEMIE Act (P.L. 109-450).
Sodium.--The Committee encourages the Secretary to explore
funding a study by the Institute of Medicine of the National
Academy of Sciences that will examine and make recommendations
regarding various means that could be employed to reduce
dietary sodium intake to levels recommended by the Dietary
Guidelines for Americans. These should include, but not be
limited to, actions by food manufacturers, such as new product
development and food reformulation, and governmental
approaches, such as regulatory, legislative approaches, and
public and professional information and education. In addition,
the Committee encourages the Secretary to request a report from
the Surgeon General on ways in which the department could
strengthen its activities pertaining to health issues related
to salt.
Steroid use.--The Committee supports education efforts to
demonstrate the consequences of using performance-enhancing
drugs. The Department of Health and Human Services should
undertake a comprehensive campaign to educate youth on the
dangers of steroid use for 5th through 8th graders, an
education campaign authorized in the Anabolic Steroid Control
Act of 2004.
Adolescent family life
The Committee provides $30,307,000 for the Adolescent
Family Life program, which is the same as the 2007 level and
the budget request. 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. Under the Committee recommendation, the
Administration will be able to support approximately 76
discretionary demonstration grants in fiscal year 2008. The
bill includes a provision requiring funds for prevention
demonstrations to be available for abstinence education
activities under section 510(b)(2) of the Social Security Act,
as requested by the Administration.
Office of minority health
The Committee provides $49,284,000 for the Office of
Minority Health (OMH), which is $4,171,000 below the fiscal
year 2007 amount and $5,509,000 above the budget request. The
bill does not include funding for a one-time project costing
$5,000,000 in fiscal year 2007. Excluding this project, the
bill provides a $829,000 increase over fiscal year 2007 for
ongoing activities.
The OMH works with Public Health Service agencies and other
agencies of the Department to address the health status and
quality of life for racial and ethnic minority populations in
the United States. OMH develops and implements new policies;
partners with States, tribes, and communities through
cooperative agreements; supports research, demonstration, and
evaluation projects; and disseminates information.
Historically black medical schools.--The Committee
continues to be concerned about the diminished partnership
between OMH and the nation's historically black medical
schools. Consistent with previous recommendations, the
Committee encourages OMH to: (1) re-establish its unique
cooperative agreement with Meharry Medical College; (2) develop
a formal partnership with the Morehouse School of Medicine and
its National Center for Primary Care; and (3) coordinate a
response to the challenges facing the Charles R. Drew
University of Medicine and Science, including expanded
opportunities for biomedical research and support for residency
training faculty. The Committee requests a report on the status
of these activities by January 1, 2008.
Minority male consortium.--The Committee continues to
recognize the importance of the educational and preventive
health work being undertaken and implemented in campus and
community-based projects by the five historically black
colleges and universities in the New Minority Males Consortium,
Inc. The Committee bill includes additional resources over the
budget request to enable the OMH to expand the number of
participating institutions, as well as to enhance the resources
received by each of the institutions to increase their
activities and to conduct the national comparative study of the
incidence of certain health conditions and diseases among
minority males.
Obesity awareness and prevention.--The Committee encourages
the OMH to continue its effort to partner with organizations
that are focused on collaborative efforts to eliminate health
disparities by, among other things, raising awareness of
obesity as a public health epidemic and removing barriers to
obesity prevention through culturally competent community
education and helping to create community environments that
facilitate equal access to healthy lifestyles.
Office on women's health
The Committee provides $28,800,000 for the Office on
Women's Health (OWH), which is $554,000 above the fiscal year
2007 level and $1,431,000 above the budget request. The (OWH)
advises the Secretary and provides Department-wide coordination
of programs focusing specifically on women's health.
Centers of excellence.--Multidisciplinary centers of
excellence in women's health were established in 1996 to
develop standards of excellence in women's health care,
research, leadership, training and education. The 48
institutions from 40 States and Puerto Rico that have been
designated as centers of excellence participate in one of five
model programs developed by the OWH to provide comprehensive,
integrated, interdisciplinary and coordinated women's health
care: national centers of excellence in women's health,
national community centers of excellence in women's health,
ambassadors for change, region VIII demonstration projects, and
rural frontier women's health coordinating centers. This
network has successfully leveraged significant public and
private funding across all 48 sites. The Committee urges OWH to
maintain the center of excellence designation and the existing
structure of this innovative initiative, and to reconsider its
decision to discontinue funding for these centers of
excellence.
HIV/AIDS in minority communities
The Committee provides $51,891,000 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 2007 level and 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 recommends $5,941,000, which is $49,000 above
the fiscal year 2007 level and the same as the budget request.
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 includes $1,980,000 for the embryo adoption
awareness campaign, which is the same as the fiscal year 2007
level and the Administration request. These funds will be used
to educate Americans about the existence of frozen embryos
(resulting from in-vitro fertilization) which may be available
for donation/adoption.
OFFICE OF MEDICARE HEARINGS AND APPEALS
The Committee provides $65,000,000 for this Office, which
is $5,273,000 above the fiscal year 2007 level and $5,000,000
below the Administration request. This office supports hearings
at the administrative law judge level, the third level of
Medicare claims appeals. The increase over the 2007 level will
support an additional administrative law judge and attorneys,
as well as legal and administrative activities, to continue the
timely adjudication of all Medicare appeals.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
The Committee provides $61,302,000 for the health
information technology office, of which $13,302,000 is
available in budget authority and $48,000,000 is available in
program evaluation tap funding. This total is the same as the
amount made available in fiscal year 2007 and $56,570,000 below
the Administration request. In addition, $45,000,000 is
provided for health information technology activities in the
Agency for Healthcare Research and Quality (AHRQ). This AHRQ
activity is the same as the budget request and the fiscal year
2007 level.
This program was established to bring together decision-
makers to develop standards for modern health information
technology, to devise certification procedures for health IT
solutions, to develop a secure nationwide health information
network architecture, and to develop policy and technology
solutions that provide adequate privacy protections for
personal health information. The ultimate goal is the secure,
accurate, and rapid exchange of interoperable electronic health
information throughout a nationwide health information network.
The office of the national coordinator for health information
technology is responsible for promoting the use of electronic
health records in clinical practice, coordinating federal
health information systems, and collaborating with the private
sector to develop standards for a nationwide interoperable
health information technology infrastructure.
The Committee has not provided the full budget request for
health information technology due to concerns that this office
has yet to develop a detailed and integrated implementation
plan for achieving the health information technology program's
strategic goals, as recommended by the General Accounting
Office. The Committee requests that, no later than March 1,
2008, the Secretary submit a report to the House and Senate
Committees on Appropriations that provides an implementation
plan for health information technology (including related
activities funded through the Agency for Healthcare Research
and Quality and the Centers for Disease Control), which
includes performance benchmarks, milestones, and timelines for
achieving program objectives. This report should also identify
the resource requirements for achieving specific performance
benchmarks.
In addition, the Committee requests that the Secretary
develop and make available for public comment, not later than
March 1, 2008, a privacy and security framework that will
establish trust among consumers and users of electronic
personal health information and will govern all efforts to
advance electronic health information exchange. The framework
shall address generally accepted fair information practices,
including transparency; specifying the purposes of any data
collection; collecting only what is necessary for that purpose;
adhering to the uses agreed to by the individual; allowing
individuals to know and have a say in who and how their
information is used; maintaining the integrity of the data;
security; audit; strong oversight; and appropriate remedies in
the event of breach or misuse. The development of this
framework should include participation by affected stakeholders
and be conducted with adequate opportunity for public comment
and review.
The Committee requests that the Secretary report to the
House and Senate Committees on Appropriations on the
development and implementation of this framework by no later
than June 30, 2008. This report shall describe the appropriate
enforcement mechanisms to assure general conformity with the
privacy and security framework, including how various
enforcement tools, such as federal and state statutes,
government procurement policy, third-party certification, self-
attestation, business contracts, and FTC enforcement of public
claims, may assist in achieving general adoption of the privacy
framework. The Secretary's report should also include any
appropriate recommendations for Congressional or executive
action.
The Committee requests that the Secretary issue, after an
appropriate public comment and review period, such rules,
regulations, and technical requirements as may be needed to
assure implementation of the privacy and security framework,
consistent with the report to Congress. The Committee further
requests that the Secretary ensure that any Federally endorsed
or funded standards development and harmonization or product
certification products be developed consistent with all
elements of the privacy and security framework.
OFFICE OF THE INSPECTOR GENERAL
The Committee provides $44,687,000 for the Office of the
Inspector General (OIG), which is $4,879,000 above the fiscal
year 2007 level and the same as the budget request. Permanent
appropriations for this office are contained in the Health
Insurance Portability and Accountability Act of 1996, as well
as the Deficit Reduction Act of 2005. Total funds provided
between this bill and the permanent appropriations would be
$266,105,000 in fiscal year 2008.
The OIG 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 $37,062,000 for the Office of Civil
Rights (OCR), which is $2,153,000 more than the fiscal year
2007 level and the same as the budget request. This includes
authority to transfer $3,314,000 from the Medicare trust funds.
The OCR 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.
NONRECURRING EXPENSES FUND
The bill does not include new language proposed by the
Department to establish a nonrecurring expenses fund to capture
unobligated balances from discretionary accounts prior to
cancellation. While the existence of these balances points to
the need for better management of grants and contracts by the
Department's various operating divisions, the Committee may
reconsider this proposal in the future.
MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
The Committee provides an estimated $402,542,000 for
medical benefits for commissioned officers of the U.S. Public
Health Service. This is the same as the Administration request
and $31,844,000 above the fiscal year 2007 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
(INCLUDING TRANSFER OF FUNDS)
The Committee provides $1,705,382,000 for the public health
and social services emergency fund (PHSSEF) to support a
comprehensive program to prepare for and respond to the health
and medical consequences of all public health emergencies,
including bioterrorism, and to support the activities in
preparing for an influenza pandemic. This is $988,062,000 more
than the fiscal year 2007 funding level and $48,355,000 less
than the budget request.
The Office of the Assistant Secretary of Preparedness and
Emergency Response (ASPR) administers programs funded through
the PHSSEF via competitive contract, grant, or cooperative
agreement to States or private organizations. Some programs are
funded through administratively-determined formulas to States,
such as the hospital preparedness cooperative agreement grants
program. Small amounts of funding have been awarded on a non-
competitive basis where there was only one natural partner or
at the behest of Congress.
Office of the Assistant Secretary for preparedness and response
The Committee recommends $738,909,000 for activities
administered by the Office of the Assistant Secretary for
preparedness and response (ASPR). This is $42,897,000 more than
the fiscal year 2007 funding level and $11,842,000 less than
the budget request. The Pandemic Preparedness and All-Hazards
Preparedness Act, enacted into law in December of 2006, created
this new Assistant Secretary and office. Additionally, many of
the programs and activities funded in this appropriation were
funded elsewhere in previous years. ASPR is responsible for
coordinating national policies and plans for medical and public
health preparedness and for administering a variety of public
health preparedness programs, including the national disaster
medical system, the hospital preparedness cooperative agreement
program, BioShield management, and the advanced research
development program authorized by the biomedical advanced
research and development authority (BARDA).
Within the total provided for ASPR, the Committee
recommends the following amounts:
$53,000,000 for the national disaster medical system,
as requested--this activity was transferred from the
Department of Homeland Security in fiscal year 2007;
$450,991,000 for the hospital preparedness
cooperative agreement grants program, which is
$43,148,000 more than the budget request--this program
was transferred from the Health Resources and Services
Administration in fiscal year 2007 (not included within
the total is funding for a surge capacity demonstration
program);
$6,000,000 for the emergency systems for advance
registration of volunteer health professionals program,
as requested--this program was transferred from the
Health Resources and Services Administration in fiscal
year 2007;
$139,500,000 for advanced research and development,
which is $49,500,000 less than the budget request--this
activity, including $99,000,000 in funding, is being
transferred from the National Institutes of Health in
the fiscal year 2007 emergency supplemental bill (P.L.
110-28); and,
$22,363,000 for BioShield management, as requested--
this activity previously had been funded through the
strategic national stockpile appropriation within the
Centers for Disease Control and Prevention.
Anthrax.--The Committee is concerned about significant
biological threats facing the nation, particularly anthrax. The
Committee is further concerned that the Department of Health
and Human Services (HHS) seems to be far away from filling the
Strategic National Stockpile as authorized by Project
BioShield. The Committee recognizes HHS's efforts to develop a
next generation anthrax vaccine. However, given the recent
failure to add doses of an experimental anthrax vaccine to the
Strategic National Stockpile, the Committee urges HHS to
continue to give FDA-approved projects priority in procurement.
Furthermore, the Committee recognizes the importance of
maintaining a domestic supply of vaccine and building a
diversified manufacturing base and encourages HHS to continue
to support the development of a domestic biodefense
infrastructure and urges ASPR to accelerate the issuance of
anthrax therapy and vaccine requests for proposals under
project BioShield.
Preparedness data.--Ensuring national preparedness requires
regular review of the preparedness efforts of each State. The
Committee urges ASPR to collect and review State-by-State data
on benchmarks and performance measures developed pursuant to
the provisions of the Pandemic and All-Hazards Preparedness Act
and to make these data available to Congress, State and local
public health departments and governments, and the public. The
Committee further urges that as ASPR collects and evaluates
State pandemic response plans that results of these evaluations
be made available to the Congress and to the public.
Surge capacity.--The Committee is concerned that not enough
is being done at the State or Federal level to build up medical
surge capacity for use during a pandemic or other public health
emergency. The Committee urges ASPR, in consultation with
medical and public health experts, to develop benchmarks of
State readiness for medical surge capacity.
Trauma centers.--In its CDC-funded September 2006 report,
``U.S. Trauma Center Preparedness for a Terrorist Attack,'' a
panel of experts assessed 175 trauma centers and made a number
of recommendations with regard to planning and preparedness,
communication and information sharing, resource allocation, and
surge and decontamination capacities, among others. The report
also noted the need to create sources of sustainable
prospective funding for these purposes. The Committee strongly
urges ASPR to review these recommendations and to incorporate
them into the hospital preparedness cooperative agreement
grants program.
Office of public health and science
The Committee recommends $9,318,000 for the medical reserve
corps (MRC) program, which is the same as the fiscal year 2007
funding level and $5,795,000 less than the budget request. The
mission of the MRC is to improve the health and safety of
communities across the country by organizing and utilizing
public health, medical, and other volunteers. MRC members are
identified, credentialed, trained, and prepared in advance of
an emergency, and are utilized throughout the year to improve
the public health system.
Assistant Secretary for resources and technology
The Committee recommends $9,064,000 for the Office of the
Chief Information Officer, under the Assistant Secretary for
resources and technology, for information technology cyber-
security. This is the same as the fiscal year 2007 funding
level and $918,000 less than the budget request. This funding
goes to projects aimed at preventing, detecting, and responding
to security events.
Office of the Secretary
The Committee recommends $948,091,000 for public health
preparedness activities administered by the Office of the
Secretary, which is $29,800,000 less than the budget request.
No funding was provided for the Office of the Secretary within
this account in fiscal year 2007.
Pandemic influenza
The Committee recommends $948,091,000 for pandemic
influenza preparedness activities of the Secretary of HHS,
which is the same as the budget request. No funding has been
provided to the Office of the Secretary for pandemic influenza
in previous regular appropriation bills, although the Congress
included $5,657,000,000 for Department of Health and Human
Services pandemic influenza preparedness and response
activities in the fiscal year 2006 emergency supplemental
appropriations bills. Of that total, approximately
$2,500,000,000 remains available for obligation. In addition,
the Committee provides $193,081,000 for non-emergency, on-going
pandemic influenza activities within the Centers for Disease
Control and Prevention and the National Institutes of Health.
The Committee includes bill language, as requested, that
permits the Secretary to transfer funds to other HHS accounts
for the purpose of pandemic influenza preparedness and
response.
Within the total, the Committee recommends $870,000,000, to
be available until expended, for activities including the
development and purchase of vaccine, antivirals, necessary
medical supplies, diagnostics, and other surveillance tools.
The Committee also includes bill language, as requested, that
permits the Secretary to deposit products purchased with these
funds in the strategic national stockpile and that funds may be
used, as deemed necessary by the Secretary, for the
construction or renovation of privately owned facilities for
the production of pandemic vaccine and other biologicals.
Within the total, the Committee recommends $78,091,000 to
support ongoing activities, including: ensuring effective
communications, global and domestic pandemic preparedness and
planning, international in-country advanced development and
industrialization of human pandemic influenza vaccines,
advanced development of rapid tests and detection, and
management and administration.
World Trade Center
The Committee does not include funding within the Office of
the Secretary for treatment of World Trade Center responders;
instead $50,000,000 is provided under the Centers for Disease
Control and Prevention's National Institute for Occupational
Safety and Health (NIOSH). Current Federal funding for the
treatment and monitoring activities of rescue and recovery
personnel who responded to the World Trade Center site of the
September 11, 2001 attacks are administered by NIOSH. Further,
the Congress provided an additional $50,000,000 for World Trade
Center health monitoring and treatment to NIOSH in the fiscal
year 2007 emergency supplemental appropriation (P.L. 110-28).
The Committee is concerned that, more than five years after
the September 11, 2001 terrorist attacks on the U.S. and after
multiple requests from Members of Congress, the Department of
Health and Human Services still has not developed a long-term,
comprehensive plan to medically monitor all individuals who
were exposed to the toxins at the World Trade Center (WTC) site
following the terrorist attacks of 9/11 and provide
comprehensive medical services for those experiencing illnesses
or injuries as a result of the WTC exposures.
Accordingly, the Committee directs the Secretary of Health
and Human Services, together with the Director of NIOSH, and in
consultation with the Secretary of Labor, to submit a report to
the House and Senate Committees on Appropriations, and relevant
authorizing committees, that includes a long-term,
comprehensive Federal plan for monitoring, screening, analysis,
and medical treatment for all individuals who were exposed to
the toxins at the World Trade Center site, using a centers of
excellence model of service delivery, as already established
under the current program. This plan shall also address issues
of long-term medical care, worker compensation, income
security, and disability benefits for affected individuals and
liability issues for the city of New York and its contractors.
The Committee intends that this plan take into account all
affected individuals, including emergency rescue, recovery, and
clean up personnel; volunteers who responded to the attacks on
the World Trade Center, including police officers,
firefighters, emergency medical technicians, and transit
workers; and other individuals who lived, worked, or attended
school, child care, or adult day care in the New York City
disaster area; and any other individuals whom the Secretary
determines to be appropriate for inclusion.
The report shall include annual and long-term cost
estimates of providing monitoring, screening, analysis, medical
treatment, workers' compensation, income security, and
disability services. In addition, the report shall include
recommendations for new legislation, as appropriate, and be
submitted not later than four months after the enactment of
this Act.
Healthcare provider credentialing
The Committee does not include funding to start a new
program for healthcare provider credentialing. The budget
requested $3,300,000 for this activity. The Committee believes
a better use of resources is the expansion of the ongoing
credentialing program operated by ASPR (formerly HRSA) to
permit cross-State credentialing.
Covered countermeasure process fund
The Committee includes $5,000,000, to remain available
until expended, for the compensation fund established by the
Public Readiness and Emergency Preparedness (PREP) Act. The
Committee intends that funding be used to provide compensation
to individuals harmed by the administration or use of the H5N1
influenza vaccine covered by the PREP Act declaration made by
the Secretary of Health and Human Services on January 26, 2007.
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 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. 204. The Committee includes a provision limiting the
compensation of an individual working in Head Start to the
Federal Executive Level II salary.
Sec. 205. 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. 206. The Committee continues a provision permitting
the Secretary to use up to 2.4 percent of funds authorized
under the PHS Act for the evaluation of programs.
(TRANSFER OF FUNDS)
Sec. 207. The Committee continues a provision permitting
the Secretary of HHS to transfer up to one percent of any
discretionary appropriation from an account, provided that no
appropriation is increased by more than three percent by any
such transfer.
(TRANSFER OF FUNDS)
Sec. 208. 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. 209. The Committee continues a provision to make NIH
funds available for human immunodeficiency virus research
available to the Office of AIDS Research.
Sec. 210. 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. 211. 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. 212. The Committee continues a provision related to
the Medicare Advantage program.
Sec. 213. The Committee continues a provision to exempt
States from Synar provisions if certain funding criteria are
met.
Sec. 214. The Committee continues a provision to allow
funding for 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. 215. The Committee continues 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. 216. The Committee continues 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. 217. The Committee includes a provision requiring NIH-
funded authors to deposit final, peer-reviewed manuscripts in
the National Library of Medicine's PubMed Central database
within twelve months of the official date of publication.
The provision also requires that NIH implement the policy
in a manner consistent with copyright law.
Sec. 218. The Committee includes a provision requested by
the Administration clarifying that funds appropriated to NIH
institutes and centers may be used for minor repairs or
improvements to their buildings, up to $2,500,000 per project
with a total limit for NIH of $35,000,000.
Sec. 219. The Committee recommends new language precluding
funds to administer an influenza vaccine to children under 3
years of age during the 2008-2009 influenza season that
contains thimerosal.
TITLE III--DEPARTMENT OF EDUCATION
Education for the Disadvantaged
The Committee recommends $16,016,318,000 for the education
for the disadvantaged programs. This amount is $1,290,725,000
more than the fiscal year 2007 appropriation. Of the total
amount available, $7,698,807,000 is appropriated for fiscal
year 2008 for obligation after July 1, 2008 and $8,136,218,000
is appropriated for fiscal year 2009 for obligation on or after
October 1, 2008. This appropriation account includes
compensatory education programs authorized under title I of the
Elementary and Secondary Education Act of 1965 and title IV of
the Higher Education Act.
Grants to local educational agencies
Of the amounts provided for title I programs,
$6,808,971,000 is available for basic grants to local education
agencies. This amount is $563,000 more than the fiscal year
2007 funding level and the budget request.
Funding for concentration grants, which targets funds to
local educational agencies in school districts with high levels
of disadvantaged children, is $1,365,031,000, which is the same
as last year and the request level.
The Committee recommends $3,094,562,000 for targeted
grants, which is $762,219,000 more than last year and
$372,056,000 less than the request.
A total of $3,094,260,000 is included for education finance
incentive grants, which is $761,917,000 more than last year's
level and $824,417,000 more than the budget request.
The Committee recommends an increase of $1,524,699,000 for
title I grants to school districts for low-income children.
These funds, together with an additional $375,000,000 included
in the bill for the title I school improvement fund, provide a
total increase of $1,899,699,000 for title I schools--the
largest increase in the history of the program. More than 8
million low-income children qualify for title I assistance, but
fewer than half of these children are fully funded under NCLB.
Providing additional resources so that these children can
overcome the effects of poverty to succeed in school and in
life is one of the Committee's highest priorities in the bill.
Title I grants are the engine behind NCLB reforms, which
were enacted in January 2002 to ensure that all children
receive a high quality public education. NCLB requires public
schools to steadily raise achievement and to close the
achievement gap for minority, poor, and special needs children.
However, since the bipartisan enactment of NCLB, the gap
between the resources promised for reforms and the resources
actually provided has grown larger each year. The Committee's
recommendation is another step toward reversing these funding
shortfalls by providing resources to serve an additional
161,000 low-income children.
The Committee's recommended increase for title I should be
used to support scientifically-based reading instruction for
low-income, low-performing students most in need of those
programs. The Committee expects the Department to take the
necessary steps to ensure that high quality reading instruction
is provided in all title I schools. The Committee prefers to
support reading programs under title I rather than under
reading first State grants because of its extreme
dissatisfaction with the Department's mismanagement of the
reading first program which has resulted in serious conflicts
of interest and violations of Federal law.
Even start
The Committee provides $99,000,000 for even start, which is
$16,717,000 more than the fiscal year 2007 funding level. The
Administration did not request funding for this program. Even
start provides grants to States for programs focusing on the
education of low-income families, including parents eligible
for services under the Adult Education and Family Literacy Act
and their children, aged birth-7 years. 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). The Committee does not agree with the funding cut
implemented by the Administration in fiscal year 2007 or the
Administration's proposal to terminate the program in fiscal
year 2008. The funds included in the bill will restore even
start funding to its fiscal year 2006 level.
School improvement grants
The Committee provides $500,000,000 for school improvement
grants, which is $375,000,000 more than the fiscal year 2007
funding level and the same as the budget request. This formula
grant program will make awards to States to provide assistance
for local school improvement activities required for title I
schools that do not make adequate yearly progress for at least
two consecutive years.
The Committee provides the $500,000,000 for school
improvement grants in anticipation of a rising number of
schools identified for improvement. The Department of Education
reports that the number of schools identified for improvement
nationwide grew from 9,071 in the 2005-2006 school year to
10,214 in the 2006-2007 school year. The Department projects
that the number of schools identified for restructuring alone
could double by fiscal year 2008. The resources provided in the
bill demonstrate the Committee's commitment to ensuring that
chronically low-performing schools that have the greatest
challenges--the least experienced teachers, lower teacher
salaries, and higher teacher turnover--have the assistance they
need to improve student performance. Under the Committee
recommendation, as many as 10,000 school districts could
receive additional funds for these struggling schools.
Reading first State grants
The Committee recommends $400,000,000 for reading first
State grants, which is $629,234,000 less than the fiscal year
2007 funding level and $618,692,000 less than the budget
request. This program provides assistance to States and school
districts in establishing research-based reading programs for
children in kindergarten through grade three.
The Committee's recommendation reflects its extreme
dissatisfaction with the Department's mismanagement of this
program, which has resulted in serious conflicts of interest
and violations of Federal law. These unacceptable problems have
been documented by the Department of Education, Office of
Inspector General (OIG). For example, in September, 2006, the
OIG analyzed hundreds of Department emails and concluded that
the Department's program officials failed to maintain a
controlled environment that exemplified management integrity
and accountability (Office of Inspector General, U.S.
Department of Education, Final Inspection Report, The Reading
First Program's Grant Application Process (2006)).
After further investigation of reading first, the OIG found
that program administrators improperly promoted commercial
reading programs potentially in violation of Federal law
(Office of Inspector General, U.S. Department of Education,
Final Inspection Report, The Department's Administration of
Selected Aspects of the Reading First Program (2007)).
For example, the Madison School District in Wisconsin had
substantial data demonstrating that its students were learning
at the rate that reading first was aiming for. Nonetheless, the
district lost its $2,000,000 reading first grant when the
district would not purchase the unproven commercial reading
program promoted by the Department of Education's contractors.
Across the country, including in Illinois, Kentucky,
Massachusetts, Maine and New Jersey, States and districts with
programs that were not on the Department's preferential list
were either rejected for grants or pressured to change their
methods even though some argued, as did Wisconsin, that their
programs met the law's standard. This is the type of pressure
that the OIG found to be in potential violation of Federal law.
Finally, the OIG found significant bias and conflicts of
interest on the part of those hired to provide technical
assistance to States, potentially in violation of Federal law
(Office of Inspector General, U.S. Department of Education,
Final Inspection Report, RMC Research Corporation's
Administration of Reading First Program Contracts (2007)). The
Committee is particularly disturbed by the OIG's findings that
indications of bias relating to technical assistance providers
were prevalent as early as 2002 (Id.).
The seriousness of the OIG's findings is underscored by
reports that the office has made criminal referrals to the
Justice Department as a result of his investigation.
At the same time that the Department of Education was
promoting certain reading products that lacked evidence of
their validity, reading programs such as Reading Recovery and
Success for All with strong evidence of effectiveness,
according to the Department's own What Works Clearinghouse,
were virtually shut out of reading first. In fact, Department
of Education data show that schools without Reading First funds
were more likely to use Reading Recovery and Success for All--
proven approaches--than were schools receiving reading first
grants.
The Committee is displeased that the Department has
attempted to paper over these transgressions by pointing to a
modest rise in the nation's reading scores. Because only a tiny
share--about 6 percent--of all schools in the country receive
reading first funds, the Committee questions the suggestion
that reading first is responsible for those results. The
Committee notes that the reading first program currently is
being evaluated based on its performance in raising student
achievement. That evaluation is not yet complete. Further, the
Committee does not know how effective the program would have
been had States and school districts been permitted to choose
from a wider array of reading programs that are, in fact, based
on solid evidence of effectiveness.
The Committee finds that (1) Congress must fundamentally
reform the reading first program through the reauthorization of
the No Child Left Behind Act; (2) the Department must reform
its management of the program, including the removal of
individuals, contractors, and subcontractors who have a
financial interest in products or services purchased with
reading first funds; and (3) there must be a final,
scientifically rigorous impact evaluation of the program before
the Committee will make another large investment of valuable
resources into the program.
The Committee notes that, as the program is subject to
reauthorization this year, fiscal year 2007 is the final year
of funding for the current cohort of reading first schools.
Therefore, the Committee's recommendation should not impact
funding for existing grantees. Fiscal year 2008 funds will
support a new cohort of schools that will be selected based on
new State competitions. Further, the Committee expects that the
significant increase recommended for title I grants will be
used to support scientifically-based reading instruction for
low-income, low-performing students most in need of those
programs.
Early reading first
The Committee recommends $114,550,000 for early reading
first, which is $3,116,000 less than the fiscal year 2007
funding level and the budget request. This is a competitive
grant program targeted toward children from birth through age
five, and supports the development of verbal skills, phonetic
awareness, pre-reading development, and assistance for
professional development for teachers in evidence-based
strategies of instruction. All of the fiscal year 2008 funds
will be used for up to 36 new discretionary awards, which will
serve approximately 7,300 children and 600 teachers.
The Committee agrees with the Administration's finding that
there is substantial overlap between early reading first and
the early childhood educator professional development program,
and that the two programs should be consolidated. Therefore,
the Committee recommendation does not provide fiscal year 2008
funding for the early childhood educator professional
development program. The Committee expects the Department to
strengthen professional development partnerships for early
childhood educators through grants awarded under early reading
first.
The Committee has learned that several school districts
were not informed of their eligibility to compete for early
reading first grants until March 7, 2007, yet were given a
preapplication deadline of March 23, 2007--a mere two weeks
later. When the Department of Education originally announced
national grant eligibility on January 22, 2007, some school
districts were mistakenly not included on the list of eligible
districts. Following the original application deadline on
February 21, 2007, the Department issued a modification on
March 7, 2007, announcing an error in the list of eligible
districts and reopened the preapplication phase of the
competition for a only 16 days.
The Committee understands that the Department may not have
been at fault for the omission of several eligible districts.
However, once the Department was made aware of the omission, it
should have extended the deadline for a reasonable period. The
Committee requests that the Department inform it, in writing,
prior to the next grant competition of what it believes to be
the best practice for determining whether, and for how long,
grant deadlines should be extended to accommodate error and
thus ensure a fair competition.
The Committee supports and understands the need for the
early reading first program. The program has a strong research
component. The Committee notes that research on the
effectiveness of preschool curricula is one of the research
priorities identified by the Institute of Education Sciences
(IES). The bill provides $157,552,000 for research conducted by
IES. The Committee believes that IES should be the primary
place within the Department where research on educational
interventions is conducted and has provided sufficient
resources within the IES account to continue its research on
preschool education.
Striving readers
The Committee recommends $31,870,000 for striving readers,
which is $68,130,000 less than the budget request and the same
as the fiscal year 2007 funding level. Striving readers makes
competitive grants to develop, implement, and evaluate reading
interventions for middle- or high-school students who are
reading significantly below grade level. These funds will
support all continuation awards.
The Committee supports and understands the need for the
striving readers program, but it believes that it is
essentially a research activity. The Committee notes that
research on interventions for struggling adolescent and adult
readers is one of the research priorities identified by the
Institute of Education Sciences (IES). The bill provides
$157,552,000 for research conducted by IES. The Committee
believes that IES should be the primary place within the
Department where research on educational interventions is
conducted and has provided sufficient resources within the IES
account to expand research on adolescent reading.
Math now
The bill does not provide $250,000,000 as requested by the
Administration for two new programs, math now for elementary
school students and math now for middle school students. The
Committee supports efforts to improve mathematics instruction
but has concerns about beginning additional programs when
ongoing programs exist that target math and science
instruction. In addition, the Committee provides funding for
the national mathematics panel to develop mathematics content
and principles for programs like math now.
The Committee notes that research on mathematics
instruction and assessments is one of the research priorities
identified by the Institute of Education Sciences (IES). The
bill provides $157,552,000 for research conducted by IES. The
Committee believes that IES should be the primary place within
the Department where research on educational interventions is
conducted and has provided sufficient resources within the IES
account to expand research on mathematics interventions.
Literacy through school libraries
The Committee recommends $19,486,000 for literacy through
school libraries, the same as the budget request and $1,000
more than the fiscal year 2007 funding 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.
America's opportunity scholarships and promise scholarships
The Committee does not recommend funding for the promise
scholarships and America's opportunity scholarships program
proposed by the Administration at $250,000,000 and $50,000,000,
respectively. These proposed programs would provide parents
with funds either to send their children to private schools or
receive intensive tutoring assistance. Instead, the Committee
demonstrates its commitment to improving low-performing schools
by investing $500,000,000 to turn those schools around not only
for the benefit of current students but for the benefit of
younger children progressing through the school system.
State agency programs: migrant
The Committee recommends $393,900,000 for the migrant
education program. This amount is $7,376,000 more than the
fiscal year 2007 funding level and $13,605,000 more than the
budget request. This program supports special educational and
related services to children of migratory agricultural workers
and fishermen, including (1) supplementary academic education;
(2) remedial or compensatory instruction; (3) English for
limited English proficient students; (4) testing; (5) guidance
counseling; and (6) other activities to promote coordination of
services across States for migrant children whose education is
interrupted by frequent moves.
State agency programs: neglected and delinquent
For the State agency program for neglected and delinquent
children, the Committee recommends $49,797,000, which is the
same as the budget request and the fiscal year 2007
appropriation. This formula grant program provides educational
services for children and youth under age 21 in institutions
for juvenile delinquents, adult correctional institutions, or
institutions for the neglected. A portion of these funds may be
used for projects that support the successful re-entry of youth
offenders into postsecondary and vocational programs.
Evaluation
The Committee provides $9,330,000 for evaluation. This is
the same as the fiscal year 2007 funding level and $3,000 more
than 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.
The Committee supports the Department's efforts to carry
out congressionally authorized evaluations of Federal education
programs using rigorous methodologies, particularly random
assignment, that are capable of producing scientifically valid
knowledge regarding which program activities are effective. To
ensure that authorized evaluations are conducted in a rigorous
manner, are independent of the program office, and include
scientific peer review, the Committee believes that the
Institute of Education Sciences should be the lead agency for
the design and implementation of these evaluations. The
Committee believes further that it is essential for program
offices to work collaboratively with the Institute to include a
priority or requirement in program solicitations for grantee
participation in such evaluations, including random assignment,
to the extent the Institute deems appropriate and where not
specifically prohibited by law.
Comprehensive school reform
The Committee recommends $1,634,000 for the comprehensive
school reform program. This is $718,000 less than the fiscal
year 2007 funding level. The budget request did not include
funding for this program. The amount recommended will provide
continuation funding for the comprehensive school reform
clearinghouse, which disseminates information about research-
based school reforms to education practitioners and
policymakers.
Migrant education, high school equivalency program
The Committee recommends $18,550,000 for the high school
equivalency program. This amount is the same as the budget
request and the fiscal year 2007 level. The high school
equivalency program recruits migrant students age 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 Committee recommends $15,377,000 for the college
assistance migrant programs (CAMP). This amount is the same as
the fiscal year 2007 level and the budget request. 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 Committee recommends $1,278,453,000 for Federal impact
aid programs in fiscal year 2008, which is $50,000,000 more
than the fiscal year 2007 funding level and $50,353,000 more
than the budget request. This account supports payments to
school districts affected by Federal activities, such as those
that educate children whose families are connected with the
military or who live on Indian land.
The Committee recommendation also repeats language, as
requested by the Administration, 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.
Basic support payments
The Committee recommends $1,140,517,000 for basic support
payments to local educational agencies, $48,650,000 more than
the fiscal year 2007 funding level 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 $49,466,000 for payments on behalf
of Federally-connected children with disabilities, the same as
the budget request and the fiscal year 2007 appropriation.
These payments compensate school districts for the increased
costs of serving Federally-connected children with
disabilities.
Facilities maintenance
The Committee recommends $4,950,000 for facilities
maintenance, the same as the fiscal year 2007 funding level and
$353,000 more than the budget request. These capital payments
are authorized for maintenance of certain facilities owned by
the Department of Education.
Construction
The Committee recommends $17,820,000 for the construction
program, which is the same as the budget request and the fiscal
year 2007 level. This program provides formula and competitive
grants to local educational agencies that educate Federally
connected students or have Federally owned land for building
and renovating school facilities. The Committee provides
funding for the competitive program, as requested by the
Administration.
Payments for Federal property
The Committee recommends $65,700,000 for payments related
to Federal property, $1,350,000 more than the fiscal year 2007
level 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 Committee recommends $5,678,002,000 for school
improvement programs. This amount is $422,524,000 more than the
fiscal year 2007 funding level and $979,726,000 more than the
budget request. 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,
section 203 of the Educational Technical Assistance Act of
2002, and section 105 of the Compact of Free Association
Amendments Act of 2003.
State grants for improving teacher quality
The Committee recommends $3,187,439,000 for State grants
for improving teacher quality, which is $300,000,000 more than
the fiscal year 2007 funding level and $399,951,000 more than
the budget request. 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. This program also helps States carry out
activities 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 and compensation systems; and developing professional
development programs for principals. The Committee
recommendation will provide for high quality professional
development for an additional 51,000 teachers than in fiscal
year 2007.
The Committee rejects the Administration's proposal to move
$100,000,000 from this program to the teacher incentive fund
under the Innovation and Improvement account. Research shows
that teacher quality is the most important school-related
factor in determining student achievement growth. To ensure a
high-quality teacher workforce, the Committee believes that the
better investment is in providing States and local education
agencies the flexibility to choose the initiatives that work
best for them to promote retention of highly qualified teachers
and principals and to improve the quality of the teachers
through professional development activities. Also, the
Committee believes that maximum flexibility is the best course
of action while various teacher quality initiatives are
examined in the reauthorization of the No Child Left Behind
Act.
Early childhood educator professional development
The Committee does not recommend funding early childhood
educator professional development. The budget request also did
not recommend funding this program. In fiscal year 2007, the
funding level was $14,550,000. The Committee expects the
Department to continue to strengthen professional development
partnerships for early childhood educators through grants
awarded under early reading first. To that end, the Committee
has provided sufficient funding for the early reading first
program.
Mathematics and science partnerships
The Committee recommends $182,160,000 for mathematics and
science partnerships. This is the same as the fiscal year 2007
funding level and $36,000 more than the request. 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.
States then award the funds competitively to partnerships that
must include the State agency; an engineering, math, or science
department of an institution of higher education; and a high-
need school district. Other partners may also be involved.
State grants for innovative programs
The Committee recommends $99,000,000 for State grants for
innovative programs. This is the same as the fiscal year 2007
funding level. The budget request did not include funding for
this program. This program provides flexible funding to State
and local educational agencies for 27 purposes identified in
statute, including obtaining technology and technology-related
training, 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.
Educational technology State grants
The Committee recommends $272,250,000 for education
technology State grants. This is the same as the fiscal year
2007 funding level. The budget request did not include funding
for this program. The Committee recognizes that technology is
critical to our schools to ensure students are prepared to
compete in the 21st century.
The Committee notes with interest the finding of the
Department of Education that K-12 student test scores on State
math and reading tests were not significantly impacted when
students used, for one-year, various educational software
products. The Committee looks forward to the Department's
second report that measures the software's efficacy over the
course of two years. The Committee expects that report to
address more than the 16 educational software titles addressed
in the first report because there are hundreds of such titles
commercially available. It also expects the report to address
how inadequate teacher training impacts the efficacy of
software implementation in the classroom. The Committee
encourages the Department to promote software training so that
these programs may be implemented in the classrooms to achieve
maximum benefit.
The Committee continues to support all aspects of
educational technology grants, which cover a much wider array
of applications and services than software, such as
professional development, well-equipped classrooms,
administrative structures, and a curriculum that recognizes the
role technology plays in all disciplines.
Supplemental education grants
The Committee recommends $18,001,000 for supplemental
education grants to the Federated States of Micronesia and the
Republic of the Marshall Islands, which is the same as the
budget request and the fiscal year 2007 funding level. The
Compact of Free Association Amendments Act of 2003 (P.L. 108-
188) authorizes these entities to receive funding for general
education assistance. The Committee recommendation includes a
consolidated amount for supplemental education grants because
the underlying statute determines the allocation between
Micronesia and the Marshall Islands.
21st century community learning centers
The Committee recommends $1,106,166,000 for 21st century
community learning centers, $125,000,000 more than the fiscal
year 2007 funding level and $124,986,000 more than the budget
request. This program is a formula grant to States, which in
turn distribute 95 percent of the funds on a competitive basis
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.
The Committee's recommendation is part of its initiative to
help reduce the number of abortions in America. Youth who do
not spend time in structured activities after school are 37
percent more likely to become teen parents than are youth who
spend time in after school programs. After-school programs help
prevent teen pregnancy by encouraging good decision-making and
providing youth health education and positive role models in a
supervised setting after school. After-school programs can also
provide greater enrichment opportunities to help teenagers
remain in school and prepare for postsecondary education or
employment.
In addition, the Committee's recommendation reflects its
concern that, between 3 p.m. and 6 p.m., the rate of juvenile
crime triples, as well as the likelihood that unsupervised
students will become victims of crime. Lack of supervision and
boredom can increase the likelihood that a young person will
experiment with drugs and alcohol.
The $125,000,000, or 12.7 percent, increase over fiscal
year 2007 will help communities provide after-school programs
serving 1.4 million students, approximately 163,000 more than
in fiscal year 2007. The Committee intends that the Department
encourage States to use 40 percent of their additional
allocations over fiscal year 2007 (equal to $50,000,000 across
all States), as practicable, to provide supervised and
supportive after-school activities to approximately 65,000
middle and high school students.
State assessments
The Committee recommends $411,630,000 for State
assessments, the same as the budget request and $4,067,000 more
than the fiscal year 2007 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.
Javits gifted and talented education
The Committee recommends $7,596,000 for gifted and talented
education, the same as the fiscal year 2007 funding level. The
budget request did not include funding for this program. 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 of higher education and
other public and private entities.
Foreign language assistance grants
The Committee recommends $26,780,000 for foreign language
assistance grants, which is $3,000,000 more than the fiscal
year 2007 funding level and $3,025,000 more than the budget
request. 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.
The bill provides that $3,000,000 shall be available for
five-year grants to local educational agencies that would work
in partnership with one or more institutions of higher
education to establish or expand articulated programs of study
in languages critical to U.S. national security. The programs
would be designed to enable successful students, as they
advance through college, to achieve a superior level of
proficiency or professional working proficiency in critical
need languages such as Arabic, Chinese, Japanese, Korean, and
Russian, as well as the Indic, Iranian, and Turkic language
families. The Committee encourages school districts applying
for this funding to reach out to institutions and centers
funded under the Department's International Education programs
under Title VI of the Higher Education Act.
Education for homeless children and youth
The Committee recommends $66,878,000 for the education of
homeless children and youth program, which is $5,000,000 more
than the budget request and $5,007,000 more than the fiscal
year funding 2007 level. 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.
The Committee notes that funding for this program has been
essentially frozen since fiscal year 2004 while the number of
homeless children has increased approximately 50 percent to
914,225. The Committee's recommendation reflects its commitment
to these particularly disadvantaged students. The $5,000,000
increase will enable States and school districts to identify
and serve an additional 74,000 children.
Training and advisory services
The Committee recommends $7,113,000 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
fiscal year 2007 funding level. 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 three-
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. Activities also include
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 $33,907,000 for education for
Native Hawaiians, which is the same as the fiscal year 2007
funding level. The budget request did not include funding for
this program. A number of authorized 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 $33,907,000 for the Alaska Native
education equity program, which is the same as the fiscal year
2007 funding level. The budget request did not include funding
for this program. These funds are used to develop supplemental
educational programs to benefit Alaska Natives.
Rural education
The Committee recommends $168,918,000 for rural education
programs, which is the same as the fiscal year 2007 funding
level and $67,000 more than 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 Committee recommends $56,257,000 for comprehensive
centers, the same as the fiscal year 2007 level and $1,000 more
than the budget request.
These funds are used for the 21 comprehensive centers first
funded in fiscal year 2005. The centers include 16 regional
centers that will provide training and technical assistance to
State educational agencies within their geographic regions to
help them implement provisions of the Elementary and Secondary
Education Act and 5 content centers, each specializing in a
different area.
Indian Education
The Committee recommends $124,000,000 for Indian education.
This amount is $5,310,000 more than the fiscal year 2007
funding level and $5,317,000 more than the budget request. This
account supports programs authorized by part A of title VII of
the Elementary and Secondary Education Act.
Although the number of Indian students enrolling in
colleges and universities has more than doubled in the last two
and a half decades, the Department of Education finds that the
Indian student population remains subject to significant risk
factors that threaten their ability to improve their academic
achievement. The Committee provides the first increase to this
program since fiscal year 2002 in order to demonstrate its
commitment to help Indian students achieve academic success.
This increase will enable eligible schools to address the
unique educational and culturally related academic needs of
26,156 more students than last year.
The Committee recognizes that the purpose of title VII is
to support the efforts of local educational agencies (LEAs),
Indian tribes, and organizations ``to meet the unique
educational and culturally related academic needs of American
Indian and Alaska Native students'' and is a part of the United
States' trust relationship with Indian people. Title VII
programs ensure that Native students receive an education
consistent with tribal traditions, languages, and culture. In
its administration of title VII funds, the Committee directs
the Department to continue to adhere to the Statement of Policy
set forth in section 7101 of the ESEA.
Grants to local educational agencies
The Committee recommends $100,057,000 for grants to local
education agencies. 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 $19,884,000 for special programs
for Indian children. These programs make competitive awards to
improve the quality of education for Indian students. This
program also funds the American Indian Teacher Corps and the
American Indian Administrator Corps to recruit and support
American Indians as teachers and school administrators.
National activities
The Committee recommends $4,059,000 for national
activities. 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 Committee recommends $992,354,000 for innovation and
improvement programs. This amount is $154,668,000 above the
fiscal year 2007 funding level and $70,336,000 above the budget
request. 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.
The Committee urges the Department, in the development and
execution of its programs, to be mindful of the alarming
national dropout rates for African American males.
Troops-to-teachers and Transition to Teaching
The Committee recommends $14,645,000 for troops to
teachers, the same as the budget request and the fiscal year
2007 funding 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 Committee recommends $44,484,000 for transition to
teaching, which is the same as the fiscal year 2007 funding
level and $2,000 more than the budget request. Transition to
teaching is designed to help mitigate the shortage of qualified
licensed or certified teachers. The program provides
competitive grants to help support State and local educational
agencies' 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, including former military
personnel, who have substantial career experience and are
recent college graduates. Grants are made on a competitive
basis.
Writing instruction
The Committee recommends $23,533,000 for the writing
instruction. This is $2,000,000 more than the fiscal year 2007
funding level. The President's budget did not include funding
for this program. Funds are provided to support training
programs to teach writing effectively. Federal funds support 50
percent of the costs of these programs, and recipients must
contribute an equal amount.
Teaching of traditional American history
The Committee recommends $119,790,000 for the teaching of
traditional American history, $69,790,000 more than the budget
request and the same as the fiscal year 2007 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 Committee recommends $14,731,000 for school leadership
activities, which is the same as the fiscal year 2007 funding
level. The budget request did not include 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 Committee recommends $10,695,000 for advanced
credentialing. This is $6,000,000 less than the fiscal year
2007 funding level. The budget request did not include funding
for this program. The program supports activities to encourage
and support teachers seeking advanced certification or
credentialing. The Committee recommendation continues funding
to help support an unprecedented number of teachers seeking
advanced certification. These funds also will support expanded
recruitment and certification of teachers to work in high-need
schools.
Charter school grants and credit enhancement for charter school
facilities
The Committee recommends $251,394,000 for support of
charter schools. This is $1,000 more than the budget request
and the same as the fiscal year 2007 funding level for the
charter school grants and the credit enhancement for charter
school facilities, which are combined in the Committee
recommendation to enhance administrative efficiency.
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 in turn make sub-
grants to authorized public chartering agencies in partnerships
with developers of charter schools. The Committee intends the
Department to entertain applications for credit enhancement
assistance for funding under this account.
The Committee notes that recent studies of the
effectiveness of charter schools have shown mixed results and
awaits the final evaluation report that will test more
rigorously their promise. In the meantime, the Committee has
recommended continued funding.
Voluntary public school choice
The Committee recommends $26,278,000 for voluntary public
school choice, the same as the fiscal year 2007 funding level
and $3,000 more than the budget request. This program supports
efforts to establish intra-district and inter-district public
school choice programs to provide students in participating
schools with the widest variety of options for their education.
Funds are used to make competitive awards to States, school
districts or partnerships.
Magnet schools assistance
The Committee recommends $106,693,000 for the magnet
schools assistance program. This is the same as the fiscal year
2007 funding level and $8,000 more than the budget request. 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.''
Fund for the improvement of education
The Committee recommends $205,402,000 for the fund for the
improvement of education (FIE), which is $46,894,000 more than
the fiscal year 2007 funding level and $147,294,000 more than
th
