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                                                       Calendar No. 428
112th Congress                                                   Report
                                 SENATE
 2d Session                                                     112-176

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2013
                                _______
                                

                 June 14, 2012.--Ordered to be printed

                                _______
                                

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

                                 REPORT

                         [To accompany S. 3295]

    The Committee on Appropriations reports the bill (S. 3295) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education, and related agencies for the 
fiscal year ending September 30, 2013, and for other purposes, 
reports favorably thereon and recommends that the bill do pass.

                       Amount of budget authority
Total of bill as reported to the Senate.............    $777,568,714,000
Amount of 2012 appropriations.......................     741,495,738,000
Amount of 2013 budget estimate......................     777,624,610,000
Bill as recommended to Senate compared to--
    2012 appropriations.............................     +36,072,976,000
    2013 budget estimate............................         -55,896,000



                                CONTENTS

                              ----------                              
                                                                   Page

List of Abbreviations............................................     4
Summary of Budget Estimates and Committee Recommendations........     8
    Overview.....................................................     8
    Fiscal Accountability........................................     8
    Promoting Innovation.........................................     9
    Early Childhood Education....................................    11
    Prevention...................................................    12
    Assisting People With Disabilities...........................    12
    Other Highlights of the Bill.................................    13
Title I: Department of Labor:
    Employment and Training Administration.......................    15
    Employee Benefits Security Administration....................    26
    Pension Benefit Guaranty Corporation.........................    27
    Wage and Hour Division.......................................    28
    Office of Labor-Management Standards.........................    28
    Office of Federal Contract Compliance Programs...............    29
    Office of Workers' Compensation Programs.....................    29
    Occupational Safety and Health Administration................    32
    Mine Safety and Health Administration........................    33
    Bureau of Labor Statistics...................................    34
    Office of Disability Employment Policy.......................    36
    Departmental Management......................................    36
    General Provisions...........................................    39
Title II: Department of Health and Human Services:
    Health Resources and Services Administration.................    41
    Centers for Disease Control and Prevention...................    58
    National Institutes of Health................................    77
    Substance Abuse and Mental Health Services Administration....   108
    Agency for Healthcare Research and Quality...................   117
    Centers for Medicare and Medicaid Services...................   120
    Administration for Children and Families.....................   125
    Administration for Community Living..........................   139
    Office of the Secretary......................................   145
    General Provisions...........................................   156
Title III: Department of Education:
    Education for the Disadvantaged..............................   158
    Impact Aid...................................................   162
    School Improvement Programs..................................   163
    Indian Education.............................................   169
    Innovation and Improvement...................................   170
    Safe Schools and Citizenship Education.......................   176
    English Language Acquisition.................................   177
    Special Education............................................   178
    Rehabilitation Services and Disability Research..............   181
    Special Institutions for Persons With Disabilities:
        American Printing House for the Blind....................   185
        National Technical Institute for the Deaf................   186
        Gallaudet University.....................................   186
    Career, Technical, and Adult Education.......................   186
    Student Financial Assistance.................................   188
    Student Aid Administration...................................   192
    Higher Education.............................................   193
    Howard University............................................   201
    College Housing and Academic Facilities Loans Program........   201
    Historically Black College and University Capital Financing 
      Program Account............................................   201
    Institute of Education Sciences..............................   202
    Departmental Management:
        Program Administration...................................   204
        Office for Civil Rights..................................   205
        Office of the Inspector General..........................   206
    General Provisions...........................................   206
Title IV: Related Agencies:
    Committee for Purchase From People Who Are Blind or Severely 
      Disabled...................................................   208
    Corporation for National and Community Service...............   208
    Corporation for Public Broadcasting..........................   213
    Federal Mediation and Conciliation Service...................   213
    Federal Mine Safety and Health Review Commission.............   213
    Institute of Museum and Library Services.....................   214
    Medicaid and CHIP Payment and Access Commission..............   215
    Medicare Payment Advisory Commission.........................   215
    National Council on Disability...............................   215
    National Health Care Workforce Commission....................   216
    National Labor Relations Board...............................   216
    National Mediation Board.....................................   216
    Occupational Safety and Health Review Commission.............   217
    Railroad Retirement Board....................................   217
    Social Security Administration...............................   218
Title V: General Provisions......................................   223
Compliance With Paragraph 7, Rule XVI of the Standing Rules of 
  the 
  Senate.........................................................   225
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................   225
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................   226
Budgetary Impact of Bill.........................................   239
Comparative Statement of New Budget Authority....................   240

                         LIST OF ABBREVIATIONS

    ACL--Administration for Community Living
    ADAP--AIDS Drug Assistance Program
    AHEC--area health education center
    AHRQ--Agency for Healthcare Research and Quality
    ALS--amyotrophic lateral sclerosis
    AoA--Administration on Aging
    AP--Advanced Placement
    APH--American Printing House for the Blind
    ARRA--American Recovery and Reinvestment Act of 2009
    ASH--Assistant Secretary for Health
    ASPR--Assistant Secretary for Preparedness and Response
    ATSDR--Agency for Toxic Substances and Disease Registry
    BARDA--Biomedical Advanced Research and Development 
Authority
    BCA--Budget Control Act of 2011
    BLS--Bureau of Labor Statistics
    CAN--Cures Acceleration Network
    CCAMPIS--Child Care Access Means Parents in School
    CCDBG--Child Care and Development Block Grant
    CDC--Centers for Disease Control and Prevention
    CHAFL--College Housing and Academic Facilities Loans
    CHC--community health center
    CHGME--Children's Hospitals Graduate Medical Education
    CMHS--Center for Mental Health Services
    CMS--Centers for Medicare and Medicaid Services
    CNCS--Corporation for National and Community Service
    CPB--Corporation for Public Broadcasting
    CSAP--Center for Substance Abuse Prevention
    CSAT--Center for Substance Abuse Treatment
    CSBG--Community Services Block Grant
    CSEOA--Community Service Employment for Older Americans
    DOD--Department of Defense
    DOE--Department of Energy
    DOL--Department of Labor
    EBSA--Employee Benefits Security Administration
    EEOICPA--Energy Employees Occupational Illness Compensation 
Program Act
    ERISA--Employee Retirement Income Security Act of 1974
    ESEA--Elementary and Secondary Education Act
    ETA--Employment and Training Administration
    FDA--Food and Drug Administration
    FEMA--Federal Emergency Management Agency
    FIC--Fogarty International Center
    FIE--Fund for the Improvement of Education
    FIPSE--Fund for the Improvement of Postsecondary Education
    FMCS--Federal Mediation and Coalition Service
    FMSHRC--Federal Mine Safety and Health Review Commission
    FTE--full time equivalent
    FWS--Federal Work Study
    GAANN--Graduate Assistance in Areas of National Need
    GAO--Government Accountability Office
    GEAR UP--Gaining Early Awareness and Readiness for 
Undergraduate Programs
    HBCUs--Historically Black Colleges and Universities
    HCERA--Health Care and Education Reconciliation Act of 2010
    HCFAC--Health Care Fraud and Abuse Control
    HEA--Higher Education Act
    HELP--Health, Education, Labor and Pensions
    HFFI--Healthy Foods Financing Initiative
    HHS--Health and Human Services
    HITECH--Health Information Technology for Economic and 
Clinical Health
    HRSA--Health Resources and Services Administration
    IC--Institute and Center
    IDeA--Institutional Development Award
    IDEA--Individuals with Disabilities Education Act
    IES--Institute of Education Sciences
    IMLS--Institute of Museum and Library Services
    IOM--Institute of Medicine
    LEA--local educational agency
    LIHEAP--Low Income Home Energy Assistance Program
    MACPAC--Medicaid and CHIP Payment and Access Commission
    MCH--maternal and child health
    MedPAC--Medicare Payment Advisory Commission
    MIECHV--Maternal, Infant, and Early Childhood Home Visiting
    MSHA--Mine Safety and Health Administration
    NAEP--National Assessment of Educational Progress
    NAGB--National Assessment Governing Board
    NCATS--National Center for Advancing Transitional Sciences
    NCBDDD--National Center on Birth Defects and Developmental 
Disabilities
    NCES--National Center for Education Statistics
    NCHS--National Center for Health Statistics
    NCI--National Cancer Institute
    NCRR--National Center for Research Resources
    NEI--National Eye Institute
    NHGRI--National Human Genome Research Institute
    NHLBI--National Heart, Lung, and Blood Institute
    NIA--National Institute on Aging
    NIAAA--National Institute on Alcohol Abuse and Alcoholism
    NIAID--National Institute of Allergy and Infectious Disease
    NIAMS--National Institute of Arthritis and Musculoskeletal 
and Skin Diseases
    NIBIB--National Institute of Biomedical Imaging and 
Bioengineering
    NICHD--Eunice Kennedy Shriver National Institute of Child 
Health and Human Development
    NIDA--National Institute on Drug Abuse
    NIDCD--National Institute on Deafness and Other 
Communication Disorders
    NIDCR--National Institute of Dental and Craniofacial 
Research
    NIDDK--National Institute of Diabetes and Digestive and 
Kidney Disease
    NIDRR--National Institute on Disability and Rehabilitation 
Research
    NIEHS--National Institute of Environmental Health Sciences
    NIGMS--National Institute of General Medical Sciences
    NIH--National Institutes of Health
    NIMH--National Institute on Mental Health
    NIMHD--National Institute on Minority Health and Health 
Disparities
    NINDS--National Institute of Neurological Disorders and 
Stroke
    NINR--National Institute of Nursing Research
    NLM--National Library of Medicine
    NLRB--National Labor Relations Board
    NSF--National Science Foundation
    NSIP--Nutrition Services Incentives Program
    NTID--National Technical Institute for the Deaf
    OAR--Office of AIDS Research
    OBSSR--Office of Behavioral and Social Sciences Research
    OCR--Office for Civil Rights
    ODEP--Office of Disability Employment Policy
    OFCCP--Office of Federal Contract Compliance Programs
    OIG--Office of the Inspector General
    OLMS--Office of Labor-Management Standards
    OMB--Office of Management and Budget
    OMH--Office of Minority Health
    OMHA--Office of Medicare Hearings and Appeals
    ONC--Office of the National Coordinator for Health 
Information Technology
    ORR--Office of Refugee Resettlement
    ORWH--Office of Research on Women's Health
    OSEP--Office of Special Education Programs
    OSHA--Occupational Safety and Health Administration
    OWCP--Office of Workers' Compensation Programs
    OWH--Office of Women's Health
    PAIMI--protection and advocacy for individuals with mental 
illness
    PATH--Projects for Assistance in Transition From 
Homelessness
    PBGC--Pension Benefit Guaranty Corporation
    PHS--Public Health Service
    PPACA--Patient Protection and Affordable Care Act
    PPH Fund--Prevention and Public Health Fund
    PRNS--Programs of Regional and National Significance
    PROMISE--Promoting School Readiness of Minors in SSI
    RSA--Rehabilitation Services Administration
    SAMHSA--Substance Abuse and Mental Health Services 
Administration
    SAPT--Substance abuse prevention and treatment
    SCHIP--State Children's Health Insurance Program
    SEA--State educational agency
    SEOG--Supplemental Educational Opportunity Grant
    SIG--School Improvement Grants
    SPORE--Specialized Program of Research Excellence
    SPRANS--Special Projects of Regional and National 
Significance
    SSA--Social Security Administration
    SSBG--Social Services Block Grant
    SSI--Supplemental Security Income
    STEM--science, technology, engineering, and mathematics
    TANF--Temporary Assistance for Needy Families
    TB--tuberculosis
    TBI--traumatic brain injury
    TIF--Teacher Incentive Fund
    TRND--Therapeutics for Rare and Neglected Diseases
    UAC--unaccompanied alien children
    UCEDD--University Center for Excellence in Developmental 
Disabilities
    UI--unemployment insurance
    USAID--U.S. Agency for International Development
    USDA--U.S. Department of Agriculture
    USPSTF--U.S. Preventive Services Task Force
    VETS--Veterans' Employment and Training Services
    VISTA--Volunteers in Service to America
    VR--Vocational Rehabilitation
    WANTO--Women in Apprenticeship and Non-Traditional 
Occupations
    WHD--Wage and Hour Division
    WIA--Workforce Investment Act
    WIF--Workforce Innovation Fund
    WISEWOMAN--Well-Integrated Screening and Evaluation for 
Women Across the Nation

       SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS

    For fiscal year 2013, the Committee recommends total budget 
authority of $777,568,714,000 for the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies. 
Of this amount, $158,772,000,000 is current year discretionary 
funding, including offsets and $1,050,000,000 in cap 
adjustments for healthcare fraud and abuse and for program 
integrity at the SSA, in accordance with the 302(b) allocation 
for this bill.
    The Committee recommendation reflects a program level of 
$166,011,337,000 for fiscal year 2013. (Program level is 
current year discretionary funding plus additional spending 
that is offset by savings in mandatory programs and other 
adjustments to discretionary funding.)
    The bill provides discretionary program level funding of 
$12,341,781,000 for the Department of Labor, $70,999,718,000 
for the Department of HHS, $68,520,153,000 for the Department 
of Education and $14,149,685,000 for related agencies. The 
comparable fiscal year 2012 levels were $12,552,758,000 for 
Labor, $69,620,175,000 for HHS, $68,112,288,000 for Education 
and $13,831,731,000 for related agencies.

                                Overview

    The Labor, HHS, and Education, and Related Agencies 
appropriations bill constitutes the largest of the non-defense 
Federal appropriations bills being considered by Congress this 
year. But even more noteworthy than the size of the bill is the 
breadth of the critical services that are funded by this 
legislation, which range from medical research to job training, 
from home energy assistance to mental health, from student 
financial assistance to the management of SSA.
    Weighing the relative merits of such a wide range of 
priorities is difficult, especially when funding is tight. The 
Committee has tried to strike a balance between investing in 
the future prosperity of the Nation, providing a safety net for 
people who are most vulnerable in today's struggling economy, 
and increasing the fiscal accountability and effective use of 
taxpayer dollars.
    Several themes permeate the Committee's recommendation, 
described below.

                         Fiscal Accountability

    The Committee recommendation provides funding for several 
activities that reduce fraud, waste, and abuse of Federal 
funding.
    Healthcare Program Integrity.--Fraud committed against 
Federal healthcare programs diverts critical resources from 
services to some of the Nation's most vulnerable populations. 
The Committee includes $610,000,000 for HCFAC activities at 
CMS, nearly double the fiscal year 2012 level of $310,378,000. 
The historical return on investment for the Medicare Integrity 
program has been about $14 for every $1 spent. For fraud and 
abuse activities throughout Medicare and Medicaid, the Federal 
Government saves or recovers $6 for every $1 spent.
    Social Security Program Integrity.--The Committee 
recommendation includes $1,024,000,000, an increase of 
$268,000,000 over the fiscal year 2012 level, for the SSA to 
conduct continuing disability reviews and redeterminations of 
nonmedical eligibility under the SSI program. This investment 
will save approximately $8,100,000,000 over 10 years for the 
Social Security, Medicare, and Medicaid programs, a return on 
investment of $8 for every $1 spent.
    Unemployment Insurance Program Integrity.--The Committee 
recommendation includes $75,000,000, an increase of $15,000,000 
over the fiscal year 2012 level, to conduct re-employment and 
eligibility assessments and UI improper payment reviews. This 
funding will save State UI Trust funds by helping claimants 
exit the UI program faster and avoid exhausting benefits. The 
Committee recommendation also includes $30,000,000 to support 
intensive reemployment services for UI claimants, which shorten 
the length of time people receive unemployment insurance, as 
well as boost employment and earnings for claimants. No funds 
were provided in fiscal year 2012 for these services.
    Spending on Conferences and Other Administrative 
Expenses.--The Committee bill includes new provisions intended 
to prevent excessive spending on conferences and other 
administrative expenses. The provisions require departments, 
agencies, boards, and commissions funded in this act to submit 
quarterly reports to their OIG or senior ethics official on the 
costs and contracting procedures involved in any conference 
that costs more than $20,000. The provisions also limit the 
amount of Federal funding that may be spent on any single 
international conference and the number of Federal employees 
who may attend it. The provisions codify the May 2012 OMB 
memorandum related to planning for and spending on conferences, 
travel, real property, and fleet management.
    340B User Fee.--The Committee includes a provision to 
institute a new 0.1 percent user fee on 340B discount drugs. 
The fee is expected to generate $6,000,000 in fiscal year 2013, 
which will be used to implement program integrity work 
recommended by GAO and mandated by PPACA.

                          Promoting Innovation

    Just because times are lean doesn't mean that innovation 
should cease. This bill launches or continues several 
initiatives that will leverage reform and transform key Federal 
services.
    Pay for Success.--The Committee recommendation creates a 
new model, called Pay for Success, for financing and delivering 
effective services under government programs. Federal funding 
typically pays for services with the expectation, but no 
absolute guarantee that they will have positive results. Under 
Pay for Success, the Federal Government will make available 
funds to pay for defined outcomes, such as employment or 
graduation. Philanthropic groups and social impact investors 
will finance the services and would earn payments if those 
services lead to the agreed-upon outcomes. The Committee 
recommendation includes up to $10,000,000 within WIF, up to 
$9,000,000 within the Social Innovation Fund, and up to 
$25,000,000 within the PROMISE program for this new approach.
    Performance Partnerships for Disconnected Youth.--The 
Committee recommendation creates a new authority called 
Performance Partnerships that will provide States and local 
communities with unprecedented flexibility to achieve defined 
outcomes for disconnected youth. Up to 13 States and/or local 
communities will be allowed to combine funding that they 
receive through various programs within this bill, even if the 
programs are funded in different departments, for these pilot 
projects. Grantees will receive waivers to reduce bureaucratic 
obstacles to the smooth functioning of these performance 
partnerships; for example, they could be allowed to provide a 
single set of outcome data to the Departments of Education, 
HHS, and Labor, rather than slightly different data to each 
agency.
    Investing in Innovation.--The Committee bill creates a new 
organization in the Department of Education called ARPA-ED that 
will identify and promote advances in fundamental and applied 
sciences and engineering that could be translated into new 
learning technologies; develop, test, and evaluate novel 
learning technologies and related processes; and accelerate 
transformational technological advances. Modeled after the 
Defense Advanced Research Projects Agency, the entity that 
helped create the Internet, ARPA-ED will be funded as a set-
aside of up to $44,825,000 within the Investing in Innovation 
[i3] program. The Committee bill provides $149,417,000 for i3, 
which provides grants to replicate education programs that have 
high levels of effectiveness and to develop and test promising 
new ideas.
    First in the World.--The Committee bill includes 
$40,000,000 to create the First in the World Initiative in the 
Department of Education. Modeled after the Investing in 
Innovation program, the initiative will provide grants to 
colleges and universities to implement innovative and effective 
strategies that improve educational outcomes and significantly 
reduce the net price paid by students.
    Strategic Investor.--The Committee bill includes 
$20,000,000 to create a Strategic Investor initiative at BARDA. 
This new program will allow the Federal Government to partner 
with small biotechnology companies in order to foster and 
accelerate the generation of novel medical countermeasures and 
technologies. This initiative will address gaps in the 
Government's capability to respond to emerging infections, 
bioterrorism, and other public health threats.
    Promise Neighborhoods.--The Committee recommends 
$80,000,000--a more than $20,000,000 increase over the fiscal 
year 2012 level--for the Promise Neighborhoods program. 
Inspired by the successful Harlem Children's Zone program, 
Promise Neighborhoods supports local efforts to establish 
cradle-to-career services designed to improve educational 
outcomes for students in distressed neighborhoods.
    Accelerating Cures.--The Committee bill includes 
$40,000,000, four times the fiscal year 2012 level, for CAN, an 
NIH initiative to help speed the translation and application of 
discoveries that have shown signs of success at the laboratory 
level but have not advanced far enough to attract significant 
investments from the private sector. CAN will make grants to 
biotech companies, universities, and patient advocacy groups, 
and will also help facilitate FDA review for the high-need 
cures that are funded by this initiative.
    Workforce Innovation Fund.--The Committee includes 
$49,906,000 to continue WIF, which will help reform the 
Nation's workforce investment system and improve the delivery 
of training programs to workers.
    Social Innovation Fund.--The Committee recommendation 
provides $45,000,000, the same as the fiscal year 2012 level, 
for the Social Innovation Fund at CNCS. This fund mobilizes 
public and private resources to expand and evaluate promising, 
innovative community-based solutions in three areas: economic 
opportunity, healthy futures, and youth development.

                       Early Childhood Education

    Quality early childhood education has proven to have 
lasting effects for low-income children and their families. 
Investments in early childhood education not only improve 
outcomes for children and families, but save taxpayer dollars 
in the long run through lower welfare, special education, and 
criminal justice costs.
    Child Care and Development Block Grant.--The Committee 
recommendation includes $2,438,313,000, a $160,000,000 increase 
over the fiscal year 2012 level, for the CCDBG. Of this 
increase, $90,000,000 is targeted to improving the quality of 
the early childhood care and education workforce and will 
support training, education, and other professional development 
opportunities. The remaining $70,000,000 will be used to 
improve low-income families' access to quality child care by 
increasing the number of families served, subsidy rates, and 
reimbursement rates to providers.
    Head Start.--The Committee recommendation includes 
$8,038,544,000, a $70,000,000 increase over the fiscal year 
2012 level, for Head Start. In fiscal year 2012, HHS began 
implementing new regulations that will require Head Start 
grantees that do not meet certain performance standards to re-
compete for funding. This year, over $1,200,000,000 in Head 
Start grants will be re-competed, providing additional 
assurances that children in Head Start are receiving quality 
services. The Committee recommendation supports the 
implementation of this new re-competition process as well as an 
increase for each existing grantee to help defray rising 
operational costs.
    Race to the Top.--The Committee includes $600,000,000, a 
$51,040,000 increase over the fiscal year 2012 level, for the 
administration's signature education reform program. A 
significant portion of fiscal year 2013 funds will be used for 
Race to the Top--Early Learning Challenge, which will offer 
additional opportunities to States for enhancing early care and 
education.

                               Prevention

    Nearly three-quarters of all healthcare costs are 
attributable to chronic diseases, the majority of which are 
preventable. This bill promotes prevention efforts through 
discretionary funding as well as through $1,000,000,000 in 
mandatory funding that will be transferred from the PPH Fund. 
The PPH Fund was appropriated in PPACA, but PPACA gives 
Congress the authority to allocate it through the 
appropriations process.
    Community Transformation Grants.--The Committee recommends 
dedicating $280,000,000 of the PPH Fund, an increase of 
$54,000,000 over the fiscal year 2012 level, for implementing 
evidence-based public health interventions to reduce obesity 
and smoking and make preventive services more accessible.
    Childhood Immunizations.--The Committee recommends 
$557,870,000 for immunization programs authorized under section 
317 of the PHS Act, including a $190,000,000 transfer from the 
PPH Fund. This funding is sufficient to purchase an estimated 
3.5 million doses of vaccine. Immunization saves $10.20 in 
direct medical costs for every child vaccinated.
    Smoking Prevention.--Tobacco kills 440,000 people in the 
Nation each year, costing $96,000,000,000 per year in medical 
expenses. The Committee bill provides $203,117,000, including 
$95,000,000 in transfers from the PPH Fund, for the Office of 
Smoking and Health at CDC. This funding, an increase of 
$12,000,000 over the fiscal year 2012 level, will continue the 
successful media campaign ``Tips From a Former Smoker'' and 
expand State quit-lines.
    Diabetes Prevention Program [DPP].--The Committee bill 
includes $20,000,000, double the fiscal year 2012 level, for 
replicating the Diabetes Prevention Program, a set of lifestyle 
interventions that has been proven to reduce the risk of 
developing diabetes by 58 percent in individuals at high risk. 
This amount includes $10,000,000 in transfers from the PPH 
Fund.
    Elder Falls.--One out of three adults age 65 and older 
falls each year, with 20 to 30 percent of falls resulting in 
moderate to severe injury. The direct medical costs total 
$19,000,000,000 a year. Many of the falls are preventable with 
lifestyle interventions and appropriate physical supports. In a 
new initiative, the Committee bill transfers $10,000,000 from 
the PPH Fund to CDC and ACL to research and implement evidence-
based approaches to preventing elderly falls.

                   Assisting People With Disabilities

    Promoting School Readiness for Minors in SSI.--In fiscal 
year 2012, Congress created PROMISE, an unprecedented 
interagency effort to improve outcomes for children, and the 
families of children, receiving SSI benefits. This program will 
improve services for these transition-aged youth by encouraging 
State-level innovation and facilitating better coordination 
that can help young people with disabilities enter and succeed 
in competitive, integrated employment. In fiscal year 2013, the 
Committee includes $11,996,000 and the authority to allocate 
unspent vocational rehabilitation State grant funds within the 
Department of Education for this effort, in addition to 
$7,200,000 at SSA.
    Education for Individuals With Disabilities.--The Committee 
bill provides $11,677,855,000, an increase of $100,000,000 over 
the fiscal year 2012 level, under section 611 of part B grants 
to States for educating students with disabilities between the 
age of 3 and 21. The bill also includes $462,710,000, an 
increase of $20,000,000 over the fiscal year 2012 level, to 
support statewide systems of coordinated and early intervention 
services for children with disabilities 2 years old and 
younger, as well as their families.
    Special Education Research.--The bill includes $59,905,000, 
an increase of $10,000,000 over the fiscal year 2012 level, to 
support research on how children and adults with disabilities 
learn and how best to meet their learning needs.
    Assistive Technology.--The Committee bill provides 
$37,500,000, an increase of $4,664,000 over the fiscal year 
2012 level, for State assistive technology programs. These 
programs support a range of activities to serve people with 
disabilities, including State financing programs, device 
reutilization and loan programs, and device demonstrations. The 
Committee recommendation will ensure all 50 statewide assistive 
technology programs receive the minimum grant authorized under 
statute for the first time.
    Disability Hearings at the Social Security 
Administration.--The Committee recommendation includes 
$11,735,544,000, a $290,352,000 increase over the fiscal year 
2012 funding level, for SSA's administrative expenses. This 
increase will support SSA's efforts to eliminate the disability 
hearings backlog by the end of fiscal year 2013. In 2008, the 
average processing time for a disability hearing reached an 
all-time high of 532 days. As of April 2012, the average 
processing time is 354 days. The Committee recommendation will 
allow SSA to stay on target to eliminate the backlog and reduce 
the average processing time to 270 days by the end of fiscal 
year 2013.

                      Other Highlights of the Bill

    Pell Grants.--The Committee bill maintains the 
discretionary portion of the maximum Pell Grant award level at 
$4,860 for the 2013-2014 school year. Combined with mandatory 
funding, the total maximum award will rise by $85 to $5,635.
    Centers for Medicare and Medicaid Services.--The Committee 
recommends $3,156,045,000 for operations of CMS. The fiscal 
year 2012 level is $2,608,785,000. Additional funding is needed 
to continue implementation of PPACA and to accommodate a 
dramatic increase in the Medicare population, as the baby boom 
generation ages.
    National Institutes of Health.--The bill provides 
$30,723,259,000, an increase of $100,000,000, to fund 
biomedical research at the 27 Institutes and Centers that 
comprise the NIH.
    Community Health Centers.--The Committee bill includes 
$1,566,892,000 for CHCs. Combined with mandatory funding 
provided in the health reform law, the fiscal year 2013 program 
level for CHCs is $3,066,892,000--an increase of $300,000,000 
over the fiscal year 2012 level. The bill includes a statutory 
provision requiring that all fiscal year 2013 funds be awarded 
in that fiscal year, rather than delayed for future years, to 
allow for base grant adjustments for all existing CHCs and the 
expansion of the national network of clinics.
    Title I (Education for the Disadvantaged).--The Committee 
bill includes $14,616,457,000, an increase of $100,000,000 over 
the fiscal year 2012 level, for title I grants to local 
education agencies for improving education for low-income 
students. These funds support more than 90 percent of the 
15,000 school districts across the Nation.
    Children's Hospitals Graduate Medical Education.--The 
Committee recommendation includes $265,171,000 for CHGME, the 
same level as in fiscal year 2012. The Committee rejects the 67 
percent cut to this program proposed by the administration.
    Low Income Home Energy Assistance.--The Committee 
recommendation includes $3,471,672,000, the same as the fiscal 
year 2012 level, for LIHEAP. The administration proposes a 
decrease of $451,672,000.
    Community Services Block Grant.--The Committee 
recommendation includes $677,358,000, the same as the fiscal 
year 2012 funding level, for the CSBG. The administration 
proposes a decrease of $327,358,000.
    AIDS Drug Assistance Program.--The Committee recommends 
$963,299,000 for ADAP, an increase of $30,000,000 over the 
fiscal year 2012 level.
    Food Safety.--The Committee recommendation includes 
$43,848,000 for food safety activities at CDC, an increase of 
$16,075,000 over the fiscal year 2012 level. This funding will 
support food-based outbreak investigations and develop new 
laboratory and epidemiological tools.
    National Public Health Institutes.--The Committee 
recommends $10,000,000 to create a new initiative to assist 
other nations in setting up and strengthening NPHIs similar to 
America's CDC. NPHIs are science-based organizations that 
provide leadership and coordination for public health at the 
national level. Increasing the number of NPHIs worldwide will 
improve global health and enhance the U.S. capability to detect 
infectious diseases that could threaten the U.S. population.
    Misclassification of Workers.--The Committee recommendation 
includes an increase of $14,000,000 at DOL to address the 
misclassification of workers as independent contractors. 
Misclassifications deny workers their rights to unemployment 
benefits, overtime pay, and other benefits, and also reduce 
revenue to the Unemployment, Social Security, and Medicare 
trust funds, as well as to the Treasury.
    Substance Abuse and Mental Health.--The Committee 
recommendation includes a combined increase of $40,000,000 for 
the Community Mental Health Services Block Grant and the 
Substance Abuse Prevention and Treatment Block Grant, in 
recognition of the severe budget cuts taking place to public 
mental health and substance abuse treatment systems nationwide.
    Domestic Violence and Sexual Exploitation.--The Committee 
recommendation includes a $5,000,000 increase, for a total of 
$137,774,000 for family violence prevention and related 
services, which include emergency shelters and services for 
victims of domestic violence. In addition, the Committee 
recommendation includes $5,000,000 for a new program to improve 
services for child victims of sex trafficking.

                                TITLE I


                          DEPARTMENT OF LABOR


                 Employment and Training Administration


                    TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2012....................................  $3,192,692,000
Budget estimate, 2013...................................   3,231,812,000
Committee recommendation................................   3,176,063,000

    The Committee recommends $3,176,063,000 for the Training 
and Employment Services account, which provides funding 
primarily for activities under WIA.
    This account is comprised of programs designed to enhance 
the employment and earnings of economically disadvantaged and 
dislocated workers, operated through a decentralized system of 
skill training and related services. Funds provided for fiscal 
year 2013 will support the program from July 1, 2013, through 
June 30, 2014. A portion of this account's funding, 
$1,772,000,000, is available on October 1, 2013, for the 2013 
program year.
    Any reference in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of Labor or the Department of Labor, 
respectively, unless otherwise noted.
    In 1986, the United States entered into a Compact of Free 
Association with the Federated States of Micronesia and the 
Republic of the Marshall Islands. In 1994, the United States 
entered into a similar relationship with the Republic of Palau. 
The Compacts set forth the bilateral terms for the government, 
economic, and security relations between the United States and 
the FAS and the laws approving the Compacts set forth the U.S. 
policy context and interpretation for Compacts. Section 141 of 
the Compacts provides that certain FAS citizens ``may be 
admitted to, lawfully engage in occupations, and its 
territories.'' However, the Congress also stated, in section 
104(e)(1), that ``it is not the intent of Congress to cause any 
adverse consequences for an affected jurisdiction.''
    At present, it is estimated that affected areas of the 
United States are spending upwards of $200,000,000 annually for 
education, healthcare, and other services for FAS migrants, 
including high-cost treatments such as dialysis and 
chemotherapy. There is also a high-unemployment rate among the 
FAS citizens currently located in the affected areas. Employers 
in the affected areas report that there is a significant need 
for language and cultural education and job training, which 
often complicates providing FAS citizens with employment 
opportunities. The need for job training and technical 
assistance in the affected areas is critical and would help to 
alleviate some of the escalating social tensions. The Committee 
believes the National Security Council Interagency Policy 
Committee on Freely Associated State Affairs that was 
established in Senate Report 112-74 would benefit from the 
input of the Department on employment and training issues. 
Therefore, the Committee requests the Department become a 
member of the interagency group and asks for a report no later 
than 180 days after enactment of this act on its involvement.
    The Committee recognizes that there are opportunities for 
the further alignment and streamlining of employment and 
training services. The Committee encourages the Department to 
continue to work with other Federal agencies to increase 
administrative efficiencies.

Grants to States

    The Committee recommends $2,603,315,000, the same as the 
fiscal year 2012 level, for Training and Employment Services 
Grants to States. The budget request is $2,600,344,000.
    As proposed in the budget request, the Committee retains 
bill language that allows a local workforce board to transfer 
up to 30 percent between the adult and dislocated worker 
assistance State grant programs, if such transfer is approved 
by the Governor. In addition, a local board may award a 
contract to an institution of higher education or other 
eligible training provider if the board determines that it 
would facilitate the training of multiple individuals in high-
demand occupations, if such contract does not limit customer 
choice.
    Adult Employment and Training.--For adult employment and 
training activities, the Committee recommends $770,811,000, the 
same amount provided in fiscal year 2012. The budget request 
includes $769,465,000.
    This program is funded by formula to States and further 
distributed to local workforce investment areas. Three types of 
services for adults are provided through the one-stop system: 
core services, intensive services, and job training. Core 
services are available to all adults with no eligibility 
requirements. Intensive services are provided to unemployed 
individuals who are not able to find jobs through core services 
alone. Training services may be available to adults who have 
been determined unable to obtain or retain employment through 
intensive services.
    Funds made available in this bill support program year 2013 
activities that occur from July 1, 2013, through June 30, 2014. 
The bill provides that $58,811,000 is available for obligation 
on July 1, 2013, and that $712,000,000 is available on October 
1, 2013. Both categories of funding are available for 
obligation through June 30, 2014.
    Youth Training.--For youth training programs, the Committee 
recommends $824,353,000, the same as both the fiscal year 2012 
comparable amount and the budget request.
    The purpose of this program is to provide eligible youth 
with assistance in achieving academic and employment success 
through improved education and skill competencies, connections 
to employers, mentoring, training, and supportive services. The 
program also supports summer employment directly linked to 
academic and occupational learning, incentives for recognition 
and achievement, and activities related to leadership 
development, citizenship, and community service. Funds made 
available for youth training support program year 2013 
activities, which occur from April 1, 2013, through June 30, 
2014.
    Dislocated Worker Assistance.--For dislocated worker 
assistance, the Committee recommends $1,008,151,000, the same 
as the fiscal year 2012 amount. The budget request includes 
$1,006,526,000.
    This program is a State-operated effort that provides core 
and intensive services, training, and support to help 
permanently separated workers return to productive, 
unsubsidized employment. In addition, States must use statewide 
reserve funds for rapid response assistance to help workers 
affected by mass layoffs and plant closures. States must also 
use these funds to carry out additional statewide employment 
and training activities such as providing technical assistance 
to certain low-performing local areas, evaluating State 
programs, and assisting with the operation of one-stop delivery 
systems. States may also use funds for implementing innovative 
incumbent and dislocated worker training programs.
    Funds made available in this bill support program year 2013 
activities, which occur from July 1, 2013, through June 30, 
2014. The bill provides that $148,151,000 is available for 
obligation on July 1, 2013, and that $860,000,000 is available 
on October 1, 2013. Both categories of funding are available 
for obligation through June 30, 2014.

Governor's Reserve Fund

    The Committee recommendation modifies current law regarding 
the amount of WIA State grant funding that may be set aside by 
Governors. As requested by the administration, the Committee 
continues bill language authorizing the Governor of a State to 
reserve not more than 5 percent of the funds allotted to a 
State through the WIA State grant programs for statewide 
workforce investment activities. The percentage was lowered 
from 15 percent to 5 percent in fiscal year 2011, and then 
maintained at that level in fiscal year 2012. The Committee 
adds new bill language allowing Governors to reserve up to 10 
percent of WIA State grant program funding if half of the total 
set-aside is used to support on-the-job and incumbent training 
to improve the skills of workers, avert layoffs, or lead to 
employment, and is delivered on a local or regional basis for 
in-demand occupations or industries.

Federally Administered Programs

    Dislocated Worker Assistance National Reserve.--The 
Committee recommends $224,066,000 for the Dislocated Worker 
Assistance National Reserve, which is available to the 
Secretary for activities such as responding to mass layoffs, 
plant and/or military base closings, and natural disasters that 
cannot be otherwise anticipated as well as for technical 
assistance, training, and demonstration projects. This amount 
is the same as the fiscal year 2012 level. The budget request 
includes $223,688,000.
    Funds made available in this bill support activities in 
program year 2013, which occurs from July 1, 2013, through June 
30, 2014. The bill provides that $24,066,000 is available for 
obligation on July 1, 2013, and that $200,000,000 is available 
on October 1, 2013. Both categories of funding are available 
for obligation through June 30, 2014.
    As proposed in the budget request, the Committee continues 
bill language from previous years authorizing the use of funds 
under the dislocated workers program for projects that provide 
assistance to new entrants in the workforce or incumbent 
workers and assistance where there have been dislocations 
across multiple sectors or local areas of a State.
    Native American Programs.--The Committee recommends 
$47,562,000, the same amount provided in fiscal year 2012, for 
Native American programs. The budget request is $52,562,000. 
These programs are 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 employment.
    Migrant and Seasonal Farmworker Programs.--The Committee 
recommends $84,291,000, the same as the fiscal year 2012 level 
and the budget request, for migrant and seasonal farmworkers 
programs, which serve members of economically disadvantaged 
families whose principal livelihood is derived from migratory 
and other forms of seasonal farmwork, fishing, or logging 
activities. Enrollees and their families are provided with 
employment, training, and related services intended to prepare 
them for stable, year-round employment within and outside of 
the agriculture industry.
    The Committee recommendation provides that $78,104,742 be 
used for State service area grants. The Committee 
recommendation also includes bill language directing that 
$5,678,222 be used for migrant and seasonal farmworker housing 
grants, of which not less than 70 percent shall be for 
permanent housing. The principal purpose of these funds is to 
continue the network of local farmworker housing organizations 
working on permanent housing solutions for migrant and seasonal 
farmworkers. The Committee recommendation also includes 
$508,036 to be used for section 167 training, technical 
assistance, and related activities, including funds for migrant 
rest center activities.
    Women in Apprenticeship.--The Committee recommends $996,000 
for activities authorized under the WANTO Act of 1992. This 
amount is the same as the fiscal year 2012 level. The budget 
request eliminates this program. These funds provide for 
technical assistance to employers and unions to assist them in 
training, placing, and retraining women in nontraditional jobs 
and occupations.
    YouthBuild.--The Committee recommends $79,689,000, the same 
as the fiscal year 2012 level and the budget request, for the 
YouthBuild program. YouthBuild targets at-risk, high-school 
dropouts and prepares them with the skills and knowledge they 
need to succeed in a knowledge-based economy.
    Workforce Innovation Fund.--The Committee recommends 
$49,906,000, the same as the fiscal year 2012 level, for WIF, a 
program that provides competitive awards for workforce 
innovation activities. The Committee recommendation does not 
set aside $10,000,000, as requested by the administration, for 
a new initiative to improve services for disconnected youth.
    The Committee recommendation includes new bill language, as 
requested by the administration, that allows a portion of the 
funds for WIF to be used for Pay for Success pilots, which will 
provide performance-based awards to States or local governments 
and nonprofit organizations providing or arranging services 
that improve employment and education outcomes for individuals, 
including those with barriers to employment. The Committee 
expects that funds for Pay for Success pilots will only be set 
aside if it has been determined that such pilots could improve 
outcomes and eligible entities show interest. The Committee 
also expects to be notified prior to the issuance of any notice 
related to Pay for Success activity.
    The budget request includes $100,000,000 for WIF through 
the Department and an additional $25,000,000 through the 
Department of Education's VR State Grants and Adult Basic State 
Grants programs.
    The Committee is reluctant to provide an increase for WIF 
until it can gauge the program's success. The Committee notes 
that although the program was created in fiscal year 2011, with 
additional funding appropriated in fiscal year 2012, the 
Department does not plan to award the first WIF grants before 
mid- to late June 2012.
    WIF grants are intended to test innovative strategies; 
replicate and expand effective, evidence-based strategies and 
activities, including sector strategies, career pathways, 
incumbent worker training, and on-the-job training; and align 
programs and strengthen the workforce system in a State or 
region in order to substantially improve the education and 
employment outcomes for job seekers and workers, youth, and 
employers. The Committee expects activities for youth will 
improve services for individuals up to age 24.
    WIF awards will be made either to States, in partnership 
with local workforce investment boards, or to local workforce 
investment boards or consortia of such boards that serve a 
regional labor market. Priority will be given to applicants 
that demonstrate significant alignment, strategic planning, and 
coordination across the workforce development system and 
supportive services at the State, regional, or local level, and 
that support economic development goals and improved employment 
outcomes for participants, particularly those who are hardest 
to serve.
    The Committee commends ETA for its collaborative work with 
IMLS to integrate the education, employment, and training 
services provided by public libraries into the workforce 
development system. The Committee encourages ETA to continue to 
invest in building and strengthening partnerships between the 
one-stop system and public libraries and recommends that the 
ETA encourage applicants for grants under WIF to collaborate 
with public libraries.
    The budget request includes a general provision that 
provides the Secretary with the authority to waive statutes and 
regulations relating to title I of WIA and the Wagner-Peyser 
Act when the Secretary believes waivers would substantially 
improve employment and education outcomes. The Committee does 
not include this general provision.

National Activities

    The Committee remains greatly concerned about the low level 
of literacy and numeracy skills among adult workers. The 
Committee continues to encourage the Department to work with 
the Department of Education to examine and share best practices 
to help adults with the lowest literacy levels improve their 
overall skills and employment opportunities. The Committee 
requests the Department report on its progress in educating the 
workforce system on the effectiveness of adult literacy and 
basic skills programs that have successfully implemented 
strategies for delivering basic literacy instruction together 
with occupational training no later than 120 days after 
enactment of this act. Further, the Committee recommends that 
these best practices be widely disseminated to maximize 
outreach to programs that would be able to implement improved 
approaches.
    As proposed in the budget request, the Committee recommends 
eliminating funding designated for two programs: pilots, 
demonstrations, and research; and evaluation. These activities 
will instead be funded through a 0.5 percent tap on the 
Department's training and employment programs, including WIA, 
Job Corps, and the Employment Service. The new set-aside 
approach will ensure that sufficient funding is available to 
carry out comprehensive research and evaluations, including 
random assignment studies, and promote greater stability of 
funding for these efforts.
    The ETA will conduct evaluation and applied research 
activities in consultation with the Department's chief 
evaluation officer who oversees the evaluation program. Results 
will inform policy, advance the Department's mission, and 
improve its performance-based management initiatives.
    Pilots, Demonstrations, and Research.--As explained above, 
the Committee recommends eliminating funding designated for 
this program. The fiscal year 2012 funding level is $6,603,000. 
In recent years, funding levels have been sufficient only to 
carry out research activities and not pilots and 
demonstrations.
    The Committee directs the Secretary to use the authority in 
sections 170 and 171 of WIA to set aside up to $10,000,000 to 
support technical assistance, research, and demonstration 
activities by making competitive grants to nonprofit entities 
with demonstrated effectiveness in aligning education, 
workforce, and economic development programming to advance the 
quality and effectiveness of the workforce development system 
and to support innovative collaborations at the local level 
that enhance the employment and training opportunities for 
workers. This recommendation is intended to highlight the need 
to build capacity in the workforce system in a way that 
maximizes returns for job seekers, incumbent workers, and 
employers. Grant awards should support integration of the 
successful approaches identified in GAO Report 12-97, dated 
January 19, 2012, to help local workforce boards react swiftly 
to changing labor market demands and ensure workers have the 
required skills to meet those demands. Awards should also 
support capacity building or demonstration projects in local 
communities to address chronic unemployment and skills 
mismatches by disseminating information, providing technical 
assistance, or serving as an intermediary to develop and 
monitor projects that increase the alignment of education and 
training investments.
    Reintegration of Ex-Offenders.--The Committee recommends 
$80,238,000, the same as the fiscal year 2012 level, for the 
Reintegration of Ex-Offenders program. The budget request 
includes $85,238,000. This program helps prepare and assist ex-
offenders return to their communities through pre-release 
services, mentoring, and case management. The program also 
provides support, opportunities, education, and training to 
youth who are involved in court and on probation, in aftercare, 
or on parole, or who would benefit from alternatives to 
incarceration or diversion from formal judicial proceedings. 
Programs are carried out directly through State and local 
governmental entities and community-based organizations, as 
well as indirectly through intermediary organizations.
    Within the funds provided, the Committee recommendation 
includes $20,000,000, the same as fiscal year 2012 and the 
budget request, for competitive grants to national or regional 
intermediaries for activities that prepare young ex-offenders 
and school dropouts for employment. Priority should be given to 
projects that serve high-crime, high-poverty areas.
    Evaluation.--As explained above, the Committee recommends 
eliminating funding designated for evaluation. The fiscal year 
2012 funding level is $9,563,000.
    Workforce Data Quality Initiative.--The Committee 
recommends $6,000,000 for the Workforce Data Quality 
Initiative, the same as the budget request. The comparable 
fiscal year 2012 level is $6,463,000. Funds are used to assist 
States with incorporating comprehensive workforce information 
into longitudinal data systems being developed in part with the 
support of funding provided by the Department of Education. The 
initiative is also intended to help improve the quality and 
accessibility of performance data being produced by training 
providers. Twenty-five States have been awarded grants through 
this program. This funding will expand the initiative to 
approximately six additional States.

                          OFFICE OF JOB CORPS

Appropriations, 2012....................................  $1,702,947,000
Budget estimate, 2013...................................   1,650,004,000
Committee recommendation................................   1,673,210,000

    For Job Corps, the Committee recommends $1,673,210,000.
    The recommendation for operations of Job Corps centers is 
$1,569,078,000, the same as the fiscal year 2012 level. The 
budget request includes $1,545,872,000.
    The budget request for operations is based on a new reform 
effort that will close a small number of chronically low-
performing Job Corps centers based on their educational and 
employment outcomes. Some of these centers have remained in the 
bottom cohort of center performance rankings for many years and 
are failing at-risk youth in need of high-quality education and 
training services. The Committee supports the Department's 
reform effort and agrees that it is not beneficial to such 
youth or a wise use of taxpayer dollars to continue to invest 
in centers that have historically not served students well.
    However, even if a few chronically low-performing centers 
are closed, the Committee does not believe the budget request 
is sufficient to support several new centers that have opened 
in recent years and another center that is expected to open 
during program year 2013. Therefore, the Committee recommends 
no reduction to funding for operations.
    The Committee is very concerned about the Department's 
mismanagement of Job Corps funds that led to the funding 
shortfall recently announced for the remainder of program year 
2011 and the disruptions it has caused new, current, and 
transfer students. In order to conduct proper oversight, it is 
important for the Committee to understand the circumstances 
that led to the shortfall. Therefore, the Committee requests a 
detailed report that provides a timeline of when the Department 
became aware of the shortfall; the specific steps the 
Department is taking to address it; and a description of the 
impact on students and services provided to them. The report 
should also include a description of the impact on the budget 
for program year 2012 and steps the Department is taking to 
ensure that students do not face similar disruptions in the 
coming year. The report shall be submitted to the Committee no 
later than 30 days after enactment of this act. The Committee 
expects to be notified in advance of announcements made to Job 
Corps centers related to funding shortfalls.
    The Committee urges the Department to ensure that any 
center proposed for closure has exhausted all available options 
to improve, including being placed on a corrective action plan 
or performance improvement plan. The Committee also expects the 
Department to use its existing performance measures as the key 
component for developing its methodology for identifying 
centers for closure and to adhere to the process for closing a 
Job Corps center as described in section 159 of WIA, which 
includes advance announcement to the general public of the 
proposed closure; establishment of a reasonable comment period 
for interested parties to submit written comments to the 
Secretary; and notification to the Members of Congress who 
represent the district or State in which such center is 
located.
    The Committee strongly encourages the Department to provide 
Job Corps students enrolled in a closing low-performing center 
the opportunity to transfer to another higher-performing Job 
Corps center.
    The Committee requests a detailed description of the 
Department's plan for identifying centers for closure, 
including a definition of a ``low-performing center,'' the 
methodology used for identifying those centers, and a timeline 
for the closure process. The Committee expects to receive this 
information no later than 180 days after the enactment of this 
act or at least 30 days prior to any public notice published in 
the Federal Register.
    The Committee recommendation for administrative costs is 
$29,132,000, the same as the budget request. The comparable 
fiscal year 2012 level is $29,077,000.
    The Committee also recommends a total of $75,000,000 in 
construction, renovation, and acquisition funds. This amount, 
which is the same as the budget request, is available from July 
1, 2013, to June 30, 2016. The comparable fiscal year 2012 
level is $104,792,000.
    As requested by the administration, the Committee again 
includes bill language allowing the Secretary to transfer up to 
15 percent of construction, renovation, and acquisition funds, 
if necessary, to meet the operational needs of Job Corps 
centers or to achieve administrative efficiencies.
    The Committee notes that the Department recently took 
disciplinary action against a Job Corps contractor for repeated 
safety and protocol violations. The Committee believes that the 
Job Corps program, its students, and the taxpayers would be 
better served if the Department strengthened its oversight of 
the program and its contractors.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2012....................................    $448,251,000
Budget estimate, 2013...................................................
Committee recommendation................................     448,251,000

    The Committee recommends $448,251,000 for the CSEOA 
program. As in fiscal year 2012, the budget request includes a 
proposal to transfer the program to ACL in HHS. The Committee 
again recommends keeping the program in DOL.
    CSEOA provides part-time employment in community service 
activities for unemployed, low-income persons aged 55 and 
older.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2012....................................  $1,100,100,000
Budget estimate, 2013...................................   1,421,000,000
Committee recommendation................................   1,421,000,000

    The Committee recommends $1,421,000,000 in mandatory funds 
for Federal unemployment benefits and allowances.
    This program assists trade-impacted workers with services 
including: training, income support, employment, case 
management, and assistance with health insurance coverage. The 
program also includes a wage insurance option for certain 
workers at least 50 years old. These benefits and services are 
designed to help trade-impacted participants find a path back 
into middle-class jobs, improve earnings, and increase 
credential and education rates.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Appropriations, 2012....................................  $4,071,058,000
Budget estimate, 2013...................................   3,949,240,000
Committee recommendation................................   3,896,993,000

    The Committee recommends $3,896,993,000 for this account. 
The recommendation includes $3,810,882,000 authorized to be 
drawn from the Employment Security Administration account of 
the unemployment trust fund and $86,111,000 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.
    The Committee bill retains language from previous years 
that enables States to use funds appropriated under this 
account to assist other States if they are impacted by a major 
disaster declared by the President and that permits the 
Secretary to use funds to make payments on behalf of States for 
the use of the National Directory of New Hires. At the request 
of one or more States, the Secretary may reallot funds for 
States to carry out activities that benefit the administration 
of unemployment compensation laws of a requesting State.
    The Committee recommends a total of $3,016,209,000, the 
same as the budget request, for UI activities. The comparable 
fiscal year 2012 level is $3,220,438,000. The decrease in 
funding is due to an expected reduction in UI administrative 
workload. For UI State operations, the Committee recommends 
$3,004,912,000. These funds are available for obligation by 
States through December 31, 2013. Funds used for automation 
acquisitions or for competitive grants awarded to States to 
address worker misclassification, system improvements, or 
improper payments are available for obligation by States 
through September 30, 2015.
    The Committee recommendation includes $75,000,000, the same 
as the budget request, to conduct in-person re-employment and 
eligibility assessments and UI improper payment reviews and 
continues bill language allowing the Secretary to provide 
additional funding to support these activities if funds become 
available as the result of a decrease in UI workload activity. 
Congress appropriated no less than $60,000,000 for this 
activity in fiscal year 2012. This important program integrity 
initiative has been shown to help claimants exit the UI program 
faster and avoid exhausting UI benefits. The Committee intends 
for a portion of these or other administrative funds to be used 
for additional technology-based overpayment prevention, 
detection, and collection activities. The budget request 
includes a proposal for a discretionary cap adjustment 
amendment to the Balanced Budget and Emergency Deficit Control 
Act of 1985, which would provide an adjustment for $15,000,000 
of the $75,000,000 included in the budget request. The 
Committee recommendation does not use the cap adjustment, which 
has yet to be enacted.
    The Committee recommendation includes new bill language 
that provides $10,000,000, as proposed in the budget request, 
for an award program designed to incentivize States to improve 
misclassification efforts. States that are most successful will 
be able to use these incentive funds to upgrade their 
misclassification detection and enforcement programs.
    The Committee recommendation provides for a contingency 
reserve amount should the unemployment workload exceed an 
average weekly insured claims volume of 3,908,000, as proposed 
in the budget request. This contingency amount would fund the 
administrative costs of the UI workload over the level of 
3,908,000 insured unemployed persons per week at a rate of 
$28,600,000 per 100,000 insured unemployed persons, with a pro 
rata amount granted for amounts of less than 100,000 insured 
unemployed persons.
    For UI national activities, the Committee recommends 
$11,297,000, the same as the budget request. The comparable 
fiscal year 2012 level is $11,266,000. These funds are directed 
to activities that benefit the State/Federal UI program 
including helping States adopt common technology-based 
solutions to improve efficiency and performance and supporting 
training and contracting for actuarial support for State trust 
fund management.
    For the Employment Service allotments to States, the 
Committee recommends $730,842,000, the same as the budget 
request. This amount includes $22,638,000 in general funds 
together with an authorization to spend $708,204,000 from the 
Employment Security Administration account of the unemployment 
trust fund. The comparable fiscal year 2012 level is 
$700,842,000. The Committee includes new bill language 
requiring that no less than $30,000,000 be used to provide 
reemployment services to UI beneficiaries. Congress last 
appropriated funding for reemployment services in ARRA. A 
recent study found that reemployment services coupled with re-
employment and eligibility assessments not only shorten UI 
duration, but also boost employment and earnings for UI 
claimants. The Committee recommendation continues to support 
States' efforts in providing these critical workforce services 
to UI claimants.
    The Committee also recommends $20,952,000, the same as the 
budget request, for Employment Service national activities. The 
fiscal year 2012 level is $20,912,000. The administration of 
the work opportunity tax credit accounts for $18,520,000 of the 
recommended amount and the balance is for technical assistance, 
training, and the Federal share of State Workforce Agencies 
Retirement System payments.
    For carrying out the Department's responsibilities related 
to foreign labor certification activities, the Committee 
recommends $65,517,000, the same as the budget request. The 
comparable fiscal year 2012 level is $65,393,000. In addition, 
5 percent of the revenue from H-1B fees is available to the 
Department for costs associated with processing H-1B alien 
labor certification applications.
    For one-stop career centers and labor market information, 
the Committee recommends $63,473,000, the same as the fiscal 
year 2012 level. The budget request provides $115,720,000 and 
includes a proposal to co-brand and increase public awareness 
of the one-stop career center system. The Committee does not 
recommend funding for this initiative due to funding 
constraints.
    The Committee recommendation includes $12,000,000 for the 
ETA, in collaboration with ODEP, to continue to implement their 
joint plan for improving effective and meaningful participation 
of persons with disabilities in the workforce. The Committee 
expects that these funds, in combination with funding available 
to ODEP, will continue to improve the accessibility and 
accountability of the public workforce development system for 
individuals with disabilities. The budget request and fiscal 
year 2012 level is $11,976,120.
    The Committee recommendation includes new bill language, as 
proposed in the budget request, authorizing the Secretary to 
collect fees for costs associated with additional data 
collection requested by States and local governments, 
institutions of higher education, or nonprofit organizations 
under the National Agricultural Workers Survey, and to retain 
the proceeds to cover such costs.

                         STATE PAID LEAVE FUND

Appropriations, 2012....................................................
Budget estimate, 2013...................................      $5,000,000
Committee recommendation................................................

    Because of budget constraints, the Committee does not 
recommend funding to create a new State Paid Leave Fund, which 
would help States establish paid leave programs.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2012....................................    $171,000,000
Budget estimate, 2013...................................................
Committee recommendation................................................

    The Committee recommends and the budget requests such sums 
as are necessary in mandatory funds for this account. The 
budget estimates that there will be no net costs in fiscal year 
2013 because of expected repaid advances to the trust fund. The 
appropriation is available to provide advances to several 
accounts for purposes authorized under various Federal and 
State unemployment compensation laws and the Black Lung 
Disability Trust Fund, whenever balances in such accounts prove 
insufficient.
    The Committee bill includes language proposed in the budget 
request to allow the Department additional flexibility to 
access funds as needed for covered programs.

                         PROGRAM ADMINISTRATION

Appropriations, 2012....................................    $147,081,000
Budget estimate, 2013...................................     147,611,000
Committee recommendation................................     147,081,000

    The Committee recommendation of $147,081,000 for program 
administration includes $97,137,000 in general funds and 
$49,944,000 from the Employment Security Administration account 
of the unemployment trust fund.
    General funds in this account pay for the Federal staff 
needed to administer employment and training programs under 
WIA, OAA, the Trade Act of 1974, WANTO, and the National 
Apprenticeship Act. Trust funds provide for the Federal 
administration of employment security functions under title III 
of the Social Security Act.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $183,153,000
Budget estimate, 2013...................................     183,153,000
Committee recommendation................................     183,153,000

    The Committee recommends $183,153,000 for EBSA.
    EBSA plays a critical role in improving health benefits and 
retirement security for American workers and their families. 
EBSA is responsible for the enforcement of title I of ERISA in 
both civil and criminal areas and for enforcement of sections 
8477 and 8478 of the Federal Employees' Retirement Security Act 
of 1986. EBSA administers an integrated program of regulation, 
compliance assistance and education, civil and criminal 
enforcement, and research and analysis.
    Benefits under EBSA's jurisdiction consist of approximately 
$6,500,000,000,000 in assets covering approximately 150 million 
participants and beneficiaries. EBSA oversees benefit security 
for an estimated 718,000 private retirement plans, 2.6 million 
health plans, and similar numbers of other welfare benefit 
plans, such as those providing life or disability insurance.

                  Pension Benefit Guaranty Corporation

    PBGC's estimated obligations for fiscal year 2013 include 
single-employer benefit payments of $6,534,000,000, multi-
employer financial assistance of $118,000,000, and 
administrative expenses of $479,013,000. Administrative 
expenses are comprised of three activities: (1) pension 
insurance activities, $75,943,000; (2) pension plan termination 
expenses, $240,611,000; and (3) operational support, 
$162,459,000. These expenditures are financed by permanent 
authority.
    The PBGC is a wholly owned Government corporation 
established by ERISA. The law places it within DOL and makes 
the Secretary the chair of its board of directors. The 
corporation receives its income primarily from insurance 
premiums collected from covered pension plans, assets of 
terminated pension plans, collection of employer liabilities 
imposed by the act, and investment earnings. The primary 
purpose of the corporation is to guarantee the payment of 
pension plan benefits to participants if covered defined 
benefit plans fail or go out of existence.
    The President's budget proposes to continue authority for a 
contingency fund for the PBGC that provides additional 
administrative resources when the number of participants in 
terminated plans exceeds 100,000. When the trigger is reached, 
an additional $9,200,000 becomes available for every 20,000 
participants in terminated plans. A trigger also is included 
for additional investment management fees for plan terminations 
or asset growth. These additional funds would be available for 
obligation through September 30, 2014. The Committee bill 
continues these provisions to ensure that the PBGC can take 
immediate, uninterrupted action to protect participants' 
pension benefits. The Committee expects to be notified 
immediately of the availability of any funds provided by these 
provisions.
    As requested by the President's budget, the Committee bill 
also continues authority allowing the PBGC additional 
obligation authority for unforeseen and extraordinary pre-
termination expenses, after approval by the Office of 
Management and Budget and notification of the Committees on 
Appropriations of the House of Representatives and the Senate.
    The Committee is very concerned by findings of the May 2012 
PBGC IG Management Advisory report that found errors and 
inconsistencies in both the multi-employer and single-employer 
sections that were caused by a lack of quality control or 
quality review process to ensure the integrity of reported 
actuarial estimates. The Committee directs the PBGC Board of 
Directors to designate a capable agency or organization that is 
independent from the PBGC, such as the SSA, to conduct an 
annual peer review of the Single-Employer Pension Insurance 
Modeling System and Multi-Employer Pension Insurance Modeling 
System, the first of which shall be initiated no later than 3 
months after the date of enactment of this act. The Committee 
also directs PBGC to develop written quality review policies 
and procedures for all modeling and actuarial work performed by 
the Policy, Research, and Analysis Department and to conduct a 
record management review of the Policy, Research and Analysis 
Department to determine what records must be retained as 
Federal records. The PBGC shall, no later than 2 months after 
the date of enactment, submit to Congress a report, approved by 
the Board of Directors, setting forth a timetable for 
addressing the outstanding recommendations of the Office of the 
Inspector General relating to the Policy, Research and Analysis 
Department and the Benefits Administration and Payment 
Department.
    PBGC's single-employer program protects nearly 34 million 
participants in approximately 25,000 defined benefit pension 
plans. The multi-employer insurance program protects about 10 
million participants in roughly 1,500 plans.

                         Wage and Hour Division


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $227,061,000
Budget estimate, 2013...................................     237,730,000
Committee recommendation................................     237,730,000

    The Committee recommends $237,730,000 for WHD.
    The WHD is responsible for administering and enforcing laws 
that provide minimum standards for wages and working conditions 
in the United States. The Fair Labor Standards Act [FLSA], 
employment rights under the Family and Medical Leave Act, and 
the Migrant and Seasonal Agricultural Worker Protection Act are 
several of the important laws the WHD is charged with 
administering and/or enforcing.
    The Committee recommendation includes additional funds over 
the fiscal year 2012 level to address the misclassification of 
employees as independent contractors and to provide enhanced 
enforcement of overtime pay regulations. In addition, as 
proposed in the budget request, the Committee recommendation 
includes funds reallocated from the Women's Bureau for WHD 
efforts on Family and Medical Leave Act issues.
    The Committee also supports the President's request to 
provide additional resources for the WHD to increase its 
oversight of organizations participating in the special minimum 
wage program for individuals with disabilities authorized under 
section 14(c) of the FLSA, in order to protect the rights of 
workers with disabilities. The Committee also urges the WHD to 
continue exploring and implementing strategies with ODEP and 
other Federal agencies to provide additional opportunities for 
such workers to participate in competitive integrated 
employment.

                  Office of Labor-Management Standards


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $41,289,000
Budget estimate, 2013...................................      41,771,000
Committee recommendation................................      41,289,000

    The Committee recommends $41,289,000 for OLMS.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act of 1959 and related laws. These laws establish 
safeguards for union democracy and financial integrity. They 
also require public disclosure by unions, union officers, 
employers, and others. In addition, the office administers 
employee protections under federally sponsored transportation 
programs.

             Office of Federal Contract Compliance Programs


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $105,187,000
Budget estimate, 2013...................................     106,415,000
Committee recommendation................................     105,187,000

    The Committee recommends $105,187,000 for OFCCP.
    This office protects workers and potential employees of 
Federal contractors from employment discrimination prohibited 
under Executive Order 11246, section 503 of the Rehabilitation 
Act of 1973, and the Vietnam Era Veterans' Readjustment 
Assistance Act of 1974.
    The Committee notes that almost 2 years ago the Department 
issued an advance notice of proposed rulemaking regarding 
regulations for implementing section 503 of the Rehabilitation 
Act. The Committee strongly supports the administration's plan 
to issue a final rule by October of this year, as these 
regulations have not been updated in over 40 years. Changes 
included in the proposed rule would make important improvements 
in reducing barriers to employment opportunities for 
individuals with disabilities. The Committee encourages the 
Department to make technical assistance available to Federal 
contractors regarding the rule, and to increase Federal 
contractor employment opportunities for individuals with 
disabilities.

                Office of Workers' Compensation Programs


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $117,840,000
Budget estimate, 2013...................................     122,190,000
Committee recommendation................................     117,840,000

    The Committee recommends $117,840,000 for OWCP. The bill 
provides authority to expend $2,120,000 from the special fund 
established by the Longshore and Harbor Workers' Compensation 
Act.
    OWCP administers four distinct compensation programs: the 
Federal Employees' Compensation Act, the Longshore and Harbor 
Workers' Compensation Act, the Black Lung Benefits programs, 
and the Energy Employees Occupational Illness Compensation 
Program. In addition, OWCP houses the Division of Information 
Technology Management and Services.

                            SPECIAL BENEFITS

Appropriations, 2012....................................    $350,000,000
Budget estimate, 2013...................................     396,000,000
Committee recommendation................................     396,000,000

    The Committee recommends $396,000,000 for this account. 
This mandatory appropriation, which is administered by OWCP, 
primarily provides benefits under the Federal Employees' 
Compensation Act [FECA].
    The Committee recommends continuation of appropriations 
language to provide authority to require disclosure of Social 
Security account numbers by individuals filing claims under 
FECA or the Longshore and Harbor Workers' Compensation Act and 
its extensions.
    The Committee recommends continuation of appropriations 
language that provides authority to use FECA funds to reimburse 
a new employer for a portion of the salary of a newly re-
employed injured Federal worker. FECA funds will be used to 
reimburse new employers during the first 3 years of employment, 
not to exceed 75 percent of salary in the worker's first year, 
and declining thereafter.
    The Committee recommendation also continues language that 
allows carryover of unobligated balances to be used in the 
following year and that provides authority to draw such sums as 
are needed after August 15 to pay current beneficiaries. Such 
funds are charged to the subsequent year appropriation.
    The Committee also recommends continuation of 
appropriations language to provide authority to deposit into 
the special benefits account of the employees' compensation 
fund those funds that the Postal Service, the Tennessee Valley 
Authority, and other entities are required to pay to cover 
their fair share of the costs of administering the claims filed 
by their employees under FECA. Finally, the Committee continues 
to allow use of fair share collections to fund capital 
investment projects and specific initiatives to strengthen 
compensation fund control and oversight.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2012....................................    $182,227,000
Budget estimate, 2013...................................     163,220,000
Committee recommendation................................     163,220,000

    The Committee recommends a mandatory appropriation of 
$123,220,000 in fiscal year 2013 for special benefits for 
disabled coal miners. This is in addition to the $40,000,000 
appropriated last year as an advance for the first quarter of 
fiscal year 2013, for a total program level of $163,220,000 in 
fiscal year 2013. The decrease in this account below the fiscal 
year 2012 level reflects a declining beneficiary population.
    These mandatory funds are used to provide monthly benefits 
to coal miners disabled by black lung disease and their widows 
and certain other dependents, as well as to pay related 
administrative costs.
    The Committee also recommends an advance appropriation of 
$35,000,000 for the first quarter of fiscal year 2014. This 
amount is the same as the budget request. These funds will 
ensure uninterrupted benefit payments to coal miners, their 
widows, and dependents.

     DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $52,147,000
Budget estimate, 2013...................................      54,962,000
Committee recommendation................................      54,962,000

    The Committee recommends $54,962,000 for the Division of 
Energy Employees Occupational Illness Compensation. This is a 
mandatory appropriation.
    The Division administers EEIOCPA, which provides benefits 
to eligible employees and former employees of DOE, its 
contractors and subcontractors, or to certain survivors of such 
individuals. The mission also includes delivering benefits to 
certain beneficiaries of the Radiation Exposure Compensation 
Act. The Division is part of OWCP.
    In fiscal year 2013, the volume of incoming claims under 
part B of EEOICPA is estimated at about 7,300 from DOE 
employees or survivors, and private companies under contract 
with DOE, 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.
    Under part E, approximately 6,400 new claims will be 
received during fiscal year 2013. Under this authority, the 
Department provides benefits to eligible DOE contractor 
employees who were found to have work-related occupational 
illnesses due to exposure to a toxic substance at a DOE 
facility, or to the employees' survivors.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2012....................................    $301,415,000
Budget estimate, 2013...................................     308,849,000
Committee recommendation................................     308,849,000

    The Committee bill provides an estimated $308,849,000 for 
this mandatory appropriations account. This estimate is 
comprised of $58,806,000 for administrative expenses and an 
estimated $250,043,000 for benefit payment and interest costs.
    The Committee bill continues to provide indefinite 
authority for the Black Lung Disability Trust Fund to provide 
for benefit payments. In addition, the bill provides for 
transfers from the trust fund for administrative expenses for 
the following DOL agencies: up to $32,906,000 for the part C 
costs of the Division of Coal Mine Workers' Compensation 
Programs, up to $25,217,000 for Departmental Management, 
Salaries and Expenses, and up to $327,000 for Departmental 
Management, Inspector General. The bill also allows a transfer 
of up to $356,000 for the Department of the Treasury.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
can be assigned liability for such benefits or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs that are incurred in administering the benefits program 
and operating the trust fund.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $564,788,000
Budget estimate, 2013...................................     565,468,000
Committee recommendation................................     565,468,000

    The Committee recommends $565,468,000 for OSHA, which is 
responsible for enforcing the Occupational Safety and Health 
Act of 1970 in the Nation's workplaces.
    The Committee continues bill language to allow OSHA to 
retain up to $200,000 per fiscal year of tuition fees for 
training institute courses to be used for occupational safety 
and health training and education grants in the private sector.
    The Committee bill retains language that continues to 
effectively exempt farms employing 10 or fewer people from the 
provisions of the act with the exception of those farms having 
a temporary labor camp. The bill also retains language 
exempting small firms in industry classifications having a lost 
workday injury rate less than the national average from general 
schedule safety inspections.
    The Committee supports the important mission carried out by 
OSHA. BLS data reveal that on average during calendar year 2010 
one worker died of a work-related injury every 2 hours. 
Millions more were seriously hurt or contracted a fatal illness 
or disease in their workplace. These deaths and injuries take a 
massive toll on our economy and society, decreasing 
productivity and increasing the costs of medical care.
    GAO recently reported that between 1981 and 2010, the time 
it took OSHA to develop and issue safety and health standards 
ranged widely, from 15 months to 19 years, and averaged more 
than 7 years. OSHA's rulemaking on silica illustrates some of 
the challenges identified by GAO.
    According to CDC, as many as 1.7 million workers are 
exposed to dangerous levels of silica in the workplace each 
year; researchers estimate that 3,600 to 7,300 of them develop 
silicosis and approximately 200 workers die of this condition 
each year. Despite the mandate in Executive Order 12866 that 
the Office of Information and Regulatory Affairs [OIRA] 
complete its review of any proposed rule within 90 days (with a 
possible extension of another 30 days), the silica rule has 
languished at OIRA for more than 15 months. Therefore, the 
Committee directs the Department to issue a notice of proposed 
rulemaking on silica not later than 30 days after the end of 
fiscal year 2012.
    The Committee recommends $104,196,000, the same amount as 
the budget request, for grants to States under section 203(g) 
of the Occupational Safety and Health Act. These funds 
primarily are provided to States that have taken responsibility 
for administering their own occupational safety and health 
programs for the private sector and/or the public sector. State 
plans must be at least as effective as the Federal program and 
are monitored by OSHA. The Committee bill continues language 
that allows OSHA to provide grants of up to 50 percent for the 
costs of State plans approved by the agency. The Committee 
believes that, given the continuing fiscal pressures facing 
State budgets, OSHA should continue its practice of allowing 
States an extra year to match the appropriation provided by 
this bill for support of their State plans, and also should 
extend the period of expenditure for these funds for an 
additional quarter.
    The Committee also believes that OSHA's worker safety and 
health training and education programs, including the grant 
program that supports such training, are a critical part of a 
comprehensive approach to worker protection. Under the program, 
grants are made to various types of organizations representing 
employers and labor organizations for direct training of 
workers on occupational safety and health. The Committee 
recommendation includes $11,000,000 for the OSHA Susan Harwood 
Training Grant Program. The budget request and the fiscal year 
2012 level are both $10,709,000.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $372,523,000
Budget estimate, 2013...................................     371,896,000
Committee recommendation................................     376,270,000

    The Committee recommendation includes $376,270,000 for 
MSHA.
    MSHA insures the safety and health of the Nation's miners 
by conducting inspections and special investigations of mine 
operations, promulgating mandatory safety and health standards, 
cooperating with the States in developing effective State 
programs, and improving training in conjunction with States and 
the mining industry.
    The Committee bill continues language authorizing MSHA to 
use up to $2,000,000 for mine rescue and recovery activities. 
It also retains the provision allowing the Secretary to use any 
funds available to the Department to provide for the costs of 
mine rescue and survival operations in the event of a major 
disaster. In order to prepare properly for an actual emergency, 
the Committee also directs MSHA to continue to devote resources 
toward a competitive grant activity for effective emergency 
response and recovery training in various types of mine 
conditions.
    In addition, bill language is included to allow the 
National Mine Health and Safety Academy to collect not more 
than $750,000 for room, board, tuition, and the sale of 
training materials to be available for mine safety and health 
education and training activities. Bill language also allows 
MSHA to retain up to $2,499,000 from fees collected for the 
approval and certification of equipment, materials, and 
explosives for use in mines, and to utilize such sums for such 
activities. The Committee bill also provides new authority 
requested in the President's budget to allow MSHA to establish, 
collect, and retain fees for services related to the analysis 
of rock dust samples.
    The Committee continues to place a high priority on 
reducing the backlog of contested safety and health violations. 
This bill includes $2,233,000 more than the budget request to 
expand that effort. In recent years, some mine operators have 
challenged an increasing share of their mine safety violations, 
preventing enhanced accountability provisions from taking 
effect. As in last year's act, the bill provides the authority 
to transfer a portion of these funds to support related 
activities in the Office of the Solicitor. The Committee notes 
that this effort has resulted in the targeted backlog being 
reduced by over 80 percent in just less than 2 years.
    The Committee notes that the current respirable coal dust 
regulation dates back to 1980 and does not reflect changes in 
technology or work schedules of miners that have occurred in 
the decades since it was promulgated. In October 2010, MSHA 
published a proposed rule on this issue. Congress included 
language in last year's appropriations act that prohibited the 
issuance of a final rule on the issue until GAO issues a report 
related to the rulemaking or until after 240 days have passed 
after enactment of the act. In either case, MSHA is expected to 
promulgate the rule before the end of fiscal year 2012. In 
addition, the statement of the managers accompanying the act 
clarifies that MSHA could ``address any compliance assistance 
or training needs'' before beginning to implement the rule.
    The timely issuance of a final rule will help in the effort 
to end black lung disease in the Nation's miners. Within this 
account, the Committee provides resources needed to support the 
rule's continued implementation in fiscal year 2013.
    As requested by the administration, the Committee includes 
new bill language allowing the Secretary to reallocate up to 
$3,000,000 within MSHA's program lines. The Committee expects 
to be notified prior to any such reallocation. The Committee 
also expects that any reallocations will not prevent MSHA from 
addressing important issues that are proposed in the budget 
request or identified in this report. In addition to items 
identified previously, the list of priority items include: 
effective implementation of corrective actions related to the 
Upper Big Branch internal review; purchase of additional 
continuous personal dust monitors; adequate support for MSHA's 
instructional capacity for training of mine safety and health 
inspectors and other mine safety professionals; and 
continuation of the spot inspection initiative related to 
respirable coal dust.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $609,071,000
Budget estimate, 2013...................................     618,207,000
Committee recommendation................................     619,043,000

    The Committee recommends $619,043,000 for BLS. This amount 
includes $67,176,000 from the Employment Security 
Administration account of the unemployment trust fund and 
$551,867,000 in Federal funds. The Committee retains bill 
language providing that up to $1,500,000 may be used to support 
the Mass Layoff Statistics Program.
    The BLS is the principal fact-finding agency in the Federal 
Government in the broad field of labor economics.
    The Committee recognizes that the Nation requires current, 
accurate, detailed labor statistics for Federal and non-Federal 
data users. The Nation also requires Government programs to be 
administered as cost-effectively as possible. However, the 
current ability of the cooperative statistics system to meet 
those needs is in question. Any weaknesses of this system could 
reduce the ability of State and local regions to effectively 
plan for recovery, anticipate industry demand for workforce 
needs, and meet other labor market information challenges.
    Therefore, the Committee directs the Secretary to 
commission a study of and report on a comprehensive assessment 
of the proper purpose, structure, methods, and operations of 
the Federal-State cooperative statistics system, particularly 
regarding the appropriate roles and responsibilities of the 
BLS, the ETA, the State labor market information agencies, and 
the system's relationship with the Census Bureau, the NCES, 
State workforce agencies, State education agencies, and private 
vendors.
    The Committee believes the National Academies of Science 
(Committee on National Statistics) and the National Academy of 
Public Administration are very well-qualified to produce such a 
report. The Committee requests the release of an interim report 
within 12 months of the enactment of this act and a final 
report within 24 months of the enactment of this act. The 
interim report shall contain, at minimum, a rigorous assessment 
of the Current Employment Statistics Program [CES], including 
an evaluation of the accuracies of past and present methods for 
producing initial State and metro area CES estimates, 
identification of the methods most likely to produce accurate 
initial estimates, and recommendations for appropriate BLS and 
State roles and responsibilities in preparing such accurate 
estimates. The report also should consider recommendations for 
how to improve the collection of this large volume of 
information, including through the use of technology; 
coordinate the Federal and State data systems to provide 
timely, accurate, and geographically detailed information on 
employment, education and training, occupations, and worker 
skills, as well as ease of access and technical assistance; and 
improve responsiveness to the data needs of labor market 
participants and policymakers at the Federal, State, and local 
levels.
    The Committee directs the Secretary to use such sums as may 
be necessary for this study, allocated equally from funds 
available to the Secretary, BLS, ETA, and the States. The State 
contribution should be made through a set-aside from BLS 
cooperative system grants to States.
    The Committee commends the BLS for its roughly 4-decade 
commitment to gather, extrapolate, and disseminate critical 
information about the experiences of youth, women, and men in 
the labor market through the National Longitudinal Surveys 
[NLS]. These data have informed the development of public 
policy and provided the basis for both historic and predictive 
analysis of market trends across decades and generations 
related to job creation, employment training, joblessness, 
education, housing, health, and the economy. The Committee 
recognizes that these longitudinal surveys serve as an 
essential national data source for long-term and ongoing 
analysis of the economic health of America and are an 
invaluable resource for Congress, as well as the public and 
private sectors, especially during times of economic 
uncertainty. As such, the Committee continues to support the 
NLS and recommends that the frequency of NLS data collection 
should not be less than biennially.
    The Committee recommendation includes sufficient funds to 
initiate a pilot input price index that would track price 
changes as establishments shift from domestic to foreign 
sources. Within this pilot project, the Committee directs BLS 
to develop a competitiveness audit that would compare the price 
of selected imports with comparable domestically produced goods 
and services.
    Within available resources, the Committee encourages BLS to 
prioritize work on the Contingent Work Supplement to the 
Current Population Survey.

                 Office of Disability Employment Policy

Appropriations, 2012....................................     $38,879,000
Budget estimate, 2013...................................      38,953,000
Committee recommendation................................      38,953,000

    The Committee recommends $38,953,000 for ODEP. The 
Committee intends that at least 80 percent of these funds shall 
be used to design and implement research and technical 
assistance grants and contracts to develop policy that reduces 
barriers to competitive, integrated employment for youth and 
adults with disabilities.
    The mission of ODEP is to provide leadership, develop 
policy and initiatives, and award grants furthering the 
objective of eliminating physical and programmatic barriers to 
the training and employment of people with disabilities. The 
Committee strongly supports each of the components of ODEP's 
mission and, in particular, urges the Secretary to ensure that 
ODEP carries out its leadership role with respect to 
governmentwide policies related to the training and employment 
of individuals with disabilities. The Committee believes that 
ODEP should put a high priority on providing support and 
technical assistance to Federal agencies for the implementation 
of Executive Order 13548 regarding hiring of persons with 
disabilities. The Committee also encourages ODEP to provide any 
support necessary for OFCCP to provide technical assistance to 
Federal contractors in meeting their obligations under section 
503 of the Rehabilitation Act.
    The Committee looks forward to the findings from the 
government-wide review involving ODEP that is intended to lead 
to better program outcomes for individuals with disabilities 
through improved coordination and alignment of disability 
programs, including better sharing of data, goal setting, and 
measuring of progress.
    The Committee recommendation includes $12,000,000 for ODEP, 
in collaboration with the ETA, to continue to implement their 
joint plan for improving effective and meaningful participation 
of persons with disabilities in the workforce. The Committee 
expects that these funds, in combination with funding available 
to the ETA, will continue to improve the accessibility and 
accountability of the public workforce development system for 
individuals with disabilities.

                        Departmental Management


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $362,999,000
Budget estimate, 2013...................................     348,927,000
Committee recommendation................................     348,927,000

    The Committee recommendation includes $348,927,000 for the 
departmental management account. An amount of $326,000 is 
available by transfer from the Black Lung Disability Trust 
Fund.
    The primary goal of the Department is to protect and 
promote the interests of American workers. The departmental 
management appropriation pays the salaries and related expenses 
of staff responsible for formulating and overseeing the 
implementation of departmental policy and management activities 
in support of that goal. In addition, this appropriation 
includes a variety of operating programs and activities that 
are not involved in departmental management functions, but for 
which other appropriations for salaries and expenses are not 
suitable.
    The Committee recommendation includes $12,000,000 within 
the legal services activity to continue support of the 
Department's efforts to reduce the backlog of mine safety cases 
before FMSHRC. Additionally, up to $2,000,000 provided to MSHA 
are available by transfer to legal services to support an 
increased capacity of the Commission to process caseloads 
pending before it. The Committee notes that this effort has 
resulted in the targeted backlog being reduced by over 80 
percent in fewer than 2 years. The Committee also continues to 
expect the Department to make every effort to support the 
timely processing of contested citations, particularly for 
operators that have the highest proportion of significant and 
substantial citations or other evidence of unacceptable health 
and safety records, as well as other efforts that reduce the 
number of contested citations.
    The Committee recommendation includes $94,984,000 for the 
Bureau of International Labor Affairs [ILAB]. These funds are 
available to help improve working conditions and labor 
standards for workers around the world and carry out ILAB's 
statutory mandates and international responsibilities. The 
Committee bill continues language from last year's act 
regarding the authority to fund microfinance activities, and 
funding levels for programs to combat exploitative child labor 
and model worker rights programs in countries with which the 
United States has trade preference programs or free trade 
agreements. The Committee expects ILAB to maintain its current 
effort on programs to combat exploitative child labor.
    The bill continues to provide an extra quarter for 
obligation of $66,500,000 of ILAB's appropriation as requested 
in the budget.
    The Committee recommendation provides $9,000,000, the same 
amount as the budget request, for program evaluation and allows 
these funds to be available for obligation through September 
30, 2014. The Committee bill also continues the authority of 
the Secretary to transfer these funds to any other account in 
the Department for evaluation purposes. The Committee bill 
includes requested authority to use up to 0.5 percent of 
certain Department appropriations for evaluation activities 
identified by the chief evaluation officer. The bill language 
differs slightly from last year's bill by including the 
Training and Employment Services in the list of accounts 
covered by this authority, as proposed in the budget request. 
The Committee expects to be notified of the planned uses of 
funds derived from this authority.
    The Committee recommendation provides $9,081,000 for the 
Women's Bureau as proposed in the budget request. While this 
amount is less than last year's level of $11,559,000, the 
Committee expects that additional resources provided to the WHD 
will allow the Department to strengthen its activities related 
to family and medical leave issues. In addition, funds 
available to the Bureau will enable it to undertake critical 
work, including in collaboration with other Federal agencies, 
in addressing the pay gap. The Committee continues bill 
language allowing the Bureau to award grants.
    The Committee is aware that, on April 10, 2012, the 
Department announced a significant change in the manner in 
which sensitive economic data are released to the news media 
and public. Members of Congress, the news media, and public 
interest groups have raised substantial concerns regarding this 
proposed policy change. The Committee understands that the 
Department and news organizations have been discussing 
significant modifications to the proposal, and that the 
Department has delayed implementation of all aspects that do 
not deal with the process of issuing credentials. The Committee 
directs the Department to collaborate with the news media in 
developing a revised policy that responds to the reasonable 
concerns of both the Department and the news media.
    The Committee directs the Department to issue a report to 
both the House and Senate Committees on Appropriations no later 
than 30 days after enactment of this act outlining all the 
Department's considerations, processes, and decision points 
related to the Department's concerns about the prior policy and 
justification of the initial April 10, 2012 policy. This report 
also shall include a statement of any concerns the Bureau of 
Labor Statistics may have regarding the Department's policy.

                    VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2012....................................    $264,437,000
Budget estimate, 2013...................................     258,870,000
Committee recommendation................................     262,821,000

    The Committee recommends $262,821,000 for VETS, including 
$38,185,000 in general revenue funding and $224,636,000 to be 
expended from the Employment Security Administration account of 
the unemployment trust fund.
    This account provides resources for VETS to maximize 
employment opportunities for veterans and transitioning 
servicemembers, including protecting their employment rights. 
VETS carries out its mission through a combination of grants to 
States, competitive grants, and Federal enforcement and 
oversight.
    The Committee provides $14,000,000 for the transition 
assistance program [TAP]. The budget request proposes 
$12,000,000 and the fiscal year 2012 funding level is 
$8,983,000. The additional resources provided above the budget 
request are needed to meet updated projections developed after 
the President's budget was proposed. The budget request assumes 
that 160,000 transitioning servicemembers will use TAP in 
fiscal year 2013, while the latest projections put the figure 
at approximately 201,000 members.
    The Committee recognizes the valuable work of VETS in 
providing assistance to veterans seeking employment through the 
Jobs for Veterans State Grants Program. Under this program, 
grants are used to fund Disabled Veterans' Outreach Program 
[DVOP] specialists and Local Veterans' Employment 
Representatives [LVERs]. However, the Committee recognizes that 
the current funding formula for DVOPs and LVERs poses 
challenges for larger rural States because it is strictly 
population-based and does not take service delivery area into 
account. As a result, the very few DVOPs and LVERs in these 
States have too much area to cover to provide personalized 
assistance to veterans or to build relationships with local 
employers. Therefore, the Committee provides funds above the 
budget request to be used to address the service challenges of 
such States and directs the Department to use the additional 
funds to establish innovative access points and/or service 
arrangements to help build the capacity of DVOPs and LVERs with 
larger service delivery areas and proportions of rural 
population. In addition, the Committee urges VETS to use any 
funds available from fiscal year 2012's end-of-year 
reallocation process to begin this effort.

                  INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2012....................................     $19,814,000
Budget estimate, 2013...................................      21,852,000
Committee recommendation................................      19,814,000

    The Committee recommends $19,814,000 for the IT 
Modernization account.
    Funds available in this account are used for two primary 
activities. The first is departmental support systems for which 
$7,985,000 is provided. These funds help align IT investments 
with the Department's strategic objectives. The second budget 
activity, for which $11,829,000 is provided, assists the 
Department in consolidating and optimizing common IT 
infrastructure services, protecting privacy, and improving 
timely and efficient services to the public.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012....................................     $83,688,000
Budget estimate, 2013...................................      85,108,000
Committee recommendation................................      83,688,000

    The Committee recommends $83,688,000 for the DOL OIG. The 
bill includes $77,790,000 in general funds and authority to 
transfer $5,898,000 from the Employment Security Administration 
account of the unemployment trust fund. In addition, an amount 
of $327,000 is available by transfer from the Black Lung 
Disability Trust Fund.
    OIG was created to protect the integrity of departmental 
programs as well as the welfare of beneficiaries served by 
those programs. Through a comprehensive program of audits, 
investigations, inspections, and program evaluations, OIG 
attempts to reduce the incidence of fraud, waste abuse, and 
mismanagement, and to promote economy, efficiency, and 
effectiveness.

                           General Provisions

    General provision bill language is included to:
    Limit the use of Job Corps funding for compensation of an 
individual that is not a Federal employee at a rate not to 
exceed Executive Level II (section 101).
    Provide for general transfer authority (section 102).
    Prohibit funding for the procurement of goods and services 
utilizing forced or indentured child labor in industries and 
host countries already identified by the Labor Department in 
accordance with Executive Order 13126 (section 103).
    Require that funds available under section 414(c) of the 
American Competitiveness and Workforce Improvement Act of 1998 
may only be used for competitive grants for training in 
occupations and industries for which employers are using H-1B 
visas to hire foreign workers (section 104).
    Limit the use of ETA funds by a recipient or subrecipient 
for compensation of an individual at a rate not to exceed 
Executive Level II (section 105).
    Prohibit the Secretary from taking any action to alter the 
procedure for redesignating local areas under subtitle B of 
title I of WIA (section 106).
    Provide the ETA with authority to transfer funds provided 
for technical assistance services to grantees to program 
administration when it is determined that those services will 
be more efficiently performed by Federal employees (section 
107).
    Allow up to 0.5 percent of discretionary appropriations 
provided in this act for all DOL agencies to be used by the 
Office of the Chief Evaluation Officer for evaluation purposes 
consistent with the terms and conditions in this act applicable 
to such office (section 108).
    Allow the Secretary to reserve up to 3 percent of funds 
available under section 272(b) of the Trade Act of 1974 to 
conduct evaluations and provide technical assistance relating 
to the activities carried out under the Community College and 
Career Training Grant program (section 109).
    Prohibit funding to promulgate, administer, enforce, or 
otherwise implement the final rules entitled ``Wage Methodology 
for the Temporary Non-Agricultural Employment H-2B Program'' 
(76 Fed. Reg. 3452 (January 19, 2011)) and ``Temporary Non-
Agricultural Employment of H-2B Aliens in the United States'' 
(77 Fed. Reg. 10038 (February 21, 2012)) (section 110).
    Transfer the claims function under several Federal statutes 
currently performed by GAO to DOL (section 111).

                                TITLE II

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

    The administration request for HHS reflects a proposal to 
increase program evaluation transfers under section 241 of the 
PHS Act from 2.5 percent to 3.2 percent. Through these 
transfers, PHS agencies contribute a percentage of their budget 
authority to fund program evaluation activities throughout the 
Department. The percentage is specified in section 205 of the 
title II general provisions.
    The Committee rejects the proposed increase to 3.2 percent 
because of concern about the effect of this proposal on PHS Act 
agencies that are used as a source of evaluation transfers, 
most notably NIH. Increasing the total amount of funding that 
is available for transfers makes it easier to provide increases 
to selected programs that fund evaluation activities or to 
supplant discretionary budget authority. For example, the 
administration proposes in fiscal year 2013 to begin funding 
the Minority HIV/AIDS Initiative entirely with program 
evaluation transfers; that program is currently funded with 
budget authority. But to programs that are the source of the 
transfers, an increase in the evaluation tap, as proposed by 
the administration, would be a de facto funding cut. With 
regard to NIH, which the administration proposes to level fund 
at $30,623,259,000, increasing the tap to 3.2 percent would 
result in a net reduction of more than $200,000,000. For this 
reason, the Committee maintains the evaluation transfer amount 
at 2.5 percent, the same level as in fiscal year 2012.
    Any references in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of HHS or the Department of HHS, 
respectively, unless otherwise noted.

              Health Resources and Services Administration

    The Committee recommendation provides $6,517,188,000 in 
this bill for HRSA, including $25,000,000 in transfers under 
section 241 of the PHS Act. In addition, the Committee 
recommends $25,000,000 in transfers from the PPH Fund.
    The total program level for HRSA in fiscal year 2013 is 
$6,542,188,000.
    The fiscal year 2012 comparable program level is 
$6,510,035,000 and the budget request is $6,382,146,000. The 
budget request includes $60,000,000 in transfers under section 
241 of the PHS Act and $10,000,000 in transfers from the PPH 
Fund.
    HRSA activities support programs to provide healthcare 
services for mothers and infants; the underserved, elderly, and 
homeless; rural residents; and disadvantaged minorities. This 
agency supports cooperative programs in community health, AIDS 
care, healthcare provider training, and healthcare delivery 
systems and facilities.

                     BUREAU OF PRIMARY HEALTH CARE

Appropriations, 2012....................................  $1,585,064,000
Budget estimate, 2013...................................   1,579,975,000
Committee recommendation................................   1,585,064,000

    The Committee recommendation for the activities of the 
Bureau of Primary Health Care is $1,585,064,000.

Community Health Centers

    The Committee provides $1,566,892,000 in this bill, the 
same as the fiscal year 2012 level, for the community health 
centers program. The budget request is $1,561,803,000.
    Combined with the $1,500,000,000 in mandatory funding 
appropriated for fiscal year 2013 in PPACA, the Committee's 
recommended program level totals $3,066,892,000.
    This group of programs includes community health centers, 
migrant health centers, healthcare for the homeless, and public 
housing health service grants. The Committee continues to 
support the ongoing effort to increase the number of people who 
have access to medical services at health centers.
    The administration proposes obligating only $1,220,000,000 
of the fiscal year 2013 mandatory funding for this program in 
fiscal year 2013, leaving $280,000,000 to be awarded in later 
years. The Committee feels strongly that the congressional 
intent of the PPACA funding for community health centers was to 
enable individuals possessing affordable health insurance for 
the first time in 2014 to have as many entry points to the 
healthcare system as possible. For that reason, the Committee 
includes a new statutory provision requiring HRSA to award all 
fiscal year 2013 funds by September 30, 2013. Such awards shall 
include $48,000,000 in base grant adjustments to ensure that 
existing centers are surviving and thriving, even as new 
centers come online.
    Within the amount provided, the Committee provides up to 
$94,893,000 under the Federal Tort Claims Act [FTCA], available 
until expended. These funds are used to pay judgments and 
settlements, occasional witness fees and expenses, and related 
administrative costs. The Committee intends FTCA coverage 
funded through this bill to be inclusive of all providers, 
activities, and services included within the health centers' 
federally approved scope of project.
    Health Care for the Homeless [HCH].--The Committee is aware 
of HRSA's intention to issue guidelines on permanent supportive 
housing. The Committee remains strongly supportive of HCH 
programs providing comprehensive healthcare services to 
residents of permanent supportive housing or other housing 
programs that are targeted to homeless populations but do not 
limit tenant length of stay.
    Hepatitis Data Collection.--The Committee commends HRSA for 
initiating data collection on hepatitis B and C testing and 
chronic hepatitis diagnoses in the Bureau of Primary Care 
Uniform Data Sets. The Committee requests a status report on 
the new hepatitis data to demonstrate disease burden and 
diagnosis rates among community health center providers in the 
fiscal year 2014 budget justification.
    Native Hawaiian Health Care.--The Committee includes 
sufficient funding in the community health centers program to 
support healthcare activities funded under the Native Hawaiian 
Health Care Program, which is specifically cited in the bill. 
The Committee expects that not less than the fiscal year 2012 
level be provided for these activities in fiscal year 2013.

Free Clinics Medical Malpractice Coverage

    The Committee provides $40,000 for payments of claims under 
the FTCA to be made available for free clinic health 
professionals as authorized by section 224(o) of the PHS Act. 
The fiscal year 2012 comparable level and the budget request 
both include $40,000 for this program. This appropriation 
extends FTCA coverage to medical volunteers in free clinics in 
order to expand access to healthcare services to low-income 
individuals in medically underserved areas.

National Hansen's Disease Program

    The Committee includes $16,045,000 for the National 
Hansen's Disease Program. This amount is the same as the fiscal 
year 2012 comparable level and the budget request. The program 
consists of inpatient, outpatient, and long-term care and 
training and research in Baton Rouge, Louisiana; a residential 
facility at Carville, Louisiana; and 11 outpatient clinic sites 
in the continental United States and Puerto Rico.

National Hansen's Disease Program Buildings and Facilities

    The Committee provides $127,000 for the repair and 
maintenance of buildings at the Gillis W. Long Hansen's Disease 
Center. This amount is the same as the fiscal year 2012 
comparable level and the budget request.

Payment to Hawaii for Hansen's Disease Treatment

    The Committee provides $1,960,000, the same amount as the 
fiscal year 2012 level and the budget request, for Hansen's 
disease services. Payments are made to the State of Hawaii for 
the medical care and treatment of persons with Hansen's disease 
in hospital and clinic facilities at Kalaupapa, Molokai, and 
Honolulu. Expenses above the level of appropriated funds are 
borne by the State of Hawaii.

                      BUREAU OF HEALTH PROFESSIONS

Appropriations, 2012....................................    $725,684,000
Budget estimate, 2013...................................     557,187,000
Committee recommendation................................     727,862,000

    The Committee recommendation for the activities of the 
Bureau of Health Professions is $727,862,000. The budget 
estimate includes $35,000,000 in transfers available under 
section 241 of the PHS Act; the Committee recommendation does 
not include those transfers. In addition, the Committee 
recommends transferring $25,000,000 to the Bureau from the PPH 
Fund.
    The total program level assumed in this bill for the Bureau 
is $752,862,000.
    The Bureau of Health Professions provides policy leadership 
and grant support for health professions workforce development. 
The mission of the Bureau is to identify shortage areas while 
working to make them obsolete. Its programs are intended to 
ensure that the Nation has the right clinicians, with the right 
skills, working where they are needed.

Training for Diversity

            Centers of Excellence
    The Committee provides $22,909,000, the same as the fiscal 
year 2012 comparable level and the budget request, for the 
Centers of Excellence Program.
    Institutions that are designated as centers of excellence 
are private institutions whose mission is to train 
disadvantaged minority health professionals for service in 
underserved areas. Funds are used for the recruitment and 
retention of students, faculty training, and institutional 
improvements.
            Health Careers Opportunity Program
    The Committee does not provide funding for the Health 
Careers Opportunity Program. The fiscal year 2012 comparable 
level is $14,822,000. The budget request eliminates funding for 
this program.
    The purpose of this program is to create an educational 
pipeline to increase the number of individuals from 
educationally or economically disadvantaged backgrounds who 
enter the health and allied health professions. The program 
provides activities for disadvantaged students through formal 
academic and research training and programming and student 
enhancement services.
    The Committee notes that the Department of Education 
provides academic and other support services to students from 
disadvantaged backgrounds. Federally funded health workforce 
development programs will also continue to promote training of 
individuals from disadvantaged backgrounds. In addition, all 
grantees under the Primary Care Training and Enhancement 
program must have recruitment and retention strategies in place 
to increase the representation of disadvantaged minority 
trainees.
            Faculty Loan Repayment
    The Committee provides $1,243,000 for the Faculty Loan 
Repayment Program. This amount is the same as the fiscal year 
2012 comparable level and the budget request.
    This program provides for the repayment of education loans 
for individuals from disadvantaged backgrounds who are health 
professions students or graduates, and who have agreed to serve 
for at least 2 years as a faculty member of a health 
professions school.
            Scholarships for Disadvantaged Students
    The Committee provides $47,452,000 for the Scholarships for 
Disadvantaged Students Program. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    This program provides grants to health professions schools 
for student scholarships to individuals who are from 
disadvantaged backgrounds and are enrolled as full-time 
students in such schools.

Primary Care Training and Enhancement

    The Committee provides $48,962,000 for Primary Care 
Training and Enhancement programs. The fiscal year 2012 
comparable level is $38,962,000 and the budget request is 
$50,962,000.
    This program supports the expansion of training in internal 
medicine, family medicine, pediatrics, and physician 
assistance. Funds may be used for developing training programs 
or providing direct financial assistance to students and 
residents. The Committee once again urges HRSA to prioritize 
the training of physician assistants and includes bill language 
allowing HRSA to determine the funding amount for this 
activity.
    The Committee is troubled that the HRSA guidance for this 
program currently prevents schools from applying for a grant 
unless they are fully accredited. Training programs cannot gain 
full accreditation until they are already up and running. By 
restricting the grant competition to training programs with 
full accreditation, HRSA is precluding one of two major goals 
of this grant program--increasing the number of new primary 
care training programs. The Committee directs HRSA to change 
its guidance in fiscal year 2013 to allow funds to be used to 
develop a training program and apply for accreditation.

Pediatric Loan Repayment

    The Committee does not include funding, requested in the 
President's budget, to create a new loan repayment program for 
pediatricians authorized in section 523 of PPACA. The budget 
request includes $5,000,000 for this initiative.

Training in Oral Health Care

    The Committee recommends $32,392,000 for Training in Oral 
Health Care programs, the same as the fiscal year 2012 
comparable level and the budget request.
    These programs support a variety of training opportunities 
in the field of oral health. Funds may be used to expand 
training in general dentistry, pediatric dentistry, public 
health dentistry, dental hygiene, and other oral health 
programs. Funds may be used to plan and operate training 
programs, as well as to provide financial assistance to 
students and residents.
    The Committee notes that there are over 200 dental faculty 
vacancies in the United States. Therefore, the Committee 
intends that the general and the pediatric dentistry loan 
repayment programs should receive $8,000,000 each.

Interdisciplinary, Community-Based Linkages

            Area Health Education Centers
    The Committee provides $27,220,000, the same as the fiscal 
year 2012 comparable level, for AHECs. The budget request 
eliminates funding for this program.
    AHECs link university health science centers with community 
health service delivery systems to provide training sites for 
students, faculty, and practitioners. The program supports 
three types of projects: core grants to plan and implement 
programs; special initiative funding for schools that have 
previously received AHEC grants; and model programs to extend 
AHEC programs with 50 percent Federal funding.
    The Committee recognizes the importance of community health 
workers in addressing the health needs of individuals who may 
not have access to regular healthcare services. The AHEC 
community training model provides a uniquely appropriate 
opportunity to bring the training of community health workers 
to scale. HRSA is encouraged to provide technical assistance on 
and disseminate best practices for training community health 
workers to existing AHECs.
            Mental and Behavioral Health
    The Committee provides $2,892,000, the same as the fiscal 
year 2012 comparable level, for Mental and Behavioral Health 
programs. The budget request for fiscal year 2013 is 
$7,892,000, including $5,000,000 in transfers available under 
section 241 of the PHS Act.
    These programs provide grants to higher education 
institutions and accredited training programs to recruit and 
train professionals and faculty in the fields of social work, 
psychology, psychiatry, marriage and family therapy, substance 
abuse prevention and treatment, and other areas of mental and 
behavioral health.
    Graduate Psychology Education grants train psychology 
graduate students to provide supervised behavioral and mental 
health services to underserved populations. With significant 
numbers of returning war veterans and a rapidly growing 
generation of elderly, the Nation's mental health 
infrastructure is certain to experience increased strain for 
years to come as individuals and their families increasingly 
turn to behavioral healthcare professionals in local 
communities. The Committee supports efforts to help integrate 
psychology trainees at Federally Qualified Health Centers to 
provide behavioral and mental health services to underserved 
populations, particularly those in rural America.
            Geriatric Education
    The Committee provides $30,629,000 for geriatric education 
programs. This amount is the same as the fiscal year 2012 
comparable level and the budget request.
    Geriatric programs include: geriatric education centers, 
the Geriatric Academic Career Awards program, and the Geriatric 
Training for Physicians, Dentists, and Behavioral and Mental 
Health Professionals program.
    The Committee commends HRSA for recognizing the immediacy 
of the eldercare workforce crisis by identifying ``enhancing 
geriatric/elder care training and expertise'' as a top priority 
in the fiscal year 2013 budget justification. The Nation's 
health professions must be prepared to meet the unique and 
often complex health needs of America's older adults. This is 
especially critical in primary care settings. The Committee 
requests that HRSA provide a report detailing how geriatric 
training content is being integrated into primary care training 
in HRSA-supported institutions.
            Health Professions Workforce Information and Analysis
    The Committee recommends $7,782,000 for health professions 
workforce information and analysis. The fiscal year 2012 
comparable level is $2,782,000. The budget request does not 
include new budget authority but proposes $10,000,000 in 
transfers available under section 241 of the PHS Act.
    The program provides for the collection and analysis of 
targeted information on the Nation's healthcare workforce, 
research on high-priority workforce questions, the development 
of analytic and research infrastructure, and program evaluation 
and assessment.

Public Health and Preventive Medicine Training Programs

    The Committee provides $35,111,000 for public health and 
preventive medicine training programs, including $10,111,000 in 
budget authority and $25,000,000 in transfers from the PPH 
Fund. The fiscal year 2012 comparable level is $8,111,000 in 
budget authority and $25,000,000 in funding from the PPH Fund. 
The budget request includes $9,609,000 in budget authority and 
$10,000,000 from the PPH Fund.
    The Committee recommendation includes $5,420,000 for 
preventive medicine residencies and $5,000,000 for integrative 
medicine residencies. The fiscal year 2012 level for 
integrative medicine residencies is $3,000,000. The increase 
provided in the Committee recommendation is intended to expand 
the national technical assistance and evaluation activities.
    These programs support awards to schools of medicine, 
osteopathic medicine, and public health to provide for 
residency training programs in preventive medicine and public 
health, and for financial assistance to trainees enrolled in 
such programs.

Nursing Workforce Development Programs

    The Committee provides $231,099,000, the same amount as the 
fiscal year 2012 level, for nursing workforce development 
programs. The budget request is $231,099,000 in budget 
authority and an additional $20,000,000 in transfers available 
under section 241 of the PHS Act.
    The Committee recommendation includes the following 
programs at the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Advanced Education Nursing......................................          63,925          63,925          63,925
Advanced Education Nursing--Section 241 transfer................  ..............          20,000  ..............
Nurse Education, Practice, and Retention........................          39,182          39,182          39,182
Nursing Workforce Diversity.....................................          15,819          15,819          15,819
Nurse Loan Repayment and Scholarship Program....................          83,135          83,135          83,135
Nurse Faculty Loan Program......................................          24,553          24,553          24,553
Comprehensive Geriatric Education...............................           4,485           4,485           4,485
----------------------------------------------------------------------------------------------------------------


    Within funds available for the Nursing Education and 
Retention program, the Committee intends that no less than 
$5,000,000 be awarded to nurse-managed health centers.
    The Committee is concerned that many nursing education and 
training programs are unable to guarantee required clinical 
placements to students who have completed the appropriate 
classroom work. These individuals remain full-time students 
longer than otherwise necessary, accumulating more student loan 
debt, while they await placement for their required clinical 
rotation. The Committee directs HRSA to prioritize applications 
for nursing education and training programs that provide 
incoming freshman students with a guarantee of high-quality 
clinical placements in hospitals, nursing homes, visiting nurse 
programs, and other care settings during their junior and 
senior years of study.

Children's Hospitals Graduate Medical Education

    The Committee provides $265,171,000, the same as the fiscal 
year 2012 level, for the CHGME program. The budget request is 
$88,000,000.
    The program provides support for graduate medical education 
training programs in both ambulatory and in-patient settings 
within freestanding children's teaching hospitals. CHGME 
payments are determined by a per-resident formula that includes 
an amount for direct training costs added to a payment for 
indirect costs. Payments support training of resident 
physicians as defined by Medicare in both ambulatory and 
inpatient settings.
    The Committee recognizes the program's contributions to the 
future pediatric workforce and children's healthcare. The 56 
freestanding children's hospitals receiving CHGME funding train 
40 percent of all general pediatric residents and 43 percent of 
all pediatric specialty residents.

National Practitioner Data Bank

    The Committee provides $28,016,000 for the National 
Practitioner Data Bank. This amount is the same as the fiscal 
year 2012 comparable level and the budget request. As in 
previous years, bill language is included to ensure that user 
fees are collected to cover all costs of processing requests 
and providing such information to data bank users.
    The National Practitioner Data Bank collects certain 
adverse information, medical malpractice payment history, and 
information related to healthcare fraud and abuse. The data 
bank is open to healthcare agencies and organizations that make 
licensing and employment decisions.

                    MATERNAL AND CHILD HEALTH BUREAU

Appropriations, 2012....................................    $853,355,000
Budget estimate, 2013...................................     854,807,000
Committee recommendation................................     854,807,000

    The Committee recommendation for the MCH Bureau is 
$854,807,000.
    The mission of the Bureau is to improve the physical and 
mental health, safety, and well-being of the Nation's women, 
infants, children, adolescents, and their families. This 
population includes fathers and children with special 
healthcare needs.

Maternal and Child Health Block Grant

    The Committee provides $640,098,000, the same as the budget 
request, for the MCH block grant. The fiscal year 2012 
comparable level is $638,646,000.
    The MCH block grant program provides a flexible source of 
funding that allows States to target their most urgent maternal 
and child health needs. The program supports a broad range of 
activities including providing prenatal care, well child 
services, and immunizations; reducing infant mortality; 
preventing injury and violence; expanding access to oral 
healthcare; addressing racial and ethnic disparities; and 
providing comprehensive care through clinics, home visits, and 
school-based health programs.
    The Committee includes bill language requiring that the 
State grant portion of the block grant be funded at no less 
than $556,333,000. The fiscal year 2012 comparable level is 
$549,729,000 and the budget request is $551,181,000.
    The Committee includes bill language identifying 
$62,634,000 for the Title V SPRANS set-aside. Within that 
total, the Committee recommendation includes sufficient funding 
to continue the set-asides for oral health, epilepsy, sickle 
cell anemia, and fetal alcohol syndrome at no less than fiscal 
year 2012 levels.
    Healthy Homes Activities.--The Committee is encouraged by 
recent meetings between HRSA and CDC to expand healthy homes 
activities within maternal and child health programs that have 
a home visiting focus. The Committee urges HRSA and CDC to 
continue to work collaboratively on this effort and requests an 
update on progress within 90 days of enactment of this act.
    Perinatal Hepatitis B.--The Committee is concerned by high 
rates of mother-to-child transmission of hepatitis B in the 
United States. Given the large number of at-risk women being 
seen in HRSA-funded health settings, the Committee requests a 
report within 6 months of enactment of this act that includes 
best practices for how to eliminate perinatal hepatitis B 
transmission.
    Pregnancy Risk Prevention.--The Committee strongly supports 
efforts to provide women and healthcare providers with 
information about prenatal exposures to medications, chemicals, 
radiation, infections, and other substances. Access to this 
information can reduce the incidence of preventable birth 
defects, prematurity, or complications of pregnancy that limit 
quality of life and increase costs in our healthcare system.
    Vision and Eye Health.--The Committee is concerned that 1 
in 4 school-aged children has a vision problem significant 
enough to affect learning. Many serious ocular conditions in 
children are treatable if diagnosed at an early stage. The 
Committee encourages HRSA to continue to support the 
development of a public health infrastructure to promote a 
comprehensive continuum of vision care for children through 
strong partnerships, sound science, and targeted policy 
initiatives.

Sickle Cell Anemia

    The Committee provides $4,665,000 for the sickle cell 
anemia demonstration program. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    This program provides grants and contracts to help 
coordinate service delivery for individuals with sickle cell 
disease, including genetic counseling and testing; training of 
health professionals; and coordination of education, treatment, 
and continuity of care programs for individuals with sickle 
cell disease.

Traumatic Brain Injury

    The Committee provides $9,760,000 for the Traumatic Brain 
Injury program. This amount is the same as the fiscal year 2012 
comparable level and the budget request.
    The program supports implementation and planning grants to 
States for coordination and improvement of services to 
individuals and families with traumatic brain injuries. Such 
services can include: pre-hospital care, emergency department 
care, hospital care, rehabilitation, transitional services, 
education, employment, long-term support, and protection and 
advocacy services.
    The Committee includes no less than the fiscal year 2012 
funding level for protection and advocacy services, as 
authorized under section 1305 of Public Law 106-310.

Autism and Other Developmental Disorders

    The Committee provides $47,142,000 for the Autism and Other 
Developmental Disorders initiative. This amount is the same as 
the fiscal year 2012 comparable level and the budget request.
    The program supports surveillance, early detection, 
education, and intervention activities on autism and other 
developmental disorders, as authorized in the Combating Autism 
Act of 2006.
    The Committee directs HRSA to fund research on evidence-
based practices for interventions for individuals with autism 
and other developmental disabilities, for development of 
guidelines for those interventions, and for information 
dissemination at no less than fiscal year 2012 levels.

Newborn Screening for Heritable Disorders

    The Committee provides $9,834,000 for the newborn heritable 
disorders screening program, as described in section 1109 of 
the Newborn Screening Saves Lives Act of 2008. The fiscal year 
2012 comparable level and the budget request are also 
$9,834,000.
    This program provides funding to improve States' ability to 
provide newborn and child screening for heritable disorders. 
Newborn screening provides early identification and follow-up 
for treatment of infants affected by certain genetic, 
metabolic, hormonal, and/or functional conditions.
    The Committee encourages HRSA to collaborate with and 
support non-governmental entities that help educate and support 
States as they consider expanding their screening panels. The 
Committee believes that this activity is beneficial to the 
existing efforts of HRSA.

Healthy Start

    The Committee provides $103,532,000 for the Healthy Start 
infant mortality initiative. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    The primary purpose of Healthy Start is to reduce infant 
mortality by 50 percent and generally improve maternal and 
infant health in at-risk communities. Grants are awarded to 
State and local health departments and nonprofit organizations 
to conduct an infant mortality review, develop a package of 
innovative health and social services for pregnant women and 
infants, and evaluate these efforts.
    The Committee continues to encourage HRSA to support 
efforts to evaluate and address racial disparities in 
stillbirth and sudden unexpected infant deaths.
    The Committee expects HRSA to give full and fair 
consideration to all applicants, including grantees with 
expiring or recently expired project periods.

Universal Newborn Hearing Screening and Early Intervention

    The Committee provides $18,660,000 for universal newborn 
hearing screening and early intervention activities. This 
amount is the same as the fiscal year 2012 comparable level and 
the budget request.
    This program awards grants to 53 States and territories 
that support statewide systems of newborn hearing screening, 
audiologic diagnostic testing before 3 months of age, and 
enrollment in early intervention programs before the age of 6 
months.

Emergency Medical Services for Children

    The Committee provides $21,116,000 for the Emergency 
Medical Services for Children [EMSC] program. This amount is 
the same as the fiscal year 2012 comparable level and the 
budget request.
    The EMSC program makes funding available to every State EMS 
office to improve emergency care for children and to pay for 
research and dissemination of best practices.
    The Committee is particularly concerned by the low 
availability of pediatric emergency medical services in rural 
and remote areas and urges HRSA to give priority to applicants 
who propose a focus on populations in these areas. To the 
extent possible, HRSA should work with other Federal agencies 
that have an interest in expanding emergency systems in rural 
and remote areas.

                            HIV/AIDS BUREAU

Appropriations, 2012....................................  $2,392,178,000
Budget estimate, 2013...................................   2,471,772,000
Committee recommendation................................   2,422,178,000

    The Committee recommendation includes $2,422,178,000 for 
the HIV/AIDS Bureau, including $25,000,000 in transfers under 
section 241 of the PHS Act.
    The mission of the Bureau is to address the unmet care and 
treatment needs of persons living with HIV/AIDS who are 
uninsured or underinsured. The Bureau administers the Ryan 
White Care Act, which provides a wide range of community-based 
services, including primary and home healthcare, case 
management, substance abuse treatment, mental health services, 
and nutritional services.

Emergency Assistance

    The Committee provides $666,071,000, the same as the fiscal 
year 2012 level, for emergency assistance grants to eligible 
metropolitan areas disproportionately affected by the HIV/AIDS 
epidemic. The budget request is $671,258,000.
    Grants are provided to metropolitan areas meeting certain 
criteria. Two-thirds of the funds are awarded by formula, and 
the remainder is awarded through supplemental competitive 
grants.

Comprehensive Care Programs

    The Committee provides $1,390,827,000 for HIV healthcare 
and support services. The fiscal year 2012 comparable level is 
$1,360,827,000 and the budget request is $1,422,341,000.
    Funds are awarded to States to support HIV service delivery 
consortia, the provision of home- and community-based care 
services for individuals with HIV disease, continuation of 
health insurance coverage for low-income persons with HIV 
disease, and support for State AIDS drug assistance programs.
    The Committee includes bill language providing $963,299,000 
for AIDS medications in ADAP. The fiscal year 2012 comparable 
level is $933,299,000 and the budget request is $1,000,000,000. 
The Committee intends that the increase provided for ADAP be 
awarded according the statutory formula. The Committee 
encourages HRSA to engage in a process with States to determine 
the best allocation for the past emergency funds based upon the 
growth of the program and cost containment measures in place as 
of January 1, 2013.

Early Intervention Services

    The Committee provides $215,086,000, the same as the fiscal 
year 2012 level, for early intervention grants. The budget 
request is $235,564,000.
    Funds are awarded competitively to primary healthcare 
providers to enhance healthcare services available to people at 
risk of HIV and AIDS. Funds are used for comprehensive primary 
care, including counseling, testing, diagnostic, and 
therapeutic services.

Children, Youth, Women, and Families

    The Committee provides $77,167,000, the same as the fiscal 
year 2012 level, for grants for coordinated services and access 
to research for women, infants, children, and youth. The budget 
request is $69,582,000.
    Funds are awarded to community health centers, family 
planning agencies, comprehensive hemophilia centers, county and 
municipal health departments, and other nonprofit community-
based programs that provide comprehensive primary healthcare 
services to populations with or at risk for HIV.

AIDS Dental Services

    The Committee provides $13,485,000 for AIDS Dental 
Services. This amount is the same as the fiscal year 2012 
comparable level and the budget request.
    This program provides grants to dental schools, dental 
hygiene schools, and postdoctoral dental education programs to 
assist with the cost of providing unreimbursed oral healthcare 
to patients with HIV.

AIDS Education and Training Centers

    The Committee provides $34,542,000 for the AIDS Education 
and Training Centers [AETCs]. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    AETCs train healthcare practitioners, faculty, and students 
who care for AIDS patients outside of the traditional health 
professions education venues and support curriculum development 
on the diagnosis and treatment of HIV infection for health 
professions schools and training organizations.

                       HEALTH CARE SYSTEMS BUREAU

Appropriations, 2012....................................     $82,534,000
Budget estimate, 2013...................................      82,534,000
Committee recommendation................................      82,534,000

    The Committee recommendation for the Health Care Systems 
Bureau is $82,534,000.
    The Health Care Systems Bureau protects the public health 
and improves the health of individuals through efforts to 
support and enhance the systems by which healthcare is 
delivered in America.

Organ Donation and Transplantation

    The Committee provides $24,015,000 for organ donation and 
transplantation activities. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    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. A portion of the appropriated funds may 
be used to educate the public and health professionals about 
organ donations and transplants and to support agency staff 
providing clearinghouse and technical assistance functions.
    The Committee encourages the Division of Transplantation 
and the United Network for Organ Sharing to continue their 
dialogue with experts regarding the methodology used to 
determine lung transplantation eligibility for pulmonary 
hypertension patients.

National Cord Blood Inventory

    The Committee provides $11,887,000 for the National Cord 
Blood Inventory. This amount is the same as the fiscal year 
2012 comparable level and the budget request.
    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.

C.W. Bill Young Cell Transplantation Program

    The Committee provides $23,330,000 for the C.W. Bill Young 
Cell Transplantation Program. This amount is the same as the 
fiscal year 2012 comparable level and the budget request.
    The Committee continues to strongly support cell 
transplantation through the use of cord blood, bone marrow, 
peripheral blood stem cells, and other sources of adult stem 
cells that may be available in the future. The Committee 
appreciates HRSA's efforts to increase the diversity of the 
registry and the program's research efforts to improve the 
availability, efficiency, safety, and cost of transplants and 
the effectiveness of program operations.

Office of Pharmacy Affairs

    The Committee provides $4,472,000 for the Office of 
Pharmacy Affairs. This amount is the same as the fiscal year 
2012 comparable level and the budget request.
    The Office of Pharmacy Affairs administers the 340B Drug 
Pricing program, which requires drug manufacturers to provide 
discounts or rebates to a set of programs and hospitals that 
serve a disproportionate share of low-income patients.
    The Committee remains strongly committed to the Office's 
plans to develop a transparent system to verify the accuracy of 
the 340B ceiling price. Therefore, the Committee includes a 
statutory provision, requested by the administration, to allow 
a nominal cost recovery fee to fund the implementation of 
program integrity provisions recommended by the Inspector 
General and included in PPACA. The fee will be set at 0.1 
percent for covered entities and is expected to generate 
$6,000,000 in fiscal year 2013. The Committee expects HRSA to 
report the expected and actual amounts generated by the fee in 
HRSA's annual budget justification.
    Audit Procedure.--The Committee commends HRSA for 
conducting audits of covered entities and recertifying 
eligibility for all program participants in an effort to ensure 
340B program integrity. The Committee is aware that HRSA 
recently published a program notice that referenced an audit 
protocol to be made public at a later date. Given that the 
audit process is well underway, the Committee urges HRSA to 
make public information on the general audit process, including 
areas of review, as soon as possible and consider suspending 
audits until this information is publicly available.

Poison Control Centers

    The Committee provides $18,830,000 for poison control 
center activities. This is the same amount as the fiscal year 
2012 comparable level and the budget request.
    The Poison Control Centers program currently supports a mix 
of grantees. Most serve States; a few serve multistate regions; 
and, in a handful of cases, more than one grantee serves a 
single State.
    The Committee notes that poisoning is now the leading cause 
of injury death, with rates higher than that of car accidents. 
Treatment guidance for over 70 percent of poison exposures can 
be provided over the phone. Providing services over the phone 
reduces emergency department visits, ambulance use, and 
hospital admissions, resulting in a savings of $7 for every $1 
spent on poison control centers. For that reason, the Committee 
is strongly supportive of ensuring that all citizens have 
access to poison control hotlines.

                              RURAL HEALTH

Appropriations, 2012....................................    $138,172,000
Budget estimate, 2013...................................     122,232,000
Committee recommendation................................     144,072,000

    The Committee recommendation for rural health programs is 
$144,072,000.
    The Office of Rural Health Policy [ORHP] administers HHS 
rural health programs, coordinates activities related to rural 
healthcare within HHS, and analyzes the possible effects of 
policy on 62 million residents of rural communities. ORHP 
advises the Secretary on the effects of Medicare and Medicaid 
on rural citizens' access to care, the viability of rural 
hospitals, and the availability of physicians and other health 
professionals.

Rural Healthcare Services Outreach Grants

    The Committee provides $57,553,000 for rural health 
outreach grants. The fiscal year 2012 comparable level and the 
budget request are $55,553,000. This program supports projects 
that demonstrate new and innovative models of outreach in rural 
areas, such as integration and coordination of health services.
    The Committee recommendation includes $2,000,000 to 
replicate successful models of oral healthcare delivery. Such 
models should focus on diverting care from emergency rooms, 
disease management, and prevention of early childhood caries.

Rural Health Research

    The Committee provides $9,866,000 for the Rural Health 
Research program. This amount is the same as the fiscal year 
2012 comparable level and the budget request.
    Funds are used for rural health research centers, the 
National Advisory Committee on Rural Health, and a reference 
and information service. Supported activities focus on 
improving the delivery of health services to rural communities 
and populations.

Rural Hospital Flexibility Grants

    The Committee provides $41,040,000, the same as the fiscal 
year 2012 level, for rural hospital flexibility grants. The 
budget request is $26,200,000.
    Under this program, HRSA works with States to provide 
support and technical assistance to critical access hospitals 
to focus on quality and performance improvement and to 
integrate emergency medical services.
    The Committee commends HRSA for its work on telehealth and 
electronic health records in rural hospitals, with a focus on 
mental healthcare for veterans. The Committee understands that 
the grant cycle is completed, and has modified the bill 
language to give HRSA flexibility to determine future needs in 
this area.

Rural Access to Emergency Devices

    The Committee provides $5,000,000 for rural access to 
emergency devices. The fiscal year 2012 comparable level is 
$1,100,000. The budget request eliminates funding for this 
program.
    Funding is used to purchase automated external 
defibrillators, place them in public areas where cardiac 
arrests are likely to occur, and train lay rescuers and first 
responders in their use.

State Offices of Rural Health

    The Committee provides $10,036,000 for State Offices of 
Rural Health. This amount is the same as the fiscal year 2012 
comparable level and the budget request.
    These offices help States strengthen rural healthcare 
delivery systems by enabling them to coordinate care and 
improve support and outreach in rural areas.

Black Lung Clinics

    The Committee provides $7,140,000 for black lung clinics. 
This amount is the same as the fiscal year 2012 comparable 
level and the budget request.
    This program funds clinics that treat respiratory and 
pulmonary diseases of active and retired coal miners, steel 
mill workers, agricultural workers, and others with 
occupationally related respiratory and pulmonary impairments. 
These clinics reduce the incidence of high-cost inpatient 
treatment for these conditions.

Radiation and Exposure Screening and Education Program

    The Committee provides $1,935,000 for activities authorized 
by the Radiation Exposure Compensation Act. This amount is the 
same as the fiscal year 2012 comparable level and the budget 
request.
    This program provides grants for the education, prevention, 
and early detection of radiogenic cancers and diseases 
resulting from exposure to uranium during mining and milling at 
nuclear test sites.

Telehealth

    The Committee provides $11,502,000 for telehealth 
activities. This amount is the same as the fiscal year 2012 
comparable level and the budget request.
    The Telehealth program promotes the effective use of 
technologies to improve access to health services for people 
who are isolated from healthcare and to provide distance 
education for health professionals.

                            FAMILY PLANNING

Appropriations, 2012....................................    $293,870,000
Budget estimate, 2013...................................     296,838,000
Committee recommendation................................     293,870,000

    The Committee provides $293,870,000 for the title X family 
planning program.
    The title X program supports preventive and primary 
healthcare services at clinics nationwide through four key 
functions: (1) providing individuals with comprehensive family 
planning and related preventive health services, including all 
FDA-approved methods of contraception; (2) training for family 
planning clinic personnel; (3) data collection and research 
aimed at improving the delivery of services; and (4) 
information dissemination and community-based education and 
outreach activities.
    Comprehensive Services.--The Committee is aware that title 
X clinics have been denied designation as National Health 
Service Corps sites, under the reasoning that they do not 
provide referral to comprehensive primary care services. 
However, the Committee notes that all title X grantees are 
required to certify that they provide, or provide referral to, 
a full range of primary care services. If HRSA is sufficiently 
satisfied that a title X clinic provides ``comprehensive 
primary care services'', the Committee believes that that 
should satisfy the identical requirement in other HRSA 
programs. The Committee directs HRSA to align the definition of 
``comprehensive primary care services'' in title X and the 
National Health Service Corps. In addition, the Committee 
directs the Secretary to provide guidance to title X-only 
funded grantees about how to meet the requirements to receive 
assignment of National Health Service Corps personnel.
    Program Guidance.--The Committee supports efforts to review 
and update the title X program guidance and administrative 
directives. In particular, the Committee requests that the 
guidance clarify that title X funds may be used for clinic 
training on and implementation of information technology 
systems, including electronic medical records. The Secretary is 
encouraged to complete the guideline revisions in 2012 to 
enable the publicly supported family planning network to 
sufficiently prepare for the changing healthcare delivery 
system.

                           PROGRAM MANAGEMENT

Appropriations, 2012....................................    $159,894,000
Budget estimate, 2013...................................     162,517,000
Committee recommendation................................     162,517,000

    The Committee provides $162,517,000 for program management 
activities.

               HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

Appropriations, 2012....................................      $2,807,000
Budget estimate, 2013...................................       2,807,000
Committee recommendation................................       2,807,000

    The Committee recommends $2,807,000 for the Health 
Education Assistance Loan [HEAL] program.
    The Committee includes a general provision (section 522) to 
transfer the administration of the HEAL program to the 
Department of Education, as requested by the administration.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2012....................................    $241,477,000
Budget estimate, 2013...................................     241,477,000
Committee recommendation................................     241,477,000

    The Committee provides that $241,477,000 be released from 
the vaccine injury compensation trust fund in fiscal year 2013. 
Of that amount, $6,477,000 is for administrative costs.
    The National Vaccine Injury Compensation program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and death 
benefits. The vaccine injury compensation trust fund is funded 
by excise taxes on certain childhood vaccines.

               Centers for Disease Control and Prevention

    The Committee recommendation provides $6,140,413,000 in 
this bill for CDC, including $371,357,000 in transfers under 
section 241 of the PHS Act and $55,358,000 in mandatory funds 
under the terms of EEOICPA. In addition, the Committee 
recommends $858,000,000 in transfers from the PPH Fund.
    The total program level for CDC in fiscal year 2013 is 
$6,998,413,000.
    The fiscal year 2012 comparable program level is 
$6,937,385,000 and the budget request is $6,715,419,000. The 
budget request includes $667,503,000 in transfers under section 
241 of the PHS Act and $903,210,000 in transfers from the PPH 
Fund.
    The activities of CDC focus on several major priorities: 
providing core public health functions; responding to urgent 
health threats; monitoring the Nation's health using sound 
scientific methods; building the Nation's health 
infrastructure; assuring the Nation's preparedness for emerging 
infectious diseases and potential pandemics; and providing 
leadership in the implementation of nationwide prevention 
strategies that are conducive to good health.

                 IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2012....................................    $588,947,000
Budget estimate, 2013...................................     597,620,000
Committee recommendation................................     588,947,000

    The Committee recommendation for the activities of the 
National Center for Immunization and Respiratory Diseases is 
$588,947,000; this amount includes $12,864,000 in transfers 
available under section 241 of the PHS Act. In addition, the 
Committee recommends transferring $190,000,000 to the Center 
from the PPH Fund.
    The total program level recommended for the Center is 
$778,947,000.
    The mission of the National Center for Immunization and 
Respiratory Diseases is the prevention of disease, disability, 
and death through immunization and by control of respiratory 
and related diseases.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Section 317 Immunization Program................................         367,870         426,839         367,870
Immunization Program--PPH Fund..................................         190,000          72,460         190,000
Program Implementation and Accountability.......................          62,302          62,887          62,302
    National Immunization Survey--Section 241 transfer (non-add)          12,864          13,765          12,864
Influenza Planning and Response.................................         158,775         107,894         158,775
Influenza Planning and Response--Transfer from Public Law 111-32  ..............          51,049  ..............
----------------------------------------------------------------------------------------------------------------

    Healthcare Workers.--The Committee is aware that healthcare 
workers are at high risk during seasonal influenza epidemics 
and periodic influenza pandemics. Yet, this is when their work 
is most needed. The Committee recommends that CDC work in 
partnership with CMS to ensure that all healthcare workers 
receive the annual influenza vaccination.
    Immunization Infrastructure.--The Committee strongly 
supports investments in strengthening the systems around 
immunization delivery, and encourages CDC to develop further 
strategies to (1) modernize immunization information systems; 
(2) prepare public health departments for changes in the 
healthcare delivery system, including new billing procedures 
related to privately insured patients; and (3) strengthen the 
evidence base to inform immunization policy and program 
monitoring.
    Immunization Registries.--The Committee remains concerned 
about the low rate of adult immunizations. The Committee urges 
CDC to continue supporting States that wish to establish and 
expand their use of immunization registries, with a particular 
focus on improving information sharing about patients' 
vaccination histories across different providers and generating 
reminders to providers and patients about recommended 
vaccinations, especially for adults.
    Section 317 Immunization Program.--The Committee recognizes 
that high rates of childhood immunization coverage are 
important for reducing child mortality and saving costs over a 
lifetime. For every $1 spent on the childhood series of 
vaccines, $10.20 is saved. Therefore, the Committee transfers 
$190,000,000 from the PPH Fund for the section 317 immunization 
program. The additional funding will allow more recommended 
immunizations to be available through the existing network of 
private and public immunization providers, and support and 
expand the network as needed.
    The Committee requests an updated report on the section 317 
program no later than February 1, 2013, to reflect fiscal year 
2014 cost estimates for the program, optimum funding to support 
State and local operations, and a discussion of the evolving 
role of the program as expanded coverage for vaccination 
becomes more available from private and public sources.
    Vaccine Adverse Event Reporting System [VAERS].--The 
Committee understands that a strong vaccine safety monitoring 
system is essential to ensure that our Nation's vaccines are 
safe, and to ensure the success of the national immunization 
program and a low incidence of vaccine-preventable diseases. 
VAERS, a national spontaneous reporting system co-administered 
by CDC and FDA, requires healthcare providers and vaccine 
manufacturers to voluntarily report certain vaccine adverse 
events to VAERS, accepts voluntary reports from the public, and 
requires this information be made available to the public. The 
Committee directs CDC and FDA to communicate with physicians 
about the importance of reporting vaccine adverse events, 
regardless of whether those events are already part of the 
Vaccine Injury Table.

 HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS 
                               PREVENTION

Appropriations, 2012....................................  $1,099,934,000
Budget estimate, 2013...................................   1,145,678,000
Committee recommendation................................   1,101,934,000

    The Committee recommendation for the activities of the 
National Center for HIV, Viral Hepatitis, Sexually Transmitted 
Diseases [STDs], and TB Prevention is $1,101,934,000. In 
addition, the Committee recommends transferring $10,000,000 to 
the Center from the PPH Fund.
    The total program level recommended for the Center is 
$1,111,934,000.
    Established in 1994, the Center brings together the CDC's 
work on HIV/AIDS, viral hepatitis, STDs, and TB, with the 
exception of the Global AIDS program, which is housed in the 
Center on Global Health.
    The Committee includes a modified version of a provision 
requested by the administration to give flexibility for CDC and 
the States to support cross-program coordination activities 
with 10 percent of the HIV prevention, TB, STI, and viral 
hepatitis funding streams. The Committee provision limits the 
flexibility to HIV prevention and TB funds for two reasons: 
first, there is a drastically smaller amount of funding 
available in viral hepatitis; and second, the Committee 
believes that STI funding is already authorized to support 
cross-cutting activities across a variety of sexually 
transmitted infections.
    The Committee recommends funding for the following 
activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research (total)...............         786,176         826,407         786,176
    HIV Prevention by Health Departments........................         392,636         402,447         392,636
    National Programs to Improve HIV Program Effectiveness......         363,702         384,026         363,702
    School Health--HIV..........................................          29,838          39,934          29,838
Viral Hepatitis.................................................          19,672          29,694          19,672
Viral Hepatitis Screening--PPH Fund.............................          10,000  ..............          10,000
Sexually Transmitted Infections.................................         153,788         153,886         155,788
Tuberculosis....................................................         140,298         135,691         140,298
----------------------------------------------------------------------------------------------------------------

    Within funds provided for national activities in HIV 
prevention, the Committee intends that CDC spend no less than 
last year's level on surveillance activities.
    The Committee urges CDC to use the additional flexibility 
provided by the Committee in health department prevention 
funding to increase testing rates across the country.
    Division of Viral Hepatitis.--The Committee intends that 
funding be used to continue CDC's viral hepatitis screening and 
testing initiatives, in support of the HHS goal to identify 65 
percent to 75 percent of chronically infected persons who do 
not know their status. The Committee acknowledges the need to 
build an evidence base of effectiveness, and encourages the 
Division to ensure that outcomes continuously inform activities 
undertaken in the field. The Committee encourages CDC to focus 
on best practices that can be replicated in various 
jurisdictions with varying levels of resources.
    Hepatitis Screening Guidelines.--The Committee notes that 
hepatitis B and hepatitis C testing guidelines are not aligned 
across HHS operating divisions, and expects CDC to work 
expeditiously with ASH, AHRQ, and the USPSTF to develop 
consistent national testing guidelines by January 1, 2013, to 
improve testing rates. In particular, hepatitis B guidelines 
should focus on the dramatic health disparity impacting the 
U.S. Asian and Pacific Islander populations and hepatitis C 
guidelines should address the prevalence of the disease in the 
baby boomer population.
    Infertility Prevention Program.--The Committee bill 
provides a $2,000,000 increase in the Infertility Prevention 
Program. Chlamydia is the most commonly reported STD in the 
United States, yet remains under-reported due to a lack of 
symptoms in most cases. It is entirely curable with simple 
antibiotics. Left untreated, chlamydia damages reproductive 
organs and can lead to infertility, ectopic pregnancies, and 
increased risk of acquiring HIV. Routine screening is critical 
for preventing the spread of this silent disease. The Committee 
strongly supports the partnership between State departments of 
public health and clinics that have a strong focus on 
reproductive health.
    Rapid Testing.--The Committee notes that the use of rapid 
tests significantly increases the percentage of persons with 
newly identified HIV who receive their testing results. The 
Committee encourages CDC to continue expanding the use of rapid 
HIV tests.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2012....................................    $252,476,000
Budget estimate, 2013...................................     279,477,000
Committee recommendation................................     269,274,000

    The Committee recommendation for the activities of the 
National Center for Emerging and Zoonotic Diseases is 
$269,274,000. In addition, the Committee recommends 
transferring $51,750,000 to the Center from the PPH Fund.
    The total program level recommended for the Center is 
$321,024,000.
    The National Center for Emerging and Zoonotic Infectious 
Diseases aims to detect, prevent, and control infectious 
diseases from spreading, whether they are naturally occurring, 
unintentional, or the result of terrorism.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Vector-Borne Diseases...........................................          23,083  ..............          23,083
Lyme Disease....................................................           8,717  ..............           8,717
Food Safety.....................................................          27,113          43,848          43,848
Prion Disease...................................................           4,969  ..............           4,969
Chronic Fatigue Syndrome........................................           4,707  ..............           4,707
Emerging Infectious Diseases....................................         123,359         182,232         123,359
Epidemiology and Laboratory Capacity Program--PPH Fund..........          40,000          40,000          40,000
National Healthcare Safety Network..............................          14,840          27,468          14,840
Healthcare-Associated Infections--PPH Fund......................          11,750          11,750          11,750
Quarantine......................................................          25,866          25,929          25,929
----------------------------------------------------------------------------------------------------------------

    Antibiotic Resistance.--The Committee commends CDC's 
antimicrobial stewardship efforts, such as the GetSmart 
program, but remains concerned about the lack of available data 
on both resistance trends and antibiotic use in the United 
States for both humans and animals. The Committee requests a 
report from CDC, in coordination with its partners on the 
Interagency Task Force on Antimicrobial Resistance, regarding 
the type and scope of data collected in the United States on 
antibiotic consumption and resistance trends. The report should 
compare this level of data with the level and scope of data 
collected around the world and the benefits or drawbacks of 
collecting such data. In addition, the report should identify 
what statutory and other obstacles exist in the United States 
that might prevent the collection of more comprehensive data.
    Emerging Infection Surveillance.--The Committee urges CDC 
to create strong partnership opportunities between this Center 
and the Center on Global Health in order to coordinate better 
the Nation's surveillance of emerging infections and monitoring 
activities at home and abroad.
    Food Safety.--The Committee remains strongly supportive of 
CDC's system of surveillance and outbreak response on food-
borne illness. The Committee is very concerned about changes in 
private lab testing that reduce the ability of State labs to 
identify quickly the fingerprint of a particular outbreak. The 
Committee intends that the recommended funding increase be used 
to support upgrades to PulseNet and develop new laboratory 
tools. In addition, CDC should enhance and integrate 
surveillance of disease, improve outbreak and response 
timeliness, and help address deficits in local capacity to 
prevent and stop illness. The Committee supports the expansion 
of the number of Foodborne Diseases Centers for Outbreak 
Response Enhancement [FoodCORE] and Food Safety Centers of 
Excellence. These centers will serve a critical role through 
the development and dissemination of best practices and tools 
for food safety surveillance and outbreak response.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2012....................................    $756,377,000
Budget estimate, 2013...................................     633,019,000
Committee recommendation................................     798,445,000

    The Committee recommendation for the activities of the 
National Center for Chronic Disease Prevention and Health 
Promotion is $798,445,000. In addition, the Committee 
recommends transferring $457,050,000 to the Center from the PPH 
Fund.
    The total program level assumed in this bill for the Center 
is $1,255,495,000.
    The mission of the National Center for Chronic Disease 
Prevention is to provide national leadership in promoting 
health and well-being through prevention and control of chronic 
diseases. Nearly one-half of all American adults have at least 
one chronic illness; such diseases account for nearly 70 
percent of all U.S. deaths and three-quarters of all healthcare 
costs in the United States.
    The budget proposes a consolidation of five programs within 
the Center including: arthritis; comprehensive cancer; heart 
disease and stroke; diabetes; and nutrition, physical activity, 
and obesity. This consolidation proposal is the latest in a 
series of efforts by the administration and this Committee to 
coordinate better the obesity-related chronic disease 
prevention programs in the Center. The Committee rejects the 
proposed consolidation, not because the need to improve 
coordination has gone away but because budget constraints make 
it impossible to achieve without cutting funding to numerous 
States. Yet, the Committee remains concerned by the lack of 
coordination in the four State grant programs that address 
obesity-related chronic disease: Diabetes; Heart Disease and 
Stroke; Community Health Promotion; and Nutrition, Physical 
Activity, and Obesity.
    The Committee is aware that the target populations for 
these four State grant programs, and the interventions 
recommended by these four programs, are identical. Therefore, 
the Committee recommends that CDC provide flexibility to States 
to use up to 5 percent of their funds in any of these four 
grant programs to address cross-cutting issues among them. The 
Committee intends this flexibility be used to support 
activities that align the goals, eligibility, evaluation, and 
performance metrics of these programs.
    Within the total provided for the National Center for 
Chronic Disease Prevention and Health Promotion, the following 
amounts are available for the following categories of funding:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Chronic Disease Block Grant.....................................  ..............         378,607  ..............
Office of Smoking and Health--PPH Fund..........................          83,000          89,000          95,000
Office of Smoking and Health....................................         108,077         108,117         108,117
    Environmental Health Lab (non-add)..........................           1,963  ..............           1,963
Nutrition, Physical Activity, and Obesity.......................          33,998  ..............          43,998
Nutrition, Physical Activity, and Obesity--PPH Fund.............          10,000  ..............  ..............
School Health...................................................          13,522  ..............          13,522
    Food Allergies (non-add)....................................             487  ..............             487
Community Health Promotion......................................           6,106  ..............           6,106
Glaucoma........................................................           3,319  ..............           3,319
Visual Screening Education......................................             508  ..............             508
Alzheimer's Disease.............................................           1,802  ..............          11,802
Inflammatory Bowel Disease......................................             677  ..............             677
Interstitial Cystitis...........................................             651  ..............             651
Excessive Alcohol Use...........................................           2,440  ..............           2,440
Chronic Kidney Disease..........................................           2,081  ..............           2,081
Prevention Research Centers.....................................          17,900  ..............          17,900
Prevention Research Centers--PPH Fund...........................          10,000  ..............          10,000
Prevention Research Centers--Section 241 transfer...............  ..............          25,000  ..............
Heart Disease and Stroke........................................          54,975  ..............          54,975
Diabetes........................................................          64,434  ..............          64,434
Cancer Prevention and Control--PPH Fund.........................  ..............         260,871  ..............
Cancer Prevention and Control (total)...........................         348,304          62,794         346,332
    Breast and Cervical Cancer..................................         204,779  ..............         204,779
        WISEWOMAN (non-add).....................................          20,629  ..............          20,629
    Breast Cancer Awareness for Young Women.....................           4,881  ..............           4,881
    Cancer Registries...........................................          50,014  ..............          50,014
    Colorectal Cancer...........................................          42,830  ..............          42,830
    Comprehensive Cancer........................................          20,199  ..............          20,199
    Johanna's Law...............................................           4,972  ..............           3,000
    Ovarian Cancer..............................................           4,882  ..............           4,882
    Prostate Cancer.............................................          13,114  ..............          13,114
    Skin Cancer.................................................           2,138  ..............           2,138
    Cancer Survivorship Resource Center.........................             495  ..............             495
Oral Health.....................................................          14,644          14,653          18,644
Safe Motherhood/Infant Health...................................          43,803          43,848          43,803
Arthritis.......................................................          13,001  ..............          13,001
Epilepsy........................................................           7,757  ..............           7,757
National Lupus Patient Registry.................................           4,438  ..............           2,000
Racial and Ethnic Approaches to Community Health................          13,940  ..............          23,940
Racial and Ethnic Approaches to Community Health--PPH Fund......          40,000  ..............          40,000
Community Transformation Grants--PPH Fund.......................         226,000         146,340         280,000
Diabetes Prevention Program.....................................  ..............  ..............          10,000
Diabetes Prevention Program--PPH Fund...........................          10,000  ..............          10,000
Million Hearts Initiative--PPH Fund.............................  ..............           5,000           5,000
Workplace Wellness--PPH Fund....................................          10,000           4,000          10,000
Let's Move--PPH Fund............................................           5,000           4,000  ..............
Breastfeeding Promotion and Support Grants--PPH Fund............           7,050           2,500           7,050
----------------------------------------------------------------------------------------------------------------

    Alzheimer's and Healthy Aging.--The Committee commends the 
Healthy Brain Initiative [HBI] for its leadership in bringing 
attention to the public health crisis of Alzheimer's disease 
and for its work on cognitive impairment surveillance in 38 
States. The Committee notes that developing a population-based 
surveillance system with longitudinal follow-up is a key 
recommendation in the National Public Health Road Map to 
Maintaining Cognitive Health. The increase provided in the 
Committee recommendation is intended to further develop this 
system and to develop effective public health messages to 
promote cognitive health in older adults, as recommended in the 
recent progress report on the HBI.
    Cancer Registries.--The Committee commends CDC for its work 
to improve the ability of the cancer registries to support 
enhanced access for researchers and the early capture of 
particularly aggressive cancers.
    Cardiomyopathy.--The Committee is aware of CDC estimates 
that sudden cardiac arrest [SCA] is the leading cause of death 
on school property, with one student athlete falling victim to 
SCA every 3 to 4 days. The risk of SCA is highest among those 
with undiagnosed cardiomyopathy. The Committee is pleased with 
the information that CDC has developed for schools, coaches, 
and parents on prevention of concussion in student athletes, 
and encourages CDC to augment this effort with information 
about how to identify children with cardiomyopathy and how to 
respond appropriately and quickly to SCA. CDC is further 
encouraged to disseminate this information through the CDC Web 
site and the Division on Adolescent School Health.
    Chronic Kidney Disease [CKD].--The Committee continues to 
support early detection of CKD, particularly among high-
incidence minority populations. The Committee urges CDC to 
continue early detection activities and the CKD Health 
Evaluation and Risk Information Sharing project.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee applauds CDC for partnering with NHLBI to develop a 
national action plan to address COPD. The Committee is pleased 
to note that CDC is updating its COPD surveillance summary, 
maximizing use of the currently available research data.
    Community Transformation Grants [CTG].--The Committee 
commends CDC for the recent announcement of a community grant 
competition within the CTG program. The funding announcement 
for this competition assumed that funds would be awarded for a 
2-year period and the budget request did not anticipate another 
funding announcement in fiscal year 2013. The Committee 
recommendation includes an additional $54,000,000 above the 
fiscal year 2012 level for CTG. The Committee directs CDC to 
award this funding in another round of community grants in 
fiscal year 2013.
    Diabetes in Native Americans/Native Hawaiians.--The 
Committee commends CDC for its focus on the high incidence of 
diabetes and kidney disease among Native American, Alaska 
Native, Native Hawaiian, and Filipino populations. The 
Committee strongly supports the Native Diabetes Wellness 
Program.
    Glaucoma.--The Committee continues to believe that 
education and screening programs for glaucoma and other age-
related eye diseases are a low-cost means of preventing and 
reducing the risk of blindness, especially in minority 
populations.
    Heart Disease and Stroke.--The Committee is pleased that 
the Center is developing a cardiovascular disease surveillance 
system and continues to provide support for the Sodium 
Reduction Communities program. The Committee recommends 
$5,000,000 in transfers from the PPH Fund to support the 
Million Hearts initiative.
    Lupus.--The Committee applauds the completed development of 
five lupus patient registries across the country meant to 
identify reliable epidemiological and burden of illness data on 
lupus. The Committee recommendation is sufficient to conduct 
cohort studies of registry patients to study further long-term 
outcomes, socioeconomic burdens, and mortality associated with 
the disease. Studies should be designed to follow an 
established, population-based cohort with lupus to determine 
over time the treatment, healthcare access, and natural history 
(severity, morbidity, mortality, etc.) of cohort members and 
the factors (including genetic and other biological factors 
such as antibody levels) associated with these outcomes.
    Maternal Mortality Reviews.--State-based maternal mortality 
reviews identify deaths, review associated factors, and take 
action to institute changes to decrease pregnancy-related 
mortality. A uniform pregnancy mortality dataset tool, which 
includes an electronic comprehensive case abstraction form, 
would ensure that the information needed for review and action 
would be consistent for public health purposes. The Committee 
encourages CDC, in consultation with relevant State and 
national stakeholders, to develop a uniform pregnancy mortality 
dataset tool for guidance to States on data collection, review, 
and analysis, and make such a tool available to State maternal 
mortality review committees.
    Obesity.--The Committee is aware of the importance of diet 
and nutrition in reducing obesity rates among targeted 
populations, from school-aged children to seniors. Critical to 
the success of this effort is training individuals how to 
prepare foods that are healthful, flavorful, and delivered in 
the most cost-effective manner. In accomplishing these 
objectives, the Committee encourages CDC to support strategies 
that engage institutions with demonstrated culinary training 
expertise in the areas of ingredient selection, culinary 
technique, flavor development, and menu development across a 
wide range of volume food service operations, including 
institutional foodservice. The Committee encourages the Center 
to support strategies that engage such institutions throughout 
its nutrition and health promotion programs.
    Office on Smoking and Health [OSH].--The Committee includes 
$203,177,000 for OSH, including $95,000,000 in transfers from 
the PPH Fund. While much progress has been made in reducing 
tobacco use, the Committee continues to believe that tobacco 
prevention and cessation must be a priority. As noted in the 
U.S. Surgeon General Report issued in March, tobacco use 
remains a ``pediatric epidemic''; more than 3.6 million middle 
and high school children actively smoke, with an additional 1.4 
million trying their first cigarette each year. Funding from 
OSH is particularly important in fiscal year 2013 because, 
despite clear evidence of cost-effectiveness, States have cut 
funding for tobacco prevention programs by a total of 36 
percent in the last 4 years.
    The Committee is pleased with the initial reported results 
of the OSH media campaign. In the first 2 weeks of this 
campaign, calls to State quitlines more than doubled and the 
number of hits to www.smokefree.gov, the Government's Web site 
offering quit assistance, more than tripled. In addition, 
previous experience from State and local media campaigns 
promoting quitlines shows at least 5 to 6 smokers try to quit 
on their own for every one person who calls a quitline. The 
Committee expects OSH to commit at least the same amount in 
fiscal year 2013 for a media campaign and quitlines as it did 
in fiscal year 2012.
    The Committee commends the Environmental Health Laboratory 
for its ongoing work on tobacco products, including its 
successful partnership with the FDA in implementing the Family 
Smoking Prevention and Tobacco Control Act. The Committee 
expects OSH to transfer the same amount it did in fiscal year 
2012 to the Environmental Health Laboratory. The Committee 
notes that this transfer is to be provided to the lab in a 
manner that supplements and in no way replaces existing funding 
for tobacco-related activities.
    Oral Health.--The Committee is greatly encouraged by pilot 
programs across the country demonstrating new disease 
management interventions, public health media campaigns, and 
prevention strategies that can reduce the rate of dental 
caries. The Committee intends that no less than $150,000 be 
available for CDC to engage in planning and technical 
assistance to improve and expand joint public-private media 
campaigns at the national, State, and local levels. This may 
include an oral health literacy program in response to a report 
from the IOM which noted that ``individuals and many healthcare 
professionals remain unaware of the risk factors and preventive 
approaches for many oral diseases, and they do not fully 
appreciate how oral health affects well being.''
    In addition, the Committee has included sufficient funding 
for CDC to convene a conference examining innovative strategies 
to address early childhood caries [ECC] and to update the 
agency's previous work on an ECC consensus statement. Through 
this conference, CDC in collaboration with leading researchers, 
clinicians, payors, and consumer groups will identify the most 
recent science and research advancing ECC disease management.
    Johanna's Law.--The Committee recognizes that fiscal year 
2012 was the fifth year of Federal funding for the 
gynecological awareness campaign authorized in Johanna's Law. 
Over the last 5 years, CDC has developed and distributed 
gynecologic cancer-specific fact sheets, Web sites, public 
service announcements and other public education materials. The 
Committee recommendation includes $1,500,000 for an evaluation 
of Johanna's Law to determine the effectiveness of this 
awareness campaign on gynecological cancer detection rates.
    In addition, the Committee is concerned that the mortality 
rate for ovarian cancer has remained relatively unchanged over 
the last 40 years, while overall U.S. cancer mortality rates 
have declined dramatically. The Committee recommendation for 
Johanna's Law includes $1,500,000 for a review of the state of 
the science on ovarian cancer, to be submitted no later than 1 
year after enactment of this act. The review should be 
conducted by a workgroup of both public and private sector 
stakeholders, and it should identify a national plan of action 
for improved prevention efforts, detection methods, care and 
treatment for the full continuum of life, and basic and public 
health research. The report and plan that follow should include 
at least: an evaluation and summary of the existing state of 
the science; an assessment of existing government initiatives; 
and an identification of and recommendations for other public 
and private sector efforts that would help the Nation make 
progress in reducing the incidence and mortality of ovarian 
cancer.
    The Committee understands that women with the BRCA1 and 
BRCA2 genetic mutations are at elevated risk for both breast 
and ovarian cancers. Therefore, the Committee encourages CDC to 
explore ways in which the risk of ovarian cancer can be 
integrated into the larger public health system in cancer 
prevention and treatment, particularly in public health 
programs aimed at women at risk for breast cancer.
    Racial and Ethnic Approaches to Community Health [REACH].--
The Committee is aware of the tremendous success of the REACH 
program. From 2001 to 2009, physical activity rates among 
minority populations in REACH communities increased from 7 to 
12 percent, compared to a U.S. average in the general 
population of 2 to 5 percent. These outcomes are all the more 
impressive considering the high rates of obesity and obesity-
related illness in REACH communities. The Committee strongly 
supports the REACH model of partnering with communities that 
are underserved and often disaffected, both to identify health 
disparities of concern to the community and then to implement 
community-based, evidence-based, and culturally competent 
approaches to reduce or eliminate those disparities.
    Preterm Birth.--The Committee commends CDC for funding 
State-based perinatal collaboratives that focus on improving 
birth outcomes using known prevention strategies such as 
reducing early elective deliveries.
    Sleep Disorders.--Evidence is growing that chronic 
circadian disruptions and disorders can cause significant 
safety and health issues such as increased risk of 
cardiovascular disease, breast cancer, diabetes, obesity, motor 
vehicle crashes, and difficulty adhering to school and work 
schedules. CDC is encouraged to continue current surveillance 
efforts on sleep patterns that assist researchers in this area.
    Well-Integrated Screening and Evaluation for Women Across 
the Nation.--The Committee once again includes bill language 
requiring CDC to make competitively awarded grants under 
section 1509 of the PHS Act available to not less than 21 
States, tribes, or tribal organizations. WISEWOMAN helps 
uninsured and under-insured low-income women avoid heart 
disease and stroke by providing preventive health services; 
referrals to local healthcare providers, as needed; and 
lifestyle counseling and interventions tailored to identify 
risk factors to promote lasting, healthy behavior change.

     NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, 
                         DISABILITY AND HEALTH

Appropriations, 2012....................................    $137,287,000
Budget estimate, 2013...................................      18,476,000
Committee recommendation................................     134,500,000

    The Committee recommendation for the activities of the 
National Center on Birth Defects and Developmental Disabilities 
[NCBDDD] is $134,500,000. The budget request transfers an 
additional $107,089,000 from the PPH Fund; the Committee 
rejects that proposed transfer.
    This Center improves the health of children and adults by 
preventing birth defects, developmental disabilities, and 
complications of heredity blood disorders and by promoting 
optimal child development and health and wellness among 
children and adults living with disabilities.
    For the second consecutive fiscal year, the budget request 
includes a proposal to consolidate 14 programs in the Center 
into a broadly defined program on disability and health. For 
the second time, the Committee rejects the consolidation 
proposal. The Committee notes with dismay that the proposal was 
submitted to Congress without the accompanying information that 
the fiscal year 2012 statement of the managers specifically 
stated would be a requirement for consideration of any such 
proposal in fiscal year 2013. The Committee reiterates that no 
consolidation will be considered without an assessment of the 
needs of the populations currently served and an analysis of 
the impact of a consolidation on those populations.
    Within the total provided, the following amounts are 
provided for the following categories of funding:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Child Health and Development--PPH Fund..........................  ..............          49,957  ..............
Child Health and Development/Birth Defects and Developmental              61,966           8,653          60,161
 Disabilities (total)...........................................
    Birth Defects...............................................          20,192  ..............          18,387
        Fetal Death (non-add)...................................             806  ..............             806
    Fetal Alcohol Syndrome......................................           9,862  ..............           9,862
    Folic acid..................................................           2,779  ..............           2,779
    Infant health...............................................           7,868  ..............           7,868
    Autism......................................................          21,265  ..............          21,265
Autism--PPH Fund................................................  ..............          21,340  ..............
Health and Development with Disabilities--PPH Fund..............  ..............          43,841  ..............
Health and Development with Disabilities/Human Development and            56,574           7,360          57,585
 Disability (total).............................................
    Disability and health.......................................          17,779  ..............          17,779
    Limb loss...................................................           2,820  ..............           2,820
    Tourette Syndrome...........................................           1,698  ..............           1,698
    Early Hearing Detection and Intervention....................          10,630  ..............          10,630
    Muscular Dystrophy..........................................           5,828  ..............           5,828
    Paralysis Resource Center...................................           6,700  ..............           6,700
    Attention-Deficit Hyperactivity Disorder....................           1,715  ..............           1,715
    Fragile X...................................................           1,681  ..............           1,681
    Spina Bifida................................................           5,734  ..............           5,734
    Congenital Heart Failure....................................           1,989  ..............           3,000
Public Health Approach to Blood Disorders--PPH Fund.............  ..............          13,291  ..............
Blood Disorders (total).........................................          18,747           2,463          16,754
    Public Health Approach to Blood Disorders...................  ..............  ..............          10,754
    Hemophilia..................................................          16,633  ..............  ..............
    Hemophilia Treatment Centers................................  ..............  ..............           6,000
    Thallasemia.................................................           1,856  ..............  ..............
----------------------------------------------------------------------------------------------------------------

    Cerebral Palsy [CP].--The Committee commends CDC for 
releasing the first multisite, population-based study on the CP 
population in the country. In addition to updating prevalence 
estimates, this report provided estimates of co-occurring 
developmental disabilities, gross motor function, and walking 
ability among children with CP. The Committee encourages the 
CDC to update these figures regularly.
    Fragile X--Fragile X-Associated Disorders [FXD].--The 
Committee encourages CDC to continue to focus its efforts on 
data collection to identify and define the population impacted 
by FXD and the public health impact of these conditions. CDC is 
further encouraged to support epidemiological research, 
surveillance, screening, and the promotion of early 
interventions and supports.
    Hemophilia Treatment Centers [HTCs].--The Committee intends 
that funds provided for HTCs be used to continue surveillance 
and research at an expanded number of hemophilia treatment 
centers.
    Public Health Approach to Blood Disorders.--The Committee 
includes sufficient funding to continue and expand work on 
bleeding and clotting disorders, as well as hemoglobinopathies. 
The Committee remains supportive of the blood safety 
surveillance program focused on thalassemia. Because 
thalassemia patients are transfused every 2 weeks and thus are 
the largest users of red blood cells, closely monitoring their 
health effectively protects all transfused patients, whether 
due to surgery, childbirth, trauma, or any other cause.
    Spina Bifida.--The Committee intends the funding provided 
for the National Spina Bifida Program [NSBP] to be used to 
support the continuation of a data collection initiative to 
improve the efficacy and quality of care. Further, the 
Committee intends the NSBP to serve as a model for programs 
assisting other individuals living with similar complex 
conditions.
    Tourette Syndrome.--The Committee intends that CDC continue 
to educate health professionals, educators, and the general 
public about Tourette syndrome and to expand the scientific 
knowledge base on prevalence, risk factors, and co-morbidities 
of this disorder.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2012....................................    $391,741,000
Budget estimate, 2013...................................     415,069,000
Committee recommendation................................     391,741,000

    The Committee recommendation for Public Health Scientific 
Services is $391,741,000; this amount includes $247,769,000 in 
transfers available under section 241 of the PHS Act. In 
addition, the Committee recommends transferring $70,000,000 to 
these activities from the PPH Fund.
    The total program level assumed in this bill for these 
services is $461,741,000.
    This funding supports the work of all of the CDC Centers by 
compiling statistical information to inform public health 
policy. In particular, these activities assure the accuracy and 
reliability of laboratory tests; apply digital information 
technology to help detect and manage diseases, injuries, and 
syndromes; and develop and inform the public health community 
on sound public health surveillance, laboratory protocols, and 
epidemiological practices.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Health Statistics--Section 241 transfer.........................         138,683         161,833         138,683
Health Surveillance--PPH Fund...................................          35,000          35,000          35,000
State/Local Lab Sustainability--PPH Fund........................  ..............          20,000  ..............
Community Guide--PPH Fund.......................................          10,000          10,000          10,000
Public Health Workforce and Career Development..................          35,929          35,695          35,929
Public Health Workforce Capacity--PPH Fund......................          25,000          25,000          25,000
----------------------------------------------------------------------------------------------------------------

    The Committee requests that CDC include in the fiscal year 
2014 congressional budget justification a listing of all 
internal laboratories with a description of their 
responsibilities and their annual funding and staffing levels. 
The laboratories should be categorized by biosafety level.
    Seminal Surveys.--The Committee continues to support strong 
data quality and accessibility within the ongoing seminal 
health surveys, in particular the National Health Interview 
Survey and National Health and Nutrition Examination Survey.
    Sexual and Gender Identity Inclusion in Health Data 
Collection.--The Committee recognizes the steps CDC has taken 
to include questions relating to sexual orientation in the 
National Health Interview Survey. The Committee remains 
supportive of inclusion of gender identity questions. The 
Committee urges CDC to ensure that milestones established in 
the July 2011 national data progression plan are met.
    Vital Statistics.--The Committee recommendation includes 
sufficient funding to collect 12 months of vital statistics 
data within the calendar year.

                          ENVIRONMENTAL HEALTH

Appropriations, 2012....................................    $104,998,000
Budget estimate, 2013...................................     103,672,000
Committee recommendation................................     114,667,000

    The Committee recommendation for the National Center for 
Environmental Health is $114,667,000. In addition, the 
Committee recommends transferring $35,000,000 to the Center 
from the PPH Fund.
    The total program level assumed in the bill for this Center 
is $149,667,000.
    The National Center for Environmental Health addresses 
emerging pathogens and environmental toxins that pose 
significant challenges to public health. The Center conducts 
surveillance and data collection to determine which substances 
in the environment are getting into people and to what degree. 
The Center also determines whether these substances are harmful 
to humans and at what level of exposure.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Environmental Health Laboratory.................................          42,383          42,394          42,383
    Newborn Screening Quality Assurance Program (non-add).......           6,825  ..............           6,825
    Newborn Screening for Severe Combined Immunodeficiency                   965  ..............             965
     Diseases (non-add).........................................
Environmental Health Activities (total).........................          35,322          33,962          36,986
    Environmental Health Activities.............................          12,160  ..............          12,160
    Safe Water..................................................           7,109  ..............           7,109
    Volcanic Emissions..........................................             197  ..............             197
    Amyotrophic Lateral Sclerosis Registry......................           5,869  ..............           5,869
    Climate Change..............................................           7,359           4,875           4,875
    Built Environment and Health Initiative.....................           2,628  ..............           6,776
Environmental and Health Outcome Tracking Network--PPH Fund.....          35,000          29,000          35,000
Asthma..........................................................          25,298  ..............          25,298
Healthy Homes/Childhood Lead Poisoning..........................           1,995  ..............          10,000
Healthy Home and Community Environments.........................  ..............          27,316  ..............
----------------------------------------------------------------------------------------------------------------

    ALS.--The Committee commends the Center for launching a 
tool within the ALS registry to promote clinical trial 
enrollment and for exploring the addition of a biorepository. 
The Committee encourages CDC to work with stakeholders and 
researchers to help raise awareness of the registry in both the 
patient community and the research community, and to ensure 
that the registry collects information that is useful for ALS 
research and treatment development. The Committee further 
encourages CDC to work with CMS to explore how the registry may 
help improve care and promote standards of care for those 
living with the disease as well as other opportunities to 
advance ALS research.
    Asthma.--The budget request again proposes to consolidate 
CDC's National Asthma Control program with the Healthy Homes/
Childhood Lead Poisoning program. The Committee notes that this 
proposal contains few details on how the consolidated program 
would bridge the different models and settings currently 
employed by the two individual programs. For that reason, the 
Committee again rejects the administration's proposal. The 
Committee directs CDC to continue its support of the asthma 
program, its approach to asthma control, its community 
partners, and its successful interventions.
    Blood Lead Reference Value.--The Committee applauds CDC for 
doing away with the use of the ``blood lead level of concern'' 
methodology. The Committee encourages CDC to raise awareness of 
the new blood lead reference value. The Committee is interested 
in the potential for point-of-care screening devices, 
particularly in at-risk communities.
    Healthy Homes and Lead Poisoning Prevention Program.--The 
Committee recommendation includes sufficient funding for 
national surveillance efforts that can better target HUD lead 
poisoning prevention efforts, technical assistance to local 
public health officials, and national leadership on the science 
of lead poisoning.
    National Environmental Public Health Tracking Network.--The 
Committee commends CDC for providing technical support to 
States and cities that have demonstrated interest in conducting 
public health tracking activities with their own resources.

                     INJURY PREVENTION AND CONTROL

Appropriations, 2012....................................    $137,693,000
Budget estimate, 2013...................................     137,754,000
Committee recommendation................................     137,693,000

    The Committee recommendation for the National Center for 
Injury Prevention and Control is $137,693,000. In addition, the 
Committee recommends transferring $3,000,000 to the Center from 
the PPH Fund.
    The total program level assumed in this bill for the Center 
is $140,693,000.
    CDC is the lead Federal agency for injury prevention and 
control. Programs are designed to prevent premature death and 
disability and reduce human suffering and medical costs caused 
by fires and burns, poisoning, drowning, violence, and traffic 
accidents. The national injury control program at CDC 
encompasses nonoccupational injury and applied research in 
acute care and rehabilitation of the injured.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Intentional Injury (total)......................................          93,282          93,317          93,282
    Domestic Violence and Sexual Violence.......................          31,042  ..............          31,042
        Child Maltreatment (non-add)............................           6,959  ..............           6,959
    Youth Violence Prevention...................................          14,968  ..............          14,968
    Domestic Violence Community Projects........................           5,411  ..............           5,411
    Rape Prevention.............................................          39,389  ..............          39,389
    All Other Intentional Injury................................           2,472  ..............           2,472
Unintentional Injury (total)....................................          30,966          30,988          30,966
    Traumatic Brain Injury......................................           6,026  ..............           6,026
    All Other Unintentional Injury..............................          24,940  ..............          24,940
        Elderly Falls (non-add).................................           1,958  ..............           1,958
Elderly Falls--PPH Fund.........................................  ..............  ..............           3,000
Injury Control Research Centers.................................           9,974           9,977           9,974
National Violent Death Reporting System.........................           3,471           3,472           3,471
----------------------------------------------------------------------------------------------------------------

    Falls Prevention Interventions.--The Committee includes 
$3,000,000 from the PPH Fund to expand older adult falls 
prevention activities at CDC, in coordination with ACL. The 
Committee intends that CDC use the funding to conduct research 
to evaluate and disseminate the most effective fall prevention 
interventions and that ACL use the funding provided that agency 
to conduct outreach and demonstration programs to expand the 
implementation of effective interventions.

                     OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2012....................................    $292,588,000
Budget estimate, 2013...................................     249,364,000
Committee recommendation................................     292,588,000

    The Committee recommendation for occupational safety and 
health programs is $292,588,000; this amount includes 
$110,724,000 in transfers available under section 241 of the 
PHS Act, the same as was transferred in fiscal year 2012. The 
budget request assumes $249,364,000 in transfers.
    CDC's National Institute for Occupational Safety and Health 
[NIOSH] is the only Federal agency responsible for conducting 
research and making recommendations for the prevention of work-
related illness and injury. The NIOSH mission is implemented by 
conducting scientific research (both applied and basic) and 
translating the knowledge gained into products and services 
that impact workers in settings from corporate offices to 
construction sites to coal mines.
    The Committee recommendation includes funding for the 
following activities at the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Education and Research Centers..................................          24,268  ..............          24,268
Personal Protective Technology..................................          16,791  ..............          16,791
Personal Protective Technology--Section 241 transfer............  ..............          16,880  ..............
Healthier Workforce Center......................................           5,016  ..............           5,016
Healthier Workforce Center--Section 241 transfer................  ..............           5,026  ..............
National Occupational Research Agenda...........................         111,366          91,724         111,366
    Section 241 transfer (non-add)..............................         110,724          91,724         110,724
Mining Research.................................................          52,363  ..............          52,363
Mining Research--Section 241 transfer...........................  ..............          52,687  ..............
Other Occupational Safety and Health Research--Section 241 Trans- ..............          83,047  ..............
   fer..........................................................
Other Occupational Safety and Health Research...................          82,784  ..............          82,784
    Miners Choice (non-add).....................................             646  ..............             646
    National Mesothelioma Registry and Tissue Bank (non-add)....           1,020  ..............           1,020
----------------------------------------------------------------------------------------------------------------

    Education and Research Centers.--The Committee directs CDC 
to spend no less than last year for this program.
    Mining Research.--The Committee requests that the fiscal 
year 2014 congressional budget justification include a 5-year 
history of mining research funding and FTE by type of mine 
research, in particular the proportion of resources dedicated 
to coal and metal/nonmetal research.
    Other Occupational Safety and Health Research.--The 
Committee requests that the fiscal year 2014 congressional 
budget justification include a 5-year history of the funding 
and FTE supported by this program, broken down by industry and 
location.
    Regional Proximity to Industry.--The Committee strongly 
supports NIOSH's regional distribution of research facilities. 
NIOSH is a leader in applied research and the Committee 
believes that interaction with a wide variety of industries is 
key to NIOSH's success. The Committee requests a staffing plan 
for all facilities owned and leased by NIOSH over the coming 5 
fiscal years, to be submitted no later than March 1, 2013. The 
plan should include on-site contractors, any notable 
projections for retirement, and site-specific plans for 
recruitment.
    National Occupational Research Agenda.--The Committee 
directs CDC to spend no less than last year for the 
Agriculture, Forestry, and Fishing Program within the National 
Occupational Research Agenda.

      ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATIONSATION ACT

Appropriations, 2012....................................     $55,358,000
Budget estimate, 2013...................................      55,358,000
Committee recommendation................................      55,358,000

    The Committee recommendation for EEOICPA is $55,358,000. 
This mandatory funding supports NIOSH scientists who 
reconstruct radiation dose levels to inform compensation 
decisions.

                             GLOBAL HEALTH

Appropriations, 2012....................................    $347,594,000
Budget estimate, 2013...................................     362,889,000
Committee recommendation................................     362,594,000

    The Committee recommends $362,594,000 for global health-
related activities at CDC.
    The Center for Global Health leads international programs 
and coordinates CDC's global efforts with the goal of promoting 
health and preventing disease in the United States and abroad. 
The Center has a particular focus on ensuring rapid detection 
and response to emerging health threats.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Global AIDS Program.............................................         117,118         117,156         117,118
Global Immunization Program (total).............................         160,287         175,417         160,287
    Polio Eradication...........................................         111,286         126,365         111,286
    Measles and Other Vaccine Preventable Diseases..............          49,001          49,052          49,001
Global Disease Detection and Emergency Response.................          41,601          41,659          46,601
    Global Disease Detection Centers (non-add)..................          35,604          35,604          40,604
Parasitic Diseases and Malaria..................................          19,367          19,417          19,367
Global Public Health Capacity Development.......................           9,221           9,240           9,221
National Public Health Institutes...............................  ..............  ..............          10,000
----------------------------------------------------------------------------------------------------------------

    National Public Health Institutes [NPHIs].--In many 
countries around the world, public health functions are spread 
across the ministries of health. Laboratory work, surveillance, 
outbreak response, and budget are often disconnected and 
fragmented, making public health efforts less efficient and 
less effective. This fragmentation is a barrier to 
collaboration among nations on preventing the spread of 
infectious disease and setting common health research goals. 
NPHIs are science-based organizations that bring together the 
public health functions of a government. They use evidence to 
inform health practice and policies, determine the 
effectiveness of health investments and practices, and provide 
a locus of coordination for donor resources in developing 
nations.
    The Committee is aware that the International Association 
of National Public Health Institutes has begun to transfer its 
technical assistance functions to CDC, making CDC the global 
leader on building NHPI capacity around the world.
    In recognition of the leadership role that CDC plays in 
global public health, the Committee has included a new 
initiative to support the creation of NPHIs in developing 
countries. The Committee has provided $10,000,000 to be 
available over a 2-year period for CDC to work in at least five 
countries. The Committee expects CDC's engagement to be time-
limited, extending from 3 to 5 years. The Committee further 
expects this initiative to engage countries in all regions of 
the world; however, the Committee understands that any country 
engaged must show a high level of commitment to reorganize its 
ministry of health in this manner.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2012....................................  $1,299,479,000
Budget estimate, 2013...................................   1,228,360,000
Committee recommendation................................   1,299,479,000

    The Committee recommendation for the Office of Public 
Health Preparedness and Response [OPHR] is $1,299,479,000.
    The Committee does not support transferring any balances 
from Public Law 111-32, the Supplemental Appropriations Act, 
2009, in fiscal year 2013. In fiscal year 2012, $30,000,000 was 
transferred from such balances for an additional amount for the 
Strategic National Stockpile and the budget request proposes 
transferring an additional $46,776,000. The Committee feels 
strongly that additional transfers would impair the HHS flu 
plan that the supplemental appropriations bill was designed to 
implement.
    The mission of OPHR is to build and strengthen national 
preparedness for public health emergencies including natural, 
biological, chemical, radiological, and nuclear incidents. OPHR 
administers national response programs and assets, as well as 
grants to States and localities to enhance preparedness efforts 
across the country.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
State and Local Preparedness and Response Capability (total)....         657,418         641,917         657,418
    Public Health Emergency Preparedness Cooperative Agreement..         641,671  ..............         641,671
    Academic Centers for Public Health Preparedness.............           7,980  ..............           7,980
    All Other State and Local Capacity..........................           7,767  ..............           7,767
CDC Preparedness and Response Capability (total)................         138,269         146,999         138,269
    Upgrading CDC Capacity......................................         109,467  ..............         109,467
    BioSense....................................................          20,727  ..............          20,727
    Real-time Lab Reporting.....................................           8,075  ..............           8,075
Strategic National Stockpile....................................         503,792         439,444         503,792
Strategic National Stockpile Transfer from Public Law 111-32....          30,000          46,776  ..............
----------------------------------------------------------------------------------------------------------------

    Public Health Emergency Preparedness Cooperative 
Agreement.--The Committee directs that CDC award no less than 
last year's level through the cooperative agreement with State 
and local public health departments.

                          CDC-WIDE ACTIVITIES

Appropriations, 2012....................................    $617,913,000
Budget estimate, 2013...................................     487,648,000
Committee recommendation................................     593,193,000

    The Committee provides $593,193,000 for public health 
leadership and support activities at CDC. In addition, the 
Committee includes $41,200,000 in transfers from the PPH Fund, 
the same as was transferred in fiscal year 2012 and the budget 
request.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Preventive Health and Health Services Block Grant...............          79,545  ..............          79,545
Business Services Support.......................................         394,682         368,529         383,529
Buildings and Facilities........................................          24,946  ..............          11,000
Public Health Leadership and Support............................         118,740         119,119         119,119
National Prevention Strategy--PPH Fund..........................           1,000           1,000           1,000
Public Health Infrastructure--PPH Fund..........................          40,200          40,200          40,200
----------------------------------------------------------------------------------------------------------------

    The Committee is pleased with the progress CDC made on 
improving its congressional budget justification in fiscal year 
2013 and appreciates the detailed information on programs, 
grant awards, and staffing levels. The Committee continues to 
urge CDC to give a clear accounting of how funds are being 
spent in this annual budget document. The budget justification 
should not only be an accounting of how funds will be spent in 
the coming year, but also how funds have been spent in the 
past. Therefore, the Committee directs that the fiscal year 
2014 justification include information on programs as they 
existed in fiscal year 2013, as well as any new structure the 
budget may propose for the funding in fiscal year 2014. The 
Committee expects progress on transparency to continue as CDC 
seeks additional funding flexibility.
    Chief Disability and Health Officer.--The Committee 
commends CDC for appointing a chief disability and health 
officer, as well as establishing a disability and health work 
group that recently prepared its 1-year progress report. The 
Committee encourages CDC to continue to support and strengthen 
public health research activities focused on people with 
disabilities. Specifically, CDC is encouraged to: recognize 
disability as a key determinant in national surveys and 
surveillance systems; address health disparities among people 
with disabilities; enhance health promotion and prevention and 
access to healthcare for people with disabilities; foster 
knowledge translation and communication efforts to bring 
persons with disabilities reliable health information; develop 
new disability research initiatives through partnerships across 
CDC centers and other Federal agencies; and develop public and 
private partnerships to support and advance disability issues.
    Extramural Research.--In last year's Senate report, the 
Committee requested a report from CDC by March 1 of each year 
that details the breakdown of intramural and extramural funding 
for each program. CDC has yet to produce such a report. The 
Committee directs CDC to comply with this request either in a 
stand-alone report or in the annual budget justification.
    Preventive Health and Health Services Block Grant.--The 
committee recommends $79,545,000, the same as the fiscal year 
2012 level, for the Preventive Health and Health Services Block 
Grant. The budget request eliminates all funding for this 
program.
    Repairs and Improvements.--The Committee is dismayed by the 
lack of clear information about CDC's building repair needs. 
The Committee directs CDC to devise a system to categorize 
needed repairs into security, life/safety repairs, condition 
index, and other repairs. CDC is further directed to print the 
number of repairs in the annual congressional budget 
justification each year, with cost estimates. The Committee 
understands that such a list is ever-changing and suggests that 
CDC print an ``as of'' date in the justification.
    Working Capital Fund [WCF].--The Committee is pleased with 
the progress CDC has made to set up and create a strong 
auditing system for a new WCF. The Committee hopes to see the 
WCF begin operations in fiscal year 2014 to achieve greater 
cost efficiencies across the administrative operations of the 
agency.
    The WCF is a revolving fund that pays for consolidated 
business services for CDC. The Centers of CDC will pay into the 
fund according to the amount of services they use. CDC is in 
the process of setting up an audited and transparent system, in 
which the Center directors participate in decisionmaking, to 
determine those amounts.

                     National Institutes of Health

    The Committee provides $30,731,459,000 for NIH activities 
within the jurisdiction of this bill, including $8,200,000 in 
transfers available under section 241 of the PHS Act. The 
budget request is $30,631,459,000, the same as the fiscal year 
2012 level.
    The Committee notes that the net amount for NIH in the 
budget request would actually be a cut of more than 
$200,000,000 below the fiscal year 2012 level following 
implementation of the administration's proposal to increase the 
program evaluation tap on PHS agencies from 2.5 percent to 3.2 
percent. As explained in the introduction to the HHS title in 
this report, the Committee rejects that proposed increase and 
maintains the tap at 2.5 percent.
    The Institute and Center appropriation levels listed below 
for fiscal year 2012 reflect the transfers announced by HHS in 
April to increase funding for Alzheimer's disease research.
    Recommended funding levels for some ICs are slightly below 
the fiscal year 2012 levels, or increase less than others, due 
to small reallocations or changes in scientific opportunity 
reflected in the administration's budget request. For example, 
the Committee agrees with the administration that all of the 
funding for public access activities and the National Center 
for Biotechnology Information should be provided directly to 
NLM beginning in fiscal year 2013 instead of partly through 
direct funding to NLM and partly through contributions from 
other ICs. This change accounts for the relatively large 
apparent increase for NLM and some minor reductions to other 
ICs. In addition, as in prior years, the recommended levels for 
the ICs reflect a redistribution of funding for AIDS research, 
as some ICs increase their work in this area and others do 
less.
    Other than these reallocations, funding for most of the ICs 
is increased over the fiscal year 2012 levels by the same 
percentage.

                       NATIONAL CANCER INSTITUTE

Appropriations, 2012....................................  $5,067,396,000
Budget estimate, 2013...................................   5,068,864,000
Committee recommendation................................   5,084,227,000

    The Committee recommends an appropriation of $5,084,227,000 
for NCI. Of this amount, $8,000,000 is available for repairs 
and improvements to the NCI facility in Frederick, Maryland.
    Angiogenesis.--The Committee commends NCI for planning a 
scientific workshop to explore the effect of medication, diet, 
and lifestyle on angiogenic levels. The Committee encourages 
NIH to use this workshop to engage with the Trans-Institute 
Angiogenesis Research Program on implementing a vigorous agenda 
that examines current angiogenesis therapies in order to 
improve outcomes. The Committee also encourages NCI to examine 
angiogenic levels in the body prior, during, and after 
treatments. In addition, all relevant Institutes are urged to 
coordinate efforts to study the correlation of platelet 
proteomes to angiogenesis with the goal of developing a health 
marker.
    Breast Cancer.--The Committee remains concerned about the 
toll of triple negative breast cancer and urges NCI to 
collaborate with ORWH, NIMHD, OMH, and OWH to help improve 
treatment and survival rates.
    Cancer Disparities.--The Committee urges NCI to fund basic, 
translational, and clinical research on cancer disparities in 
regions of the country that have a high predominance of 
economically disadvantaged African Americans. Specifically, the 
Committee urges further research on novel immune therapeutics 
intervention in cancer areas relevant to human papilloma virus 
and genomics etiologies in cancer areas relevant to smoking and 
obesity.
    Liver Cancer.--The Committee recognizes NCI's efforts in 
the area of liver cancer, but encourages a stronger effort to 
include funding of a specialized program of research excellence 
on this disease as well as liver cancer program projects 
focusing on pathogenesis, detection, and/or therapeutics.
    Lung Cancer.--The Committee commends NCI for its National 
Lung Screening Trial and urges the Institute and partner 
agencies to move forward in translating these findings into 
public health recommendations. The Committee requests an update 
in the fiscal year 2014 congressional budget justification 
about the benefits of screening among high-risk groups 
including women, African-American men, and those with other co-
morbidities.
    Melanoma.--The Committee continues to encourage NCI to 
support research directed at the biology of tumor initiation 
including UV radiation as a carcinogen, the immunologic and 
addictive effects of UV radiation, host risk factors, and risk 
reduction strategies. Research into the relative utility of 
novel early detection strategies is encouraged, including 
leveraging recent advances in imaging technology. Despite two 
recent drug approvals for advanced melanoma, cures are rare. 
Research strategies with curative potential that build on these 
advances should be supported, including examining mechanisms of 
drug resistance to molecularly targeted therapies such as BRAF 
gene inhibitors. The Committee also urges more research on 
treatment strategies for the 50 percent of patients without 
BRAF mutations, as well as on predictive biomarkers that 
correlate with immune response to ipilimumab. Finally, the 
Committee urges NCI to promote collaborations between industry, 
the extramural program, and foundations that will accelerate 
translational and clinical research.
    Minority Communities.--The Committee continues to remain 
concerned at the disproportionately high rate at which minority 
populations suffer from virtually every form of cancer. The 
Committee requests that NCI and NIMHD prepare a joint report on 
efforts to end this disparity and effective ways to communicate 
with minorities on this important issue.
    Neuroblastoma.--The Committee encourages NCI to expand its 
research portfolio on this deadly pediatric cancer, including 
the development of new treatment options for children suffering 
from central nervous system [CNS] relapses. The Committee 
requests an update on this research, including the potential 
utilization of chimeric antibody immunotherapy for CNS-relapsed 
neuroblastoma, in the fiscal year 2014 congressional budget 
justification.
    Pancreatic Cancer.--While survival rates for many types of 
cancer have steadily improved, the rate for pancreatic cancer 
has remained in the single digits for over 40 years. With the 
number of new cases of pancreatic cancer projected to increase 
55 percent between 2010 and 2030, the Committee urges NCI to 
create a comprehensive, long-term research strategy for this 
disease that focuses on increasing survival. The plan should 
not be simply a summary of recent and ongoing research 
activities. Rather, it should set out concrete goals for the 
future. The Committee requests an update in the fiscal year 
2014 congressional budget justification on the steps NCI is 
taking to create such a plan.
    Pediatric Cancer.--The Committee continues to urge NCI to 
devote more of its funding specifically for research on 
pediatric cancer, including pediatric low-grade astrocytoma. 
The Committee requests an update in the fiscal year 2014 
congressional budget justification, including efforts that 
could result in more effective, less toxic treatments.
    Robotic Biorepository Technology.--In order to determine 
the genetic differences in the development, progression, and 
response to treatment of individuals with cancer, biospecimens 
(e.g. blood, urine, tumor tissue) must be collected and 
evaluated. Under some circumstances, high throughput, robotic 
instruments for the processing and storage of biospecimens can 
improve the efficiency and consistency of handling and 
distribution of these samples. In an effort to adequately 
address the increasing demand for these specimens, an automated 
approach should be considered when appropriate. Robotic 
biorepositories may also allow researchers to expand the 
collection of tissue specimens. A related goal is to ensure an 
adequate supply of high-quality human biospecimens from 
multiethnic communities for research to understand and overcome 
cancer health disparities. The Committee encourages NCI to 
explore the applicability of robotic biospecimen collection 
technologies and the establishment of regional robotic 
biorepositories in an effort to advance cancer research.
    Shared Medical Decisionmaking.--The Committee encourages 
NCI's collaboration with OBSRR to study shared medical 
decisionmaking and to identify ways to improve communications 
between healthcare providers and their patients.
    Tumor Lysis Syndrome [TLS].--The Committee understands that 
identifying high-risk patients, taking preventive measures, and 
closely monitoring patients are all key in fighting TLS, a 
life-threatening oncologic emergency that is frequently 
encountered during and/or after the treatment of a variety of 
cancers. The Committee encourages NCI to convene an expert 
panel or working group to evaluate current risk assessment 
models, recommend a standardized assessment tool, and develop a 
plan of action to validate and disseminate the tools in 
clinical practice.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2012....................................  $3,076,115,000
Budget estimate, 2013...................................   3,076,067,000
Committee recommendation................................   3,085,390,000

    The Committee recommendation includes $3,085,390,000 for 
NHLBI.
    Asthma.--The Committee continues to urge NHLBI to increase 
research on and awareness of asthma, and to collaborate with 
the FDA, NIAID, NICHD, NIMHD, and OMH in this regard.
    Basic Behavioral Research Translation.--NHLBI is encouraged 
to speed the translation of basic research results in the 
behavioral and social sciences to clinical or other 
applications.
    Cardiovascular Disease.--The Committee continues to believe 
that research on heart disease, stroke, and other forms of 
cardiovascular disease should be a top priority for NIH. Given 
promising cardiovascular scientific opportunities and projected 
escalating costs and prevalence, the Committee strongly urges 
NHLBI to boost funding for its cardiovascular portfolio to 
further support studies that will build on past accomplishments 
and enhance prevention and treatment efforts. In particular, 
the Institute should aggressively focus on and expand current 
cardiovascular research and actively invest in novel areas, 
including initiatives highlighted in its Division of 
Cardiovascular Diseases Strategic Plan.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee applauds NHLBI for its plans to host a forum of 
stakeholders and representatives from Federal agencies to share 
information about current activities related to COPD and 
discuss the development of a national action plan to address 
this disease, the third highest cause of death in the United 
States. The Committee requests an update in the fiscal year 
2014 congressional budget justification.
    Jackson Heart Study.--The Committee recognizes that the 
Jackson Heart Study in Jackson, Mississippi, as authorized in 
the PHS Act, is the largest investigation of cardiovascular 
disease in the African-American population. The Committee 
acknowledges the continued need for comprehensive research at 
NHLBI and NIMHD to address this disease in African Americans 
and the important implications for such research to all persons 
threatened by cardiovascular disease.
    Lymphangioleiomyomatosis [LAM].--The Committee remains very 
interested in efforts to find a cure for LAM, a progressive and 
often fatal lung disease in women. The Committee supports both 
intramural and extramural means of expanding research on LAM 
and urges NHLBI to use all available mechanisms as appropriate, 
including Translational Program Project Grants, to stimulate a 
broad range of clinical and basic research. The Committee 
commends NIH for supporting multicenter LAM trials and 
encourages additional support of such trials.
    Marfan Syndrome.--The Committee commends NHLBI for its 
leadership of the Genetically Triggered Thoracic Aortic 
Aneurysms and Cardiovascular Conditions Registry [GenTac]. The 
Committee encourages the Institute to use GenTac to advance 
research on surgical outcomes for Marfan syndrome patients who 
undergo different procedures to repair compromised aortas and 
valves.
    Pediatric Cardiomyopathy.--The Committee commends NHLBI for 
its commitment to pediatric cardiomyopathy research and urges 
the Institute to maintain support of the Pediatric 
Cardiomyopathy Registry and Pediatric Cardiomyopathy Specimen 
Repository. The Committee encourages NHLBI to establish a 
pediatric cardiomyopathy task force that will focus on defining 
standards of care, identifying gaps in basic and clinical 
research, developing a research agenda, and working towards 
better genetic screening methods.
    Pulmonary Fibrosis.--The Committee supports ongoing efforts 
to study pulmonary fibrosis and notes the promising strategy of 
researching fibrosis across organs. The Committee encourages 
NHLBI to develop a strategy for enhancing research on this 
disease.
    Scleroderma.--The Committee encourages NHLBI to support 
additional research on the impact of connective tissue 
diseases, such as scleroderma, on the pulmonary system.
    Sickle Cell Trait.--The Committee commends NHLBI for its 
efforts to develop a research agenda on sickle cell trait and 
its relation to exertion-related illness and other conditions. 
The Committee encourages the Institute to reach out to medical 
societies in hematology and sports medicine, as well as 
athletic associations, to collaboratively develop and undertake 
research that can inform current policies related to sickle 
cell trait screening and participation in athletic activities.
    Sleep Disorders.--The Committee applauds NIH's Sleep 
Disorders Research Plan, published by the National Center on 
Sleep Disorders Research. The Committee urges the Institute to 
work with other ICs to implement the plan's recommendations for 
improving sleep research and training, and for advancing multi-
Institute collaborations.
    Stem Cell Biology.--The Committee encourages NHLBI to 
support additional research in the development of blood stem 
cells from induced pluripotent stem [iPS] cells and to address 
barriers to the clinical translation of iPS cell technology.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2012....................................    $410,322,000
Budget estimate, 2013...................................     408,212,000
Committee recommendation................................     409,449,000

    The Committee recommendation includes $409,449,000 for 
NIDCR.
    Temporomandibular Disorders [TMD].--The Committee 
recognizes the advances that have been made as a result of 
NIDCR funding toward understanding the pain associated with TMD 
and encourages the Institute to continue basic and clinical 
research in this area. The Committee also encourages NIDCR to 
collaborate with other ICs regarding the etiology and 
pathogenesis of TMD as well as the co-morbid chronic pain 
conditions and disorders that solely or predominately affect 
women. An under-researched aspect of these disorders is the jaw 
joint. NIDCR should work with NIAMS and NIBIB to develop 
research opportunities in the area of joint pain and 
dysfunction. Topics that need further research include: the 
kinematics and biomechanics of the jaw in normal and disease 
states; the development of biomarkers in bone, muscle, and 
cartilage that are predictive of temporomandibular disease 
progression; the interactions of the temporomandibular joint 
musculoskeletal system with the nervous system; and the 
development of non-invasive measures of temporomandibular joint 
bone, cartilage, and muscle structure, degradation, and repair. 
The Committee urges NIDCR, NIAMS, NIBIB, and other relevant ICs 
to organize a workshop to assess the state of the science and 
identify research gaps and future scientific directions to 
advance understanding of the temporomandibular joint.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2012....................................  $1,795,348,000
Budget estimate, 2013...................................   1,792,107,000
Committee recommendation................................   1,797,539,000

    The Committee recommendation includes $1,797,539,000 in 
this bill for NIDDK.
    Burden of Digestive Diseases.--Due to advancements in 
diagnosis and greater understanding of many digestive 
conditions, the Committee requests that NIDDK update its report 
on the burden of digestive diseases in the United States to 
provide more accurate information on the current economic and 
health impacts of these conditions.
    Chronic Pelvic Pain.--Interstitial cystitis often coexists 
with several poorly understood and neglected chronic pain 
conditions. The Committee applauds the progress made by the 
Institute to understand the overlapping nature of these 
disorders through the Multidisciplinary Approach to the Study 
of Chronic Pelvic Pain [MAPP] Research Network. NIDDK is 
encouraged to continue its focus on understanding co-morbidity 
in the second phase of the MAPP project.
    Diabetes Prevention.--The Committee applauds NIDDK for its 
continued efforts to build on the successes of the Diabetes 
Prevention Program and encourages the use of additional 
resources to improve prevention and treatment of diabetes in 
order to bring the Nation closer to a cure.
    Fecal Incontinence.--The Committee commends NIDDK for its 
launch of the Bowel Control Awareness Campaign and recognizes 
that fecal incontinence significantly hinders the work and 
social lives of those affected. The Committee prioritizes 
research addressing this condition to improve patient quality 
of life and to meet the research goals indicated in the NIDDK 
report ``Opportunities and Challenges in Digestive Diseases 
Research: Recommendations of the National Commission on 
Digestive Diseases.''
    Functional Gastrointestinal Disorders [FGIDs].--The 
Committee understands that FGIDs can dramatically impact 
children's social and educational development, and encourages 
NIDDK to work with NICHD to support research addressing FGIDs 
in children.
    Inflammatory Bowel Disease.--The Committee commends NIH for 
its support of the Human Microbiome Project and notes the 
significance of this groundbreaking research in advancing the 
understanding of inflammatory bowel disease and its impact on 
pediatric patients. The Committee requests an update on this 
program in the fiscal year 2014 congressional budget 
justification.
    Interstitial Cystitis.--The Committee continues to 
encourage a focus on research and treatment relating to 
interstitial cystitis, which impacts individuals of all ages. 
The Committee encourages the inclusion of research focused on 
this disease in children as a part of these activities.
    Polycystic Kidney Disease [PKD].--The Committee continues 
to urge NIDDK to collaborate with other Institutes and leverage 
discoveries from its portfolio of PKD grants for the purpose of 
developing a comprehensive strategic plan for PKD and other 
related neoplastic diseases. For example, the Committee 
understands that Pioglitazone, a drug that may have potential 
for treating PKD, is being studied in Parkinson's patients and 
is partially funded through NINDS.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2012....................................  $1,624,830,000
Budget estimate, 2013...................................   1,624,707,000
Committee recommendation................................   1,629,631,000

    The Committee recommendation includes $1,629,631,000 for 
NINDS.
    ALS.--The Committee is aware that basic research on ALS and 
a reservoir of pre-approved FDA drugs may provide the basis for 
drug development that could offer meaningful therapy for those 
with the disease. The Committee encourages NINDS to support 
clinical trials on ALS that are scientifically well-founded and 
have the opportunity to advance to ``bedside'' quickly.
    Dystonia.--The Committee recognizes the advancements that 
dystonia research has contributed towards an understanding of 
neuromuscular disorders and neurotrauma and encourages NINDS to 
continue to prioritize dystonia research.
    Epilepsy.--The Committee applauds the establishment and 
work of the Interagency Collaborative to Advance Research in 
Epilepsy, led by NINDS, as a means to focus Federal agencies 
and voluntary organizations on epilepsy research. The Committee 
also commends NINDS for announcing the next conference on 
curing epilepsy, to be held in March 2013, and for starting a 
new initiative to develop ways to manage epilepsy with no 
seizures and no therapeutic side effects. These new grants, the 
EUREKA grants and the Epilepsy Centers without Walls grants, 
are supporting creative and collaborative research that could 
lead to advances in prevention, diagnosis, or treatment of 
epilepsy and related co-morbidities. Additionally, the 
Committee commends NINDS for supporting the Partners Against 
Mortality in Epilepsy conference on sudden unexplained death in 
epilepsy. Finally, the Committee urges NINDS to heed the 
recommendations of the 2012 IOM report ``Epilepsy Across the 
Spectrum: Promoting Health and Understanding''.
    Headache Disorders.--The Committee encourages NINDS to put 
a higher priority on the causes of headache disorders as well 
as innovative treatments.
    Network for Excellence in Neuroscience Clinical Trials.--
The Committee encourages NINDS to continue supporting the 
Network for Excellence in Neuroscience Clinical Trials 
[NeuroNEXT] program. The Committee urges NIH to increase the 
efficiency of clinical trials conducted through NeuroNext, 
facilitate patient recruitment and retention, and increase the 
quality of the neuroscience trials. The Committee also 
encourages NIH to work with other stakeholders to develop 
surrogate endpoints to more efficiently determine the success 
of a study.
    Spinal Muscular Atrophy [SMA] Translational Research.--The 
Committee commends NINDS for supporting SMA therapy development 
projects through its Cooperative Program for Translational 
Research. This collaborative program has proven highly 
successful in accelerating the development of SMA therapies for 
testing in the clinic and facilitating the submittal of 
investigational new drug applications to the FDA. The Committee 
urges NINDS to use this approach as a model as it shifts its 
investment in SMA to the best opportunities based on current 
science, and to use the Cooperative Program for Translational 
Research to continue to advance and broaden the SMA drug 
pipeline. The Committee also applauds NINDS for its work on 
validating SMA biomarkers through the NeuroNEXT initiative.
    Stroke.--The Committee remains concerned that NIH spends 
only 1 percent of its budget on stroke research and strongly 
urges NINDS to expand its stroke portfolio. The Committee 
commends the leadership of NINDS in the decade-long work of the 
Stroke Progress Review Group and requests another status 
report, in the fiscal year 2014 congressional budget 
justification, on its Phase 2 stroke planning process to 
advance the most promising areas in prevention, treatment, and 
recovery research.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2012....................................  $4,486,473,000
Budget estimate, 2013...................................   4,495,307,000
Committee recommendation................................   4,508,932,000

    The Committee recommendation includes $4,508,932,000 for 
NIAID.
    Antibacterial Resistance.--The Committee applauds NIAID's 
decision to target antibiotic-resistant bacterial infections as 
the initial priority for the expansion of its clinical trials 
networks beyond HIV/AIDS. To further support research on 
antibacterial resistance, new antibacterial drugs, and new 
diagnostics, the Committee recommends that NIAID form a blue 
ribbon panel of experts including representatives from 
infectious diseases professional societies, the pharmaceutical 
and diagnostics industries, and others to create an 
antibacterial resistance strategic plan to assist in 
prioritizing research critical in this area.
    Anti-Malarial Medications.--The Committee encourages NIAID 
to increase its support for public-private partnerships focused 
on developing anti-malarial medications and for research and 
development of alternatives to artemisinin combination 
therapies in response to the rapidly emerging threat of 
artemisinin resistance.
    Food Allergies.--The Committee is pleased with the support 
and clinical advancement of promising food allergy research at 
NIAID and NIDDK. NIH is currently evaluating potential 
immunotherapy protocols for clinical implementation in children 
and adults with food allergy. The Committee encourages NIAID to 
continue its public-private partnerships in support of clinical 
immunological, immunomodulator, and mechanistic studies, with 
private donors and foundations as components of ongoing 
clinical trials.
    Hepatitis B.--The Committee is pleased with the emergence 
of new and improved drugs to treat hepatitis B and the role 
that NIAID continues to play in this effort. However, drugs are 
effective in only half of the population, and for those 
patients that can take these medications there is still only a 
50 percent reduction in mortality over a 10-year period. The 
Committee urges a more aggressive effort in this area.
    Microbicides.--The Committee encourages NIAID to continue 
coordination with USAID, the State Department, and others to 
advance antiretroviral [ARV]-based microbicide development 
efforts, with the goals of enabling regulatory approval of the 
first safe and effective microbicide for women and supporting 
product development and efficacy trials of alternative ARV-
based microbicides.
    Neglected Tropical Diseases [NTDs].--The Committee urges 
NIAID to continue its investment in neglected tropical disease 
and malaria research, including translational research for 
NTDs, and to work with other agencies as a part of the Global 
Health Initiative to foster research and ensure that basic 
discoveries are translated into solutions.
    Nontuberculous Mycobacterial [NTM] Disease.--The Committee 
urges NIAID to intensify research into NTM infections so that 
more effective interventions can be developed for patients.
    Regional Biocontainment Laboratories [RBLs].--NIAID 
established 13 RBLs in response to the NIAID Strategic Plan for 
Biodefense Research in 2002. Since their creation, the RBLs 
have not received any additional Federal funding from NIAID 
specifically for facility operations. The Committee asks NIAID 
to provide a report by June 1, 2013, that details NIAID's plans 
for the RBLs. The report shall include, at a minimum, projected 
Federal funding needs, program goals, and a long-term plan for 
the RBLs.
    Specimen Collection.--Collecting specimens is critical to 
research and development of diagnostic tests or other 
activities intended to advance the treatment, detection, 
identification, prevention, or control of antimicrobial-
resistant infections. The Committee urges NIAID, in conjunction 
with CDC, ASPR, and the FDA, to consult with representatives 
from diagnostics and pharmaceutical companies, academia, and 
professional societies to explore the most effective way to 
provide samples, including the feasibility of creating a 
biorepository of prospectively collected specimens.
    TB.--The Committee strongly urges NIAID to expand its 
research into the development of new TB diagnostic tests, 
drugs, and vaccines, particularly regarding drug-resistant TB 
and totally drug-resistant TB.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2012....................................  $2,427,742,000
Budget estimate, 2013...................................   2,378,835,000
Committee recommendation................................   2,387,112,000

    The Committee recommendation includes $2,387,112,000 for 
NIGMS.
    Institutional Development Awards [IDeA].--The Committee 
provides $276,480,000 to continue increased support for the 
IDeA program. The Committee recognizes the importance of the 
Centers of Biomedical Research Excellence [COBRE] and the IDeA 
Networks of Biomedical Research Excellence [INBRE] programs. 
The Committee believes the IDeA program has made a significant 
contribution to biomedical research and creating a skilled 
workforce. Therefore, the Committee continues the $45,882,000 
increase from fiscal year 2012 and recommends that one-half the 
increase go toward new COBRE awards. The increase should be 
paid for by a reduction in funding across NIH ICs.
    The Committee encourages the NIH Director to expand the 
program to support co-funding IDeA projects across NIH ICs to 
foster the development of efforts in IDeA State programs. 
Further, as an Office of Experimental Program to Stimulate 
Competitive Research [EPSCoR] program, the focus of IDeA should 
continue to be on improving the necessary infrastructure and 
strengthening the biomedical research capacity and capability 
of research institutions. Unfortunately, many institutions in 
EPSCoR-qualifying States who could benefit from the IDeA 
program are ineligible for funding. Therefore, the Committee 
directs the IDeA Director to expand IDeA eligibility to all NSF 
EPSCoR-eligible States.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                              DEVELOPMENT

Appropriations, 2012....................................  $1,320,151,000
Budget estimate, 2013...................................   1,320,600,000
Committee recommendation................................   1,324,603,000

    The Committee recommendation includes $1,324,603,000 for 
NICHD.
    Children in Military Families.--Given that nearly 2 million 
children live in military families and 700,000 children have 
been affected by a recent or current deployment of a parent, 
the Committee commends NICHD for supporting research on the 
impact of these experiences on child health and well-being and 
on the effectiveness of programs designed to address the 
psychosocial and mental health needs of children and their 
families. Studies are needed to examine the unique 
developmental challenges of children when the mother or female 
head of household is deployed to a combat zone, the process of 
adjustment when military personnel return home, and the long-
term consequences of separation and reintegration on children's 
development.
    Chromosome Abnormalities.--The Committee continues to 
support additional research on chromosome abnormalities and 
urges NICHD to consider holding a state of the science meeting 
focusing on strategies aimed at devising treatments for 
recurring and nonrecurring copy number changes. The Committee 
further urges new funding to support other independent 
investigators whose work can provide pilot data or insight into 
future directions for the study of more chromosome 
abnormalities, particularly those involving chromosome 18. The 
Committee requests an update on these activities, focusing on 
non-Down syndrome research, in the fiscal year 2014 
congressional budget justification.
    Demographic Research.--The Committee commends NICHD for 
supporting large-scale databases, such as the National 
Longitudinal Survey of Youth, the Child Development Supplement 
of the Panel Study of Income Dynamics, and the Fragile Families 
and Child Well-Being Study, and demographic research 
activities, such as the Population Research Infrastructure 
Program. These investments have generated key scientific 
findings, illuminating in particular the relationship between 
socioeconomic status and individuals' health and well-being. As 
NICHD implements its ambitious reorganization and scientific 
visioning process in fiscal year 2013, the Committee urges the 
Institute to continue its commitment to supporting demography 
and population science.
    Kidneys and Childhood Development.--The Committee urges 
NICHD, in consultation with NIDDK, to undertake efforts to 
examine the role of normal kidney development and/or function 
in neonatal and child health. Specific areas to be addressed 
should include: kidney function in low-birth weight infants; 
how chronic acidosis, untreated hypertension, or recurrent 
urinary tract infections affect child development; the impact 
of childhood-onset hypertension on adult cardiovascular health; 
and the identification of genetic and epigenetic factors that 
may subsequently result in kidney injury and progression of 
hypertension and chronic kidney disease.
    Orthotics and Prosthetics.--As America's population ages, 
the demand for orthotic and prosthetic care to address the 
effects of stroke, diabetes, cardiovascular disease, and other 
health issues continues to grow. To date, little comparative 
effectiveness and outcomes research has been conducted to 
establish which patients benefit most from which orthotic and 
prosthetic services, supports, and devices. The Committee 
supports evidence-based research in prosthetic and orthotic 
care, and urges NICHD and the National Center for Medical 
Rehabilitation Research to coordinate with DOD and the 
Department of Veterans' Affairs to develop and pursue a 
research agenda that responds to the most pressing needs of the 
field.
    Pediatric Functional Gastrointestinal Disorders [FGIDs].--
The Committee encourages NICHD to work with NIDDK to support 
research addressing FGIDs in children.
    Pheochromocytoma.--The Committee is concerned that the 
current funding for the diagnosis, pathophysiology, and 
molecular biology of pheochromocytoma is inadequate to meet the 
rapidly expanding patient base and growing need for research 
into pheochromocytoma and paraganglioma. The Committee 
recommends NIH expand the funds available for this effort.
    Preeclampsia.--The Committee is concerned by the lack of 
progress made in understanding the causes of and risks 
associated with preeclampsia and the related conditions of 
eclampsia and HELLP syndrome, which can result in disability or 
death for a mother and premature delivery or death for an 
infant. The Committee encourages NICHD to work with other ICs 
to share research findings and facilitate additional research 
into ways to better prevent, manage, and identify interventions 
for these conditions.
    Preterm Births.--The Committee commends NICHD on its work 
to prevent preterm births and encourages the Institute to take 
into account that there are a number of conditions which 
increase the risk of neurologic damage. The Committee urges 
NICHD and NINDS to undertake studies into interventions during 
pregnancy and/or labor to improve neonatal outcome, 
particularly neurologic outcome. The Committee also requests 
that NICHD identify the steps necessary to establish one or 
more transdisciplinary research centers for prematurity as 
recommended by the IOM.
    Severe Maternal Morbidity.--The Committee understands that 
NICHD is exploring the feasibility of holding a scientific 
workshop to harmonize definitions for maternal morbidity. The 
Committee urges NICHD to reach a positive decision, as uniform 
definitions would help Federal, State, and local agencies and 
research institutions establish standardized and interoperable 
processes for surveillance, data collection, and research.
    Spinal Muscular Atrophy [SMA] Care Protocols.--The 
Committee is aware that clinical practice guidelines for SMA 
are under preliminary development by advocacy groups in concert 
with expert investigators and clinicians. In the absence of 
evidence-based care protocols, the efficacy of the care 
received by SMA patients depends largely upon geographic 
proximity to experienced care centers and clinicians. Many SMA 
patients receive care that is inconsistent with best practices, 
and this variability negatively impacts individual patients as 
well as clinical trial results for SMA therapies. The Committee 
encourages NICHD to support natural history and care studies of 
SMA to facilitate the development of clinical practice 
guidelines that will bring uniformity to the medical care 
received by SMA patients and significantly improve the 
management of the disease. The Committee further encourages 
NICHD to facilitate the sharing of data and data sources 
between stakeholders involved in such studies.
    Vulvodynia.--The Committee is pleased with the progress 
that NICHD has made over the last fiscal year in expanding 
extramural research support for vulvodynia, ensuring adequate 
representation of vulvodynia experts on peer-review panels, 
convening a vulvodynia workshop, and developing a research plan 
on this condition. The Committee calls upon the Director to 
build upon these initial efforts by carrying out the 
recommendations from the strategic research plan and expects to 
be updated on the Institute's progress in the fiscal year 2014 
congressional budget justification. The Committee also notes 
that vulvodynia frequently coexists with other persistent pain 
conditions, including interstitial cystitis, fibromyalgia, 
temporomandibular disorders, irritable bowel syndrome, 
endometriosis, headache, and chronic fatigue syndrome. The 
Committee is pleased with NICHD's participation in the trans-
NIH research initiative to support studies aimed at identifying 
etiological and mechanistic pathways of these overlapping 
conditions, and the Institute is encouraged to continue its 
work in this area.

                         NATIONAL EYE INSTITUTE

Appropriations, 2012....................................    $702,049,000
Budget estimate, 2013...................................     693,015,000
Committee recommendation................................     695,115,000

    The Committee recommendation includes $695,115,000 for NEI.
    Diabetic Eye Disease.--The Committee continues to support 
the important work of the NEI Diabetic Retinopathy Clinical 
Research Network.
    Genetic Basis of Eye Disease.--The Committee commends NEI 
for identifying more than 500 genes associated with both common 
and rare eye diseases, enabling an understanding of disease 
mechanisms and development of potential therapies for such 
blinding eye conditions as age-related macular degeneration 
[AMD], glaucoma, and retinitis pigmentosa [RP]. The Committee 
is pleased that NEI's AMDGene Consortium has validated eight 
previously known gene variants and identified 19 new gene 
variants, and that the NEI Glaucoma Human Genetics 
Collaboration [NEIGHBOR] has identified the first risk variant 
in a gene thought to play a role in the development of the 
optic nerve head, the degeneration of which leads to glaucoma 
and loss of peripheral vision.
    Translational Research.--The Committee recognizes NEI's 
translational research initiatives and is pleased that the NEI-
led human gene therapy clinical trial for Leber congenital 
amaurosis has resulted to date in 15 patients being treated and 
experiencing visual improvement. The Committee applauds NEI's 
pioneering work that is enabling further research into ocular 
gene therapy through the launch of clinical trials for AMD, 
choroideremia, Stargardt disease, and Usher syndrome, as well 
as pre-clinical safety trials for RP, juvenile retinoschisis, 
and achromatopsia.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2012....................................    $684,923,000
Budget estimate, 2013...................................     684,030,000
Committee recommendation................................     686,103,000

    The Committee recommendation includes $686,103,000 for 
NIEHS.
    Endocrine Disruption and Women's Health.--The Committee 
urges NIEHS to increase its research on the effects of 
endocrine-disrupting chemicals on women's health outcomes. An 
update is requested in the fiscal year 2014 congressional 
budget justification.
    Gulf Oil Spill.--The Committee commends NIEHS for the Gulf 
Long-Term Follow-Up [GuLF] Study of 55,000 clean-up and 
response workers whose activities have involved potential 
exposures to oil, combustion by-products from burning oil, and 
oil dispersants that may be associated with adverse health 
consequences. In addition, the Committee commends the National 
Toxicology Program for its assessment of the toxicological 
effects of crude and weathered oil and dispersants, as well as 
NIH for its grants to community-university consortia for 
research on the effects of the oil spill on the health of the 
people of the gulf coast. The Committee urges NIEHS and other 
Institutes to continue their support of these important 
studies.
    Women's Health and the Environment.--The Committee urges 
NIEHS to increase its research in several areas of special 
importance to women's health: exposures that may initiate or 
promote autoimmune diseases; exposures associated with risk of 
uterine fibroids; the effects of engineered nanomaterials in 
consumer products, especially cosmetics and personal care 
products; and environmental exposures that are associated with 
increased time to pregnancy.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 2012....................................  $1,121,400,000
Budget estimate, 2013...................................   1,102,650,000
Committee recommendation................................   1,124,265,000

    The Committee recommendation includes $1,124,265,000 for 
NIA.
    Alzheimer's Disease.--In order to build upon the strong 
body of work already being done in NIH-funded Alzheimer's 
Disease Research Centers, the Committee urges NIH to take 
advantage of existing well-characterized, longitudinal, 
population-based cohort studies and the existing research 
infrastructure these large-scale cohort studies have already 
established to provide new insights into risk factors and 
protective factors related to cognitive decline and dementia. 
The Committee feels strongly that additional research is needed 
in minority populations that are at particularly high risk for 
cognitive decline and dementia.
    Biology of Aging.--The Committee applauds NIA's leadership 
role in the Geroscience Interest Group, which will promote 
coordinated discussion and action across NIH on research to 
reduce the burden of age-related disease.
    Cognitive Interventions.--The Committee encourages NIA to 
continue support of studies to identify environmental, 
behavioral, and social factors that could protect against age-
related cognitive decline as well as randomized studies to test 
the efficacy of behavioral and social interventions to slow or 
reverse age-related cognitive decline.
    Demographic Research.--The Committee recognizes NIA for 
supporting research on the demographic, economic, and social 
consequences of an aging population in the United States and 
worldwide. A premier example of this research is the Health and 
Retirement Study, a longitudinal survey of more than 26,000 
Americans that is now being replicated in over 30 other 
countries.
    Measurement of Well-Being.--The Committee commends NIA for 
working with the Economic and Social Research Council in Great 
Britain to develop subjective measures of well-being as a 
complement to objective health measures and traditional 
economic indicators of progress. The Committee encourages the 
continued development of these metrics and their incorporation 
into national surveys.
    Neuropsychology and Alzheimer's.--Recognizing that 
neuropsychological assessment can provide detailed information 
about cognitive deficits related to dementia or trauma, the 
Committee encourages NIA to continue research that links 
neuropsychological markers with Alzheimer's biomarkers.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2012....................................    $535,280,000
Budget estimate, 2013...................................     535,610,000
Committee recommendation................................     537,233,000

    The Committee recommendation includes $537,233,000 for 
NIAMS.
    Heritable Connective Tissue Disorders.--The Committee 
encourages NIAMS to expand its collaborative efforts with other 
Institutes to support clinical and translational research aimed 
at identifying effective therapies for heritable connective 
tissue disorders, particularly Marfan syndrome.
    Osteogenesis Imperfecta [OI].--The Committee urges NIAMS to 
support natural history studies of OI that will facilitate 
efforts by advocacy groups and medical professional societies 
to develop clinical practice guidelines for adults living with 
OI and to increase research on emerging issues. The Committee 
encourages NIAMS to work with relevant stakeholders from 
government, medical professional societies, and advocacy groups 
on this matter and to provide an update in the fiscal year 2014 
congressional budget justification.
    Scleroderma.--The Committee continues to be pleased with 
the progress of the Institute as it relates to scleroderma. The 
Committee encourages NIAMS to concentrate efforts on 
identifying genetic components that increase the likelihood of 
developing this disease.
    Temporomandibular Disorders [TMD].--Many people who have 
TMD suffer from conditions that routinely affect other joints 
in the body, such as trauma, arthritis, and fibromyalgia. 
Therefore, the Committee calls on NIAMS to collaborate with 
NIDCR and NIBIB to bring the intellectual and scientific 
resources within these Institutes to the study of the jaw 
anatomy and physiology and the complex neural, endocrine, and 
immune system interactions that orchestrate jaw function and 
trigger jaw joint pathology. NIAMS should integrate findings 
from studies of the structure, mechanical function, metabolism, 
and blood flow of bone, joints, and muscles with studies of 
central and peripheral neural pathways, as well as the 
endocrine, paracrine, and cytokine factors that impact upon 
craniofacial structures as a means to understanding the 
underlying causes of jaw pain and dysfunction.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2012....................................    $415,880,000
Budget estimate, 2013...................................     417,297,000
Committee recommendation................................     418,562,000

    The Committee recommendation includes $418,562,000 for 
NIDCD.
    Clinical Trials for Human Communication Disorders.--The 
Committee encourages NIDCD to expand its clinical trials 
program and commends the Institute for a funding opportunity 
announcement that encourages industry collaboration and 
requires both clinical and basic scientists to be a part of 
research teams.
    Dementia and Hearing Loss.--The Committee recognizes the 
association of unaddressed hearing loss with pre-dementia and 
dementia and advocates investigating whether hearing loss is a 
cause for dementia, whether hearing-loss interventions will 
slow or halt dementia, and how rehabilitative interventions for 
hearing loss can be delivered in communities.
    Early Detection, Diagnosis, and Intervention.--The 
Committee urges NIDCD to continue research on the auditory, 
speech, language, voice, and psychosocial outcomes of children 
identified with hearing loss through newborn screening. 
Additionally, the Committee is aware of data that show a higher 
prevalence of hearing loss than thought among school-age 
children who passed newborn screening. Therefore, the Committee 
recommends more research on methods of screening for both mild 
hearing loss in infancy and for late-onset hearing loss. The 
Committee also encourages NIDCD to continue studying optimal 
sound amplification strategies for children's hearing aids, 
particularly to enhance speech recognition in noisy classrooms, 
and the effects of services and parental engagement on the 
emotional well-being of the hearing-impaired child.
    Hair Cell Regeneration and Replacement.--The Committee 
continues to place a high priority on research involving 
cellular regeneration of the inner ear. The Committee advocates 
the goals to identify genes and factors that promote 
regeneration cited in the 2012-2016 NIDCD Strategic Plan for 
Research.
    Hearing Aids and Cochlear Implants.--The Committee 
encourages additional research that compares the benefits of 
high- and lower-cost hearing aids, creates screening protocols 
for hearing loss in primary care settings, and continues 
collaborations between industry, scientists, clinicians, and 
consumers in the area of low-cost hearing aids. The Committee 
recommends further studies of the relationship between the 
success of hearing aid fittings and the cognitive capabilities 
of the hearing aid user, and supports further development of an 
automated hearing-screening kiosk. The Committee is pleased 
that NIDCD is funding cochlear implant research for those with 
severe-to-profound hearing loss and recommends additional 
studies on new electrode design and innovative approaches to 
speech processing. The Committee further urges continued 
research into studies evaluating and comparing the benefits of 
the ``bimodal'' option of an implant in one ear and a hearing 
aid in the other, and of a middle ear implantable device that 
combines electromechanical and acoustical stimulation in the 
same ear. The Committee encourages NIDCD to continue to monitor 
cochlear-implanted children as they enter school, including 
their development of higher-order cognitive and language 
skills, speech production and recognition, and behavioral and 
social adjustment.
    Hearing Impairment Among Children and Young Adults.--The 
Committee urges additional research on children and young 
adults with mild and unilateral hearing loss from all modes of 
injury. In particular, the Committee recommends further studies 
on this group's diminished educational outcomes and development 
of strategies to improve school achievement. The Committee 
commends NIDCD for ``It's a Noisy Planet!'', a public education 
effort in English and Spanish about the dangers of hearing loss 
from noise exposure. The Committee also encourages NIDCD to 
continue to explore new ways to engage and broaden audiences 
through social media.
    Hereditary Hearing Impairment.--The Committee encourages 
additional efforts by NIDCD to identify and understand the 
structure, function, and regulation of genes whose mutation 
results in deafness and other communication disorders.
    Noise-Induced and Environmental Hearing Loss.--The 
Committee continues to encourage NIDCD to promote public 
awareness of the importance of protecting hearing from noise, 
through public service announcements or other means. The 
Committee also encourages studies in normal-hearing children of 
the impact of noisy classrooms on learning, continuation of a 
study measuring hearing thresholds and noise exposure levels in 
18- to 25-year-olds, and environmental and genetic research 
into factors that predispose individuals to noise-induced 
hearing loss.
    Otitis Media.--The Committee supports continuing studies to 
develop new treatments for chronic and recurrent otitis media 
(ear infections), including treatment via a trans-tympanic 
antibiotic gel and prevention through intranasal vaccines.
    Presbycusis.--The Committee urges NIDCD to continue 
multidisciplinary physiological and neurological studies of the 
peripheral and central mechanisms of presbycusis, or age-
related hearing loss. It commends establishment of the NIDCD 
Otopathology Research Collaboration Network and NIDCD's 
National Temporal Bone, Hearing and Balance Pathology Resource 
Registry to disseminate information about temporal bone 
donation.
    Salt Intake and Salt Substitute.--The Committee encourages 
NIDCD to study whether taste perception will change following 
reduced salt intake and to determine the biological mechanisms 
of salt-taste transduction.
    Synapses.--The Committee supports research on genetic and 
cellular mechanisms of normal synapse function and on 
approaches to prevent or reverse deafness-caused disruptions.
    Tinnitus.--The Committee urges NIDCD to investigate 
preventions, treatments, and cures for tinnitus, which remains 
the most prevalent service-connected disorder for U.S. military 
personnel. Continuing research on the specific neural 
dysfunction responsible for tinnitus and on ways to suppress 
hearing system hyperactivity is essential. The Committee urges 
additional studies of the effect on tinnitus of stimulation of 
the vagus nerve with an implantable electrode.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2012....................................    $144,633,000
Budget estimate, 2013...................................     144,153,000
Committee recommendation................................     144,590,000

    The Committee recommendation includes $144,590,000 for 
NINR.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2012....................................    $459,085,000
Budget estimate, 2013...................................     457,104,000
Committee recommendation................................     458,489,000

    The Committee recommendation includes $458,489,000 for 
NIAAA.
    Prevention and Brief Intervention.--The Committee applauds 
the release of NIAAA's new youth alcohol screening guide and 
encourages the Institute to continue to promote alcohol 
screening of children and adolescents. The Committee urges 
NIAAA to pursue its plans to evaluate the guide both for 
detecting risk of alcohol problems and as an initial screen for 
other risky behaviors. The Committee also commends NIAAA's 
efforts to develop a matrix of interventions for addressing 
alcohol problems on college and university campuses and in the 
surrounding communities. Providing information on the 
effectiveness, cost, personnel requirements, and ease of 
implementation of individual and environmental interventions 
will assist college and university presidents and other 
administrators as they work to reduce harmful alcohol use among 
their students. The Committee recognizes the critical role of 
psychological research in understanding and addressing underage 
drinking.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2012....................................  $1,052,373,000
Budget estimate, 2013...................................   1,054,001,000
Committee recommendation................................   1,057,196,000

    The Committee recommendation includes $1,057,196,000 for 
NIDA.
    Collaboration With the FDA.--The Committee applauds the 
role NIDA is playing to facilitate the growth of regulatory 
science at FDA's Center for Tobacco Products. The research NIDA 
oversees will inform policies on regulating tobacco-product 
advertising, labeling, marketing, constituents, ingredients, 
and additives. As such, the Committee commends NIDA for helping 
establish the science base for regulatory policies that are 
expected to influence tobacco-product risk perceptions, 
exposures, and use patterns in the short term, and to reduce 
tobacco-related morbidity and mortality in the long term. In 
particular, the Committee recognizes that large-scale research 
on national, longitudinal cohorts like the Population 
Assessment of Tobacco and Health study will be critical for 
assessing the impact of FDA regulatory authority over tobacco 
products and help to inform future activities.
    Education.--The Committee recognizes and encourages the 
educational efforts of NIDA to inform the public of the 
deleterious effects of abused substances and the life-
threatening dangers of drug addiction. Adolescents and 
returning veterans and their families are at a high risk for 
drug abuse and therefore should be areas of focus.
    Medications Development.--The Committee encourages NIDA to 
continue its efforts to develop medications to treat diseases 
of addiction.
    Military Personnel, Veterans, and Their Families.--The 
Committee commends NIDA for its efforts to coordinate and 
support research with the Department of Veterans Affairs and 
other NIH Institutes on substance abuse and associated problems 
among U.S. military personnel, veterans, and their families. 
The Committee encourages NIDA to continue work in this area.
    Prescription Drug Abuse.--Prescription drug abuse has been 
the focus of much work by NIDA and remains a high priority. The 
Committee encourages NIDA to maintain its comprehensive 
leadership role in the effort to halt this epidemic.
    Translational Research.--The Committee encourages NIDA to 
continue its efforts to understand how genetics, age, 
environment, and other factors affect the use of experimental 
drugs and the development of addiction.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2012....................................  $1,478,868,000
Budget estimate, 2013...................................   1,479,204,000
Committee recommendation................................   1,483,687,000

    The Committee recommendation includes $1,483,687,000 for 
NIMH.
    Autism.--The Committee commends NIMH for its leadership on 
autism research and encourages the Institute to ensure that 
such research focuses on both genetic and environmental causes. 
The Committee also encourages NIMH to collaborate with NIEHS 
regarding environmental causation.
    Combination HIV Prevention.--With recent scientific 
advances demonstrating the promise of biomedical HIV prevention 
interventions, behavioral research is needed more than ever to 
bolster medication adherence and treatment uptake, document 
real-world decisionmaking processes associated with biomedical 
interventions, and better understand potential unintended and/
or undesired consequences of biomedical interventions. The 
Committee urges NIMH to support a robust HIV/AIDS behavioral 
prevention research agenda that examines these factors and 
includes operations research to optimize combination HIV 
prevention.
    Mental Health Disparities.--Rural and minority individuals 
can be vulnerable to emotional disorders for a number of 
reasons. Greater rates of poverty among some ethnic and 
minority groups and rural populations, relationships between 
low socioeconomic status and some mental disorders, and greater 
risk of poverty among people with certain mental illnesses can 
create a vicious cycle. In addition, cultural differences in 
symptom expression and attitudes toward mental illness can make 
recognition and diagnosis of mental disorders in these 
populations difficult. Further, minorities living in rural 
areas are particularly likely to be medically underserved, 
facing significant barriers to getting needed mental 
healthcare. The Committee encourages NIMH to fund research 
efforts to find innovative ways to address mental health 
disparities in underserved populations, especially in 
designated Psychiatric Manpower Shortage Areas.
    Premature Mortality.--The Committee continues to be 
concerned about premature mortality and lower life expectancy 
experienced by adults living with serious mental illness as a 
result of treatable medical conditions such as cardiovascular, 
pulmonary, endocrine, and infectious diseases. The Committee 
urges NIMH to continue its collaborations with other 
Institutes, including NIDDK and NHLBI, to pursue research to 
better understand the causes and interventions needed to 
address this crisis. The Committee requests an update in the 
fiscal year 2014 congressional budget justification.
    Psychotropic Drugs and Children.--In a November 2011 letter 
to State Medicaid directors, HHS officials noted that children 
in foster care are prescribed antipsychotic medications at 
nearly nine times the rate of other children receiving 
Medicaid. A December 2011 study by GAO reported similar 
findings, noting that prescriptions to foster children in the 
States GAO analyzed were more likely to have indicators of 
potential health risks. The Committee is pleased that NICHD, in 
collaboration with NIMH, is working to better understand the 
impact of medications on the growth and development of 
children. In light of the clinical vulnerability of many 
children in foster care, the Committee encourages both 
Institutes to assign this research a high priority as well as 
to examine evidence-based, nonpharmaceutical interventions to 
treat children with behavioral and mental health issues.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2012....................................    $512,727,000
Budget estimate, 2013...................................     511,370,000
Committee recommendation................................     512,920,000

    The Committee recommendation includes $512,920,000 for 
NHGRI.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2012....................................    $338,038,000
Budget estimate, 2013...................................     336,896,000
Committee recommendation................................     337,917,000

    The Committee recommendation includes $337,917,000 for 
NIBIB.

       NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

Appropriations, 2012....................................    $127,937,000
Budget estimate, 2013...................................     127,930,000
Committee recommendation................................     128,318,000

    The Committee recommendation includes $128,318,000 for 
NCCAM.
    Access to Natural Product Collections.--The Committee 
continues to applaud NCCAM's efforts to increase access to 
comprehensive and professionally organized natural product 
libraries, which are a major source of pharmaceutical leads and 
therapeutic agents.

      NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2012....................................    $276,179,000
Budget estimate, 2013...................................     279,389,000
Committee recommendation................................     280,236,000

    The Committee recommendation includes $280,236,000 for 
NIMHD.
    Diabetes.--The Committee recognizes that more research and 
education are needed on the disparate effects of diabetes on 
minority populations. The Committee urges NIMHD to expand its 
research on pre-diabetes and diabetes, particularly type 2 
diabetes in minority populations. This research should identify 
clinical, socioeconomic, geographical, cultural, and 
organizational factors that contribute to diabetes in such 
populations. Specifically, the Committee encourages NIMHD to 
analyze behavior and obesity.
    Obesity.--The Strategic Plan for NIH Obesity Research 
emphasizes the need for a transdisciplinary, multifaceted 
approach to address the complex factors that have resulted in 
the growing obesity problem in the United States. The Committee 
supports NIH's actions to date and the findings of the task 
force, but remains concerned that while the essential plan and 
direction may be in place, a better mechanism is needed to 
coordinate a trans-NIH, multidisciplinary effort to address the 
complicated nature of the obesity problem. The Committee urges 
NIH to intensify its investment in obesity research, in 
particular in populations that are most affected--racial and 
ethnic minorities, low-income populations, and rural 
populations. The Committee again strongly recommends that NIH 
review the benefits of establishing a Comprehensive Center of 
Excellence for Obesity Research and Prevention within NIMHD to 
better coordinate efforts within NIH and with other Federal 
agencies. The Committee believes that a comprehensive center 
could serve to capitalize on the health disparities efforts 
already underway at NIMHD and leverage both intramural and 
extramural research programs across NIH.

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

Appropriations, 2012....................................     $69,556,000
Budget estimate, 2013...................................      69,758,000
Committee recommendation................................      69,969,000

    The Committee recommendation includes $69,969,000 for FIC.
    The Committee continues to support FIC's efforts to foster 
long-term research and training partnerships between U.S. 
research institutions and those in developing countries.

          NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2012....................................    $574,823,000
Budget estimate, 2013...................................     639,033,000
Committee recommendation................................     631,346,000

    The Committee recommendation includes $631,346,000 for 
NCATS. The Committee includes bill language allowing up to 
$40,000,000 of this amount to be used for the Cures 
Acceleration Network [CAN]. The fiscal year 2012 funding level 
for CAN is $9,981,000 and the budget request includes bill 
language allowing up to $50,000,000 for this purpose.
    The Committee is encouraged by the direction of this new 
Center. In particular, the Committee applauds the recent launch 
of a collaborative program that will match researchers with a 
selection of pharmaceutical industry compounds to help 
scientists explore new treatments for patients. NCATS has 
partnered initially with three pharmaceutical companies that 
have agreed to make dozens of their compounds available for a 
new initiative called Discovering New Therapeutic Uses for 
Existing Molecules. These are compounds that have already 
cleared several key steps in the development process, but were 
abandoned by the companies because they were not 
therapeutically effective on the targeted diseases. Researchers 
will test these compounds for their effectiveness against other 
diseases and conditions. The companies will provide the 
researchers with access to the compounds and all related 
research data. Participating industry partners will retain the 
ownership of their compounds, while academic research partners 
will own any intellectual property they discover through the 
research project with the right to publish the results of their 
work. This initiative encapsulates the kind of collaboration 
between NIH and the pharmaceutical industry that the Committee 
envisioned when creating NCATS.
    Congenital Diaphragmatic Hernia [CDH].--The Committee 
encourages ORDR to support dedicated research funding directed 
for CDH, which affects approximately 1,600 babies in the United 
States every year. The Committee urges ORDR to put a high 
priority on research related to finding the causes of CDH and 
requests an update in the fiscal year 2014 congressional budget 
justification.
    Clinical and Translational Science Awards [CTSAs].--The 
Committee encourages NCATS to continue the focus of the CTSA 
program on the full spectrum of translational research.
    Dystonia.--The Committee commends ORDR's support of the 
Dystonia Coalition Patient Registry.
    Hereditary Angioedema [HAE].--The Committee recognizes that 
few treatment options are available for HAE and that they are 
not effective for all patients. The Committee encourages ORDR 
to continue to reinvigorate HAE research at NIH and help 
identify new pathways for interventions.
    Rehabilitation Research.--The Committee encourages NCATS to 
include rehabilitation research as a priority area of 
investigation.
    Therapeutics for Rare and Neglected Diseases [TRND] 
Program.--The Committee commends NIH for establishing and 
growing the TRND program, and encourages NIH to fund the 
projects with the highest likelihood of success, regardless of 
disease state. In particular, the Committee commends TRND for 
supporting a Fragile X partnership to accelerate potential new 
treatments that benefit patients with this rare and neglected 
disease. The Committee also encourages TRND to continue 
supporting development of treatments for Duchenne muscular 
dystrophy to bridge the gap between a basic research discovery 
and the testing of drugs in humans.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2012....................................    $345,522,000
Budget estimate, 2013...................................     380,851,000
Committee recommendation................................     381,981,000

    The Committee recommends $381,981,000 for NLM. This amount 
includes $8,200,000 from transfers available under section 241 
of the PHS Act. Of the funds provided, $4,000,000 is for the 
improvement of information systems, to remain available until 
September 30, 2014.
    Disaster Information Management.--The Committee applauds 
NLM's support of the Disaster Information Management Research 
Center [DIMRC], which has made important contributions to the 
Nation's disaster preparedness and response efforts through the 
rapid creation of information resources for specific events; 
development of innovative information tools to aid in disaster 
preparedness, response, and recovery; the establishment of a 
disaster information specialty among librarians; and its 
participation in the Bethesda Hospital Emergency Preparedness 
Partnership. The Committee encourages NLM to continue to work 
through DIMRC with Federal and non-Federal partners, including 
the library community, to identify and implement best practices 
for maintaining access to health information before, during, 
and after disasters; develop innovative resources and tools to 
aid emergency responders and managers; collect, organize, and 
disseminate disaster health information; promote the 
development of disaster information specialists; engage the 
library community in disaster information management; conduct 
research into disaster health informatics; and develop and 
export community-based models of health resiliency during 
disasters.

                         OFFICE OF THE DIRECTOR

Appropriations, 2012....................................  $1,458,501,000
Budget estimate, 2013...................................   1,429,161,000
Committee recommendation................................   1,431,341,000

    The Committee recommendation includes $1,431,341,000 for 
the Office of the Director [OD].
    The Committee includes bill language allowing up to 
$165,000,000 to be used for continuation of the National 
Children's Study. The budget request includes $165,000,000, but 
does not specify this amount in bill language. The fiscal year 
2012 level is $193,098,000.
    The Committee recommendation includes $544,930,000 for the 
Common Fund. This is the same amount as the budget request and 
the fiscal year 2012 level.
    Alzheimer's Disease.--The long-term costs of Alzheimer's 
disease, both in terms of lives and resources, are enormous. 
The Committee strongly urges the Director and all relevant ICs 
to increase funding for research on Alzheimer's disease to the 
greatest extent possible within their budgets. However, the 
Committee strongly disagrees with the President's budget 
request to allocate $80,000,000 of the PPH Fund for Alzheimer's 
disease research at NIH. NIH research is not an appropriate use 
of the PPH Fund. Additionally, the Committee believes it would 
set a dangerous precedent to provide specific amounts of NIH 
funding for individual diseases. The Committee notes that it 
took the same position in fiscal year 2010 when the 
administration proposed allocating specific levels of funding 
for cancer and autism research. The Committee also notes that 
NIH has flexibility to prioritize funding for individual 
diseases when the scientific opportunities and the number of 
high-quality applications warrant an increase. HHS took this 
very approach in April when it announced a transfer of 
$18,300,000 of fiscal year 2012 funds within NIH, as part of an 
overall strategy to increase NIH's investment in Alzheimer's 
research by $50,000,000.
    The Committee recommends that NIH allocate resources for 
Alzheimer's research according to the priority research 
recommendations included in the National Alzheimer's Plan 
required under the National Alzheimer's Project Act. NIH is 
also encouraged to consider entering into public-private 
partnerships to accelerate the discovery and development of 
small molecule therapeutics that could potentially improve the 
symptoms and modify the course of Alzheimer's disease.
    Career Development Awards for Clinical Researchers.--The 
Committee is encouraged by the Director's efforts to strengthen 
the biomedical research workforce and recommends the continued 
awarding of NIH Career Development Awards, or ``K'' Awards, to 
train clinical researchers.
    Cerebral Palsy.--The Committee notes that NIH funding for 
research on cerebral palsy has long been disproportionately low 
compared with that of similar diseases that affect fewer 
people. The Committee urges NIH to put a higher priority on 
cerebral palsy in fiscal year 2013.
    Chimpanzees.--The Committee commends NIH for adopting the 
IOM's recommendations regarding research involving chimpanzees 
in the December 2011 report ``Chimpanzees in Biomedical and 
Behavioral Research: Assessing the Necessity.'' The IOM found 
that chimpanzees are ``largely unnecessary'' for current 
research. One possible exception cited by the IOM is efficacy 
testing of a prophylactic hepatitis C vaccine, but the report 
pointed to several alternatives which are currently in 
development that could eliminate any need for chimpanzees in 
this type of research. The Committee urges NIH to put a 
priority on developing these alternatives.
    Class B Animal Dealers.--The Committee commends NIH for 
moving to end the use of Class B random source dealers as 
suppliers of dogs and cats to its grant recipients by recently 
announcing a ban, effective October 1, 2012, on the acquisition 
of cats from Class B random source dealers. The Committee urges 
NIH to implement the ban on the acquisition of dogs from Class 
B random source dealers no later than 2015 and requests an 
update on this matter in the fiscal year 2014 congressional 
budget justification.
    Collaboration With DOE.--The Committee commends NIH and 
DOE's national laboratories for their collaboration on research 
and development projects, which have resulted in advances in 
bioinformatics and breakthroughs in atomic resolution 
structural biology. The Committee encourages the Director and 
ICs to continue these collaborations.
    Collaboration With the FDA.--The Committee commends NIH for 
its participation in a NIH-FDA Joint Leadership Council to help 
ensure that regulatory considerations form an increasing 
component of biomedical research planning and that the latest 
science is integrated into the regulatory review process. The 
Director is urged to continue this joint effort to advance the 
translation of biomedical research discoveries into approved 
diagnostics and therapies as well as promote science to enhance 
the evaluation tools used for regulatory review.
    Congenital Muscular Dystrophy.--The Committee applauds NIH 
for its growing support of congenital muscle disease research, 
particularly in congenital muscular dystrophy and congenital 
myopathy, which will yield returns across the muscular 
disorders. The Committee also commends NINDS and NIAMS for its 
financial support of scientific conferences to identify common 
therapeutic targets and action plans toward clinical trial 
readiness. The Committee urges NIH to continue supporting 
grants and other funding mechanisms to advance key congenital 
muscle disease initiatives for clinical trial readiness and 
requests an update in the fiscal year 2014 congressional budget 
justification on total dollars spent on congenital muscular 
dystrophy and congenital myopathy research.
    Cystic Fibrosis [CF].--While the life expectancy of CF 
patients has slowly improved, the Committee remains concerned 
regarding the severe morbidity and early mortality associated 
with the condition. The Committee supports further research 
regarding treatments that target the underlying cause of CF, 
building upon the success of the recently approved new drug 
Kalydeco. The Committee encourages support for protein 
structural studies that may advance the understanding of 
mechanisms of action of CF drugs in clinical development and 
also encourages the use of new technologies to discover, 
develop, and characterize the effect of new treatments, 
including the use of airway imaging to characterize the 
function of the airways. The Committee also notes the potential 
for research in CF to have applications on a wide array of 
human diseases, and urges continued work to identify the 
applications of CF treatments to other disease states.
    Doctors of Veterinary Medicine [DVMs] and Loan Repayment 
Programs.--The Committee recognizes the important role that 
DVMs play in the biomedical research enterprise because of 
their background and training in disease processes across all 
animals, including cross-species virus transmission, and animal 
models. As with other medical professionals, large debt upon 
graduation influences their choice to pursue careers in 
biomedical research. DVMs participate on clinical research 
teams and are eligible in that capacity for loan repayments 
under the Clinical Research and Clinical Research for 
Individuals from Disadvantaged Backgrounds loan repayment 
programs. NIH is encouraged to make this information more 
widely known to potential applicants, ICs, and reviewers.
    Down Syndrome.--The Committee commends NIH for its ongoing 
efforts to implement the NIH Down Syndrome Research Plan and 
for establishing the NIH Down Syndrome Consortium, which is 
focused on facilitating a dialogue between trans-NIH Institutes 
and the Down syndrome patient community. Increased Federal 
funding for translational research is important, and investing 
in Down syndrome-centered research has the potential for 
benefiting many other diseases and conditions such as 
Alzheimer's disease. The Committee encourages NIH to increase 
the amount invested in investigator-driven research grants and 
plan for the development of the Down syndrome clinical 
database, research registry, and biobank. NIH is also urged to 
establish workshops and mentoring programs to encourage young 
researchers and scientists to successfully pursue NIH grants 
for Down syndrome research.
    Drug Allergy.--The Committee is concerned about the 
incidence of allergic reactions to drugs for debilitating and 
potentially fatal diseases including cancer, HIV/AIDS, cystic 
fibrosis, and rheumatoid arthritis. The Committee requests an 
update in the fiscal year 2014 congressional budget 
justification regarding ways in which NCI, NHLBI, NIAMS, and 
other relevant Institutes can collaborate with NIAID to support 
research on desensitization of patients who have allergic 
reactions to potentially life-saving medications.
    Duchenne Muscular Dystrophy.--The Committee is aware of 
multiple governmental and nongovernmental efforts to develop 
patient registries containing valuable data from patients with 
Duchenne muscular dystrophy. Such registries are critically 
important to continue advancing Duchenne public health and 
research projects, but the Committee is concerned about the 
lack of coordination and potential duplication of efforts. The 
Committee encourages NIH, working through the Muscular 
Dystrophy Coordinating Committee and with the private 
organizations that predominantly fund these registries, to 
convene a meeting to discuss coordination of all the Duchenne 
patient registries to the extent possible. The Committee 
requests an update on this topic in the fiscal year 2014 
congressional budget justification.
    Eating Disorders.--The Committee continues to be concerned 
about the alarming effects of eating disorders on women's 
health including elevated mortality rates and associated health 
consequences, such as serious cardiac conditions, kidney 
failure, gastrointestinal disorders, and osteoporosis. The 
Committee urges NIH to expand, intensify, and coordinate its 
activities with respect to research on eating disorders and to 
examine the possibility of creating collaborative consortia on 
eating disorders research with a specific emphasis on basic and 
clinical investigations into the causes, diagnosis, and 
treatment of these conditions. The Committee requests an update 
on this topic in the fiscal year 2014 congressional budget 
justification.
    Eosinophil-Associated Disorders.--The Committee is pleased 
that a NIAID working group is developing a research agenda on 
eosinophilic disorders. The Committee requests an update in the 
fiscal year 2014 congressional budget justification regarding 
programmatic initiatives being undertaken based on the working 
group's recommendations. In addition to NIAID and NIDDK, the 
Committee urges NHLBI, NICHD, NIMH, and other relevant 
Institutes to participate in these efforts. Further, NIH should 
seek opportunities to collaborate with private sector 
organizations on this initiative.
    False Positives and Replications.--The Committee supports 
NIH's effort to develop a consensus on the issues of false-
positive research results. This effort will encourage policies 
on the publishing of replications (and nonreplications) of 
previous research and advance scientific knowledge.
    Fragile X-Associated Disorders.--The Committee commends NIH 
for the NICHD-led effort to update the NIH Research Plan on 
Fragile X Syndrome and Associated Disorders in light of the 
significant progress made toward targeted drug treatments since 
the plan was published. The Committee urges NIH to fully 
implement and prioritize the updated goals and objectives. In 
particular, NIH is encouraged to support translational research 
that shows significant promise of safer and more effective 
treatments for Fragile X-associated disorders. The Committee 
also encourages NIH to work with CDC to support and coordinate 
Federal investments in data collection efforts related to 
Fragile X.
    Glomerular Disease.--The Committee continues to be 
concerned about the impact of idiopathic nephrotic syndrome 
[NS] and primary focal segmental glomerulosclerosis [FSGS] 
within the minority community, particularly given the 
increasing body of research linking FSGS to gene variants 
predominately expressed in African Americans. The Committee 
urges NIMHD to collaborate with NIDDK on NS and FSGS research. 
The Committee commends ORDR for its support of the Nephrotic 
Syndrome Rare Diseases Clinical Research Network and recognizes 
the potential impact of this study for patients with NS and 
FSGS and their families. Finally, the Committee urges NIDDK to 
continue to support research on NS and FSGS in order to develop 
treatments and cures that could ultimately prevent end-stage 
renal disease.
    Human Tissue Supply.--The Committee remains committed to 
matching the increased needs of NIH-funded researchers, both 
intramural and extramural, who rely upon human tissues and 
organs to study human diseases, both common and rare, and who 
strive to translate research advances and discoveries into 
treatments and cures. Furthermore, the Committee recognizes 
that the national demand for high-quality human biospecimens 
will continue to grow, as will its importance to advancing 
translational research across NIH. Therefore, the Committee 
urges the Director to expand core and trans-NIH support for its 
nationwide human tissue and organ procurement program.
    Interstitial Cystitis [IC].--The Committee commends ORWH 
for its support of research on IC. The Committee understands 
that IC disproportionately affects women and encourages ORWH to 
continue to work with NIDDK to support specialized centers of 
research that serve as a valuable source of IC research.
    Lupus.--Given the scope and impact lupus has on virtually 
every organ system in the body, advances in lupus research 
require studies that transcend multiple disciplines, including 
genetics, basic and applied immunology, proteomics, and 
therapeutics. Therefore, the Committee urges the establishment 
of a trans-NIH coordinating committee on lupus that could focus 
on developing a comprehensive NIH research strategy and 
identifying gaps in lupus research.
    Lymphatic Research and Lymphatic Disease.--The Committee 
commends the trans-NIH Coordinating Committee for Lymphatic 
Research [CCLR] for its efforts. As the Committee has 
previously requested, more oversight and engagement are needed 
by the Director and ICs to help make meaningful advances in 
research of the lymphatic system and medical care for lymphatic 
diseases. Furthermore, in keeping with the 2007 CCLR Working 
Group recommendations, the Committee urges the CCLR to work 
cooperatively to create interdisciplinary programs to train new 
investigators, such as an annual primer course for doctoral and 
postdoctoral candidates. The Committee also expects greater 
involvement by NIBIB, especially in carrying forth the CCLR 
Working Group quantitative and molecular imaging 
recommendations. Finally, the Committee urges NCATS to provide 
representation to the CCLR.
    mHealth.--New mobile and wireless health technologies, 
known as mHealth, are likely to have a profound impact on 
biomedical research and the delivery of healthcare. The 
Committee applauds OBSSR for leading efforts to systematically 
evaluate the impact of new technologies. The Committee is 
pleased that virtually all of the NIH Institutes and NSF are 
collaborating in this area.
    Minority Researchers.--The Committee is deeply concerned by 
the findings of the recent study ``Race, Ethnicity, and NIH 
Research Awards,'' which shows a disparity in the rates at 
which African Americans received NIH R01 grants. The Committee 
looks forward to the findings of the blue ribbon panel 
examining this matter.
    Mitochondrial Disease.--The Committee applauds the progress 
that NIH has made to advance research on mitochondrial disease 
and dysfunction. Among other activities, NICHD has worked to 
cultivate new researchers in the field and, in collaboration 
with ORDR and NINDS, continued support for the North American 
Mitochondrial Disease Consortium. ORDR also convened a major 
workshop with the participation of numerous ICs to identify 
scientific opportunities and barriers to research advances. The 
Committee requests that a strategy to implement the workshop 
recommendations be developed.
    Mucopolysaccharidoses [MPS].--The Committee encourages 
NINDS, NICHD, NIDDK, NIAMS, and ORDR to continue to expand 
research efforts in the development of effective treatments for 
MPS. The Committee also urges all relevant ICs and ORDR to 
continue funding research consortia and conferences on MPS and 
other lysosomal diseases, such as the annual Lysosomal Disease 
Network WORLD meeting and the Gordon research conference 
scheduled for 2013. Finally, the Committee encourages NIAMS to 
continue to support investigator-initiated research focused on 
the skeletal complications associated with MPS.
    National Children's Study.--The Committee is troubled that 
after appropriating nearly $1,000,000,000 for the NCS since the 
first work on it began in fiscal year 2000, only a few thousand 
children have been enrolled and fundamental questions about the 
project's implementation still remain, particularly regarding 
the methods that will be used to recruit participants. The 
Committee hopes that the budget request, a 15-percent reduction 
below the fiscal year 2012 level, represents a positive sign 
that NIH intends to bring the costs of the NCS under control 
and spend its appropriation more efficiently.
    NIH's recently announced plan to switch to a provider-based 
rather than a household-based recruitment strategy will help 
achieve some of the necessary savings and may offer scientific 
benefits as well. At the same time, special efforts must be 
made to ensure that the new strategy will not leave out 
disadvantaged or underrepresented groups that are most 
negatively affected by health disparities. Plans to collect 
environmental as well as biological samples also should not be 
sacrificed.
    Most important, it remains unclear whether a provider-based 
approach can accommodate the original goal of constructing a 
national probability sample that could be generalized to the 
entire U.S. population. The Committee believes NIH should make 
every possible effort to fulfill that goal within a sustainable 
long-term budget.
    The Committee directs the Secretary to enter into an 
agreement within 90 days of enactment of this act with the 
National Academy of Sciences to review the NCS' sampling 
strategy.
    The Committee is also aware of the confusion and disruption 
caused by NIH's decision to let the Vanguard Study contracts 
expire--a decision that caught many academic institutions by 
surprise. The Committee strongly urges NIH to improve its level 
of communication with the research community about any future 
changes to the project.
    National Primate Research Centers.--The Committee supports 
the NPRCs and expects they will receive the same level of 
attention in the OD that they received in the now-dissolved 
National Center for Research Resources.
    Neurofibromatosis [NF].--The Committee continues to support 
efforts to increase funding and resources for NF research and 
treatment at multiple NIH Institutes, including NCI, NHLBI, 
NINDS, NICHD, NIMH, NIDCD, NIAMS, NEI, and NHGRI. The Committee 
requests brief updates on NF-related activities at these ICs in 
the fiscal year 2014 congressional budget justification.
    Overlapping Chronic Pain Conditions.--The Committee 
recognizes that NIH has taken seriously its repeated calls for 
an improved and expanded research effort to better understand 
overlapping chronic pain conditions including chronic fatigue 
syndrome, endometriosis, fibromyalgia, interstitial cystitis, 
irritable bowel syndrome, chronic headache, temporomandibular 
disorders, and vulvodynia. The Committee is aware that initial 
progress is being made toward the development and 
implementation of a trans-NIH research initiative to support 
studies aimed at identifying etiological and mechanistic 
pathways of these overlapping conditions, with a state of the 
science meeting scheduled for summer 2012. The Committee hopes 
that the meeting will lay out a clear and concrete set of 
recommendations for an aggressive trans-NIH research agenda. 
The Committee notes that the chronic pain conditions listed 
above are also ideal candidates for inclusion in the Patient-
Reported Outcomes Measurement Information System, as many 
chronic pain patients use multiple individualized approaches to 
manage pain symptoms.
    Pain.--The Committee commends NIH for its efforts so far to 
respond to the IOM report ``Relieving Pain in America: A 
Blueprint for Transforming Prevention, Care, Education and 
Research.'' For example, NIH has designated NINDS as the lead 
Institute for coordinating pain research efforts across the 
organization; selected a cadre of 11 Centers of Excellence for 
Pain Education; begun to develop new informational material for 
the public and medical professionals on pain conditions; and 
instituted more frequent meetings of the NIH Pain Consortium. 
The Committee strongly urges NIH to expand on such efforts 
while giving appropriate attention to overlapping chronic pain 
conditions that solely or disproportionately impact women. The 
Committee believes that pain research would be an appropriate 
subject for inclusion in the Common Fund, as advances in this 
area would benefit all Institutes. Finally, the Committee 
agrees with the IOM report recommendation that NIH increase 
financial resources and staffing support for the Pain 
Consortium.
    Pediatric Low Grade Astrocytoma [PLGA].--The Committee is 
encouraged by advancements in research on slow-growing 
children's brain tumors but remains concerned by the long-term 
physical and cognitive disabilities caused by surgery, 
chemotherapy, and radiation treatments for PLGA children. The 
Committee urges NIH to establish a special emphasis panel with 
a focus on identifying and validating new therapeutic targets 
in these tumors. Research should emphasize the development of 
novel preclinical models of pediatric brain tumors (both mouse 
and other nonmammalian models), novel drug development and 
testing, target identification and validation, and improved 
drug delivery modalities. The Committee requests an update on 
these topics in the fiscal year 2014 congressional budget 
justification.
    Pregnancy Health Status.--Epidemiologic studies have shown 
that a woman's health status during pregnancy is associated 
with her health after pregnancy, suggesting that findings in 
pregnancy may be a better indicator for determining a woman's 
future health status than traditional risk factors. The 
Committee encourages NICHD, NHLBI, and NIDDK to work together 
to more closely study these epidemiologic findings in an effort 
to identify predictive markers during pregnancy for subsequent 
heart disease and diabetes; develop tests to evaluate health 
after pregnancy; and test interventions both during and after 
pregnancy that may mitigate risk.
    Rehabilitation Research.--The Committee recognizes and 
supports efforts of the Blue Ribbon Panel on Medical 
Rehabilitation Research to identify gaps in rehabilitation 
research. The Committee believes that the panel's findings 
warrant meaningful steps by the Director to enhance the stature 
of, and emphasis is on, medical rehabilitation and disability 
research at NIH.
    Sex-Based Biology.--It is now more than 10 years since the 
IOM report ``Exploring the Biological Contributions to Human 
Health: Does Sex Matter?'' confirmed that biological 
differences between males and females affect health, burden of 
disease, healthcare, and health outcomes, but significant 
disparities continue to exist. Understanding the basic biology 
of the impact of sex/gender in development, diagnosis, and 
treatment of disease could help improve the health of women. 
Therefore, the Committee urges NIH to analyze sex at all levels 
of biomedical research, including the basic animal and cellular 
levels, and to form interdisciplinary teams of basic and 
clinical investigators interested in unraveling the biology of 
sex differences.
    Sleep Disorders.--The Committee recognizes that sleep or 
circadian disorders impact conditions such as hypertension, 
diabetes, obesity, heart attack, and stroke. The Committee 
urges implementation of the National Sleep Disorders Research 
Plan's recommendations for the continuation of multi-Institute 
research collaborations to address such conditions.
    Tox21 Program.--The Committee supports NIH's leadership 
role in the Tox21 program, a collaborative effort with the EPA 
and the FDA to adopt advanced molecular biological and 
computational methods in lieu of animal toxicity tests for 
conducting chemical risk assessments. The Committee encourages 
NIH to continue to expand its extramural support for the use of 
human biology-based experimental and computational approaches 
in health research to further define toxicity and disease 
pathways and develop tools for their integration into 
evaluation strategies. Extramural and intramural funding should 
be made available for the evaluation of the relevance and 
reliability of Tox21 methods and prediction tools to assure 
readiness and utility for regulatory purposes, including pilot 
studies of pathway-based risk assessments. The Committee asks 
NIH to provide a report on fiscal year 2012 and 2013 funding 
for these activities in the fiscal year 2014 congressional 
budget justification.
    Tuberous Sclerosis Complex [TSC].--The Committee 
understands that TSC is the largest single genetic cause of 
more prevalent neurological disorders such as autism and 
epilepsy and therefore encourages NINDS to focus resources on 
new drug targets for TSC and encourages NINDS and NIMH to focus 
resources on clinical trials for TSC. Because TSC impacts tumor 
growth and health of multiple organ systems, including skin, 
lung, kidney, and brain, the Committee encourages NCI, NIAMS, 
NHLBI, NIDDK, NINDS, NICHD, and ORDR to focus resources on 
methods to detect and treat manifestations of TSC in these 
organ systems.
    Underrepresented Groups in Science.--The Committee commends 
OBSSR for its work to establish a comprehensive and cohesive 
process to track the efforts of government, universities, 
private foundations, and associations to enhance minority 
participation in the sciences.

                        OFFICE OF AIDS RESEARCH

    OAR coordinates the scientific, budgetary, legislative, and 
policy elements of the NIH AIDS research program. The Committee 
recommendation does not include a direct appropriation for OAR. 
Instead, the Director of OAR and the Director of NIH together 
determine the total for AIDS research within the total NIH 
appropriation, and the Director of OAR determines and allocates 
distribution of those funds to the ICs and OAR. The 
recommendation includes a general provision permitting the NIH 
Director and OAR to shift up to 3 percent of AIDS research 
funding among Institutes and Centers throughout the year if 
needs change or unanticipated opportunities arise.
    The Committee commends NIH for supporting the AIDS and non-
AIDS funding allocations at their current relative rates and 
endorses the continuation of this policy. The Committee 
recognizes that OAR's AIDS allocation to each IC is based on 
scientific need and opportunity. Therefore, individual IC AIDS 
budgets may not each grow at the same rate, but total AIDS and 
non-AIDS funding will continue to grow at a comparable rate.
    The Committee includes bill language permitting OAR to use 
up to $8,000,000 for construction or renovation of National 
Primate Research Centers. This amount is the same as the fiscal 
year 2012 level and the budget request.

                        BUILDINGS AND FACILITIES

Appropriations, 2012....................................    $125,308,000
Budget estimate, 2013...................................     125,308,000
Committee recommendation................................     125,308,000

    The Committee recommendation includes $125,308,000 for NIH 
buildings and facilities. This funding will remain available 
for obligation for 5 years, as in the fiscal year 2012 bill. 
The budget request proposes making the funding available until 
expended.

       Substance Abuse and Mental Health Services Administration

    The Committee recommends $3,472,213,000 for SAMHSA. The 
recommendation includes $129,667,000 in transfers available 
under section 241 of the PHS Act. The comparable level for 
fiscal year 2012 is $3,476,682,000 and the administration 
request is $3,316,266,000. In addition, the Committee 
recommends transferring $88,000,000 to SAMHSA from the PPH 
Fund. The total program level assumed in this bill for SAMHSA 
is $3,560,213,000.
    SAMHSA is responsible for supporting mental health programs 
and alcohol and other drug abuse prevention and treatment 
services throughout the country, primarily through categorical 
grants and block grants to States.
    The Committee continues to provide funding for Programs of 
Regional and National Significance [PRNS] under each of 
SAMHSA's statutorily created centers and directs that SAMHSA 
shall account for all of its PRNS funding in this manner, which 
shall include future budget requests. SAMHSA's authorization 
states that the agency's work to improve the provision of 
mental health and substance abuse services shall be established 
and carried out by the agency's three centers. Therefore, 
SAMHSA shall account for the funding for all of its programs, 
contracts and activities through the accounts, budget line 
items, and categories identified in this act and the 
accompanying Senate report. The Committee requests that the 
fiscal year 2014 congressional justification include budgetary 
and programmatic information on programs as they existed in 
fiscal year 2013, even if the budget request proposes a new 
structure or consolidation in fiscal year 2014.
    The Committee is extremely concerned that the increases 
provided to the Community Mental Health Services Block Grant 
[MHBG] and SAPT Block Grant in last year's conference report 
were eroded by the administration's decision to tap 1.25 
percent of both block grants for program evaluation transfers 
pursuant to section 241 of the PHS Act. In prior years the 
administration has exempted these block grants from being used 
as a source for these evaluation transfers. The Committee 
directs SAMHSA and the Department to exempt these two programs 
from being used as a source for PHS evaluation transfers in 
fiscal year 2013, as was done prior to fiscal year 2012.

                   CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2012....................................    $953,859,000
Budget estimate, 2013...................................     923,895,000
Committee recommendation................................     968,497,000

    The Committee recommends $968,497,000 for mental health 
services. The recommendation includes $21,039,000 in transfers 
available under section 241 of the PHS Act. In addition, the 
Committee recommends transferring $45,000,000 to CMHS from the 
PPH Fund. The total program level assumed in this bill for CMHS 
is $1,013,497,000. Included in the recommendation is funding 
for programs of regional and national significance, the MHBG, 
children's mental health services, PATH, and PAIMI.

Programs of Regional and National Significance

    The Committee recommends $270,394,000 for PRNS within CMHS. 
The comparable level for fiscal year 2012 is $275,756,000 and 
the administration request is $219,550,000. In addition, the 
Committee recommends that $45,000,000 be transferred to PRNS 
from the PPH Fund. The total program level assumed in this bill 
for PRNS at CMHS is $315,394,000. These programs address 
priority mental health needs through developing and applying 
evidence-based practices, offering training and technical 
assistance, providing targeted capacity expansion grants, and 
changing the delivery system through family, client-oriented, 
and consumer-run activities.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Seclusion and Restraint.....................................           2,444           1,149           2,444
    Youth Violence Prevention...................................          23,156          23,156          12,817
    National Child Traumatic Stress Initiative..................          45,713          45,713          48,713
    Children and Family Programs................................           6,474           6,474           6,474
    Consumer and Family Network Grants..........................           6,224           4,966           6,224
    MH System Transformation and Health Reform..................          10,603          10,603          10,603
    Project LAUNCH..............................................          34,640  ..............          34,640
    Primary and Behavioral Healthcare Integration...............          30,749  ..............          30,749
    Primary and Behavioral Healthcare Integration--PPH Fund.....          35,000          26,004          35,000
    Suicide lifeline............................................           5,512           5,512           5,512
    Suicide lifeline--PPH Fund..................................           1,705  ..............           1,705
    GLS Youth Suicide Prevention (State Grants).................          29,682          29,374          29,682
    GLS Youth Suicide Prevention (State Grants)--PPH Fund.......           5,760  ..............           5,760
    GLS Youth Suicide Prevention (Campus Grants)................           4,966           4,858           4,966
    GLS Youth Suicide Prevention (Campus Grants)--PPH Fund......           1,530  ..............           2,535
    AI/AN Suicide Prevention Initiative.........................           2,938           2,938           2,938
    Homelessness Prevention Programs............................          30,772          30,772          30,772
    Minority AIDS...............................................           9,265          22,770           9,265
    Criminal and Juvenile Justice Programs......................           6,672           4,281           4,281
    Grants for Adult Trauma Screening and Brief Intervention....  ..............           2,896           2,896
SCIENCE AND SERVICE:
    GLS Suicide Prevention Resource Center......................           4,948           4,948           4,948
    GLS Suicide Prevention Resource Center--PPH Fund............           1,005  ..............  ..............
    Practice Improvement and Training...........................           7,863           7,437           7,437
    Primary & Behavioral Healthcare Integration T.A.............           1,996  ..............           1,996
    Primary & Behavioral Healthcare Integration T.A.--PPH Fund..  ..............           1,996  ..............
    Consumer & Consumer Support T.A. Centers....................           1,923           1,923           1,923
    Minority Fellowship Program.................................           5,089           3,755           5,089
    Disaster Response...........................................           1,052           2,950           2,950
    Homelessness................................................           2,302           2,302           2,302
    HIV/AIDS Education..........................................             773             773             773
----------------------------------------------------------------------------------------------------------------

    Child Trauma.--The Committee reiterates its strong support 
for the National Child Traumatic Stress Initiative [NCTSI] and 
its work on behalf of children, families, and communities 
affected by a wide range of trauma, including physical and 
sexual abuse, natural disasters, sudden death of a loved one, 
and the impact of war on military families. The Committee 
provides $48,713,000 under section 582 of the PHS Act to 
support the continuance of the current model and mission of the 
NCTSI by providing grants to the National Center for Child 
Traumatic Stress [NCCTS] and academic, clinical, and community-
based centers for the purposes of developing knowledge of best 
practices, offering trauma training to child-serving providers, 
and providing mental health services to children and families 
suffering from PTSD and other trauma-related disorders. The 
Committee is aware that SAMHSA is developing a new definition 
of trauma-informed services to be used by NCTSI grantees and 
expects to be informed of any major changes before they are 
implemented.
    The Committee also recognizes the extraordinary value of 
the core data set developed by the NCCTS. Within the total 
provided, the Committee provides $1,500,000 to the NCCTS for 
the targeted collection of new outcome data from selected NCTSI 
centers and related analyses and reports.
    Minority Fellowship Program.--The Committee continues to be 
concerned that while minorities represent 30 percent of the 
population and are projected to increase to 40 percent by 2025, 
only 23 percent of recent doctorates in psychology, social 
work, and nursing were awarded to minorities. The Committee 
has, therefore, continued funding at last year's level for the 
Minority Fellowship Program.
    Primary and Behavioral Healthcare Integration.--The 
Committee continues to direct SAMHSA to ensure that new 
Integration grants awarded for fiscal year 2013, from both 
discretionary and PPH funds, are funded under the authorities 
in section 520K of the PHS Act.
    Project LAUNCH.--The Committee intends that funds provided 
to Project LAUNCH not duplicate activities eligible for funding 
elsewhere in the Department. The Committee reiterates its 
intention that funds provided to this program focus on mental 
health promotion and promotion strategies for children aged 0 
to 8.
    Seclusion and Restraint.--The Committee recommends 
$2,444,000 for seclusion and restraint activities at CMHS. The 
Committee is deeply concerned that a recent Department of 
Education report showed that tens of thousands of students with 
disabilities are physically restrained in school systems across 
the country. There are also widespread media reports of persons 
with mental illnesses and developmental disabilities living in 
congregate care facilities who are subject to excessive use of 
seclusion and restraint causing psychological trauma, serious 
physical injury, and even death. The Committee urges SAMHSA to 
partner with other Federal agencies to reduce and ultimately 
eliminate the use of seclusion and restraints in institutional, 
community, and educational settings, and to promote evidence-
based alternatives to restraint and seclusion, including the 
use of positive behavioral interventions and supports.
    Suicide Prevention in Indian Populations.--The Committee 
remains concerned about the high incidence of drug and alcohol 
abuse and suicide in American Indian populations. SAMHSA is 
encouraged to continue its efforts in providing culturally 
competent suicide prevention training courses to selected 
gatekeepers in Indian country. These courses should teach 
community leaders, school personnel, and families how to 
identify and talk with at-risk individuals to motivate them to 
seek help. Courses should also include mental health support 
services information tailored to the specific geographical 
location of the participants in each program. The Committee 
further urges SAMHSA to collaborate with the Indian Health 
Service to identify priority communities and help ensure 
sustainability within American Indian/Alaska Native 
communities.

Community Mental Health Services Block Grant

    The Committee recommends $479,756,000 for the MHBG. The 
comparable fiscal year 2012 funding level and the 
administration request is $459,756,000. The recommendation 
includes $21,039,000 in transfers available under section 241 
of the PHS Act.
    The MHBG distributes funds to 59 eligible States and 
territories through a formula based on specified economic and 
demographic factors. Grant applications must include an annual 
plan for providing comprehensive community mental health 
services to adults with a serious mental illness and children 
with a serious emotional disturbance.
    The Committee provides an increase to the MHBG in 
recognition of the severe budget cuts taking place to State and 
local mental health services and facilities nationwide. At the 
same time, public mental health systems are reporting an 
increase in demand for services. The MHBG is the primary source 
of financial support for evidence-based, comprehensive services 
for low-income and uninsured persons living with serious mental 
illnesses. Increased funding for this safety net program is 
needed to meet the growing demand for services resulting from 
the economic downturn, as well as the mental healthcare needs 
of returning Iraq and Afghan war veterans and their families.

Children's Mental Health Services

    The Committee recommends $117,315,000 for the children's 
mental health services program. This amount is the same as the 
comparable fiscal year 2012 level. The administration request 
is $88,557,000. This program provides grants and technical 
assistance to support a network of community-based services for 
children and adolescents with serious emotional, behavioral, or 
mental disorders. Grantees must provide matching funds and 
services must be coordinated with the educational, juvenile 
justice, child welfare, and primary healthcare systems.
    The Committee rejects the administration's proposed cut to 
this important program. The Committee notes that in the United 
States every year 5,000 young people between the ages of 14 and 
24 commit suicide, and 600,000 make an attempt that is serious 
enough to require an emergency room visit. Furthermore, the 
Committee understands that 75 percent of psychiatric illness 
occurs before the age of 24. This public health crisis is 
exacerbated by the fact that there are only 7,500 child and 
adolescent psychiatrists and 3,500 child psychologists 
nationwide to treat this vulnerable population. The Committee 
encourages SAMHSA to seek innovative means to increase the 
number of children's mental health professionals, including 
efforts to develop bachelor's degree and master's level 
training curricula focusing on evidence-based interventions.

Projects for Assistance in Transition From Homelessness

    The Committee recommends $64,794,000 for PATH. This amount 
is the same as the comparable fiscal year 2012 level and the 
administration request. PATH addresses the needs of individuals 
with serious mental illness who are experiencing homelessness 
or are at risk of homelessness. Funds are used to provide an 
array of services, such as screening and diagnostic services, 
emergency assistance, case management, and referrals to the 
most appropriate housing environment.

Protection and Advocacy for Individuals With Mental Illness

    The Committee recommends $36,238,000 for PAIMI. This amount 
is the same as the comparable fiscal year 2012 funding level 
and the administration request. This program helps ensure that 
the rights of mentally ill individuals are protected while they 
are patients in all public and private facilities, or while 
they are living in the community, including in their own homes. 
Funds are allocated to States according to a formula based on 
population and relative per capita incomes.

Mental Health State Prevention Grants

    The Committee recommendation does not include funding 
requested by the administration to create the Mental Health 
State Prevention Grant program. The administration requests 
$55,000,000 for this program, which would promote the wellness 
of children, youth, and young adults up to age 25. Rather than 
create a new program, the Committee has provided increases to 
the MHBG and to the SAPT Block Grant.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2012....................................  $2,200,574,000
Budget estimate, 2013...................................   2,187,270,000
Committee recommendation................................   2,191,145,000

    The Committee recommends $2,191,145,000 for substance abuse 
treatment programs, including programs of regional and national 
significance and the substance abuse prevention and treatment 
block grant to the States. The recommendation includes 
$81,200,000 in transfers available under section 241 of the PHS 
Act. In addition, the Committee recommends transferring 
$25,000,000 to CSAT from the PPH Fund. The total program level 
assumed in this bill for CSAT in fiscal year 2013 is 
$2,216,145,000.

Programs of Regional and National Significance

    The Committee recommends $370,813,000 for PRNS within CSAT. 
The comparable fiscal year 2012 level is $400,242,000 and the 
administration request is $334,139,000. The recommendation 
includes $2,000,000 in transfers available under section 241 of 
the PHS Act. In addition, the Committee recommends transferring 
$25,000,000 to PRNS from the PPH Fund. The total program level 
assumed in this bill for PRNS in fiscal year 2013 is 
$395,813,000.
    Programs of regional and national significance include 
activities to increase capacity by implementing service 
improvements using proven evidence-based approaches as well as 
science-to-services activities that promote the identification 
of practices thought to have potential for broad service 
improvement.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Opioid Treatment Programs/Regulatory Activities.............           8,886           8,886           8,886
    SBIRT.......................................................          28,187  ..............          28,187
        SBIRT--Section 241 transfer (non-add)...................           2,000  ..............           2,000
    SBIRT--PPH Fund.............................................          25,000          30,000          25,000
    TCE--General................................................          27,980          13,256          13,256
    Pregnant and Postpartum Women...............................          15,970          15,970          15,970
    Strengthening Treatment Access and Retention................           1,672           1,000           1,000
    Recovery Community Services Program.........................           2,445           2,445           2,445
    Access to Recovery..........................................          98,268          93,776          87,666
    Children and Families.......................................          30,620          29,678          29,678
    Treatment Systems for Homeless..............................          41,571          41,571          41,571
    Minority AIDS...............................................          65,863          52,359          65,863
    Criminal Justice Activities.................................          66,903          65,135          65,135
SCIENCE AND SERVICE:
    Addiction Technology Transfer Centers.......................           9,064           8,081           9,064
    Minority Fellowship Program.................................             546             546             546
    Special Initiatives/Outreach................................           2,267           1,436           1,436
----------------------------------------------------------------------------------------------------------------

    Addiction Technology Transfer Centers [ATTCs].--The 
Committee continues to direct SAMHSA to ensure that ATTCs 
maintain a primary focus on addiction treatment and recovery 
services in order to strengthen the addiction workforce. As 
more individuals become eligible for substance abuse services 
through Medicaid and private insurance, the ATTC network is 
critical to ensure there are enough skilled workers to meet the 
demand in substance use disorder services.
    Addiction Workforce.--As the provision of quality substance 
use disorder services is dependent on an adequate, qualified 
workforce and SAMHSA is the lead Federal agency charged with 
improving these services, the Committee directs SAMHSA to 
continue to focus on developing the addiction workforce and 
identifying ways to address the current and future workforce 
needs of the addiction prevention, treatment, and recovery 
fields.
    Drug Treatment Courts.--The Committee continues to direct 
SAMHSA to ensure that all funding appropriated for drug 
treatment courts is allocated to serve people diagnosed with a 
substance use disorder as their primary condition. In addition, 
the Committee urges CSAT to ensure that State substance abuse 
agencies are eligible to apply for all drug treatment court 
grant programs in its portfolio. The Committee expects CSAT to 
ensure that non-State substance abuse agency applicants for any 
drug treatment court grant in its portfolio continue to 
demonstrate evidence of working directly and extensively with 
the corresponding State substance abuse agency in the planning, 
implementation, and evaluation of the grant.
    Hepatitis Testing.--The Committee notes the high incidence 
of hepatitis among injection drug users and urges SAMHSA to 
implement viral hepatitis testing as a standard of care in 
drug-treatment programs, consistent with the HHS Action Plan 
for the Prevention, Care and Treatment of Viral Hepatitis. The 
Committee encourages SAMHSA to use established best practices 
for infectious disease testing, including rapid tests.
    HIV Testing.--The Committee urges SAMHSA to expand 
voluntary routine HIV-testing services at substance abuse and 
mental health treatment clinics, consistent with the National 
HIV/AIDS Strategy Implementation Plan. The Committee requests 
an update on the implementation of these activities in SAMHSA's 
fiscal year 2014 congressional budget justification.
    Minority AIDS.--The Committee is concerned by SAMHSA's 
proposal to transfer funds to CMHS from the Minority Aids 
Initiative [MAI] administered by CSAT. According to NIDA, 1 in 
4 of those living with HIV in 2009 reported use of alcohol or 
drugs at a level that warranted treatment. In addition, 
research shows alcohol and drug use are major risk factors for 
HIV/AIDS. The Committee directs SAMHSA to maintain funding for 
CSAT's MAI and to focus on building capacity and outreach 
efforts to individuals with, or at risk of developing, a 
primary substance use disorder and to improve efforts to 
identify such individuals to prevent the spread of the disease.
    Oral Fluid Testing.--The Committee commends SAMHSA for 
updating its substance abuse testing guidelines to include oral 
fluid and encourages the agency to continue to advance oral 
fluid testing guidelines.
    Screening, Brief Intervention, and Referral to Treatment 
[SBIRT].--The Committee continues to direct SAMHSA to ensure 
that funds provided for SBIRT are used for existing evidence-
based models of providing early intervention and treatment 
services to those at risk of developing substance abuse 
disorders.

Substance Abuse Prevention and Treatment Block Grant

    The Committee recommends $1,820,332,000 for the SAPT block 
grant. The comparable funding level for fiscal year 2012 is 
$1,800,332,000. The administration request is $1,448,630,000. 
The recommendation includes $79,200,000 in transfers available 
under section 241 of the PHS Act. The block grant provides 
funds to States to support alcohol and drug abuse prevention, 
treatment, and rehabilitation services. Funds are allocated to 
the States according to a formula.
    The Committee rejects, as it did last year, the 
administration's request for a waiver of the statutory 
requirement that 20 percent of the SAPT block grant be set 
aside for substance abuse prevention. The administration 
proposes to reallocate these set-aside funds to a new Substance 
Abuse State Prevention Grant program. The Committee remains 
concerned that creating another State grant program with new 
requirements would represent an unnecessary and burdensome 
approach and would not support services being delivered on a 
continuum of prevention, treatment, and recovery support 
services.

Substance Abuse State Prevention Grants

    As explained above, the Committee recommendation does not 
include funding to create Substance Abuse State Prevention 
Grants. The administration request is $404,501,000 for this 
program, which did not receive funding in fiscal year 2012.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2012....................................    $185,956,000
Budget estimate, 2013...................................      58,877,000
Committee recommendation................................     184,433,000

    The Committee recommends $184,433,000 for CSAP, the sole 
Federal organization with responsibility for improving 
accessibility and quality of substance abuse prevention 
services.

Programs of Regional and National Significance

    The Committee provides $184,433,000 for PRNS within CSAP. 
Through these programs, CSAP supports: development of new 
practice knowledge on substance abuse prevention; 
identification of proven effective models; dissemination of 
science-based intervention information; State and community 
capacity building for implementation of proven, effective 
substance abuse prevention programs; and programs addressing 
new needs in the prevention system.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Strategic Prevention Framework/Partnership for Success......         109,754  ..............         109,754
    Mandatory Drug Testing......................................           5,196           4,906           4,906
    Minority AIDS...............................................          41,307          41,307          41,307
    Sober Truth on Preventing Underage Drinking (STOP Act)--PPH   ..............           7,000  ..............
     Fund.......................................................
    Sober Truth on Preventing Underage Drinking (STOP Act)......           6,987  ..............           7,000
SCIENCE AND SERVICE:
    Fetal Alcohol Spectrum Disorder.............................           9,802           1,000           9,802
    Center for the Application of Prevention Technologies.......           8,059           7,511           7,511
    Science and Service Program Coordination....................           4,780           4,082           4,082
    Minority Fellowship Program.................................              71              71              71
----------------------------------------------------------------------------------------------------------------

    The Committee recommendation includes funding for the 
Strategic Prevention Framework State Incentive Grant/
Partnerships for Success [SPFSIG/PFS] programs at last year's 
level. The Committee is disappointed that the agency did not 
follow its direction in last year's statement of the managers 
regarding these programs. Although Congress rejected the 
administration's proposed cut for fiscal year 2012 and level-
funded the SPFSIG/PFS programs, SAMHSA did not use funding from 
expiring grants to reinvest in new SPFSIG/PFS awards, as 
envisioned by Congress. Rather, SAMHSA proposed a new 1-year 
Prevention Achievement Grant program, which was not adequately 
described and for which no funding was explicitly appropriated 
by Congress. The Committee believes that by issuing 1-year 
grants and making frequent changes to its prevention programs, 
SAMHSA makes it difficult for States to plan and build 
capacity. In addition, with youth drug use rates increasing and 
perceptions of harm decreasing, especially for marijuana, 
SAMHSA's lack of long-term vision for prevention funding is 
deeply troubling.
    The Committee reiterates its strong support for SPFSIG/PFS 
programs, which are promising approaches to preventing the 
onset and reducing the progression of substance abuse, 
including childhood and underage drinking. The Committee 
intends that continuation awards for SPFSIG/PFS grantees should 
be made at amounts no less than what grantees received in 
fiscal year 2012. Furthermore, SAMHSA shall use any additional 
funding to provide new grants under SPFSIG/PFS. The Committee 
intends that these new grants shall be awarded as the program 
was originally designed prior to fiscal year 2011, with similar 
eligible applicants, a multiyear project period, reliance on 
epidemiological workgroups, and financial incentives for 
grantees that meet performance targets. The Committee expects 
SAMHSA to awards these multiyear grants on an annual, 
incremental basis rather than fully funding them in fiscal year 
2013.
    The Committee recognizes substance abuse prevention as a 
unique and distinct field and urges SAMHSA to promote 
programming consistent with this finding. The Committee intends 
that funds specifically appropriated for bona fide substance 
abuse and underage drinking prevention purposes shall not be 
consolidated with, reallocated to, or used for any other 
programs or initiatives in SAMHSA which do not have youth drug 
and underage alcohol abuse as a primary purpose, even if these 
other programs may have secondary effects on these goals.
    Underage Drinking.--The Committee provides a total of 
$5,000,000 for Sober Truth on Preventing Underage Drinking 
[STOP] Act Community Based Coalition Enhancement Grants. The 
Committee understands that building on the infrastructure of 
current and past Drug Free Communities grantees is the most 
effective way to invest limited Federal dollars to deal with 
underage drinking issues at the community level.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2012....................................    $136,293,000
Budget estimate, 2013...................................     119,657,000
Committee recommendation................................     128,138,000

    The Committee recommends $128,138,000 for health 
surveillance and program support activities. The recommendation 
includes $27,428,000 in transfers available under section 241 
of the PHS Act. In addition, the Committee recommends 
transferring $18,000,000 to this account from the PPH Fund. The 
total program level assumed in this bill for health 
surveillance and support is $146,138,000.
    This activity supports Federal staff and the administrative 
functions of the agency. It also provides funding to SAMHSA's 
surveillance and data collection activities, including national 
surveys such as the National Survey on Drug Use and Health.
    The Committee directs SAMHSA to provide within 90 days of 
enactment of this act a report to Congress that describes: 
SAMHSA's proposed plan for implementing its Behavioral Health 
Quality Plan, including any proposed changes or additions to 
current outcome data measures for both discretionary grants and 
the SAPT Block Grant, including the use of dashboards; a 
description of the extent to which SAMHSA is coordinating the 
development of outcome measures with other HHS agencies, 
specifically CMS; and the extent to which SAMHSA has sought and 
received stakeholder input on changes to data collection and 
outcome measures.

               Agency for Healthcare Research and Quality

Appropriations, 2012....................................    $369,053,000
Budget estimate, 2013...................................     334,357,000
Committee recommendation................................     364,053,000

    The Committee provides $364,053,000 for AHRQ through 
transfers available under section 241 of the PHS Act. In 
addition, the Committee recommends transferring $12,000,000 to 
AHRQ from the PPH Fund. The total program level assumed in this 
bill for AHRQ is $376,053,000.
    AHRQ was established in 1990 to enhance the quality, 
appropriateness and effectiveness of health services, as well 
as access to such services. In order to fulfill this mission, 
AHRQ conducts, supports, and disseminates scientific and 
policy-relevant research on topics such as reducing medical 
errors, eliminating healthcare disparities, using information 
technology, and comparing the effectiveness of drugs and 
medical procedures. AHRQ-supported research provides valuable 
information to researchers, policymakers, healthcare providers, 
and patients on ways to improve our Nation's health system and 
make healthcare more affordable.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    The Committee provides $236,331,000 for research on health 
costs, quality, and outcomes [HCQO]. The comparable funding 
level for fiscal year 2012 is $235,768,000 and the 
administration request is $206,635,000. In addition, the 
Committee recommends that $12,000,000 be transferred to HCQO 
from the PPH Fund. The total program level assumed in this bill 
for HCQO is $248,331,000. The HCQO research activity is focused 
upon improving clinical practice, improving the healthcare 
system's capacity to deliver quality care, and tracking 
progress toward health goals through monitoring and evaluation.
    Within the total provided for HCQO, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Patient-Centered Health Research................................          16,600          10,000          10,000
Prevention/Care Management......................................          15,904          15,904          15,904
Prevention/Care Management--PPH Fund............................          12,000          12,000          12,000
Value...........................................................           3,730           3,614           3,614
Health Information Technology...................................          25,572          25,572          25,572
Patient Safety..................................................          65,585          62,614          66,614
Crosscutting Activities Related to Quality, Effectiveness and            108,377          88,931         114,627
 Efficiency.....................................................
----------------------------------------------------------------------------------------------------------------

    Within the Prevention portfolio, the Committee recommends 
that $5,000,000 from the PPH Fund be transferred to support the 
Research Centers for Excellence in Clinical Preventive 
Services. The Committee also recommends $7,000,000 in PPH Fund 
transfers to support the work of the USPSTF.
    Broadening the Evidence Base.--AHRQ's research portfolio 
focuses predominantly on patient safety and healthcare quality. 
The Committee urges AHRQ to develop a more balanced research 
agenda, supporting all aspects of healthcare research outlined 
in its statutory mission, including: the cost and utilization 
of, and access to, healthcare; and the ways in which healthcare 
services are organized, delivered, and financed.
    Healthcare Delivery Systems.--The Committee notes that 
identifying and disseminating improvements to the design of 
hospital rooms and healthcare facilities has the potential to 
prevent medical errors, reduce associated costs, and save 
lives. Within the Patient Safety portfolio, the Committee 
includes $4,000,000 for research grants authorized by section 
933 of the PHS Act. These grants will provide for the creation 
of multi-disciplinary teams, consisting of patients and their 
families, clinicians, technology experts, and engineers, to 
develop and test interventions that improve the safety of 
healthcare services as well as improve accountability and 
value. This is a new activity that was not funded in fiscal 
year 2012. The administration did not request funding for this 
activity.
    Investigator-Initiated Research.--The Committee continues 
to prioritize investments in investigator-initiated research, 
which forms the backbone of AHRQ's ability to improve 
healthcare with creative and innovative approaches to ongoing 
and emerging healthcare issues. Within the Crosscutting 
Activities portfolio, the Committee provides $43,364,000, the 
same amount as the fiscal year 2012 level, for investigator-
initiated research. The administration request is $29,259,000 
for this research. The recommended funding level will allow 
ARHQ to support new investigator-initiated research grants to 
advance discovery and the free marketplace of ideas.
    Maternal-Fetal Medicine.--The practice of maternal-fetal 
medicine has made great strides. The Committee encourages AHRQ, 
in collaboration with NICHD, to conduct clinical comparative 
effectiveness research to guide best practices and clinical 
management. Special emphasis should be placed on the use of 
progesterone, when to use it and in whom, as well as on 
research that will provide guidance on optimal timing of 
delivery for maternal and fetal conditions.
    Medication Therapy Management.--The Committee recognizes 
the importance of medication therapy management [MTM] as a 
critical component of primary care services. In order to 
further integrate MTM services into primary care, the Committee 
encourages AHRQ to perform a systematic review that includes: 
the breadth and context of MTM services, a synthesis of what is 
currently known about the comparative effectiveness of MTM 
programs and program components, and a delineation of the gaps 
in the existing evidence base.
    Moving Research Into Practice.--Health services research 
has great potential to improve health and healthcare when 
widely disseminated and used. The Committee continues to 
support AHRQ's research translation activities, including 
practice-based research centers and learning networks that are 
designed to better understand healthcare delivery and quickly 
move the best available research and decisionmaking tools into 
healthcare practice.
    Quality Measure Development.--The Committee notes that 
there are significant gaps in the quality measures that 
determine whether Americans are receiving good healthcare. 
Strong, patient-centered quality measures that fill in current 
gaps will enable the evaluation and reduction of geographic 
variations in care quality and health disparities while 
improving the delivery of healthcare services, patient health 
outcomes, and population health. For this reason, the Committee 
recommendation includes $4,000,000 within the Crosscutting 
portfolio for AHRQ, in consultation with CMS, to develop 
quality measures as authorized under section 931 of the PHS 
Act. This is a new activity that was not funded in fiscal year 
2012. The administration did not request funding for this 
activity.
    Scientific Freedom in Contracted Research.--The Committee 
continues to be concerned that contractual prior restraint 
clauses on the publication of research may inadvertently stifle 
scientific freedom and hinder the dissemination of findings 
that can inform health policymaking. The Committee urges AHRQ 
to ensure that researchers have the opportunity to publish 
research findings in peer-reviewed journals without 
unreasonable restrictions to allow greater review and input 
from the scientific community.
    Training Grants.--The Committee is concerned about declines 
in the number of, and funding for, training grants for the next 
generation of researchers. Within the Crosscutting Activities 
portfolio, the Committee provides $2,250,000 for new, competing 
pre- and post-doctoral training grants. The comparable funding 
level for fiscal year 2012 is $1,500,000. The administration 
request did not include funding for new training grants.

                   MEDICAL EXPENDITURES PANEL SURVEYS

    The Committee provides $59,300,000, the same as the 
administration request and the comparable funding level for 
fiscal 2012, for Medical Expenditure Panel Surveys [MEPS]. 
These surveys collect detailed information annually from 
households, healthcare providers, and employers regarding how 
Americans use and pay for healthcare. The data from MEPS are 
used to develop estimates of healthcare utilization, 
expenditures, sources of payment, and the degree of health 
insurance coverage of the U.S. population.

                            PROGRAM SUPPORT

    The Committee recommends $68,422,000 for program support. 
This amount is the same as the administration request. The 
comparable funding level for fiscal year 2012 is $73,985,000. 
This activity funds the overall management of AHRQ, including 
salaries, benefits, and overhead costs such as rent. The 
Committee recommendation will support 305 FTEs, the same level 
as fiscal year 2012. The Committee recommendation does not 
include funding for tenant improvement costs associated with 
AHRQ's relocation. As requested by the administration, funding 
associated with a new long-term lease for AHRQ is included in 
the Office of the Secretary account.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

Appropriations, 2012

                                                        $184,279,110,000

Budget estimate, 2013

                                                         178,791,197,000
Committee recommendation
                                                         178,791,197,000

    The Committee recommends $178,791,197,000 in mandatory 
funding for grants to States for Medicaid.
    The fiscal year 2013 recommendation excludes 
$90,614,082,000 in fiscal year 2012 advance appropriations for 
fiscal year 2013. As requested by the administration, 
$106,335,631,000 is provided for the first quarter of fiscal 
year 2014.
    The Medicaid program provides medical care for eligible 
low-income individuals and families. It is administered by each 
of the 50 States, the District of Columbia, Puerto Rico, and 
the territories. Federal funds for medical assistance are made 
available to the States according to a formula that determines 
the appropriate Federal matching rate for State program costs. 
This matching rate is based on the State's average per capita 
income relative to the national average and cannot be less than 
50 percent.

                   PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2012

                                                        $230,741,378,000

Budget estimate, 2013

                                                         251,718,000,000
Committee recommendation
                                                         251,718,000,000

    The Committee recommends $251,718,000,000 in mandatory 
funding for payments to healthcare trust funds.
    This entitlement account includes the general fund subsidy 
to the Federal Supplementary Medical Insurance Trust Fund for 
Medicare part B benefits and for Medicare part D drug benefits 
and administration, plus other reimbursements to the Federal 
Hospital Insurance Trust Fund for part A benefits and related 
administrative costs that have not been financed by payroll 
taxes or premium contributions.
    The Committee provides $189,520,000,000 for the Federal 
payment to the Supplementary Medical Insurance Trust Fund. This 
payment provides matching funds for premiums paid by Medicare 
part B enrollees. The Committee further provides 
$60,744,000,000 for the general fund share of benefits paid 
under Public Law 108-173, the Medicare Prescription Drug, 
Improvement and Modernization Act of 2003. As in previous 
years, the Committee includes bill language requested by the 
administration providing indefinite authority for paying the 
general revenue portion of the part B premium match and 
provides resources for the part D drug benefit program in the 
event that the annual appropriation is insufficient.
    The Committee recommendation also includes $424,000,000 to 
be transferred to the Supplementary Insurance Trust Fund as the 
general fund share of part D administrative expenses. The 
Committee recommendation includes $610,000,000 in 
reimbursements to the HCFAC fund.

                           PROGRAM MANAGEMENT

Appropriations, 2012....................................  $3,820,112,000
Budget estimate, 2013...................................   4,820,808,000
Committee recommendation................................   4,370,112,000

    The Committee recommends $4,370,112,000 for CMS program 
management.

Research, Demonstrations, and Evaluations

    The Committee recommends $23,900,000 for research, 
demonstrations, and evaluation activities. The comparable level 
for fiscal year 2012 is $21,160,000. The administration 
requests $24,600,000, funded within program operations. The 
Committee includes sufficient funding to fulfill the 
President's request for the Medicare Current Beneficiaries 
Survey, the Research Data Assistance Center, public use data 
files, and Medicaid Analytic Data.
    CMS research and demonstration activities expand efforts 
that improve the efficiency of payment, delivery, access, and 
quality of the Medicare and Medicaid programs.
    Food Allergies.--In the United States, a patient visits an 
emergency department every 3 minutes for the treatment of a 
food-related allergic reaction. The Committee believes that 
proper management of food allergies could improve patient 
outcomes, reduce costs, and decrease the incidence of 
preventable death. The Committee encourages CMS to consider 
food allergy patients in other disease management pilot 
programs.

Program Operations

    The Committee recommends $3,156,045,000 for program 
operations. The comparable funding level for fiscal year 2012 
is $2,608,785,000 and the budget request is $3,618,487,000.
    The program operations account covers a broad range of 
activities including claims processing and program safeguard 
activities performed by Medicare contractors. These contractors 
also provide information, guidance, and technical support to 
both providers and beneficiaries.
    The Committee includes additional funding for program 
operations above the fiscal year 2012 level to help support the 
work required of CMS to implement PPACA.
    PPACA requires CMS in fiscal year 2013 to support States as 
they attempt to meet the January 1, 2014, deadline for a viable 
State-based health insurance exchange. The Committee 
recommendation includes funding to provide technical assistance 
to States, design and build the Federal fall-back exchange, 
educate Americans on the availability of subsidies, and develop 
systems to determine eligibility and protect the private health 
information of those who apply for health insurance through an 
exchange.
    The Committee recommendation also includes increased 
funding for the National Medicare Education program. This 
funding supports beneficiary materials, Internet sites, contact 
centers and support services. The Committee notes that as the 
baby boom generation ages into Medicare, the population of 
Medicare beneficiaries will grow by 36 percent by the end of 
this decade, according to Census estimates. With a record 
number of Americans signing up for Medicare benefits, the 
Committee recognizes the need to help them set up their 
Medicare benefit plans and to modify beneficiary materials and 
support systems according to the ways baby boomers are most 
accustomed to accessing information.
    Community First Choice Option.--The Committee commends CMS 
on the completion of the final rule for the implementation of 
the Community First Choice Option. The Committee directs CMS to 
provide information to State Medicaid Directors about the 
availability of the Community First Choice Option as a way to 
help States meet their obligations to expand opportunities for 
home and community based services for people with disabilities 
under the Supreme Court's decision in Olmstead v. L.C. and the 
Americans with Disabilities Act.
    Continuous Oxygen Therapy.--The Committee continues to 
encourage innovative and more cost-effective methods for 
treating hard-to-heal wounds. The Committee appreciates CMS' 
interest in commissioning a technology assessment through AHRQ 
to review evidence on continuous oxygen delivery.
    Health Insurance Literacy.--The Committee recognizes that 
to most effectively implement PPACA in medically underserved 
and at-risk communities, individuals with limited literacy and 
numeracy skills will need special attention. The Committee 
encourages CMS to work with experts to develop effective 
programs to educate these consumers on their rights and the 
resources available to help them access insurance coverage.
    Healthcare Integrated General Ledger and Accounting System 
[HIGLAS].--The Committee is pleased with the continued progress 
being made to develop and fully implement HIGLAS using ongoing 
funding from this appropriation. Over the past 7 years, at 
least $467,000,000 in additional interest has been earned in 
the Medicare Trust Funds as a result of HIGLAS implementation. 
With deployment to 14 fee-for-service Medicare contractors and 
19 Medicare administrative contractor sites, the program is on 
schedule and within its budget. The Committee expects 
deployment to continue as the remaining contractor sites are 
brought onto the system, achieving 100 percent compliance. The 
Committee requests that the fiscal year 2014 budget 
justification include lessons learned in the implementation of 
this program that may serve as a guide for other similar 
efforts to implement automated systems using commercially 
available software in the Federal Government.
    Hepatitis Screening.--An estimated two-thirds of chronic 
hepatitis C cases are baby boomers who are currently beginning 
to enroll in Medicare in large numbers. Viral hepatitis is very 
costly to treat when diagnosed in the later stages of the 
disease. The Committee believes that opt-out hepatitis B and C 
screenings at the Welcome to Medicare physical exam would 
identify a significant number of beneficiaries with 
asymptomatic liver disease and reduce Medicare costs overall. 
The Committee encourages CMS to work with CDC to determine the 
prevalence of viral hepatitis in the soon-to-enroll Medicare 
population and to develop a cost-benefit analysis on this type 
of screening.
    Pediatric Dental Services.--Although virtually all dental 
disease is fully preventable, tooth decay remains the most 
common chronic illness among children and oral healthcare is 
the most prevalent unmet healthcare need among children. 
Currently, 34 States allow dental hygienists to provide dental 
care outside of a dental office without a prior exam or pre-
authorization by a dentist. The Committee urges CMS to update 
Medicaid dental regulations to reflect how dental services are 
currently delivered in the majority of the country.
    Rural Hospital Flexibility.--In 1997, Congress created the 
Medicare Rural Hospital Flexibility Program for the purposes of 
improving access to hospital and other health services for 
rural residents. For those hospitals that did not meet the 
requirement for a minimum distance to another hospital or 
critical access hospital [CAH] of more than a 35-mile drive, or 
a 15-mile drive based on mountainous terrain or areas with only 
secondary roads, the program allowed a State to waive the 
distance requirement for one or more facilities designated as a 
necessary provider. The Committee requests a list of all CAH 
facilities grandfathered into the program through the State 
waiver system.
    Vaccinations.--The Committee is concerned that the majority 
of healthcare workers, who are at high risk of contracting 
infectious disease, do not get regularly recommended 
vaccinations. In addition, adult vaccination rates are 
particularly low for minority groups. The Committee supports 
efforts by CMS to incorporate seasonal influenza vaccination 
rates into hospital payment updates and performance metrics and 
urges CMS to require Medicare-certified hospitals to offer the 
seasonal influenza vaccine to healthcare workers.

State Survey and Certification

    The Committee recommends $375,203,000, the same as the 
fiscal year 2012 level, for State survey and certification 
activities. The administration's request is $387,353,000.
    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety, and program 
standards. On-site surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys.
    The Committee encourages CMS to complete its efforts to 
collect uniform staffing data based on payroll extracts from 
skilled nursing facilities and nursing facilities reimbursed by 
Medicare and Medicaid. The Committee requests an update from 
CMS on its progress in the fiscal year 2014 budget 
justification.

High-Risk Insurance Pools

    The Committee includes $44,000,000, the same as the fiscal 
year 2012 level, for high-risk insurance pools. The budget 
request is $22,004,000.

Federal Administration

    The Committee recommends $770,964,000, the same as the 
fiscal year 2012 level, for Federal administration costs. The 
budget request is $792,964,000.

                  HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2012....................................    $309,790,000
Budget estimate, 2013...................................     610,000,000
Committee recommendation................................     610,000,000

    The Committee recommends $610,000,000, to be transferred 
from the Medicare trust funds, for health care fraud and abuse 
control [HCFAC] activities.
    The Committee recommendation includes a base amount of 
$311,000,000 and an additional $299,000,000 through a budget 
cap adjustment authorized by section 251(b) of the Balanced 
Budget and Emergency Deficit Control Act of 1985.
    This amount, in addition to the $1,296,665,000 in mandatory 
monies for these activities, will provide a total of 
$1,906,665,000 for HCFAC activities in fiscal year 2013.
    Improper Payments.--The Committee is encouraged by the work 
of the Medicare fee-for-service [FFS] Recovery Audit Contractor 
[RAC] program. While there is clear value in rectifying 
improper payments, the Committee feels strongly that a larger 
benefit of the Medicare FFS RAC program lies in its ability to 
help identify potential vulnerabilities in the payment system. 
The list of potential vulnerabilities, which CMS identifies 
from RAC reports, allows CMS to make system changes that can 
prevent improper payments in the future. Unfortunately, in 
2010, a GAO report found that CMS has no formal process in 
place to ensure that RAC-identified vulnerabilities are 
addressed. The Committee directs CMS to include in its annual 
report to Congress an accounting of reported vulnerabilities 
each fiscal year broken down by type of improper payment, 
including the number of vulnerabilities identified; the 
financial cost of the vulnerabilities reported; the number that 
have been addressed with a change to the system; the number 
that have a system change identified but are waiting for the 
change to be made; the number that CMS has decided a system 
change is unfeasible; and the number that are waiting CMS 
review.
    Senior Medicare Patrol [SMP].--The Committee strongly 
supports the SMP, administered by ACL with historical financial 
assistance from CMS. The Committee is concerned that the return 
on investment [ROI] calculation included in the performance 
metrics of the program does not adequately reflect outcome data 
on SMP fraud referrals. The Committee requests that a more 
accurate ROI calculation be developed for this important 
program. The Committee further directs CMS, ACL, DOJ, and HHS 
OIG to work to improve the process of informing beneficiaries 
and volunteers when their tips result in a conviction, a 
recovery, or a change to Medicare policies.
    Transparency Reporting.--The Committee urges CMS to ensure 
transparency and accountability through the accurate reporting 
of transfers of value from drug, device, and group purchasing 
industries to physicians and teaching hospitals. The Committee 
encourages CMS to finalize procedures to comply with section 
6002 of PPACA in time to require data collection in 2013. The 
Committee supports the statutory goal of posting payment 
reports information on a public Web site no later than 
September 30, 2014.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2012....................................  $2,847,514,000
Budget estimate, 2013...................................   2,756,485,000
Committee recommendation................................   2,756,485,000

    The Committee recommends $2,756,485,000 in fiscal year 2013 
mandatory funds for payments to States for child support 
enforcement and family support programs. In addition, the 
Committee recommends $1,100,000,000 in advance funding for the 
first quarter of fiscal year 2014, the same as the budget 
request and the comparable advance provided last year for the 
first quarter of fiscal year 2013.
    These funds support States' efforts to promote the self-
sufficiency and economic security of low-income families, 
including administrative expenses matching funds and incentive 
payments to States for child support enforcement; grants to 
States to help establish and administer access and visitation 
programs between non-custodial parents and their children; 
payments to territories for benefits to certain aged, blind, or 
disabled individuals; and temporary benefits for certain 
repatriated citizens.

               LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2012....................................  $3,471,672,000
Budget estimate, 2013...................................   3,020,000,000
Committee recommendation................................   3,471,672,000

    The Committee recommends $3,471,672,000 for LIHEAP. LIHEAP 
provides home heating and cooling assistance to low-income 
households, generally in the form of payments to energy vendors 
on behalf of the recipient. The Committee recommendation 
represents a 50-percent increase over the fiscal year 2008 non-
emergency funding level.

State Formula Block Grant

    The Committee recommendation includes $3,371,672,000 for 
the State formula block grant. The comparable fiscal year 2012 
funding level is $3,471,672,000 and the budget request is 
$2,820,000,000. The Committee maintains bill language that 
allocates these funds to States based on the same formula 
distribution that has been used since fiscal year 2009.
    Within this amount, the Committee recommendation includes 
up to $3,000,000, the same as the comparable fiscal year 2012 
funding level and the budget request, for program integrity and 
oversight efforts.

Contingency Fund

    The Committee recommendation includes $100,000,000 for the 
contingency fund. This program was not funded in fiscal year 
2012; the budget request is $200,000,000. The contingency fund 
supports grants to States that are adversely affected by 
extreme heat or cold, energy prices, or other energy-related 
emergencies. While average home energy costs for many 
households decreased this past year, the costs for households 
dependent on home fuel oil and other home-delivered fuels 
remain at record levels. Low-income households dependent on 
home-delivered fuels are also generally not protected by State 
laws that prohibit utility companies from shutting off service 
during the winter. Therefore, the Committee encourages HHS to 
direct these funds to those States hit hardest by increases in 
home energy costs and facing other energy-related emergencies.

                     REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2012....................................    $768,334,000
Budget estimate, 2013...................................     805,358,000
Committee recommendation................................     805,358,000

    The Committee recommends $805,358,000 for refugee and 
entrant assistance programs. These programs provide a variety 
of benefits and services to refugees, asylees, Cuban and 
Haitian entrants, trafficking victims, and torture victims 
(referred to below as ``refugees''). The programs also fund 
temporary shelter and services for unaccompanied alien children 
apprehended by law enforcement who are in Federal custody 
awaiting adjudication of their immigration status.

Transitional and Medical Services

    The Committee recommendation includes $343,000,000 for 
Transitional and Medical Services [TAMS]. The comparable fiscal 
year 2012 funding level is $323,195,000 and the budget request 
is $403,000,000. TAMS provides grants to States and nonprofit 
organizations to provide up to 8 months of cash and medical 
assistance to incoming refugees as well as foster care services 
to unaccompanied minors.
    In fiscal year 2012 HHS reprogrammed $49,100,000 from TAMS 
to the UAC program in response to a significant increase in the 
number of unaccompanied alien children placed into HHS' care 
through the first half of the year. This reprogramming will not 
impact the TAMS program because the number of refugees arriving 
in the United States has been significantly less than the 
amount allowed under law, and assumed in the fiscal year 2012 
appropriation. The Committee recommendation assumes current 
trends will continue in fiscal year 2013 and the number of 
refugees actually arriving in the United States will continue 
to be less than the amount allowed under law. The Committee 
will continue to work with HHS and revisit these estimates as 
necessary.
    Within the total, the Committee recommendation includes not 
less than $65,000,000 for the voluntary agency matching grant 
program, which provides grants to resettlement agencies to 
support comprehensive services for arriving refugees, including 
case management, job development, job placement, and interim 
housing and cash assistance, with the goal of refugees becoming 
self-sufficient within their first 4 months in the United 
States. Refugees enrolled in this program are not eligible for 
regular transitional and medical assistance. The Committee 
continues to support the voluntary agency matching grant 
program and encourages HHS to explore the continued expansion 
of this program.

Victims of Trafficking

    The Committee recommendation includes $9,775,000, the same 
as the comparable fiscal year 2012 funding level and the budget 
request, for the Victims of Trafficking program. This program 
supports a national network for identifying, certifying, and 
providing comprehensive services to international victims of 
trafficking.

Social Services

    The Committee recommendation includes $153,407,000, the 
same amount as the budget request, for social services 
programs. The comparable fiscal year 2012 funding level is 
$115,107,000. These funds include formula and discretionary 
grants to States and nonprofit organizations to provide a 
variety of employment and support services to recently arrived 
refugees.
    In fiscal year 2012 HHS reprogrammed $38,300,000 from 
social services to the UAC program in response to a significant 
increase in the number of children placed into HHS' care 
through the first half of the year. Discretionary social 
services grants are typically awarded for a 12-month budget 
period at the end of the fiscal year. Under this reprogramming, 
discretionary grants will be awarded at the end of fiscal year 
2012 but for a shorter budget period. This effectively shifts 
the budget period for these grants from starting at the end of 
the fiscal year to the middle of the fiscal year. The Committee 
recommendation will allow eligible grants to be fully funded in 
fiscal year 2013 for a 12-month budget period starting in the 
middle of the fiscal year.
    The Committee strongly encourages ORR to explore the use of 
existing discretionary funds for case management services for 
particularly vulnerable refugee populations. Refugees enrolled 
in the matching grant program, which generally include those 
refugees easiest to place in employment, have access to such 
services but other refugees generally do not beyond their first 
30 to 90 days in the United States. Intensive case management 
services can help connect refugees to other support services 
and provide a comprehensive approach to integration for those 
that need it most.

Preventive Health

    The Committee recommendation includes $4,730,000, the same 
as the comparable fiscal year 2012 funding level and the budget 
request, for preventive health services for refugees. This 
program funds grants to coordinate and promote refugees' access 
to health screening, treatment, and follow-up services.

Targeted Assistance

    The Committee recommendation includes $48,401,000, the same 
as the budget request, for targeted assistance for refugees. 
The comparable fiscal year 2012 funding level is $20,201,000. 
This program provides additional funds to States with an influx 
of refugee arrivals and a high concentration of refugees facing 
difficulties achieving self-sufficiency.
    In fiscal year 2012 HHS reprogrammed $28,200,000 from the 
targeted assistance program to the UAC program. As with social 
services grants, targeted assistance grants are typically 
awarded for a 12-month budget period at the end of the fiscal 
year. Under this reprogramming, these grants will be awarded 
for a shorter budget period, effectively shifting the budget 
period from starting at the end of the fiscal year to the 
middle of the fiscal year. The Committee recommendation will 
allow eligible grants to be fully funded in fiscal year 2013 
for a 12-month budget period beginning in the middle of the 
fiscal year.

Unaccompanied Alien Children

    The Committee recommendation includes $235,000,000 for the 
UAC program. The comparable fiscal year 2012 funding level is 
$284,281,000 and the budget request is $175,000,000. The UAC 
program provides shelter and support services to unaccompanied 
alien children apprehended in the United States by the 
Department of Homeland Security or other law enforcement 
agencies. Children are taken into HHS' care pending resolution 
of their claims for relief under U.S. immigration law or 
release to an adult family member or guardian.
    If current trends continue, the number of children placed 
into HHS' care could nearly double from around 8,000 in recent 
years to over 14,000 in fiscal year 2012. To address this 
increase, HHS reprogrammed a total of $115,600,000 to the UAC 
program from other ORR programs in fiscal year 2012. A 
significant amount of this increase was for emergency-related 
costs associated with a sudden increase in children that 
required HHS to quickly acquire shelter space. As HHS acquires 
more permanent shelter space, these costs should decrease in 
fiscal year 2013. The Committee recommendation provides an 
increase over the budget request to support an increase in the 
number of children being placed into HHS' care and will 
continue to work with HHS to revise these estimates as 
necessary.
    Many of the children placed into HHS' care are victims of 
abuse, neglect, or trafficking, or otherwise have physical or 
mental health issues. The Committee is particularly concerned 
about the impact this increase in children will have on the 
availability of support services, including access to pro bono 
legal representation, child advocates, social workers, 
physicians, and psychologists. The Committee strongly supports 
placing these children in areas where these vital services are 
readily available. As HHS pursues additional shelter space, it 
should provide assurances that children will have adequate 
access to these services.
    Within the total, the Committee provides $6,100,000 to 
continue the pro bono legal services initiative to support 
legal representation for both released and detained children. 
These funds are to be used to train legal counsel to detect 
abuse, mistreatment, labor exploitation, and trafficking of 
these children.

Victims of Torture

    The Committee recommendation includes $11,045,000 for the 
Victims of Torture program. This amount is the same as the 
comparable fiscal year 2012 funding level and the budget 
request. This program provides treatment, social, and legal 
services to victims of torture and training to healthcare 
providers on treating the physical and psychological effects of 
torture.

   PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2012....................................  $2,278,313,000
Budget estimate, 2013...................................   2,603,313,000
Committee recommendation................................   2,438,313,000

    The Committee recommends $2,438,313,000 for the CCDBG, a 
State formula grant that provides financial assistance to low-
income families to help pay for child care and to improve the 
quality of States' child care programs.
    The Committee recommends that $90,000,000 of the increase 
over the fiscal year 2012 level should be used for formula 
grants to States, tribes, and territories to improve the 
quality of the early childhood care and education workforce. 
These funds should support activities such as training, 
education, and other professional development (including 
coaching, mentoring, and other on-site training and technical 
assistance for staff) that are linked to a career pathway or 
lattice; technical assistance to help providers become licensed 
and comply with licensing and regulatory requirements; 
scholarships for further education; and compensation 
improvement (including rewards or bonuses) linked to increased 
credential or degree completion. States should work with their 
State Early Childhood Advisory Councils in coordinating these 
activities. States should report on the number of providers and 
staff, including by type of child care setting and age of 
children served in the setting, that receive support through 
these funds and the kind of support they receive. States 
applying for these funds should also provide assurances that 
funds will be prioritized first in areas with significant 
concentrations of poverty and unemployment that lack access to 
high-quality early care and education programs, or for 
otherwise underserved populations such as children with 
disabilities or special needs. Additionally, any use of child 
assessments should conform to the recommendations of the 
National Research Council's reports on early childhood and 
assessment. Finally, these funds should be used to supplement 
and not to supplant Federal, State, and local funds otherwise 
used for these purposes.
    The Committee recommends that the remaining $70,000,000 
increase over the fiscal year 2012 level should be used for the 
regular block grant. In recent years, many States have 
struggled to maintain key child care policies and have 
tightened eligibility requirements, added to waitlists, 
increased family copayments, and left reimbursement rates for 
providers stagnant. As a result, fewer families are receiving 
assistance and many that do are struggling to find quality 
affordable child care options. This increase will allow States 
to increase the number of families served and generally improve 
low-income families' access to quality affordable child care.
    The Committee recommendation also maintains several 
existing set-asides at their comparable fiscal year 2012 
funding levels. The Committee recommendation includes 
$19,396,000 for resource and referral programs and school-aged 
child care activities. Of this amount $1,000,000 is specified 
for a national toll-free referral line and Web site to provide 
child care consumer education information to low-income 
families, including information about the quality of child care 
programs, such as information under a State or local quality 
rating and improvement system, and information to help families 
access available child care in their community through linkages 
to State and local data sources. The Committee recommendation 
also includes $9,871,000 for child care research and evaluation 
activities. Finally, in addition to the funds specified above 
for improving the quality of the early childhood workforce, the 
Committee recommendation also maintains existing set-asides for 
quality improvement activities. These quality improvement funds 
are in addition to the 4-percent quality improvement set-aside 
established in the authorizing legislation.
    Tribes Participating in Public Law 102-477 Programs.--The 
Committee appreciates the administration's response to concerns 
raised in last year's Senate Committee report over the 
imposition of additional reporting, auditing and accounting 
requirements on ``477 tribes'', which includes the 
administration of CCDBG funding. For 20 years tribes have 
operated 477 programs and integrated employment, training, and 
related services to improve the effectiveness of these services 
and better serve tribal needs consistent with the policy of 
self-determination. The Committee appreciates the importance of 
ensuring appropriate transparency and accountability of Federal 
funds but believes that requirements to separately report on 
funding by CFDA numbers is contrary to the intent of section 14 
of Public Law 102-477 and would impair the efficiency of the 
477 initiative. The Committee appreciates that the 
administration has accordingly suspended such requirements. The 
Committee continues to believe that any reporting, accounting, 
or auditing requirements to improve transparency and 
accountability should be consistent with the intent of Public 
Law 102-477 and should not impose unnecessary or burdensome 
requirements on tribes and should be in response to specific 
identified problems. The Committee expects the administration 
to continue to work with the 477 Tribal Work Group so that any 
new guidelines or requirements continue to promote tribal 
flexibility in the administration of employment, training, and 
related services under the 477 program. The Committee directs 
HHS to provide a briefing to the Committees on Appropriations 
of the House and the Senate by September 30, 2012 on the status 
of the Tribal Work Group discussions.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2012....................................  $1,700,000,000
Budget estimate, 2013...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

    The Committee recommends $1,700,000,000 in mandatory funds 
for the SSBG. This amount is the same as the comparable fiscal 
year 2012 funding level and the budget request. The SSBG is a 
flexible source of funding that allows States to provide a 
diverse array of services to low-income children and families, 
the disabled, and the elderly.
    The Committee continues to regard the SSBG as a critical 
source of funding for services that protect children from 
neglect and abuse, including providing foster and respite care, 
as well as related services for children and families, persons 
with disabilities, and older adults. The Committee recognizes 
the importance of this program, especially in providing mental 
health and counseling services to underserved populations, and 
recommends continued usage and flexibility of these funds for 
such purposes.

                 CHILDREN AND FAMILY SERVICES PROGRAMS

Appropriations, 2012....................................  $9,734,982,000
Budget estimate, 2013...................................   9,515,657,000
Committee recommendation................................   9,818,982,000

    The Committee recommends $9,818,982,000 in budget authority 
for children and families services programs. In addition, the 
Committee recommends $5,762,000, the same as the comparable 
fiscal year 2012 funding level and the budget request, in 
transfers available under section 241 of the PHS Act. These 
funds support a variety of programs for children, youth, and 
families; the developmentally disabled; Native Americans; 
victims of child abuse, neglect, and domestic violence; and 
other vulnerable populations.

Head Start

    The Committee recommendation includes $8,038,544,000 for 
Head Start. The comparable fiscal year 2012 funding level is 
$7,968,544,000 and the budget request is $8,054,000,000. Head 
Start provides comprehensive early childhood education and 
development services for low-income children and families, 
focusing on cognitive and language development, socio-emotional 
development, physical and mental health, and parental 
involvement.
    Within the total, the Committee recommendation includes up 
to $25,000,000 for transition-related costs associated with the 
Head Start Designation Renewal System [DRS]. The Committee 
recommendation does not include bill language, requested by the 
administration, making these funds available through fiscal 
year 2014. In November 2011, carrying out provisions in the 
Improving Head Start for School Readiness Act of 2007, ACF 
published a final rule which requires grantees that do not meet 
certain standards to re-compete for funding through the DRS. In 
fiscal year 2012, over $1,200,000,000 in grants will be re-
competed, with new awards expected to be made in fiscal year 
2013. These additional funds will support implementation of the 
DRS and provide start-up related costs to new grantees to 
minimize any disruption in services. In addition, the Committee 
encourages HHS to consider the unique challenges faced by Head 
Start grantees in remote and frontier areas when reviewing such 
grantees' compliance with health and dental screening 
requirements as part of the DRS.
    The Committee recommendation also supports an approximately 
0.6 percent cost-of-living adjustment for each grantee. This 
will help defray rising operational costs so that grantees can 
maintain services for the approximately 962,000 low-income 
children and their families in Head Start programs.

Consolidated Runaway and Homeless Youth Program

    The Committee recommendation includes $97,355,000, the same 
as the fiscal year 2012 level and the budget request, for the 
consolidated runaway and homeless youth program. This program 
supports the Basic Centers program, which provides temporary 
shelter, counseling, and after-care services to runaway and 
homeless youth under age 18 and their families; the 
Transitional Living Program, which provides longer-term shelter 
and services for older youth; and a national toll-free runaway 
and homeless youth crisis hotline.

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth

    The Committee recommendation includes $17,901,000, the same 
as the fiscal year 2012 level and the budget request, for 
education and prevention grants to reduce sexual abuse of 
runaway and homeless youth. This program provides competitive 
grants for street-based outreach and education services for 
runaway and homeless youth who are subjected to or are at risk 
of being subjected to sexual abuse or exploitation.

Child Abuse Prevention and Treatment State Formula Grants

    The Committee recommendation includes $26,432,000 for child 
abuse prevention and treatment State formula grants. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request. This program provides formula 
grants to States to improve their child protective service 
systems.

Child Abuse Prevention and Treatment Discretionary Activities

    The Committee recommendation includes $25,744,000 for child 
abuse prevention and treatment discretionary activities. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request. This program supports 
discretionary grants for research, demonstration, and technical 
assistance to increase the knowledge base of evidence-based 
practices and to disseminate information to State and local 
child welfare programs.

Child Abuse Prevention and Treatment Community-Based Grants

    The Committee recommendation includes $41,527,000 for child 
abuse prevention and treatment community-based grants. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request. This program provides formula 
grants to States that then disburse funds to local, community-
based organizations to improve local child abuse prevention and 
treatment efforts, including providing direct services and 
improving the coordination between State and community-based 
organizations.

Abandoned Infants Assistance

    The Committee recommendation includes $11,553,000 for the 
Abandoned Infants Assistance program. This amount is the same 
as the comparable fiscal year 2012 funding level and the budget 
request. This program provides discretionary grants to public 
and private community and faith-based organizations to develop, 
implement, and operate demonstration projects that prevent the 
abandonment of infants and young children impacted by substance 
abuse and HIV. Funds may be used to provide respite care for 
families and caregivers, allow abandoned infants and children 
to reside with their natural families or in foster care, and 
carry out residential care programs for abandoned infants and 
children who are unable to reside with their families or be 
placed in foster care.

Child Welfare Services

    The Committee recommendation includes $280,650,000 for 
child welfare services. This amount is the same as the 
comparable fiscal year 2012 funding level and the budget 
request. This formula grant program helps State and tribal 
public welfare agencies improve their child welfare services 
with the goal of keeping families together. States and tribes 
provide a continuum of services that prevent child neglect, 
abuse or exploitation; allow children to remain with their 
families, when appropriate; promote the safety and permanence 
of children in foster care and adoptive families; and provide 
training and professional development to the child welfare 
workforce.

Child Welfare Research, Training, and Demonstration

    The Committee recommendation includes $31,092,000, the same 
as the budget request, for child welfare research, training, 
and demonstration projects. The comparable fiscal year 2012 
funding level is $26,092,000. This program provides grants to 
public and nonprofit organizations for demonstration projects 
that encourage experimental and promising types of child 
welfare services, as well as projects that improve education 
and training programs for child welfare service providers.
    The Committee recommends an increase of $5,000,000, as 
requested by the administration, to enhance efforts to prevent 
domestic child sex trafficking and improve services for child 
victims of sex trafficking. These funds will be used to train 
and build capacity in existing organizations that come into 
contact with at-risk youth, such as child welfare agencies, 
foster group homes, runaway and homeless youth programs, law 
enforcement, and courts, to better identify and serve this very 
vulnerable population.
    The Committee has previously encouraged ACF to work with 
ACL and other HHS agencies to evaluate intergenerational 
approaches for improving outcomes for at-risk youth and 
families. The Committee is particularly interested in 
initiatives that are place-based and leverage the service of 
older volunteers with supportive housing. Such initiatives have 
demonstrated potential to reduce demand for social services 
while improving the health and well-being of participating 
seniors by increasing their civic and societal engagement. The 
Committee strongly encourages HHS to use existing discretionary 
resources for such initiatives to support intermediary and 
community-based organizations developing projects that 
demonstrate this approach.

Adoption Opportunities

    The Committee recommends $39,179,000 for the Adoption 
Opportunities program. This amount is the same as the 
comparable fiscal year 2012 funding level and the budget 
request. The Adoption Opportunities program funds discretionary 
grants to help facilitate the elimination of barriers to 
adoption and provide technical assistance to help States 
increase the number of children adopted, particularly children 
with special needs.
    Consistent with the reauthorization of this program, the 
Committee continues to expect that these funds will focus on 
facilitating the adoption of older children, minority children, 
and children with special needs. Specifically, the Committee 
expects HHS to focus new grants on strengthening postadoption 
services and the recruitment of adoptive parents for these 
populations of children.

Adoption Incentives

    The Committee recommends $39,346,000 for adoption 
incentives. This amount is the same as the comparable fiscal 
year 2012 funding level and the budget request. This program 
provides incentive payments to States based on a formula in law 
to encourage States to increase the number of adoptions of 
children from the foster care system, with an emphasis on 
children who are the hardest to place. If the payments due to 
States are higher than the amount of funds available, the 
payments are reduced on a pro rata basis based on the amount 
available.

Social Services and Income Maintenance Research

    The Committee recommends $5,762,000, the same as the fiscal 
year 2012 level, for social services and income maintenance 
research. This entire amount is funded through transfers 
available under section 241 of the PHS Act, the same as in 
fiscal year 2012. The budget request is $13,762,000, of which 
$5,762,000 is funded through transfers available under the PHS 
Act. These funds support research and evaluation of cost-
effective programs that increase the stability and economic 
independence of American families, and contribute to the 
healthy development of children and youth.
    Due to budget constraints, the Committee recommendation 
does not include a $3,000,000 increase requested by the 
administration for an early childhood care and education 
research and evaluation study. Similarly, the Committee 
recommendation does not include a $5,000,000 increase requested 
by the administration for a new initiative to improve services 
for disconnected youth. However, the Committee does include a 
new general provision on Performance Partnerships involving 
disconnected youth. This new bill language provides the 
Departments of HHS, Education, and Labor flexibility to 
encourage local and State-level innovation among programs 
serving disconnected youth.

Developmental Disabilities

    In fiscal year 2012 HHS moved the administration of 
developmental disabilities programs from ACF to the newly 
established ACL. The Committee supports this administrative 
change and funds these programs within ACL in fiscal year 2013.

Voting Access for Individuals With Disabilities

    In fiscal year 2012 HHS moved the administration of the 
voting access for individuals with disabilities program from 
ACF to ACL. The Committee supports this administrative change 
and funds this program within ACL in fiscal year 2013.

Native American Programs

    The Committee recommends $48,583,000 for Native American 
programs. This amount is the same as the comparable fiscal year 
2012 funding level and the budget request. These funds support 
a variety of programs to promote self-sufficiency and cultural 
preservation activities among Native American, Native Hawaiian, 
Alaska Native, and Pacific Islander organizations and 
communities.
    Within the total, the Committee recommendation includes 
$12,000,000 for Native American language preservation 
activities, including no less than $4,000,000 for language 
immersion programs authorized by section 803C(b)(7)(A)-(C) of 
the Native American Programs Act, as amended by the Esther 
Martinez Native American Language Preservation Act of 2006. The 
Committee continues to strongly encourage ACF to give priority 
to grantees with rigorous immersion programs.

Community Services Block Grant

    The Committee recommendation includes $677,358,000, the 
same as the comparable fiscal year 2012 funding level, for the 
Community Services Block Grant [CSBG]. The budget request is 
$350,000,000. The CSBG is a formula grant to States and Indian 
tribes to provide a wide range of services and activities to 
alleviate causes of poverty in communities and to assist low-
income individuals in becoming self-sufficient. States are 
required to pass on at least 90 percent of these funds to local 
community-based organizations, the vast majority of which are 
community action agencies.
    The Committee continues to strongly support this program, 
which provides critical flexible funding for local 
organizations that serve as a central source of assistance for 
low-income populations. These local organizations typically 
administer larger Federal programs such as Head Start and 
LIHEAP. The CSBG provides critical funding to support the 
administration of these programs at the local level, as well as 
flexible funding to fill in service gaps and meet the 
particular needs of local communities.

Community Economic Development

    The Committee recommendation includes $29,943,000 for the 
community economic development program. This amount is the same 
as the comparable fiscal year 2012 funding level and the budget 
request. This program provides grants to community development 
corporations to support employment and business development 
opportunities for low-income individuals.
    Within the total for community economic development, the 
Committee recommendation includes up to $10,000,000 for the 
Healthy Foods Financing Initiative [HFFI]. This amount is the 
same as the comparable fiscal year 2012 funding level and the 
budget request. The HFFI is a joint initiative with the 
Department of Agriculture and Department of the Treasury to 
provide financial and technical assistance to community 
development financial institutions, nonprofit organizations, 
and businesses to expand access to healthy foods in low-income 
and underserved communities.

Rural Community Facilities

    The Committee recommendation includes $5,981,000 for the 
rural community facilities program. The comparable fiscal year 
2012 funding level is $4,981,000; the budget request eliminates 
funding for this program. The rural community facilities 
program provides grants to regional nonprofit organizations to 
provide training and technical assistance to low-income rural 
communities in developing and managing safe and affordable 
water and wastewater treatment facilities. These funds support 
projects in communities that generally cannot access resources 
and services through similar programs at the Department of 
Agriculture and the Environmental Protection Agency.

Assets for Independence

    The Committee recommendation includes $19,869,000 for the 
Assets for Independences [AFI] program. This amount is the same 
as the comparable fiscal year 2012 funding level and the budget 
request. The AFI program provides discretionary grants to 
organizations to support individual development accounts that 
encourage low-income individuals to create savings accounts for 
dedicated purposes, such as buying a home, paying for college, 
or starting a business.
    In addition, the Committee recommendation includes new bill 
language requested by the administration that will allow HHS to 
recapture unused funds by grantees and reallocate them to new 
or existing projects. AFI grantees are required to match 
individual savings with equal amounts of Federal and non-
Federal funds. Grantees have 5 years to expend funds but some 
have struggled to encourage enough savings or to provide a 
sufficient match to be able to expend their full grant during 
that time. This new language will allow HHS to recapture after 
3 years unused funds that HHS determines grantees will be 
unable to spend within their grant period and award it to other 
organizations.
    The Committee also includes new bill language requested by 
the administration providing for a $1,000,000 evaluation of 
individual development account demonstration projects through 
the AFI program.

Domestic Violence Hotline

    The Committee recommendation includes $4,197,000 for the 
national domestic violence hotline. The comparable fiscal year 
2012 funding level is $3,197,000 and the budget request is 
$4,500,000. This national, toll-free hotline provides 
information and assistance to victims of domestic violence 24 
hours a day.

Family Violence Prevention and Services

    The Committee recommendation includes $133,547,000 for 
family violence prevention and services programs. The 
comparable fiscal year 2012 funding level is $129,547,000 and 
the budget request is $135,000,000. These funds support 
programs to prevent family violence and provide immediate 
shelter and related assistance for victims of domestic violence 
and their dependents. The Committee recommends an increase for 
this program, as well as for the national domestic violence 
hotline, to respond to an increase in demand for emergency 
domestic violence shelter services over the last several years. 
According to a 2011 survey of over 1,700 domestic violence 
programs, on any given day 67,000 victims receive services but 
an additional 10,000, including 6,700 requesting emergency or 
transitional housing, are turned away because of a lack of 
resources.

Education and Training Vouchers

    The Committee recommendation includes $45,174,000 for 
education and training vouchers for foster care youth. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request. This program supports vouchers of 
up to $5,000 per year for expenses related to postsecondary 
education and vocational training for foster care youth up to 
21 years of age.

Disaster Human Services Case Management

    The Committee recommends $1,992,000 for disaster human 
services case management. This amount is the same as the 
comparable fiscal year 2012 funding level and the budget 
request. This program assists States in establishing the 
capacity to provide case management services in a timely manner 
in the event of a disaster. It ensures that States are able to 
meet social service needs during disasters by helping disaster 
victims prepare recovery plans, referring them to service 
providers and FEMA contacts in order to identify needed 
assistance, and providing ongoing support and tracking through 
the recovery process.

Program Administration

    The Committee recommendation includes $201,645,000 for ACF 
program administration, which supports the administration of 
all ACF programs. The comparable fiscal year 2012 funding level 
is $198,645,000 and the budget request is $206,447,000. These 
amounts have been adjusted to reflect the move of the 
Administration on Developmental Disabilities to the new ACL.
    The Committee recommends an increase for program 
administration to support the implementation of the new Head 
Start Designation Renewal System as described earlier under the 
Head Start heading.

                   PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2012....................................    $408,065,000
Budget estimate, 2013...................................     408,065,000
Committee recommendation................................     408,065,000

    The Committee recommends $408,065,000 for promoting safe 
and stable families. The Committee recommendation includes 
$345,000,000 in mandatory funds authorized by the Social 
Security Act and $63,065,000 in discretionary appropriations.
    This program supports activities that can prevent the 
emergence of family crises that might require the temporary or 
permanent removal of a child from his or her home. Grants allow 
States to operate coordinated programs of family preservation 
services, time-limited family reunification services, 
community-based family support services, and adoption promotion 
and support services.

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2012....................................  $5,153,000,000
Budget estimate, 2013...................................   4,810,000,000
Committee recommendation................................   4,810,000,000

    The Committee recommends $4,810,000,000 in mandatory funds 
for payments for foster care and permanency. In addition, the 
Committee recommends $2,200,000,000, the same as the budget 
request, in advance mandatory funding for the first quarter of 
fiscal year 2014. The comparable advance provided last year for 
the first quarter of fiscal year 2013 is $2,100,000,000. These 
funds support programs that assist States with the costs of 
maintaining eligible children in foster care, prepare children 
for living on their own, assist relatives with legal 
guardianship of eligible children, and find and support 
adoptive homes for children with special needs.
    The Committee recommendation includes a program level of 
$4,143,000,000, the same as the budget request, for foster care 
programs. The comparable fiscal year 2012 program level is 
$4,288,000,000. This program provides matching reimbursement 
funds for State costs associated with operating and managing 
their foster care programs.
    The Committee recommendation includes a program level of 
$2,537,000,000, the same as the budget request, for adoption 
assistance. The comparable fiscal year 2012 program level is 
$2,495,000,000. The adoption assistance program provides funds 
to States for maintenance payments and the nonrecurring costs 
of adoption for children with special needs. The goal of this 
program is to facilitate the adoption of hard-to-place children 
in permanent homes and thus prevent long, inappropriate stays 
in foster care.
    The Committee recommendation includes a program level of 
$140,000,000 for the independent living program. This amount is 
the same as the comparable fiscal year 2012 program level and 
the budget request. The independent living program provides 
services to foster children under 18 and foster youth ages 18 
to 21 to help them make the transition to independent living by 
engaging in a variety of services including educational 
assistance, life skills training, and health services. States 
are awarded grants based on their share of the number of 
children in foster care, subject to a matching requirement.
    The Committee recommendation includes a program level of 
$90,000,000, the same as the budget request, for the 
guardianship assistance program. The comparable fiscal year 
2012 program level is $80,000,000. This program provides 
assistance payments to relatives taking legal guardianship of 
eligible children who have been in foster care.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2012....................................  $1,697,264,000
Budget estimate, 2013...................................   2,152,712,000
Committee recommendation................................   1,708,105,000

    The Committee recommends an appropriation of $1,708,105,000 
for ACL, which includes $52,115,000 in Medicare trust funds. In 
addition, the Committee recommends that $17,000,000 be 
transferred to ACL from the PPH Fund. The total program level 
assumed in this bill for ACL is $1,725,105,000.
    ACL was established by HHS in April 2012 with the goal of 
increasing access to community supports for older Americans and 
people with disabilities. This new agency was created by 
combining the organizational components of AoA, the HHS Office 
on Disability, and the Administration on Developmental 
Disabilities. ACL is charged with administering programs 
authorized under the Older Americans Act [OAA] and the 
Developmental Disabilities Act, as well as promoting community 
living policies throughout the Federal Government for older 
Americans and people with disabilities.

Home and Community-Based Supportive Services

    The Committee recommends an appropriation of $366,916,000 
for home- and community-based supportive services program. This 
amount is the same as the comparable funding level for fiscal 
year 2012 and the administration request. This program provides 
formula grants to States and territories to fund a wide range 
of social services that enable seniors to remain independent 
and in their homes for as long as possible. State agencies on 
aging award funds to designated area agencies on aging that, in 
turn, make awards to local service providers. This activity 
supports services such as transportation, adult day care, 
physical fitness programs, as well as in-home assistance such 
as personal care and homemaker assistance.

Preventive Health Services

    The Committee recommends $20,945,000 for preventive health 
services. This amount is the same as the comparable funding 
level for fiscal year 2012 and the administration request. This 
program funds activities that help seniors stay healthy and 
avoid chronic disease, thus reducing the need for costly 
medical interventions. The Committee continues language from 
the fiscal year 2012 bill requiring States to use these funds 
for interventions that are evidence-based and effective, such 
as enhanced fitness and wellness programs, depression 
screening, and medication management programs. These evidence-
based prevention programs have been shown through randomized-
controlled trials to be effective at helping older adults 
improve their health status and lower their use of healthcare 
services.

Protection of Vulnerable Older Americans

    The Committee recommends $21,797,000, the same as the 
comparable level for fiscal year 2012 and the administration 
request, for grants to States for protection of vulnerable 
older Americans. This activity funds the long-term care 
ombudsman program and the prevention of elder abuse program. 
Both programs provide formula grants to States to prevent the 
abuse, neglect, and exploitation of older individuals. The 
ombudsman program focuses on the needs of residents of nursing 
homes and other long-term care facilities, while the elder 
abuse prevention program targets the elderly community at 
large.

National Family Caregiver Support Program

    The Committee recommends $153,621,000 for the national 
family caregiver support program. This amount is the same as 
the comparable level for fiscal year 2012 and the 
administration request. Funds appropriated for this activity 
establish a multifaceted support system in each State for 
family caregivers, allowing them to care for their loved ones 
at home for as long as possible. States may use funding to 
provide information to caregivers about available services, 
assistance to caregivers in gaining access to services, 
caregiver counseling and training, respite care to enable 
caregivers to be temporarily relieved from their caregiving 
responsibilities, and limited supplemental services that fill 
remaining service gaps.

Native American Caregiver Support Program

    The Committee recommendation includes $6,364,000 to carry 
out the Native American caregiver support program. This amount 
is the same as the comparable level for fiscal year 2012 and 
the administration request. This program provides grants to 
tribes for the support of American Indian, Alaskan Native, and 
Native Hawaiian families caring for older relatives with 
chronic illness or disability, as well as for grandparents 
caring for grandchildren.

Congregate and Home-Delivered Nutrition Services

    The Committee recommends an appropriation of $439,070,000 
for congregate nutrition services and $216,831,000 for home-
delivered meals. Both amounts are the same as the comparable 
funding levels for fiscal year 2012 and the administration 
request.
    These programs address the nutritional needs of older 
individuals. Funded projects must make home-delivered and 
congregate meals available at least once a day, 5 days a week, 
and each meal must meet a minimum of one-third of daily dietary 
requirements. While States receive separate allotments of funds 
for congregate meals, home-delivered meals, and supportive 
services, they have flexibility to transfer funds between these 
programs.

Nutrition Services Incentives Program

    The Committee recommendation includes $160,389,000 for the 
nutrition services incentives program [NSIP]. This amount is 
the same as the comparable funding level for fiscal year 2012 
and the administration request. NSIP augments funding for 
congregate and home-delivered meals provided to older adults. 
Funds provided under this program are dedicated exclusively to 
the provision of meals. NSIP rewards effective performance by 
States and tribal organizations in the efficient delivery of 
nutritious meals to older individuals through the use of cash 
or commodities.

Aging Grants to Indian Tribes and Native Hawaiian Organizations

    The Committee recommends $27,601,000 for grants to Native 
Americans. This amount is the same as the comparable funding 
level for fiscal year 2012 and the administration request. 
Under this program, awards are made to eligible organizations 
based on their share of Native Americans, Native Alaskans, and 
Native Hawaiians aged 60 and over.

Aging Network Support Activities

    The Committee recommends $7,873,000 for aging network 
support activities. This amount is the same as the comparable 
funding level for fiscal year 2012 and the administration 
request. These funds support activities that expand public 
understanding of aging and the aging process, apply social 
research and analysis to improve access to and delivery of 
services for older individuals, test innovative ideas and 
programs, and provide technical assistance to agencies that 
administer programs authorized by the OAA.
    Within funding for aging network support activities, the 
Committee provides $998,000 to continue the 24-hour call center 
that provides Alzheimer's family caregivers with professional 
care consultation and crisis intervention. This amount is the 
same as the comparable funding level for fiscal year 2012 and 
the administration request.
    Mental Health.--The Committee notes that approximately 20 
to 25 percent of older adults have a mental or behavioral 
health problem, with White men aged 85 and older having the 
highest rates of suicide of any group in the United States. The 
Committee urges ACL to expand its efforts to address the mental 
and behavioral health needs of older adults, including 
implementation of the mental and behavioral health provisions 
in the OAA. The Committee also urges ACL to designate an 
officer responsible for administering mental health services 
for older Americans.

Alzheimer's Disease Demonstration Grants to States

    The Committee recommendation includes $4,011,000 for 
Alzheimer's disease demonstration grants to States. This amount 
is the same as the comparable funding level for fiscal year 
2012. The administration request is $9,537,000. This program 
funds competitive grants to States to test and implement new 
models of care for individuals with Alzheimer's disease.

Lifespan Respite Care

    The Committee recommends $4,990,000 for the Lifespan 
Respite Care program. The comparable funding level for fiscal 
year 2012 level and the administration request is $2,490,000. 
The Lifespan Respite Care program provides grants to States to 
expand respite care services to family caregivers, improve the 
local coordination of respite care resources, and improve 
access to and quality of respite care services, thereby 
reducing family caregiver strain.
    The Committee recognizes the essential role of family 
caregivers who provide a significant proportion of our Nation's 
health and long-term services and supports for the chronically 
ill and aging. Respite care can provide family caregivers with 
relief necessary to maintain their own health, bolster family 
stability and well being, and avoid or delay more costly 
nursing home or foster care placements. The Committee urges the 
Secretary to ensure that State agencies, as well as aging and 
disability research centers [ADRCs], use these funds to serve 
all age groups, chronic conditions, and disability categories 
equitably and without preference.

Chronic Disease Self-Management Program

    The Committee recommends $10,000,000 be transferred from 
the PPH Fund to ACL for the Chronic Disease Self-Management 
Program [CDSMP]. This amount is the same as the comparable 
funding level in fiscal year 2012 and the administration 
request. This program assists those with chronic disease with 
managing their conditions and improving their health status. 
Topics covered by the program include nutrition, appropriate 
use of medications, fitness, and effective communications with 
healthcare providers. The Committee notes that the CDSMP has 
been shown through multiple studies to result in significant 
and measurable improvements in health and quality of life, as 
well as reductions in hospitalizations and emergency room 
visits.

Elder Falls Prevention

    The Committee recommends that $7,000,000 in mandatory 
funding be transferred from the PPH Fund for elder falls 
prevention activities at ACL, in coordination with CDC. This is 
a new activity that was not funded in fiscal year 2012. The 
administration did not request funding for this program.
    The Committee notes that falls are the leading cause of 
fatal and nonfatal injuries for those 65 and older. Each year, 
1-in-3 Americans aged 65 and older falls. Every 15 seconds, an 
older adult is treated in the emergency room for a fall-related 
injury. Preventing falls will help seniors stay independent and 
in their homes, avoiding costly hospitalizations and hip 
fractures, which frequently lead to nursing home placement. The 
Committee intends that funds provided to ACL should be used for 
public education about the risk of these falls, as well as 
implementation and dissemination of community-based strategies 
that have been proven to reduce the incidence of falls among 
seniors.

Adult Protective Services Demonstrations

    The Committee recommendation includes $8,000,000 for adult 
protective services demonstrations. This amount is the same as 
the administration request. This is a new program that did not 
receive funding in fiscal year 2012. This program, as 
established in the Elder Justice Act, will provide competitive 
grants to States to test and evaluate innovative approaches to 
preventing and responding to elder abuse.

Senior Medicare Patrol

    The Committee recommends $9,402,000 for the Senior Medicare 
Patrol [SMP] program. This amount is the same as the comparable 
funding level for fiscal year 2012 and the administration 
request. These funds support a network of retired senior 
volunteers who educate older adults on preventing and 
identifying healthcare fraud and abuse.
    The Committee strongly supports the SMP program, 
administered by ACL with historical financial assistance from 
CMS. The Committee is concerned that the return on investment 
[ROI] calculation included in the performance metrics of the 
program does not adequately reflect outcome data on SMP fraud 
referrals. The Committee requests that a more accurate ROI 
calculation be developed for this important program. The 
Committee requests that ACL, CMS, DOJ, and the HHS OIG work to 
improve the process of informing beneficiaries when their tips 
directly result in a conviction, a recovery, or a change to 
Medicare policies.

Elder Rights Support Activities

    The Committee recommends $4,088,000 for elder rights 
support activities. This amount is the same as the comparable 
funding level for fiscal year 2012 and the administration 
request. This activity supports programs that provide 
information, training, and technical assistance to legal and 
aging services organizations in order to prevent and detect 
elder abuse and neglect.

Aging and Disability Resource Centers

    The Committee recommendation includes $6,457,000 for ADRCs. 
This amount is the same as the comparable funding level for 
fiscal year 2012. The administration did not request funding 
for this program. ADRCs provide ``one stop shop'' entry points 
into long-term care at the community level. The Committee 
recommendation continues funding for this program in 
recognition of the centers' role in providing access to a range 
of home- and community-based resources that allow seniors and 
individuals with disabilities to maintain their independence.

State Health Insurance Assistance Program

    The Committee recommendation includes $52,115,000 for State 
Health Insurance Assistance Programs [SHIPs], which provide 
accurate and understandable health insurance information to 
Medicare beneficiaries and their families. This is the same as 
the comparable fiscal year 2012 level. The administration 
request is $51,902,000. The Committee concurs with the 
administration's proposal to transfer this grant program to ACL 
from CMS and includes bill language that reflects this 
transfer. The Committee notes that many SHIPs are already 
housed in, or are partnered with, area agencies on aging. 
Activities of the SHIPs are also aligned with ACL's mission to 
develop a comprehensive system of home- and community-based 
services to help seniors maintain their health and 
independence.

Community Service Employment for Older Americans

    The Committee recommendation does not include funding for 
the CSEOA program in ACL, as proposed by the administration. 
The administration request is $448,251,000 for this program. 
The Committee continues to provide funding for this program in 
the Department of Labor.

Developmental Disabilities State Councils

    The Committee recommendation includes $74,774,000 for State 
councils on development disabilities. This amount is the same 
as the comparable fiscal year 2012 funding level and the budget 
request. These State councils work to develop, improve, and 
expand the system of services and supports for people with 
developmental disabilities. By engaging in activities such as 
training, educating the public, building capacity, and 
advocating for change in State policies, these councils support 
the inclusion and integration of individuals with developmental 
disabilities in all aspects of community life.

Developmental Disabilities Protection and Advocacy

    The Committee recommendation includes $40,865,000 for 
protection and advocacy programs for people with developmental 
disabilities. This amount is the same as the comparable fiscal 
year 2012 funding level and the budget request. This formula 
grant program provides funds to States to establish and 
maintain protection and advocacy systems to protect the legal 
and human rights of persons with developmental disabilities who 
are receiving treatment, services, or rehabilitation.

Voting Access for Individuals With Disabilities

    The Committee recommendation includes $5,235,000 for voting 
access for individuals with disabilities. This amount is the 
same as the comparable fiscal year 2012 funding level and the 
budget request. This program provides grants to protection and 
advocacy organizations to ensure that individuals with 
disabilities have the opportunity to participate in every step 
of the electoral process, including registering to vote, 
accessing polling places, and casting a vote.

Developmental Disabilities Projects of National Significance

    The Committee recommendation includes $8,317,000 for 
projects of national significance to assist persons with 
developmental disabilities. This amount is the same as the 
comparable fiscal year 2012 funding level and the budget 
request. This program funds grants and contracts that develop 
new technologies and demonstrate innovative methods to support 
the independence, productivity, and integration into the 
community of persons with developmental disabilities.

University Centers for Excellence in Developmental Disabilities

    The Committee recommendation includes $38,792,000 for 
University Centers for Excellence in Developmental Disabilities 
[UCEDDs]. This amount is the same as the comparable fiscal year 
2012 funding level and the budget request. The UCEDD program 
supports a network of 67 university-based centers that provide 
interdisciplinary education, conduct research, and develop 
model services for children and adults with disabilities. The 
centers serve as the major vehicle to translate disability-
related research into community practice and to train the next 
cohort of future professionals who will provide services and 
supports to an increasingly diverse population of people with 
disabilities.

Program Administration

    The Committee recommends $29,652,000, the same as the 
administration request, for program administration. The 
comparable funding level for fiscal year 2012 is $29,311,000. 
These levels have been adjusted for comparability to reflect 
the administrative costs associated with the Administration for 
Developmental Disabilities and the Office on Disability, which 
are now part of ACL. These funds support salaries and related 
expenses for program management and oversight activities.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2012....................................    $542,197,000
Budget estimate, 2013...................................     421,895,000
Committee recommendation................................     535,639,000

    The Committee recommends $535,639,000 for general 
departmental management [GDM]. The recommendation includes 
$69,211,000 in transfers available under section 241 of the PHS 
Act. Funding levels have been adjusted to reflect the transfer 
to ACL of the Office on Disability.
    This appropriation supports activities that are associated 
with the Secretary's role as policy officer and general manager 
of the Department. It supports health activities performed by 
the Office of the Assistant Secretary for Health [ASH], 
including the Office of the Surgeon General. GDM funds also 
support the Department's centralized services carried out by 
several Office of the Secretary staff divisions, including 
personnel management, administrative and management services, 
information resources management, intergovernmental relations, 
legal services, planning and evaluation, finance and 
accounting, and external affairs.
    The Committee recommendation includes an increase of 
$2,800,000, requested by the administration, for acquisition 
reform activities. The Committee does not include funding for 
abstinence-only education programs, consistent with the 
administration request. The comparable fiscal year 2012 funding 
level for abstinence-only education programs is $4,991,000.
    The Committee recommendation includes $250,000 for 
continued support of the Advisory Council on Alzheimer's 
Research, Care, and Services.
    Antimicrobial Resistance.--The Committee commends the work 
of the Interagency Task Force on Antimicrobial Resistance 
[ITFAR], particularly the final action plan, but is concerned 
that the plan is missing measurable benchmarks and completion 
deadlines. The Committee urges the Secretary to designate an 
office and director within ASH or ASPR to lead the task force 
and coordinate the Federal response. The Committee further 
recommends that the task force work with non-government 
antimicrobial resistance experts to help set priorities and 
provide expert input on a routine basis.
    Biovigilance Network.--The Committee recognizes the 
leadership of ASH and the Office of Blood Safety and 
Availability in coordinating efforts between CDC, FDA, NIH, 
AHRQ, HRSA, and CMS, as well as experts in transfusion medicine 
and blood banking, in the development and implementation of 
surveillance systems to track medical errors and adverse events 
occurring at any point in the collection, processing, 
distribution, or transfusion of blood. The Committee urges ASH 
to further these biovigilance efforts as a public/private 
collaboration allowing for in-depth analysis of the data 
collected as well as the development of interventions and best 
practices that can be implemented to eliminate errors and 
waste, thus improving patient health and safety and reducing 
costs.
    Drug Shortages.--The Committee urges the Secretary, in 
consultation with FDA, to establish an interagency and intra-
agency task force to address drug shortages. The task force 
should have stakeholder input, including an expert in how 
shortages affect pediatric patients. The study should examine 
whether other countries have experienced drug shortages, the 
extent and effect of the shortages, as well as any steps these 
countries are taking to mitigate or prevent such shortages.
    Freely Associated States.--Pursuant to the Compact of Free 
Association Act of 1985 (Public Law 99-239), and continued 
under the Compact of Free Association Amendments Act of 2003 
(Public Law 108-188), citizens of the FAS are accorded the 
privilege of freely traveling and residing in the United States 
without a set time limit. Upon arrival, FAS migrants often 
arrive with serious medical needs, requiring acute care such as 
dialysis and chemotherapy. As such, affected jurisdictions are 
seeing an increase in the number of cases involving 
tuberculosis, hepatitis, and sexually transmitted diseases 
which is putting a further strain on already constrained public 
health resources and education services. The Secretary is 
directed to work within the National Security Council 
Interagency Policy Committee on Freely Associated State Affairs 
to implement an effective action plan that addresses some of 
these issues. The Secretary should also provide effective 
guidance and feedback to the island nations through the Joint 
Economic Management Committee and Joint Economic Management 
Financial Accountability Committee process by ensuring that 
funds provided to the FAS nations are spent wisely to develop 
capacity in the islands to promote economic development, 
provide pre-health screenings, and to create an education 
program to ensure that FAS migrants know what is expected of 
them upon arrival to the affected jurisdictions.
    Global Health Threats.--The Committee acknowledges the 
urgent need for new technologies in the fight against global 
health threats as well as the need to sustain and protect U.S. 
investment in this important research. The Committee urges the 
FDA, CDC, and NIH to each create metrics to measure progress 
and to develop concrete plans to prioritize and incorporate 
global health research, product development, and regulation 
into the U.S. global health and development strategies, in line 
with the new HHS Global Health Strategy.
    Human Services Transportation.--The Committee 
recommendation includes $1,000,000 for a competitive grant to 
provide technical assistance to local government and nonprofit 
transportation providers. This assistance should focus on the 
most cost-effective ways to provide transportation assistance 
and information to persons with disabilities. In addition, 
because of rising fuel prices, such technical assistance should 
include expanding the use of accessible, fuel-efficient taxi 
service for persons with disabilities and those receiving 
dialysis. Congress appropriated $998,000 for a similar purpose 
in fiscal year 2012.
    Overdose Prevention.--Accidental deaths from overdose, 
particularly from prescription drugs such as opioids, are on 
the rise and have become the leading cause of preventable death 
for individuals under the age of 65 in the United States. The 
Committee strongly encourages the Secretary to launch a public 
awareness campaign to educate the public and health 
professionals about the signs, symptoms, and risk factors for 
overdose, as well as how individuals can make linkages to 
recovery and treatment services. The Committee urges the 
Secretary to develop the campaign with the participation of 
Federal agencies including SAMHSA, NIDA, HRSA, FDA, and the 
Office of National Drug Control Policy.
    Pain Management.--A recent IOM report concluded that pain 
represents a public health crisis that impacts more than 1 out 
of every 3 adults, costs the American economy over 
$560,000,000,000 in added healthcare costs and lost 
productivity, and results in unnecessary human suffering. The 
Committee requests that HHS develop a comprehensive plan with 
specific goals, actions, and timeframes regarding reducing 
barriers to pain management, educating the public, improving 
professional education, and refocusing pain research efforts at 
NIH. The Committee requests that this plan be submitted to the 
House and Senate Committees on Appropriations by March 2013.
    Traumatic Brain Injury [TBI].--The Committee notes that TBI 
is a leading cause of death and disability worldwide, 
especially in children and young adults ages 1 to 44. Due to 
the high prevalence of TBI, the Committee believes there is a 
need for multidisciplinary approaches to rapid evaluation and 
diagnosis of injured patients who have the potential for the 
development of TBI, as well as the development of early 
intervention and treatment protocol for use in preventing TBI 
and improving patient outcomes. The Secretary is encouraged to 
support a competitively awarded program of academic centers 
focused on developing and implementing multidisciplinary 
approaches to the early diagnosis and innovative treatment 
models for TBI victims.
    Urban-Based Network.--The Committee continues to encourage 
the Secretary and other agencies within the Department such as 
HRSA, AHRQ, CDC, CMS, and OMH to partner with NIMHD in 
supporting a network of urban-based institutions focused on, 
and with demonstrated commitment and capacity to, addressing 
recruitment and training needs of minority and urban 
underserved populations and reducing health disparities in 
these urban communities.

Teen Pregnancy Prevention

    The Committee recommendation includes $113,047,000 for the 
Teenage Pregnancy Prevention [TPP] program, which is the same 
as the comparable funding level for fiscal year 2012. The 
recommendation includes $8,455,000 in transfers available under 
section 241 of the PHS Act. The administration requests 
$109,022,000 for the TPP program, with $104,790,000 funded 
through transfers from the PPH Fund.
    This program supports competitive grants to public and 
private entities to replicate evidence-based teen pregnancy 
prevention approaches. The Committee recommendation includes 
$4,000,000 to continue the Federal evaluation of the projects 
funded by this program.

Office of Minority Health

    The Committee recommends $55,782,000, the same as the 
fiscal year 2012 funding level, for OMH. The administration 
request is $41,100,000. OMH focuses on strategies designed to 
decrease health disparities and to improve the health status of 
racial and ethnic minority populations in the United States. 
OMH establishes goals and coordinates all departmental activity 
related to improving health outcomes for disadvantaged and 
minority individuals. The Committee strongly urges continuation 
of existing programs run by OMH to address health disparities 
in rural and disadvantaged populations.
    The Committee recommendation includes $1,000,000 to 
continue the national health education program on lupus for 
healthcare providers, with the goal of improving diagnosis for 
those with lupus and reducing health disparities. This program 
is intended to engage healthcare providers, educators, and 
schools of health professions in working together to improve 
lupus diagnosis and treatment through education.
    Cancer in Asian/Pacific Islanders.--Asian and Pacific 
Islanders [API] have a high incidence of stomach cancer and 
liver cancers compared to Caucasians. The Committee continues 
to urge the Department to focus on the unique and pressing 
needs regarding cancer in the API population.
    Chronic Kidney Disease [CKD].--The Committee continues to 
prioritize early detection and treatment of CKD in minority 
communities to improve health outcomes and eliminate health 
disparities. In particular, the Committee urges the Department 
to focus on the prevention of CKD in Filipino populations, who 
have one of the highest rates of incidence per capita. The 
Committee encourages OMH to partner with minority health 
professions schools to educate providers on the benefits and 
opportunities for early detection and treatment of CKD.
    Health Disparities in Women.--Women of racial and ethnic 
minorities face higher rates of obesity, cancer, diabetes, 
heart disease, HIV/AIDS, and other diseases when compared with 
white women. A disproportionately higher rate of preterm birth 
exists among African-American women that cannot be accounted 
for by known risk factors. The Committee encourages HHS to 
conduct research into the causes of these health disparities 
and develop and evaluate interventions to address these causes.
    Hepatitis B.--The Committee urges OMH to expand hepatitis B 
outreach and preventive programs specific to API and other 
groups disproportionately affected by this disease.
    Offices of Minority Health.--The Committee continues to be 
encouraged by the Department's implementation of the Action 
Plan to Reduce Racial and Ethnic Health Disparities, as well as 
the National Stakeholder Strategy for Achieving Health Equity. 
The Committee strongly supports the Offices of Minority Health 
in the Office of the Secretary, AHRQ, CDC, CMS, FDA, HRSA, and 
SAMHSA, which are charged with leading the strategy. The 
Secretary is encouraged to work closely with communities, as 
well as the public and private sectors, in this effort.

Office of Women's Health

    The Committee recommends $29,120,000, the same as the 
administration request, for OWH. The comparable level for 
fiscal year 2012 is $33,682,000. OWH develops, stimulates, and 
coordinates women's health research, healthcare services, and 
public and healthcare professional education across the 
Department. It advances important crosscutting initiatives and 
develops public-private partnerships, providing leadership and 
policy direction, and initiating and synthesizing program 
activities to redress the disparities in women's health.
    The Committee recommendation includes $3,010,000 to 
continue the violence against women's initiative. This 
initiative provides funding to public health programs that 
integrate domestic and sexual violence assessment and 
intervention into basic care, as well as encourages 
collaborations between healthcare providers, public health 
programs, and domestic and sexual violence programs.

HIV/AIDS in Minority Communities

    The Committee recommends $53,681,000 for this program, 
which addresses high-priority HIV prevention and treatment 
needs of minority communities heavily impacted by HIV/AIDS. The 
funding level provided is the same as the comparable level for 
fiscal year 2012. The administration request is $53,891,000. 
The Committee provides funding for this activity through budget 
authority, rather than through transfers available under 
section 241 of the PHS Act as requested by the administration. 
These funds are available to key operating divisions of the 
Department with expertise in HIV/AIDS services to assist 
minority communities with education, community linkages, and 
technical assistance.

Embryo Donation and Adoption

    The Committee does not provide funding for embryo donation 
and adoption awareness activities, consistent with the 
administration request. The fiscal year 2012 funding level for 
this program is $1,996,000. The Committee notes that this 
program has had a limited number of applicants since its 
inception and the administration has been unable to demonstrate 
its effectiveness.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2012....................................     $72,011,000
Budget estimate, 2013...................................      84,234,000
Committee recommendation................................      79,908,000

    The Committee provides $79,908,000 for OMHA. OMHA is 
responsible for hearing Medicare appeals at the administrative 
law judge level, which is the third level of Medicare claims 
appeals. The Office ensures that Medicare beneficiaries who are 
dissatisfied with the initial decisions about their benefits or 
eligibility can appeal and exercise their right to a hearing in 
front of an administrative law judge. The Committee 
recommendation provides additional funding to OMHA to address 
its growing backlog of cases and expand its capacity to 
adjudicate Medicare appeals.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2012....................................     $61,226,000
Budget estimate, 2013...................................      66,257,000
Committee recommendation................................      66,257,000

    The Committee makes available $66,257,000 to ONC, which 
includes $49,842,000 in transfers available under section 241 
of the PHS Act. ONC 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.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2012....................................     $50,083,000
Budget estimate, 2013...................................      58,579,000
Committee recommendation................................      55,483,000

    The Committee recommends an appropriation of $55,483,000 
for the HHS OIG. In addition to discretionary funds provided in 
this act, the Health Insurance Portability and Accountability 
Act of 1996 provides a permanent appropriation of $196,669,000 
for OIG.
    OIG conducts audits, investigations, and evaluations of the 
programs administered by the Department's operating and staff 
divisions, including the recipients of the Department's grant 
and contract funds. In doing so, OIG addresses issues of waste, 
fraud, and abuse and makes recommendations to improve the 
efficiency and effectiveness of the Department's programs and 
operations. The recommended increase over the fiscal year 2012 
level should be used to support staff previously funded through 
ARRA, who will be redirected toward other departmental 
priorities.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2012....................................     $40,938,000
Budget estimate, 2013...................................      38,966,000
Committee recommendation................................      38,966,000

    The Committee recommends $38,966,000 for OCR, which is 
responsible for enforcing civil rights-related statutes in 
healthcare and human services programs. To enforce these 
statutes, OCR investigates complaints of discrimination, 
conducts program reviews to correct discriminatory practices, 
and implements programs to generate voluntary compliance among 
providers and constituency groups of health and human services. 
OCR also has responsibility for implementing and enforcing 
privacy protections under the HITECH Act.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2012....................................    $497,350,000
Budget estimate, 2013...................................     527,151,000
Committee recommendation................................     527,151,000

    The Committee provides an estimated $527,151,000 in 
mandatory funds for retirement pay and medical benefits for 
commissioned officers of the U.S. Public Health Service [PHS]. 
This account provides for retirement payments to PHS officers 
who are retired due to age, disability, or length of service; 
payments to survivors of deceased officers; and medical care to 
active duty and retired officers, as well as their dependents.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2012....................................    $983,231,000
Budget estimate, 2013...................................   1,057,262,000
Committee recommendation................................   1,020,220,000

    The Committee recommends $1,020,220,000 for the Public 
Health and Social Services Emergency Fund [PHSSEF]. This 
appropriation supports the activities of ASPR and other 
components within the Office of the Secretary to prepare for 
the health consequences of bioterrorism and other public health 
emergencies, including pandemic influenza. It also provides 
funding for the Department's cybersecurity efforts.
    The Committee does not support transferring additional 
balances from Public Law 111-32, the Supplemental 
Appropriations Act, 2009, to CDC as proposed by the 
administration. The Committee believes that the remaining 
supplemental funds should be used for the purposes for which 
they were intended, namely increasing domestic influenza 
vaccine production capacity, improving international pandemic 
preparedness efforts, and developing better vaccines, 
antivirals, and diagnostics. Specifically, the Committee 
strongly supports BARDA's International Influenza Vaccine 
Manufacturing Capacity Building Program. Through this program, 
HHS helps developing countries build sustainable influenza 
vaccine production capacity, which includes establishing 
manufacturing facilities and ensuring a skilled in-country 
workforce. So far, 12 developing countries have received 
technical and financial support from BARDA to establish 
influenza vaccine manufacturing capacity. In 2005, the capacity 
to produce pandemic influenza vaccine in these countries was 
less than 1 million doses. By 2016, continued financial support 
from BARDA will enable manufacturers in these countries to 
produce up to 300 million doses of vaccine to respond to a 
pandemic. The Committee notes that the capability of developing 
countries to produce influenza vaccine within their borders is 
crucial to reducing the threat of a global pandemic. The 
Committee strongly urges BARDA to continue this effort with 
existing balances from the fiscal year 2009 supplemental.

Office of the Assistant Secretary for Preparedness and Response

    The Committee recommendation includes $944,821,000 for 
activities administered by ASPR. The administration request is 
$981,863,000 and the comparable funding level for fiscal year 
2012 is $925,612,000. ASPR was created by the Pandemic and All-
Hazards Preparedness Act to lead the Department's activities 
regarding preventing, preparing for, and responding to public 
health emergencies, including disasters and acts of terrorism.
    Virtual Training.--The Committee notes the need, 
particularly at the local level, to improve surge capacity and 
enhance community and hospital preparedness for public health 
emergencies using today's enabling training technologies. 
Virtual training tools have the potential to revolutionize 
medical emergency response training with a corresponding 
reduction in costs. The Committee urges ASPR to develop and 
standardize such hospital preparedness training using state-of-
the-art, 3D, medical response simulation technology with a goal 
of exporting it to all States to preclude redundant efforts.
            Hospital Preparedness Program
    The Committee's recommendation includes $324,650,000 for 
the Hospital Preparedness Program [HPP]. The administration 
request for HPP is $254,500,000 and the comparable funding 
level for fiscal year 2012 is $374,650,000. This program 
provides grants to States and localities to enhance hospital 
preparedness and improve overall surge capacity in public 
health emergencies.
    Funds will be used in fiscal year 2013 to transform HPP 
toward an emphasis on healthcare coalitions at the regional and 
community level rather than on individual hospitals. The 
Committee requests a multiyear plan from the Department 
describing this change. This plan should include the program's 
framework for determining funding levels for coalitions, 
strategies to improve coordination with public health 
departments, inclusion of nonacute hospitals and ambulatory 
care settings, and engagement with individual healthcare 
providers.
    Medical Surge Capacity.--The ability of our healthcare 
system to quickly expand beyond normal capacity during a major 
emergency is critical in securing preparedness for our Nation. 
The Committee urges the Secretary to extend health system surge 
capacity by creating a national framework to guide States and 
local entities on developing crisis standards of care in the 
event of a mass casualty event or crisis. The Secretary should 
also clarify Federal law to implement uniform liability 
applying to all volunteer health professionals during a 
declared public health emergency.
            Emergency System for Advance Registration of Volunteer 
                    Health Professionals [ESAR VHP]
    The Committee recommendation includes $4,989,000 for the 
ESAR VHP program. This amount is the same as the comparable 
funding level for fiscal year 2012. This program is a national 
network of State-based registries that allows health 
professionals to volunteer in public health emergencies and 
disasters.
    The administration requests $500,000 for this program and 
proposes discontinuing these grants, noting that all 50 States 
and the District of Columbia have developed ESAR VHP programs. 
However, the Committee believes that ESAR VHP is a critical 
component of providing workforce surge capacity in the event of 
a public health emergency. For this reason, the Committee 
provides continued funding for the ESAR VHP program and expects 
grantees to use the funds to support volunteer recruitment and 
retention, training and coordination, and integration of ESAR 
VHP with the Medical Reserve Corps at the State and local 
level.
            Biomedical Advanced Research and Development
    The Committee recommendation includes $465,000,000 for 
advanced research and development. The administration request 
is $546,671,000 for this activity and the comparable funding 
level for fiscal year 2012 is $415,000,000. As in previous 
years, the Committee includes bill language to transfer 
$415,000,000 from the Project BioShield Special Reserve Fund 
advance appropriation to fund advanced research and development 
of medical countermeasures. This amount is the same as the 
administration request and the comparable level from fiscal 
year 2012.
    Advanced Research and Development.--The fiscal year 2012 
Senate Report included language encouraging ASPR to work with 
NIAID to ensure that sufficient research is being conducted to 
develop a bioagent detection and bioterrorism warning system 
based on bioinformatics technology that would allow for the 
direct identification and sample characterization of pathogens 
in rapid fashion. The Committee requests an update on these 
efforts within 60 days of enactment of this act.
    Anthrax.--The Committee continues to be concerned about the 
country's level of preparedness against biological threats, 
most particularly anthrax. The Committee notes that BARDA is 
moving forward with developing a variety of countermeasures to 
anthrax, including antitoxins, enhancements to the current AVA 
vaccine, and most importantly a next generation recombinant 
vaccine. The Committee expects BARDA to keep it informed of its 
progress in developing a recombinant anthrax vaccine for the 
Strategic National Stockpile [SNS].
    Antibiotic Research and Development.--The Committee 
recognizes that the increasing failure of approved, life-saving 
antibiotics, as well as the plummeting number of new 
antibiotics in development, seriously threatens our Nation's 
health and potentially our security. The Committee encourages 
BARDA to continue awarding contracts for promising new 
antibiotics that otherwise might not make it to market due to 
existing challenges and particularly for new antibiotics 
intended to treat multidrug-resistant pathogens.
    Multiyear Planning Process.--The Committee notes that the 
2010 review of the Public Health Emergency Medical 
Countermeasure Enterprise endorsed a 5-year planning process to 
enable the Department to forecast, plan for, and communicate 
its long-range advanced development needs. The Committee 
directs the Department to report on the implementation of such 
a coordinated 5-year budgetary planning process based on 
medical countermeasure priorities and goals not later than 180 
days after the date of enactment of this act, and every year 
thereafter. This report should include specific information on 
the Department's planned investments for the next 5-year fiscal 
period, including: the cost of procuring and maintaining all 
materials placed in SNS, the costs associated with maintaining 
existing research and development contracts for medical 
countermeasures, and the costs associated with anticipated new 
research and development contracts for medical countermeasures.
            Strategic Investor
    The Committee recommendation includes $20,000,000 to create 
the Strategic Investor program. The purpose of this program is 
to provide financial support and business expertise to emerging 
biodefense companies that develop medical countermeasures for 
the Federal stockpile. The administration requests $50,000,000 
for this activity. Funding was not provided in fiscal year 
2012.
            Medical Countermeasure Dispensing
    The Committee recommendation includes $5,000,000, the same 
as the administration request, for the Medical Countermeasure 
Dispensing program. Funding for this program was last provided 
in fiscal year 2010.
    Funding provided by the Committee will support the 
continued implementation of the National Postal Model, which 
provides for the delivery of medical countermeasures through 
the U.S. Postal Service during a bioterrorist attack.
            Other Activities
    The Committee recommendation includes the following amounts 
for the following activities within ASPR:
  --Operations--$32,981,000;
  --Preparedness and Emergency Operations--$24,647,000;
  --National Disaster Medical System--$52,390,000; and
  --Policy, Strategic Planning, and Communications--
        $15,164,000.

Office of the Assistant Secretary for Administration

    The Committee recommends $40,000,000 for information 
technology cybersecurity in the Office of the Assistant 
Secretary for Administration. This amount is the same as the 
administration request. The comparable funding level for fiscal 
year 2012 is $39,924,000. These funds provide for continuous 
monitoring and security incident response coordination for the 
Department's computer systems and networks.

Office of the Assistant Secretary for Health

    The Committee recommendation includes $10,971,000, the same 
as the administration request, for the medical reserve corps 
program in ASH. This program is a national network of local 
volunteers who work to strengthen the public health 
infrastructure and preparedness capabilities of their 
communities. The comparable funding level for fiscal year 2012 
is $11,247,000.

Office of the Secretary

    The Committee recommendation includes $24,428,000 for 
activities within the Office of the Secretary. This amount is 
the same as the administration request. The comparable fiscal 
year 2012 funding level is $6,448,000.
            Lease Replacement
    The Committee recommendation includes $17,000,000, the same 
as the administration request, for relocation and fit-out costs 
associated with new long-term leases for HHS agencies. In 
fiscal year 2012 funding for this activity was provided in the 
accounts of each HHS agency.
            Office of Security and Strategic Information
    The Committee includes $7,428,000 for the Office of 
Security and Strategic Information to secure and strengthen the 
Department's critical assets. This amount is the same as the 
administration request. The comparable level for fiscal year 
2012 is $6,448,000.

                   PREVENTION AND PUBLIC HEALTH FUND

    The PPH Fund was created in section 4002 of PPACA. The fund 
provides $12,500,000,000 in mandatory funds over the next 10 
years to supplement investments in public health and 
prevention.
    The Committee strongly believes that additional resources 
for prevention will improve people's health and reduce 
healthcare costs over the long term. Discretionary funding is 
needed for these purposes because many of the health promotion 
activities that reach the populations most in need take place 
outside the reimbursement system, through community- and State-
based initiatives.
    In recognition of the Committee's responsibility to 
determine funding levels for community-based prevention and 
public health programs, PPACA specifically gives the Committee 
authority to transfer funds into Federal programs that support 
the goal of making America healthier.
    In fiscal year 2013, the level appropriated for the fund is 
$1,000,000,000, the same as the fiscal year 2012 level. The 
Committee includes bill language in section 220 of this act 
that requires that funds be transferred within 45 days of 
enactment of this act to the following accounts, for the 
following activities, and in the following amounts:

----------------------------------------------------------------------------------------------------------------
                                                                                                     Committee
                 Agency                             Account                     Program           recommendation
----------------------------------------------------------------------------------------------------------------
CDC.....................................  Chronic Disease             Community Transformation      $280,000,000
                                           Prevention, Health          Grants.
                                           Promotion, and Genomics.
CDC.....................................  Immunization and            Section 317 Immunization       190,000,000
                                           Respiratory Diseases.       Grants.
CDC.....................................  Chronic Disease             Office of Smoking and           95,000,000
                                           Prevention, Health          Health.
                                           Promotion, and Genomics.
CDC.....................................  CDC-Wide Activities.......  Public Health                   40,200,000
                                                                       Infrastructure grants.
CDC.....................................  Emerging and Zoonotic       Epidemiology and                40,000,000
                                           Infectious Diseases.        Laboratory Capacity
                                                                       Grants.
CDC.....................................  Chronic Disease             Racial and Ethnic               40,000,000
                                           Prevention, Health          Approaches to Community
                                           Promotion, and Genomics.    Health.
CDC.....................................  Environmental Health......  Environmental and Health        35,000,000
                                                                       Outcome Tracking Network.
CDC.....................................  Public Health Scientific    Health Surveillance and         35,000,000
                                           Services.                   Statistics.
SAMHSA..................................  Mental Health.............  Primary and Behavioral          35,000,000
                                                                       Healthcare Integration.
CDC.....................................  CDC-Wide Activities.......  Public Health Workforce...      25,000,000
HRSA....................................  Health Workforce..........  Public Health Training          25,000,000
                                                                       Centers.
SAMHSA..................................  Substance Abuse Treatment.  Screening, Brief                25,000,000
                                                                       Intervention and Referral
                                                                       to Treatment.
SAMHSA..................................  Health Surveillance and     Surveillance activities...      18,000,000
                                           Program Sup-  port.
CDC.....................................  Emerging and Zoonotic       Healthcare Associated           11,750,000
                                           Infectious Dis- eases.      Infections.
ACL.....................................  Aging and Disability        Chronic Disease Self            10,000,000
                                           Services.                   Management.
CDC.....................................  Chronic Disease             Diabetes Prevention             10,000,000
                                           Prevention, Health          Program.
                                           Promotion, and Genomics.
CDC.....................................  Public Health Scientific    Guide to Community              10,000,000
                                           Services.                   Preventive Services.
CDC.....................................  Chronic Disease             Prevention Research             10,000,000
                                           Prevention, Health          Centers.
                                           Promotion, and Genomics.
CDC.....................................  HIV/AIDS, Viral Hepatitis,  Viral Hepatitis Screening.      10,000,000
                                           STD, and TB Prevention.
CDC.....................................  Chronic Disease             Workplace Wellness grants.      10,000,000
                                           Prevention, Health
                                           Promotion, and Genomics.
SAMHSA..................................  Mental Health.............  Suicide Prevention........      10,000,000
CDC.....................................  Chronic Disease             Breast Feeding Promotion         7,050,000
                                           Prevention, Health          and Support Grants.
                                           Promotion, and Genomics.
AHRQ....................................  Health Costs, Quality, and  U.S. Preventive Services         7,000,000
                                           Outcomes.                   Task Force.
ACL.....................................  Aging and Disability        Elderly Falls Prevention..       7,000,000
                                           Services.
AHRQ....................................  Health Costs, Quality, and  Clinical Prevention              5,000,000
                                           Outcomes.                   Research Centers for
                                                                       Excellence.
CDC.....................................  Chronic Disease             Million Hearts Program....       5,000,000
                                           Prevention, Health
                                           Promotion, and Genomics.
CDC.....................................  Injury Prevention and       Elderly Falls Prevention..       3,000,000
                                           Control.
CDC.....................................  CDC-Wide Activities.......  National Prevention,             1,000,000
                                                                       Health Promotion, and
                                                                       Public Health Council.
----------------------------------------------------------------------------------------------------------------

                           General Provisions

    Section 201. The bill continues a provision placing a 
$50,000 ceiling on official representation expenses.
    Section 202. The bill continues a provision that limits the 
assignment of certain public health personnel.
    Section 203. The bill continues a provision limiting the 
use of certain grant funds to pay individuals more than an 
annual rate of executive level II.
    Section 204. The Committee recommendation continues a 
provision restricting the Secretary's use of taps for program 
evaluation activities unless a report is submitted to the 
Appropriations Committees of the House and Senate on the 
proposed use of funds.
    Section 205. The Committee recommendation continues a 
provision authorizing the transfer of up to 2.5 percent of PHS 
Act funds for evaluation activities.
    Section 206. The Committee recommendation continues a 
provision restricting transfers of appropriated funds and 
requires a 15-day notification to both the House and Senate 
Appropriations Committees.
    Section 207. The Committee recommendation continues a 
provision permitting the transfer of up to 3 percent of AIDS 
funds among ICs by the Director of NIH and the Director of the 
Office of AIDS Research at NIH.
    Section 208. The Committee recommendation retains language 
which requires that the use of AIDS research funds be 
determined jointly by the Director of NIH and the Director of 
the Office of AIDS Research and that those funds be allocated 
directly to the Office of AIDS Research for distribution to the 
Institutes and Centers consistent with the AIDS research plan.
    Section 209. The Committee recommendation continues a 
provision regarding requirements for family planning 
applicants.
    Section 210. The Committee recommendation retains language 
which states that no provider services under title X of the PHS 
Act may be exempt from State laws regarding child abuse.
    Section 211. The Committee recommendation retains language 
which restricts the use of funds to carry out the Medicare 
Advantage Program if the Secretary denies participation to an 
otherwise eligible entity.
    Section 212. The Committee recommendation modifies a 
provision which facilitates the expenditure of funds for 
international health activities.
    Section 213. The Committee recommendation continues a 
provision authorizing the Director of NIH to enter into certain 
transactions to carry out research in support of the NIH Common 
Fund.
    Section 214. The Committee continues a provision that 
permits CDC 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''.
    Section 215. The Committee recommendation includes bill 
language allowing use of funds to continue operating the 
Council on Graduate Medical Education.
    Section 216. The Committee recommendation continues a 
provision permitting NIH to use up to $3,500,000 per project 
for improvements and repairs of facilities.
    Section 217. The Committee recommendation includes a 
provision that transfers funds from NIH to HRSA and AHRQ, to be 
used for National Research Service Awards.
    Section 218. The Committee recommendation modifies a 
provision requiring a publicly available Web site that details 
expenditures from the PPH Fund.
    Section 219. The Committee recommendation includes a new 
provision that rescinds unobligated mandatory funds from the 
Abstinence Education program.
    Section 220. The Committee recommendation includes a new 
provision transferring mandatory funds from section 4002 of the 
Patient Protection and Affordable Care Act to accounts within 
the Department for activities outlined under the heading 
``Prevention and Public Health Fund'' in this report.
    Section 221. The Committee recommendation includes a new 
provision that allows the Director of CDC to detail staff in 
response to a public health emergency.
    Section 222. The Committee recommendation includes a new 
provision requiring fiscal year 2014 budget justifications to 
include certain FTE information with respect to PPACA.
    Section 223. The Committee includes a new provision 
requiring the Secretary to respond to certain correspondence.

                               TITLE III

                        DEPARTMENT OF EDUCATION

                    Education for the Disadvantaged

Appropriations, 2012.................................... $15,741,703,000
Budget estimate, 2013...................................  15,530,002,000
Committee recommendation................................  15,840,103,000

    The Committee recommends an appropriation of 
$15,840,103,000 for education for the disadvantaged.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.
    The programs in the Education for the Disadvantaged account 
help ensure that poor and low-achieving children are not left 
behind in the Nation's effort to raise the academic performance 
of all children and youth. Funds appropriated in this account 
primarily support activities in the 2013-2014 school year.

Grants to Local Educational Agencies

    Title I grants to LEAs provide supplemental education 
funding, especially in high-poverty areas, for local programs 
that provide extra academic support to help raise the 
achievement of eligible students or, in the case of schoolwide 
programs, help all students in high-poverty schools meet 
challenging State academic standards.
    The Committee recommends $14,616,457,000 for the title I 
grants to LEAs program. The comparable fiscal year 2012 level 
and budget request also are $14,516,457,000.
    Title I grants are distributed through four formulas: 
basic, concentration, targeted, and education finance incentive 
grant [EFIG].
    For title I basic grants, including up to $3,984,000 
transferred to the Census Bureau for poverty updates, the 
Committee recommends an appropriation of $6,577,904,000, the 
same amount as the fiscal year 2012 level and budget request.
    For concentration grants, the Committee recommends 
$1,362,301,000, the same amount as the fiscal year 2012 level 
and budget request.
    For grants through the targeted formula, the Committee 
recommends $3,338,126,000. The comparable fiscal year 2012 
level and budget request are $3,288,126,000.
    For grants through the EFIG formula, the Committee 
recommends $3,338,126,000. The comparable fiscal year 2012 
level and budget request are $3,288,126,000.
    Of the funds available for title I grants to LEAs, up to 
$3,984,000 shall be available on October 1, 2012; 
$3,771,296,000 will become available on July 1, 2013; and 
$10,841,177,000 will become available on October 1, 2013. The 
funds that become available on July 1, 2013, and October 1, 
2013, will remain available for obligation through September 
30, 2014.
    The Committee notes that the biggest barrier for homeless 
children and youth attempting to enroll in and attend school 
regularly is the lack of transportation. The Committee bill 
includes a new provision clarifying that title I funds may be 
used to address this transportation issue, as well as support 
homeless liaisons.
    The Committee also notes that the ESEA allows title I funds 
to be used to implement integrated student support services 
that address both the academic and nonacademic needs of 
students through partnerships of schools and nonprofit 
providers. The Committee believes, at the discretion of schools 
choosing to use funds for such activities, that such decisions 
should be based on evidence that the activities implemented 
will have a significant effect on student outcomes.

School Improvement Grants

    The Committee recommendation includes $533,552,000, the 
same amount as the fiscal year 2012 level and budget request, 
for the SIG program.
    The Committee continues authority provided by prior 
appropriations acts that addresses several issues. First, it 
continues the expansion of the number of schools that may 
receive funds through the program. This language allows schools 
to be eligible for SIG if they are eligible for title I and 
have not made adequate yearly progress for at least 2 years or 
are in the State's lowest quintile of performance based on 
proficiency rates. Second, language also allows States to make 
subgrants of not more than $2,000,000 to each participating 
school. And, a set-aside of up to 5 percent of the SIG 
appropriation may be used for national activities.
    The Committee continues to believe that the SIG program 
holds great promise for improving outcomes for students in our 
Nation's lowest-achieving schools. At the request of three 
Committee members, the GAO analyzed certain aspects of the SIG 
program, focusing particularly on challenges for successful SIG 
implementation, the Department's technical assistance and 
oversight activities, and State administration of SIG. Interim 
and final reports released during the past 12 months 
identified, among other things, that local capacity--such as 
the ability to attract and retain administrative staff with 
school turnaround expertise or high-quality teachers--
influenced implementation, and that SIG interventions were 
often challenging for low-capacity districts. Further, the GAO 
found that third-party contractors rarely were reviewed for 
contract performance. The Committee believes the Department 
should implement effective strategies that address the GAO's 
findings as soon as possible.
    The Committee also notes that Federal and non-Federal 
investments in school turnaround and comprehensive school 
reform have identified, developed, or supported research-
proven, replicable models for struggling schools. Such schools 
now have a growing number of options to match their needs. 
Therefore, the Committee bill includes new language that will 
allow schools that receive SIG funds the flexibility to choose 
and implement a research-proven, whole-school reform model.
    The Committee believes that the Department needs to take 
additional steps to support parent engagement and family 
support through SIG and other programs and activities. The 
Committee notes that evidence-based parent education and family 
support models have been shown to increase parent knowledge of 
child development; provide early detection of developmental 
delays; and increase children's school readiness and school 
success. The Committee directs the Department to address this 
issue through its national activities set-aside and other 
appropriate actions.

Striving Readers

    The Committee recommends $159,698,000, the same amount as 
the comparable fiscal year 2012 level, to continue the Striving 
Readers initiative. The budget request proposes to consolidate 
this funding within a new Effective Teaching and Learning 
program under the administration's reauthorization proposal.
    The Committee bill includes language that continues the 
competitive portion of the program as it was established in the 
fiscal year 2010 appropriations act. This comprehensive 
literacy program will advance literacy skills for all students, 
including English language learners and students with 
disabilities, from birth through grade 12.

Migrant Education Program

    The Committee recommends $393,236,000, the same as the 
fiscal year 2012 level and budget request, for the migrant 
education program.
    The title I migrant education program authorizes grants to 
SEAs for programs to meet the special educational needs of the 
children of migrant agricultural workers and fishermen. This 
appropriation also supports activities to improve interstate 
and intrastate coordination of migrant education programs, as 
well as identify and improve services to the migrant student 
population.

Neglected and Delinquent

    The Committee recommends $50,231,000, the same amount as 
the fiscal year 2012 level and budget request, for the title I 
neglected and delinquent program.
    This program provides financial assistance to SEAs for 
education services to neglected and delinquent children and 
youth in State-run institutions and for juveniles in adult 
correctional institutions. States are authorized to set aside 
at least 15 percent, but not more than 30 percent, of their 
neglected and delinquent funds to help students in State-
operated institutions make the transition into locally operated 
programs and to support the successful re-entry of youth 
offenders who are age 20 or younger and have received a 
secondary school diploma or its recognized equivalent.

Evaluation

    The Committee recommends $1,594,000 for evaluation of title 
I programs. The budget request proposes to fund evaluation 
efforts through a comprehensive evaluation authority contained 
in the administration's reauthorization proposal. The 
comparable fiscal year 2012 amount is $3,194,000.
    Evaluation funds are used to support large-scale national 
surveys that examine how the title I program is contributing to 
student academic achievement. Funds also are used to evaluate 
State assessment and accountability systems and analyze the 
effectiveness of educational programs supported with title I 
funds.
    The Committee bill also includes a new general provision in 
this title that clarifies the Department's authority to reserve 
up to 0.5 percent of each ESEA appropriation in the bill for 
evaluation of ESEA programs funded in this act. These resources 
are in addition to any funds specifically provided for 
evaluation purposes. The Department shall provide the Senate 
Committees on Appropriations and HELP with an evaluation plan 
not later than 10 days before the initial obligation of funds 
under the provision.

High School Graduation Initiative

    The Committee recommends $48,809,000, the same amount as 
the fiscal year 2012 level, for the High School Graduation 
Initiative under title I, part H of the ESEA. The budget 
request does not include any funding for this program but 
proposes to fund related activities through a broader College 
Pathways and Accelerated Learning program.
    The High School Graduation Initiative provides competitive 
grants to LEAs or SEAs to implement effective high school 
graduation and re-entry strategies in schools and districts 
that serve students in grades 6 through 12 and have annual 
school dropout rates that are above their State's average. 
Funds also are used for certain national activities, including 
evaluation, technical assistance, and dissemination of 
information on effective programs and best practices.

Special Programs for Migrant Students

    The Committee recommends $36,526,000, the same amount as 
the fiscal year 2012 level and budget request, for Special 
Programs for Migrant Students.
    The Higher Education Opportunity Act of 2008 reauthorized 
the High School Equivalency Program [HEP] and College 
Assistance Migrant Program [CAMP] within the Special Programs 
for Migrant Students, and added a new provision allowing the 
Department to reserve up to 0.5 percent of the funds 
appropriated between the two programs for outreach, technical 
assistance, and professional development activities. In 
addition, under current law, if the total amount appropriated 
is below $40,000,000, the remaining funds are to be distributed 
between the two programs in the same proportion as the amounts 
available for each program the previous year.
    HEP projects are 5-year grants to institutions of higher 
education and other nonprofit organizations to recruit migrant 
students ages 16 and older and provide the academic and support 
services needed to help them obtain a high school equivalency 
certificate and subsequently gain employment, win admission to 
a post-secondary institution or a job-training program, or join 
the military.
    CAMP projects are 5-year grants to institutions of higher 
education and nonprofit organizations to provide tutoring, 
counseling, and financial assistance to migrant students during 
their first year of postsecondary education.

                               Impact Aid

Appropriations, 2012....................................  $1,291,186,000
Budget estimate, 2013...................................   1,224,239,000
Committee recommendation................................   1,291,186,000

    The Committee recommends $1,291,186,000 for impact aid.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities. 
Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education.
    The Committee bill retains language that provides for 
continued eligibility for students affected by the deployment 
or death of their military parent, as long as these children 
still attend schools in the same school district.
    Basic Support Payments.--The Committee recommends 
$1,153,540,000, the same amount as the fiscal year 2012 level 
and budget request, for basic support payments. Under this 
statutory formula, payments are made on behalf of all 
categories of federally connected children, with a priority 
placed on making payments first to heavily impacted school 
districts and providing any remaining funds for regular basic 
support payments.
    Payments for Children With Disabilities.--The Committee 
bill includes $48,413,000, the same amount as the fiscal year 
2012 level and the budget request, for payments for children 
with disabilities. Under this program, additional payments are 
made for certain federally connected children eligible for 
services under IDEA.
    Facilities Maintenance.--The Committee recommends 
$4,845,000, the same amount as the fiscal year 2012 level and 
budget request, for facilities maintenance. This activity 
provides funding for emergency repairs and comprehensive 
capital improvements to certain school facilities owned by the 
Department and used by LEAs to serve federally connected 
military dependent students. Funds appropriated for this 
purpose are available until expended.
    Construction.--The Committee recommends $17,441,000, the 
same amount as the fiscal year 2012 level and budget request, 
for the construction program. Formula and competitive grants 
are authorized to be awarded to eligible LEAs for emergency 
repairs and modernization of school facilities.
    The Committee recommendation includes bill language 
allowing these funds to be awarded entirely through the 
authorized formula. The budget request proposes to award funds 
on a competitive basis. Last year's bill provided these funds 
entirely through competitive allocations.
    Payments for Federal Property.--The Committee recommends 
$66,947,000, the same amount as the fiscal year 2012 level, for 
payments for Federal property. The budget request eliminates 
funding for this program. These payments compensate LEAs in 
part for revenue lost due to the removal of Federal property 
from local tax rolls.

                      School Improvement Programs

Appropriations, 2012....................................  $4,544,596,000
Budget estimate, 2013...................................   2,436,203,000
Committee recommendation................................   4,544,596,000

    The Committee recommendation includes $4,544,596,000 for 
school improvement programs.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, programs in this account are based 
generally on current law, as authorized under the ESEA.

Effective Teaching and Learning: Literacy

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning: Literacy program. The budget 
request is $186,892,000. Activities supported under this 
proposed program are instead funded under current law.
    The Effective Teaching and Learning: Literacy program would 
provide competitive grants to SEAs, or SEAs in partnership with 
appropriate outside entities, to support development and 
implementation of comprehensive, evidence-based State and local 
efforts to provide high-quality literacy programs aligned with 
college- and career-ready English language standards.

Effective Teaching and Learning: Science, Technology, Engineering, and 
        Mathematics

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning: STEM program. The budget 
request is $149,716,000. Activities supported under this 
proposed program are instead funded under current law.
    The Effective Teaching and Learning: STEM would provide 
competitive grants to SEAs, or SEAs in partnership with 
appropriate outside entities, to support State and local 
efforts to implement a comprehensive strategy for the provision 
of high-quality STEM instruction and support to students from 
preschool through grade 12.

Effective Teaching and Learning for a Well-Rounded Education

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning for a Well-Rounded Education 
program. The budget request is $90,000,000. Activities 
supported under this proposed program are instead funded under 
current law.
    The Effective Teaching and Learning for a Well-Rounded 
Education program would provide competitive grants to high-need 
LEAs, SEAs, and institutions of higher education or nonprofit 
organizations in partnership with one or more high-need LEAs to 
support the development and expansion of innovative practices 
to improve teaching and learning across a well-rounded 
curriculum that includes the arts, health education, physical 
education, foreign languages, civics and government, history, 
geography, environmental education, economics and financial 
literacy, and other subjects.

College Pathways and Accelerated Learning

    The Committee recommends no funds for the proposed College 
Pathways and Accelerated Learning program. The budget request 
is $81,282,000. Activities supported under this proposed 
program are instead funded under current law.
    The College Pathways and Accelerated Learning program would 
support efforts to increase high school graduation rates and 
preparation for college matriculation and success by providing 
college-level and other accelerated courses and instruction in 
middle and high schools with concentrations of students from 
low-income families and in high schools with low graduation 
rates.

State Grants for Improving Teacher Quality

    The Committee recommends $2,466,567,000, the same amount as 
the fiscal year 2012 level, for State grants for improving 
teacher quality. The budget request does not include any 
funding for this program but instead proposes $2,466,567,000 
for a new Effective Teacher and Leaders State Grants program 
within the Innovation and Improvement account.
    The appropriation for this program primarily supports 
activities associated with the 2013-2014 academic year. Of the 
funds provided, $785,126,000 will become available on July 1, 
2013, and $1,681,441,000 will become available on October 1, 
2013. These funds will remain available for obligation through 
September 30, 2014.
    States and LEAs may use funds for a range of activities 
related to the certification, recruitment, professional 
development, and support of teachers and administrators. 
Activities may include reforming teacher certification and 
licensure requirements, addressing alternative routes to State 
certification of teachers, recruiting teachers and principals, 
and implementing teacher mentoring systems, teacher testing, 
merit pay, and merit-based performance systems. These funds may 
also be used by districts to hire teachers to reduce class 
sizes.
    The Committee bill modifies a set-aside included in prior 
year bills for competitive awards to national not-for-profit 
organizations for recruiting, training, or providing 
professional enhancement activities for teachers or teachers 
and school leaders, particularly for high-need schools most 
likely to face shortages in these areas. The Committee 
recommends that up to 5.5 percent of funds available for the 
State grants for improving teacher quality program shall be 
used for this purpose; in fiscal year 2012, the set-aside was 
1.5 percent. The bill language also differs slightly from prior 
years by allowing up to 10 percent of the set-aside funds to be 
used for related research, development, evaluation, 
dissemination, and technical assistance.

Mathematics and Science Partnerships

    The Committee recommends $149,716,000, the same as the 
comparable fiscal year 2012 level, for the mathematics and 
science partnerships program. The budget request does not 
include any funding for this program but instead proposes 
$149,716,000 for a new Effective Teaching and Learning: STEM 
program.
    The ESEA requires that when the appropriation for this 
program is higher than $100,000,000, the funds are to be 
distributed to States by formula. The Committee has been 
concerned that at recent appropriations levels, this funding 
has been spread too thinly among the States to make a 
significant impact.
    At the recommended funding level, the ESEA requires the 
Department to make competitive awards to eligible partnerships, 
which must include an engineering, math, or science department 
of an institution of higher learning and a high-need LEA. 
Partnerships will seek to improve the performance of students 
in the areas of math and science, including engineering, by 
bringing math and science teachers in elementary and secondary 
schools together with scientists, mathematicians, and engineers 
to increase the teachers' subject-matter knowledge and improve 
their teaching skills.
    The Committee notes that it is including additional 
resources under FIE to create a new, evidence-based grant 
competition jointly administered by the Department and NSF that 
will focus on developing, evaluating, and scaling-up effective 
practices that can help increase student achievement in 
mathematics, and for related activities.

Supplemental Education Grants

    The Committee recommendation includes $17,619,000, the same 
amount as the fiscal year 2012 level and budget request, for 
supplemental education grants to the Republic of Marshall 
Islands [RMI] and the Federated States of Micronesia [FSM].
    This grant program was authorized by the Compact of Free 
Association Amendments Act of 2003. These funds will be 
transferred from the Department to the Secretary of the 
Interior for grants to these entities. The Committee bill 
continues language that allows up to 5 percent to be used by 
the FSM and RMI to purchase oversight and technical assistance, 
which may include reimbursement to the Departments of Labor, 
HHS, and Education for such services.

21st Century Community Learning Centers

    The Committee recommends an appropriation of 
$1,151,673,000, the same amount as the fiscal year 2012 level 
and budget request, for the 21st Century Community Learning 
Centers program.
    Funds are allocated to States by formula, which in turn, 
award at least 95 percent of their allocations to LEAs, 
community-based organizations and other public and private 
entities. Grantees use these resources to establish or expand 
community learning centers that provide activities offering 
significant extended learning opportunities, such as before- 
and afterschool programs, recreational activities, drug and 
violence prevention, and family literacy programs for students 
and related services to their families. Centers must target 
their services to students who attend schools that are eligible 
to operate a schoolwide program under title I of the ESEA or 
serve high percentages of students from low-income families.
    A growing body of evidence demonstrates that students 
benefit academically from a longer school day, week, and year. 
The Committee notes that some school districts have adopted 
strategies to extend the school day without significant new 
investments, such as through staggered school schedules and 
innovative partnerships with community partners.
    The Committee bill includes new language to expand the 
design options for subgrants under the 21st CCLC program for 
high-quality, afterschool, before school, summer learning, and 
expanded learning time programs.
    The Committee believes that SEAs should award grants to 
high-quality programs that address individual student learning 
needs and student well-being. Funded programs should deliver 
services through a variety of high-quality and effective 
strategies for boosting learning and enrichment including 
afterschool, before school, summer school, or expanded day, 
week, or year opportunities; align with and complement, rather 
than replicate, the regular school day, by offering a range of 
activities that capture student interest and support student 
engagement to promote higher class attendance, reduce risk for 
retention or dropping out, and foster good health; integrate 
academics, enrichment, and skill development through hands-on 
experiences that make learning relevant and engaging; and 
actively address the specific learning needs and interests of 
all types of students, especially those who may benefit from 
approaches and experiences not offered in the traditional 
classroom setting.
    The Committee urges the Department to provide guidance and 
technical assistance to States, schools, and community partners 
on how to develop and maintain strong community-school 
partnerships, implement continuous quality improvement 
processes, and ensure that programs meet the needs of 
individual students. The Committee also urges the Department to 
consult with experts in the field, including State and local 
intermediaries, in creating and providing such guidance and 
technical assistance. The Committee directs the Department to 
refrain from giving priority to, showing preference for, or 
providing direction about whether communities should use these 
funds for afterschool, before school, summer school, or 
expanded school day programs, unless specifically requested by 
SEAs or LEAs.
    The Committee also directs the Secretary to report to 
Congress on the progress of the ESEA--No Child Left Behind 
waiver process initiated in the fall of 2011, specifically in 
terms of the impact on the 21st Century Community Learning 
Centers and student participation in, and access to, 
afterschool, before school, and summer learning programs, as a 
result of the flexibility provided to SEAs under waiver option 
11. The Department should report on the number of children 
served and the centers/sites offering expanded learning in the 
3 years preceding the waiver approval and the 3 years following 
waiver approval, as well as the number of hours of and 
diversity of programming available to students through such 
grants at each site and the average cost of the programs (per 
student and per site) before and after waiver approval. All 
data should be provided at the State level.

State Assessments and Enhanced Assessment Instruments

    The Committee recommends $389,214,000, the same amount as 
the fiscal year 2012 level and budget request, for State 
assessments and enhanced assessment instruments.
    This program has two components. The first provides formula 
grants to States to pay the cost of developing and implementing 
standards and assessments required by the ESEA. The Committee 
provides $380,000,000 for this purpose.
    Under the second component--grants for enhanced assessment 
instruments--appropriations in excess of the State assessment 
program are used for a competitive grant program designed to 
support efforts by States to improve the quality and 
reliability of their assessment systems. The Committee 
recommendation for the second component is $9,214,000.
    The Committee urges the Department to place a high priority 
in the fiscal year 2013 enhanced instruments grant competition 
on improving the quality of State assessments for students with 
disabilities and students with limited English proficiency, and 
to ensure the most accurate means of measuring their 
performance on these assessments.

Education for Homeless Children and Youth

    For carrying out education activities authorized by title 
VII, subtitle B of the Stewart B. McKinney Homeless Assistance 
Act, the Committee recommends $65,173,000. This amount is the 
same as the budget request and the comparable fiscal year 2012 
level.
    This program provides assistance to each State to support 
an office of the coordinator of education for homeless children 
and youth, to develop and implement State plans for educating 
homeless children, and to make subgrants to LEAs to support the 
education of those children. Grants are made to States based on 
the total that each State receives in title I grants to LEAs.
    Under the McKinney-Vento Homeless Children and Youth 
Program, SEAs must ensure that homeless children and youth have 
equal access to the same free public education, including a 
public preschool education, as is provided to other children 
and youth.
    The Committee bill also includes language under the 
Education for the Disadvantaged account clarifying the 
availability of title I funds for services to homeless children 
and youths.

Training and Advisory Services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $6,962,000. 
This is the same amount as the budget request and the 
comparable fiscal year 2012 level.
    The funds provided will support awards to operate the 10 
regional equity assistance centers [EACs]. Each EAC provides 
services to school districts upon request. Activities include 
disseminating information on successful practices and legal 
requirements related to nondiscrimination on the basis of race, 
color, sex, or national origin in education programs.

Education for Native Hawaiians

    For programs for the education of Native Hawaiians, the 
Committee recommends $34,181,000. This is the same amount as 
the budget request and the comparable fiscal year 2012 amount.
    The Committee bill continues a provision that allows 
funding provided by this program to be used for construction.

Alaska Native Educational Equity

    The Committee recommends $33,185,000, the same amount as 
the fiscal year 2012 level and budget request, for the Alaska 
Native educational equity assistance program.
    These funds address the severe educational handicaps of 
Alaska Native schoolchildren. Funds are used for the 
development of supplemental educational programs to benefit 
Alaska Natives. The Committee bill continues language that 
allows funding provided by this program to be used for 
construction. The Committee bill also includes language 
overriding the authorizing statute's requirement to make 
noncompetitive awards to certain organizations.
    The Committee is aware that the ESEA includes a priority 
for funding under this program for applications from Alaska 
Native regional nonprofit organizations, or consortia that 
include at least one Alaska Native regional nonprofit 
organization. Therefore, the Committee directs the Department 
to distribute funding for new awards under this program based 
only on the priority authorized under part C of title VII of 
the ESEA. Within 180 days of enactment of this act, the 
Committee also directs the Department to prepare and submit a 
report on activities funded under this program, including how 
such activities are achieving the purposes of the program as 
authorized in the ESEA. The report should also include a plan 
on how the Department will work to improve consultation with 
and participation of Alaska Native organizations, Alaska Native 
regional nonprofit organizations, or consortia that include at 
least one Alaska Native regional nonprofit organizations in the 
program.

Rural Education

    The Committee recommends $179,193,000, the same amount as 
the fiscal year 2012 level and budget request, for rural 
education programs.
    The Committee expects that rural education funding will be 
equally divided between the Small, Rural Schools Achievement 
Program, which provides funds to LEAs that serve a small number 
of students, and the Rural and Low-Income Schools Program, 
which provides funds to LEAs that serve concentrations of poor 
students, regardless of the number of students served.

Comprehensive Centers

    The Committee recommends $51,113,000, the same amount as 
the fiscal year 2012 level and budget request, for the 
comprehensive centers program.
    These funds provide support to a network of comprehensive 
centers that are operated by research organizations, agencies, 
institutions of higher education, or partnerships thereof, and 
provide training and technical assistance on various issues to 
States, LEAs, and schools as identified through needs 
assessments undertaken in each region. The system currently 
includes 16 regional centers, which are charged with providing 
intensive technical assistance to SEAs to increase their 
capacity to assist LEAs and schools with meeting the goals of 
the ESEA, and content centers, which are organized by topic 
area.
    The Committee strongly supports the mission of the centers, 
particularly with regard to their role in helping develop State 
capacity to meet the needs of LEAs and schools. The Committee 
also believes that the centers play an important part in the 
Department's system of technical assistance and appreciates the 
steps the Department has taken to align and coordinate its 
various technical assistance activities. The Committee 
encourages the Department to continue its efforts in 
coordinating its technical assistance activities and requests 
that the Department describe these efforts and future plans in 
the fiscal year 2014 congressional budget justification.

                            Indian Education

Appropriations, 2012....................................    $130,779,000
Budget estimate, 2013...................................     130,779,000
Committee recommendation................................     130,779,000

    The Committee recommends $130,779,000 for Indian education 
programs.

Grants to Local Educational Agencies

    For grants to LEAs, the Committee recommends $105,921,000, 
the same amount as the fiscal year 2012 level and budget 
request.
    These funds provide financial support to elementary and 
secondary school programs that serve Indian students, including 
preschool children. Funds are awarded on a formula basis to 
LEAs, schools supported and operated by the Department of the 
Interior/Bureau of Indian Education, and in some cases directly 
to Indian tribes.

Special Programs for Indian Children

    The Committee recommends $18,986,000, the same amount as 
the fiscal year 2012 level and budget request, for special 
programs for Indian children.
    Funds are used for demonstration grants to improve Indian 
student achievement through early childhood education and 
college preparation programs, and for professional development 
grants for training Indians who are preparing to begin careers 
in teaching and school administration.

National Activities

    The Committee recommends $5,872,000, the same amount as the 
comparable fiscal year 2012 funding level and budget request, 
for national activities.
    Funds will be used to expand efforts to improve research, 
evaluation, and data collection on the status and effectiveness 
of Indian education programs, and to continue grants to tribal 
educational departments for education administration and 
planning.

                       Innovation and Improvement

Appropriations, 2012....................................  $1,527,536,000
Budget estimate, 2013...................................   4,332,166,000
Committee recommendation................................   1,545,966,000

    The Committee recommends $1,545,966,000 for programs within 
the innovation and improvement account.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, programs in this account are based 
generally on current law.

Race to the Top

    The Committee recommends $549,284,000 for the Race to the 
Top [RTT] program. The budget request includes $850,000,000 for 
this program. These funds are available for obligation through 
December 31, 2013.
    RTT, which was established in ARRA, has supported and 
incentivized reforms that are designed to reduce achievement 
gaps; improve student achievement, graduation rates, and 
college enrollments; and encourage the broad replication of 
effective practices. The Committee bill continues language 
allowing local school districts to be eligible for RTT grants 
and up to 5 percent of the appropriation for this program to be 
used for evaluation and technical assistance.
    Funds also may be used for Race to the Top-Early Learning 
Challenge [RTT-ELC], a component that was added in the fiscal 
year 2011 appropriations bill. The goal of RTT-ELC is to 
improve the quality of early learning and development and close 
the achievement gap for children with high needs. The RTT-ELC 
grant competition focuses on improving early learning and 
development for young children by supporting States' efforts to 
increase the number and percentage of low-income and 
disadvantaged children in each age group of infants, toddlers, 
and preschoolers enrolled in high-quality early learning and 
development programs; and designing and implementing an 
integrated system of high-quality early learning and 
development programs and services. Grants may be made to 
States, or consortia thereof, which may make subgrants to 
appropriate entities.
    The Committee expects a significant portion of the fiscal 
year 2013 appropriation to be used for RTT-ELC. In combination 
with additional resources allocated for the CCDBG and Head 
Start programs, the Committee expects these investments to help 
improve early learning and development systems and 
opportunities for young children. The Committee bill includes 
language requiring the Departments of Education and HHS to 
jointly administer RTT-ELC.
    The Committee applauds the Department's efforts to ensure 
that rural areas have a fair opportunity to compete in recent 
grant competitions, including the LEA-level competition under 
RTT. The Committee directs the Department in developing any 
fiscal year 2013 notice under RTT to provide an absolute 
priority for rural States or rural LEAs, as applicable.

Investing in Innovation

    The Committee recommends $149,417,000, the same amount as 
the fiscal year 2012 level, for the Investing in Innovation 
program. The budget request is $150,000,000 for this purpose.
    Investing in Innovation, which was established in ARRA, has 
provided a source for replicating education programs that meet 
the highest level of evidence; expanding those with significant 
levels of evidence; and supporting promising practices for 
which there is some level of appropriate research. The 
Committee supports this three-tier evidentiary model and 
believes that this feature of the program should continue to 
guide future funding opportunities and decisions. The Committee 
also appreciates the priority given to rural applicants in the 
last two competitions and believes that this priority should 
continue to be used in the fiscal year 2013 competition. The 
Committee expects the Department to distribute grants equally 
among the absolute priority categories unless there are an 
insufficient number of qualified grants for a particular 
category.
    The Committee bill continues language from last year's bill 
providing up to 5 percent of the appropriation for this program 
to be used for evaluation and technical assistance. The 
Committee expects to be notified in advance of the proposed 
uses of these funds.
    The Committee bill also includes new language allowing up 
to 30 percent of the funds for this program to be used to 
support ARPA-ED, a new organization that will be created to 
identify and promote advances in fundamental and applied 
sciences and engineering that could be translated into new 
learning technologies; to develop, test, and evaluate novel 
learning technologies and related processes; and to accelerate 
transformational technological advances. Prior to obligating 
any funds for ARPA-ED, the Committee directs the Department to 
provide the Senate Committees on Appropriations and HELP with a 
report describing the goals, planned activities, and 
organization related to this new effort.

Effective Teachers and Leaders

    The Committee recommends no funding to create the Effective 
Teachers and Leaders State grant program. The budget request 
includes $2,466,567,000 for this program based on the 
administration's reauthorization proposal.
    The Committee has provided $2,466,567,000 for State Grants 
for Improving Teacher Quality within the school improvement 
programs account. These funds may be used for similar purposes 
as those proposed under this program.

Effective Teachers and Leaders Innovation Fund

    The Committee recommends no funding to create the Effective 
Teachers and Leaders Innovation Fund. The budget request 
includes $400,000,000 for this program based on the 
administration's reauthorization proposal.
    The Committee provides $299,433,000 for the Teacher 
Incentive Fund and additional funds for other current law 
programs that may be used for similar purposes as those 
proposed under this program.

Teacher and Leader Pathways

    The Committee recommends no funding to create the Teacher 
and Leader Pathways program. The budget request includes 
$74,676,000 for this program based on the administration's 
reauthorization proposal.
    The Committee provides resources under current law programs 
that may be used for similar purposes as those proposed under 
this new program.

Expanding Educational Options

    The Committee recommends no funding to create the Expanding 
Educational Options program. The budget request includes 
$255,036,000 for this program based on the administration's 
reauthorization proposal.
    The Committee provides resources under current law programs 
that may be used for similar purposes as those proposed under 
this new program.

Transition to Teaching

    The Committee recommends $18,200,000 for the Transition to 
Teaching program. The budget request proposes an Excellent 
Instructional Teams initiative that could support activities 
carried out under this program, but includes no funds 
specifically for Transition to Teaching. The fiscal year 2012 
level is $26,054,000 for this program.
    This program provides grants to help support efforts to 
recruit, train, and place nontraditional teaching candidates 
into teaching positions and to support them during their first 
years in the classroom. In particular, this program is intended 
to attract mid-career professionals and recent college 
graduates. Program participants are placed in high-need schools 
in high-need LEAs.

School Leadership

    The Committee recommends $29,107,000, the same amount as 
the fiscal year 2012 level, for the school leadership program. 
The budget request proposes a Teacher and Leader Pathways 
program that could support activities funded through this 
program, but includes no funds specifically for school 
leadership.
    The program provides competitive grants to assist high-need 
LEAs to recruit and train principals and assistant principals 
through activities such as professional development and 
training programs. The Committee continues to recognize the 
critical role that principals and assistant principals play in 
creating an environment that fosters effective teaching and 
high academic achievement for students. The Committee urges the 
Department to put a high priority on grants that prepare, 
place, and support school leaders in schools most in need of 
improvement, as defined by status as persistently lowest-
achieving, priority, or focus schools.

Charter Schools

    The Committee recommends a total of $254,836,000, the same 
amount as the fiscal year 2012 level, for the support of 
charter schools. The budget request proposes no dedicated 
funding for the charter schools program, instead providing 
support for such activities through a broader Expanding 
Educational Options program.
    The Committee allocates the recommended funding as follows: 
$221,836,000 for charter school grants, up to $11,000,000 for 
State facilities incentives, not less than $11,000,000 for the 
credit enhancement for charter schools facilities program, and 
up to $11,000,000 for national activities designed to support 
local, State, and national efforts to increase the number of 
high-quality charter schools.
    The Charter Schools grants program supports the planning, 
development, and initial implementation of charter schools. 
SEAs that have the authority under State law to approve charter 
schools are eligible to compete for grants. If an eligible SEA 
does not participate, charter schools from the State may apply 
directly to the Secretary.
    Under the State facilities program, the Department awards 
5-year competitive grants to States that operate per-pupil 
facilities aid programs for charters schools. Federal funds are 
used to match State-funded programs in order to provide charter 
schools with additional resources for charter school facilities 
financing.
    The credit enhancement program provides assistance to help 
charter schools meet their facility needs. Funds are provided 
on a competitive basis to public and nonprofit entities, to 
leverage non-Federal funds that help charter schools obtain 
school facilities through purchase, lease, renovation, and 
construction.
    The Committee continues bill language that allows the 
Secretary to reserve a portion of the charter school grant 
funds to make multiple awards to charter management 
organizations and other entities for the replication and 
expansion of successful charter school models that have a track 
record of success. This year's bill requires that not less than 
$30,000,000 of funds available for charter school grants shall 
be used for this purpose. Last year's bill caps this activity 
at $55,000,000 but only roughly $29,000,000 is expected to be 
used for this purpose.
    The Committee urges the Department to continue using a 
portion of the funds available for national activities to 
address issues related to services to students with 
disabilities enrolled in or interested in enrolling in charter 
schools, as well as efforts to strengthen charter authorizing 
practices that will result in a greater share of high-quality 
charter schools.

Magnet Schools Assistance

    The Committee recommends $96,733,000, the same amount as 
the comparable fiscal year 2012 level, for the magnet schools 
assistance program. The budget request includes $99,611,000 for 
this purpose.
    This program supports grants to LEAs to establish and 
operate magnet schools that are part of a court-ordered or 
federally approved voluntary desegregation plan. Magnet schools 
are designed to attract substantial numbers of students from 
different social, economic, ethnic, and racial backgrounds. 
Grantees may use funds for planning and promotional materials, 
salaries of instructional staff, and the purchase of 
technology, educational materials, and equipment.

Fund for the Improvement of Education

    The Committee recommends an appropriation of $85,735,000 
for FIE. The fiscal year 2012 appropriation is $65,775,000 and 
the budget request is $36,276,000 for this purpose.
    Within programs of national significance, the Committee 
includes $29,000,000 to continue the initiative funded in last 
year's bill that provides competitive awards to national not-
for-profit organizations or school libraries for providing 
books and childhood literacy activities to children and 
families living in high-need communities. The Committee expects 
no less than 50 percent of these funds to be made available to 
applications from school libraries proposing high-quality 
projects for increasing access to a wide range of print and 
electronic resources that provide learning opportunities to all 
students, but particularly those less likely to have access to 
such materials at home.
    The Committee recommendation also includes $19,235,000 for 
a new STEM initiative. A portion of these funds will be used 
jointly with funds provided to NSF for a program using a 
tiered-evidence model, similar to the Investing in Innovation 
program, that seeks to develop, evaluate, and scale-up proven 
practices that can help improve teaching and learning in 
mathematics. Another portion of the funds for this initiative 
will be used for STEM-related activities at IES to improve the 
evidence base for STEM programs across the Federal Government; 
this portion may also be used for providing technical 
assistance to other Federal agencies and the field to improve 
evaluations.
    Within programs of national significance, the Committee 
also recommends $2,950,000 to support inter-agency strategies 
to strengthen re-engagement activities and outcomes of Federal 
programs serving disconnected youth, $5,424,000 to continue 
awards for full-service community schools, $1,276,000 for data 
quality and evaluation initiatives, and $350,000 for peer 
review. It also includes $1,000,000 to support a new 
competition for operation of a clearinghouse on educational 
facilities, which will provide information on planning, 
designing, financing, building, maintaining, and operating 
safe, healthy, high-performance educational facilities, 
including early learning centers.
    Within the amount for FIE, the Committee also includes 
$26,500,000 for the Arts in Education program. The budget 
request includes funds for similar activities under its 
proposed Effective Teaching and Learning for a Well-Rounded 
Education program, but no funds specifically for arts in 
education. The fiscal year 2012 appropriation is $24,935,000. 
The funding is used for competitive awards for national 
nonprofit organizations engaged in arts education, professional 
development activities, and model arts education programs. 
Funds also are used for evaluation and dissemination 
activities, as well as a partnership with the National 
Endowment for the Arts. The Committee appreciates the recent 
release of the arts education report prepared by NCES. The 
Committee believes that this survey should be conducted more 
frequently than once every 10 years. The Committee also directs 
the Department to take more effective steps in disseminating 
what is being learned through the model and professional 
development grants funded under the Arts in Education program.

Teacher Incentive Fund

    The Committee recommendation includes $299,433,000, the 
same amount as the fiscal year 2012 level, for TIF. The budget 
proposal supports the program through a broader Teacher and 
Leader Innovation Fund based on the administration's 
reauthorization proposal but includes no funding specifically 
for TIF.
    The goals of TIF are to improve student achievement by 
increasing teacher and principal effectiveness; reform 
compensation systems to reward gains in student achievement; 
increase the number of effective teachers teaching low-income, 
minority, and disadvantaged students, and students in hard-to-
staff subjects; and other activities designed to increase the 
effectiveness of teachers, principals, and other personnel in 
high-need schools.

Ready-To-Learn Television

    The Committee recommendation includes $27,194,000, the same 
amount as the fiscal year 2012 level, for the Ready-to-Learn 
Television program. The budget request proposes to fund similar 
activities through its proposed Effective Teaching and 
Learning: Literacy program, but includes no funding 
specifically for Ready-to-Learn.
    The Ready-to-Learn program is intended to use the power and 
reach of public television to help prepare children, especially 
disadvantaged children, enter and succeed in school. The ESEA 
requires that all programming and digital content created under 
Ready-to-Learn be specifically designed for nationwide 
distribution over public television stations' digital 
broadcasting channels and the Internet. The act also requires 
funds to be made available to public telecommunications 
entities to ensure that these programs and related educational 
materials are disseminated and distributed to the widest 
possible audience and are made accessible to all Americans.

Advanced Placement

    The Committee recommends $36,027,000 for AP programs. The 
comparable fiscal year 2012 level is $30,027,000. The budget 
request proposes to fund similar activities through its College 
Pathways and Accelerated Learning program, but does not include 
funding specifically for AP.
    These funds support two programs, the AP Test Fee program 
and the AP Incentive [API] program. The purpose of both is to 
aid State and local efforts to increase access to AP and 
International Baccalaureate [IB] classes and tests for low-
income students. Under the test fee program, the Department 
makes awards to SEAs to enable them to cover part or all of the 
cost of test fees of low-income students who are enrolled in an 
AP or IB class and plan to take an AP or IB test. Under the API 
program, the Department makes 3-year competitive awards to 
SEAs, LEAs, or national nonprofit educational entities to 
expand access for low-income individuals to AP programs through 
activities including teacher training; development of pre-
advanced placement courses; coordination and articulation 
between grade levels to prepare students for academic 
achievement in AP or IB courses; books and supplies; and 
participation in online AP or IB courses. Under the authorizing 
statute, the Department must give priority to funding the test 
fee program.

                 Safe Schools and Citizenship Education

Appropriations, 2012....................................    $255,753,000
Budget estimate, 2013...................................     295,866,000
Committee recommendation................................     259,589,000

    The Committee recommends a total of $259,589,000 for 
activities to promote safe schools, healthy students, and 
citizenship education.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.

Promise Neighborhoods

    The Committee recommends $80,000,000 for the Promise 
Neighborhoods program. The comparable fiscal year 2012 funding 
level is $59,887,000, and the budget request is $100,000,000.
    Funds are available for obligation through December 31, 
2013. By providing an extra quarter to obligate these funds, 
the Committee gives fiscal year 2012 planning grantees 
sufficient time to develop implementation plans that could be 
funded by this bill and provides the Department ample time to 
evaluate whether prior-year implementation grantees are making 
significant progress required to justify the receipt of 
continuation awards in fiscal year 2013.
    Competitive grants are awarded to nonprofit, community-
based organizations for the development of comprehensive 
neighborhood programs designed to combat the effects of poverty 
and improve educational and life outcomes for children and 
youth, from birth through college. Each Promise Neighborhood 
grantee serves a high-poverty urban neighborhood or rural 
community.
    Two types of awards are made under this program, 1-year 
planning grants and implementation grants. Funds for planning 
grants are used by communities to develop a plan for providing 
a continuum of services and supports for the children and youth 
in a particular neighborhood. Implementation grants are awarded 
to organizations with feasible plans for achieving the goals of 
the program.
    At the funding level recommended by the Committee, the 
Department could use roughly $67,000,000 to support 
implementation grants for prior planning grant recipients or 
communities with high-quality plans for achieving the goals of 
the program. Approximately $13,000,000 would be available for 
another round of planning grants and for technical assistance 
activities.

Successful, Safe, and Healthy Students

    The Committee recommends no funds for this proposed new 
program, which is based on the administration's reauthorization 
plan. The Committee has allocated funds for related current law 
programs, as described under the individual headings in this 
account.
    Under this program, the Department would award grants to 
SEAs, title I-eligible LEAs, and their partners for programs 
designed to improve the school culture and climate; improve 
students' physical health and well-being; and improve students' 
mental health and well-being.

Safe and Drug-Free National Activities

    The Committee recommendation includes $48,600,000 for the 
national activities portion of the Safe and Drug-Free Schools 
and Communities program. The comparable fiscal year 2012 
funding level is $64,877,000. The budget request proposes to 
fund related activities within the proposed Successful, Safe, 
and Healthy Students program.
    The Committee recommendation includes funds for 
continuation costs related to safe and supportive schools 
grants and other activities.
    The Committee is aware of the Department's work with 
elementary and secondary schools and institutions of higher 
education [IHEs] to support the successful adoption of the 
National Incident Management System [NIMS]. Since all schools 
and IHEs have a critical role in emergency management, it is 
important that they adopt NIMS at the organizational and 
operational levels as part of an integrated school and campus 
emergency management plan. Therefore, the Committee encourages 
the Department to continue to collaborate with the Department 
of Homeland Security, make widely available the guidance on the 
implementation of NIMS for schools and IHEs as part of all-
hazard emergency management planning, and provide training 
resources on safety and security at large venues.

Elementary and Secondary School Counseling

    The Committee recommends $52,296,000, the same amount as 
the comparable fiscal year 2012 funding level, to establish or 
expand counseling programs in elementary and secondary schools. 
The budget request recommends consolidating this program into 
its proposed Successful, Safe, and Healthy Students program, 
but does not include any funding specifically for counseling. 
As authorized, at least $40,000,000 must be used to support 
elementary school counseling programs.

Carol M. White Physical Education for Progress Program

    The Committee recommendation includes $78,693,000, the same 
as the fiscal year 2012 level, to help LEAs and community-based 
organizations initiate, expand, and improve physical education 
programs for students in grades K-12. The budget request 
recommends this program into its proposed Successful, Safe, and 
Healthy Students program, but does not include any funding 
specifically for physical education. This funding will help 
schools and communities improve their structured physical 
education programs for students and help children develop 
healthy lifestyles to combat the national epidemic of obesity.

                      English Language Acquisition

Appropriations, 2012....................................    $732,144,000
Budget estimate, 2013...................................     732,144,000
Committee recommendation................................     732,144,000

    The Committee recommends an appropriation of $732,144,000 
for English language acquisition.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.
    The Department makes formula grants to States based on each 
State's share of the Nation's limited-English-proficient and 
recent immigrant student population. The program is designed to 
increase the capacity of States and school districts to address 
the needs of these students. The authorizing statute requires 
that 6.5 percent of the appropriation be used to support 
national activities, which include professional development 
activities designed to increase the number of highly qualified 
teachers serving limited-English-proficient students; a 
National Clearinghouse for English Language Acquisition and 
Language Instructional Programs; and evaluation activities. 
National activities funds shall be available for 2 years.
    The Committee bill continues language that requires the 
Secretary to use a 3-year average of the most recent data 
available from the American Community Survey for calculating 
allocations to all States under this program.

                           Special Education

Appropriations, 2012.................................... $12,640,709,000
Budget estimate, 2013...................................  12,687,307,000
Committee recommendation................................  12,770,709,000

    The Committee recommends an appropriation of 
$12,770,709,000 for special education programs.

Grants to States

    The Committee recommends $11,677,855,000, an increase of 
$100,000,000 more than the fiscal year 2012 level and budget 
request, for special education grants to States, authorized 
under section 611 of part B of the IDEA.
    This program provides formula grants to assist States, 
outlying areas, and other entities in meeting the costs of 
providing special education and related services for children 
with disabilities. States pass along most of these funds to 
LEAs, but may reserve some for program monitoring, enforcement, 
technical assistance, and other activities.
    The appropriation for this program primarily supports 
activities associated with the 2013-2014 academic year. Of the 
funds available for this program, $2,394,472,000 will become 
available on July 1, 2013, and $9,283,383,000 will become 
available on October 1, 2013. These funds will remain available 
for obligation through September 30, 2014.
    As requested by the administration, the Committee continues 
bill language capping the Department of the Interior set-aside 
at the prior year level, adjusted by the lower of the increase 
in inflation or the change in the appropriation for grants to 
States. This provision also would prevent a decrease in the 
amount to be transferred in case the funding for this program 
decreases or does not change.
    The bill also includes new language clarifying provisions 
of the IDEA. The first provision clarifies that penalties paid 
by States for violating maintenance of effort under part B of 
the IDEA shall be reallocated to States by formula to those 
States that did not violate those requirements. The language 
further clarifies that both the reduced State allocations due 
to penalties paid and increased amounts under the reallocation 
shall not be considered in fiscal year 2013 or future years for 
allocations under the statutory formula. These provisions are 
included in the administration's budget request.
    The bill also includes new language clarifying that the 
level of effort under part B that an LEA must meet in the year 
after it fails to maintain its fiscal effort is the level that 
it should have met in the prior year. This language clarifies 
congressional intent and is consistent with OSEP's April 4, 
2012, informal guidance letter on the issue. Finally, the bill 
includes language clarifying that funds reserved under section 
611(c) of the IDEA may be used to help improve State capacity 
to meet data collection requirements under the IDEA and improve 
data collection, quality, and use under the act.

Preschool Grants

    The Committee recommends $372,646,000, the same amount as 
the fiscal year 2012 level and budget request, for preschool 
grants. The preschool grants program provides formula grants to 
States to assist them in making available special education and 
related services for children with disabilities aged 3 through 
5. States distribute the bulk of the funds to LEAs. States must 
serve all eligible children with disabilities aged 3 through 5 
and have an approved application under the IDEA.

Grants for Infants and Families

    The Committee recommends $462,710,000, the same amount as 
the budget request, for the grants for infants and families 
program under part C of the IDEA. The comparable fiscal year 
2012 level is $442,710,000. Part C of the IDEA authorizes 
formula grants to States, outlying areas, and other entities to 
implement statewide systems for providing early intervention 
services to all children with disabilities, ages 2 and younger, 
and their families. The IDEA also gives States the option of 
extending eligibility for part C services to children 3 and 
older if they were previously served under part C and will 
continue to be served until entrance to kindergarten.
    As requested by the administration, the Committee bill 
includes new language allowing the Department to use up to 
$2,710,000 for incentive grants to States that choose to serve 
children 3 years old until entrance into elementary school. The 
IDEA currently allows up to 15 percent of the amount above 
$460,000,000 to be used for this purpose, which would be too 
small under the level of the Committee recommendation to 
effectively serve potentially interested States.

State Personnel Development

    The Committee recommends $45,011,000, the same amount as 
the budget request, for the State personnel development 
program. The comparable fiscal year 2012 amount is $43,917,000. 
This program focuses on the professional development needs in 
States by requiring that 90 percent of funds be used for 
professional development activities. The program supports 
grants to SEAs to help them reform and improve their personnel 
preparation and professional development related to early 
intervention, educational, and transition services that improve 
outcomes for students with disabilities.

Technical Assistance and Dissemination

    The Committee recommends $46,781,000, the same amount as 
the budget request and fiscal year 2012 level, for technical 
assistance and dissemination. This program supports awards for 
technical assistance, model demonstration projects, the 
dissemination of useful information, and other activities. 
Funding supports activities that are designed to improve the 
services provided under the IDEA.
    The Committee continues to support activities that address 
the need for high-quality, evidence-based technical assistance 
activities that improve the services to and outcomes for 
students with disabilities. Prior to issuing new notices for 
fiscal year 2013 competitions, the Committee directs OSEP to 
develop a long-term strategic plan for its technical assistance 
activities that is aligned with its revised monitoring and data 
reporting structures as well as the Department's other 
technical assistance activities.

Personnel Preparation

    The Committee recommends $86,205,000 for the personnel 
preparation program. The budget request is $85,799,000 and the 
comparable fiscal year 2012 amount is $88,299,000.
    Funds support competitive awards to help address State-
identified needs for personnel who are qualified to work with 
children with disabilities, including special education 
teachers and related services personnel. The program is 
required to fund several other broad areas, including training 
leadership personnel and personnel who work with children with 
low-incidence disabilities, and providing enhanced support for 
beginning special educators.

Parent Information Centers

    The Committee recommends $29,917,000 for parent information 
centers. The budget request and comparable fiscal year 2012 
amount are $28,917,000. This program makes awards to parent 
organizations to support parent training and information 
centers, including community parent resource centers. These 
centers provide training and information to meet the needs of 
parents of children with disabilities living in the areas 
served by the centers, particularly underserved parents and 
parents of children who may be inappropriately identified.

Technology and Media Services

    The Committee recommends $29,588,000, the same amount as 
the budget request and comparable fiscal year 2012 level, for 
technology and media services. This program makes competitive 
awards to support the development, demonstration, and use of 
technology and educational media activities of value to 
children with disabilities.

PROMISE: Promoting Readiness of Minors in SSI

    The Committee recommendation includes $11,996,000 for 
PROMISE and makes these funds available for obligation through 
September 30, 2014. The budget request includes $30,000,000 for 
this activity. Last year's bill provides $1,996,000 under this 
account, as well as additional resources from unclaimed VR 
State grant funds and funds provided to SSA.
    The goal of PROMISE is to improve outcomes, such as 
employment and completion of postsecondary education, of 
children who receive SSI, as well as their families. 
Competitive grants will be awarded to a small number of States 
for a period of 5 years. States will use funds to improve the 
coordination and increase the use of existing services for 
which children receiving SSI and their families are already 
eligible. The Committee includes new bill language requested by 
the administration that slightly modifies the program as it was 
initially created in last year's bill.
    As requested by the administration, the Committee bill also 
includes new bill language that allows a portion of the funds 
provided to be used for Pay for Success awards, which are 
described in the highlights section in the introduction to the 
Committee report. The Committee expects to be notified prior to 
the issuance of any notice related to the Pay for Success 
activity.

Special Olympics

    The Committee recommendation includes $8,000,000, the same 
amount as the fiscal year 2012 level and budget request, for 
Special Olympics education activities. Under the Special 
Olympics Sport and Empowerment Act of 2004, the Secretary is 
authorized to provide financial assistance to Special Olympics 
for activities that promote its expansion and for the design 
and implementation of education activities that can be 
integrated into classroom instruction and are consistent with 
academic content standards.
    The Committee bill includes language requested by the 
administration allowing funds to be used to support Special 
Olympics National and World Games. This language was not 
included in last year's bill, but has been included in bills 
from prior years.

            Rehabilitation Services and Disability Research

Appropriations, 2012....................................  $3,511,281,000
Budget estimate, 2013...................................   3,581,313,000
Committee recommendation................................   3,626,380,000

    The Committee recommends $3,626,380,000 for rehabilitation 
services and disability research.

Vocational Rehabilitation State Grants

    The Committee recommends $3,230,972,000 for VR grants to 
States. The Committee recommends the full amount authorized by 
the Rehabilitation Act of 1973 for this mandatory funding 
stream. The comparable fiscal year 2012 level is 
$3,121,712,000. The fiscal year 2013 budget request is 
$3,167,369,000 and assumes several program consolidations and 
eliminations as part of a proposal to reauthorize WIA. While 
the Senate authorizing committee has made significant progress 
on a WIA reauthorization, legislation has not yet passed the 
Senate. As a result, the Committee recommendation follows 
current law.
    Basic State grant funds assist States in providing a range 
of services to help persons with physical and mental 
disabilities prepare for and engage in meaningful employment.
    The Rehabilitation Act requires that not less than 1 
percent and not more than 1.5 percent of the appropriation in 
fiscal year 2013 for VR State grants be set aside for grants 
for Indians.
    The Committee bill continues language, as requested by the 
administration, allowing unmatched funds in excess of any funds 
requested during the reallotment process to be available for 
the PROMISE program described under the Special Education 
account and SSA. Such funds used for the PROMISE program will 
remain available for obligation through September 30, 2014.
    As requested by the administration, the Committee bill also 
includes new bill language that allows a portion of the funds 
provided under the PROMISE program to be used for Pay for 
Success awards, which are described in the highlights section 
in the introduction to the Committee report. The Committee 
expects to be notified prior to the issuance of any notice 
related to Pay for Success activity.
    The budget request also provides a $10,000,000 set-aside 
for WIF. The Committee does not recommend any funds for WIF 
from VR grants to States due to budget constraints, but instead 
recommends funding through the Department of Labor to continue 
this initiative.

Client Assistance State Grants

    The Committee recommends $12,240,000 in discretionary 
funds, the same amount provided in fiscal year 2012 and the 
budget request, for the client assistance State grants program.
    The client assistance program funds State formula grants to 
help VR clients or client applicants understand the benefits 
available to them and work with service providers. States must 
operate client assistance programs in order to receive VR State 
grant funds.

Training

    The Committee recommends $35,515,000, the same as the 
comparable fiscal year 2012 level, for training rehabilitation 
personnel. The budget request provides $30,188,000.
    The purpose of this program is to ensure that skilled 
personnel are available to serve the rehabilitation needs of 
individuals with disabilities. It supports training, 
traineeships, and related activities designed to increase the 
numbers of qualified personnel providing rehabilitation 
services. The program awards grants and contracts to States and 
public or nonprofit agencies and organizations, including 
institutions of higher education, to pay all or part of the 
cost of conducting training programs.

Demonstration and Training Programs

    The Committee recommends $6,500,000 for demonstration and 
training programs; this amount is an increase of $1,175,000 
above the comparable fiscal year 2012 funding level. The budget 
request includes $5,750,000.
    This program awards grants to States and nonprofit agencies 
and organizations to develop innovative methods and 
comprehensive services to help individuals with disabilities 
achieve satisfactory vocational outcomes. Demonstration 
programs support projects for individuals with a wide array of 
disabilities.
    The Committee recommendation includes $425,000 for new 
technical assistance activities, as requested in the budget, 
for RSA to direct program improvement resources to the areas of 
greatest need and assist the field to improve outcomes for 
individuals with disabilities.
    The Committee recommendation includes $750,000 to support a 
new competition for parent training and information centers, 
which provide information and training on transition planning, 
the adult service system, and strategies that prepare youth for 
successful employment, postsecondary education, and independent 
living outcomes. The Committee expects RSA to coordinate with 
OSEP in carrying out this activity.

Migrant and Seasonal Farmworkers

    The Committee recommends $1,262,000, the same as the 
comparable fiscal year 2012 funding level, for migrant and 
seasonal farmworkers. The budget request proposes consolidating 
this program into the VR State Grants Program.
    This program provides grants for comprehensive 
rehabilitation services to migrant and seasonal farmworkers 
with disabilities and their families.

Protection and Advocacy of Individual Rights

    The Committee recommends $18,031,000, the same amount 
provided in fiscal year 2012 and the budget request, for 
protection and advocacy of individual rights.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities who are ineligible for protection and advocacy 
services available through the Developmental Disabilities 
Assistance and Bill of Rights Act or the Protection and 
Advocacy for Individuals with Mental Illness Act.

Supported Employment State Grants

    The Committee recommends $29,068,000, the same as the 
comparable fiscal year 2012 level, for the supported employment 
State grant program. The budget request proposes consolidating 
this program into the VR State Grants program.
    This program assists the most severely disabled individuals 
by providing ongoing support needed to obtain competitive 
employment.

Independent Living State Grants

    The Committee recommends $23,359,000, the same amount 
provided in fiscal year 2012 and the budget request, for 
independent living State grants.
    This program provides formula grants to States to improve 
independent living services, support the operation of centers 
for independent living, conduct studies and analysis, and 
provide training and outreach.

Centers for Independent Living

    The Committee recommends $79,953,000, the same amount 
provided in fiscal year 2012 and the budget request, for 
independent living centers.
    These funds support consumer-controlled, cross-disability, 
nonresidential, community-based centers that are designed and 
operated within local communities by individuals with 
disabilities. These centers provide an array of independent 
living services.
    The Committee commends the work by these centers and 
encourages them to continue their efforts to facilitate the 
transition of individuals with significant disabilities from 
institutional settings to home and community based residences, 
and from school to postsecondary life, including employment.

Independent Living Services for Older Blind Individuals

    The Committee provides $34,018,000, the same amount 
provided in fiscal year 2012 and the budget request, for 
independent living services to older blind individuals.
    Through this program, assistance is provided to persons 
aged 55 or older to adjust to their blindness, continue living 
independently, and avoid societal costs associated with 
dependent care. Services most commonly provided by this program 
are daily living skills training, counseling, community 
integration, information and referral, the provision of low-
vision devices and communication devices, and low-vision 
screening.

Helen Keller National Center

    The Committee recommends $9,145,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults. This is the 
same amount as the budget request and fiscal year 2012 level.
    The Helen Keller National Center consists of a national 
headquarters in Sands Point, New York, with a residential 
training and rehabilitation facility where deaf-blind persons 
receive intensive specialized services; a network of 10 
regional field offices that provide referral and counseling 
assistance to deaf-blind persons; and an affiliate network of 
agencies.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $108,817,000, the same as the 
comparable fiscal year 2012 level, for NIDRR. The budget 
request includes $106,817,000 for this purpose.
    NIDRR develops and implements a comprehensive and 
coordinated approach to the conduct of research, demonstration 
projects and related activities that enable persons with 
disabilities to better function at work and in the community, 
including the training of persons who provide rehabilitation 
services or conduct rehabilitation research. The Institute 
awards competitive grants to support research in federally 
designated priority areas, including rehabilitation research 
and training centers, rehabilitation engineering research 
centers, research and demonstration projects, and dissemination 
and utilization projects. NIDRR also supports field-initiated 
research projects, research training and fellowships.
    The Committee strongly supports the mission of NIDRR, which 
includes research in the interrelated domains of health and 
function, employment, and participation and community living. 
NIDRR's resources should focus on each of these statutory 
research priorities to ensure the advancement of economic and 
social self-sufficiency and full community inclusion and 
participation. The Committee urges the Secretary to embrace 
NIDRR's mission and enhance its stature and visibility within 
the Department. It also urges the NIDRR director to focus 
attention on ensuring that the practical implications of 
research outcomes are summarized and research activities and 
findings are made publicly available in a timely manner.

Assistive Technology

    The Committee recommends $37,500,000 for assistive 
technology. The fiscal year 2012 funding level is $32,836,000. 
The budget request includes $30,840,000 for this purpose.
    The Assistive Technology program is designed to improve 
occupational and educational opportunities and the quality of 
life for people of all ages with disabilities through increased 
access to assistive technology services and devices. The 
program supports various activities that help States develop 
comprehensive, consumer-responsive statewide programs that 
increase access to, and the availability of, assistive 
technology devices and services.
    The Committee recommendation will ensure all 50 Statewide 
Assistive Technology programs, the District of Columbia, and 
outlying areas will receive the minimum grant provided under 
statute for the first time.
    The Committee recommendation includes $31,000,000 for State 
grant activities authorized under section 4 of the 
Rehabilitation Act of 1973, $5,500,000 for protection and 
advocacy systems authorized by section 5, and $1,000,000 for 
technical assistance activities authorized under section 6. The 
comparable fiscal year 2012 levels are $25,560,599, $4,282,890, 
and $996,114, respectively.

           Special Institutions for Persons With Disabilities


                 AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2012....................................     $24,505,000
Budget estimate, 2013...................................      24,505,000
Committee recommendation................................      24,505,000

    The Committee recommends $24,505,000 to help support APH.
    APH provides educational materials to students who are 
legally blind and enrolled in programs below the college level. 
The Federal subsidy provides approximately 70 percent of APH's 
total sales income. Materials are distributed free of charge to 
schools and States through per capita allotments based on the 
total number of students who are blind. Materials provided 
include textbooks and other educational aids in Braille, large 
type, recorded form, and computer applications. Appropriated 
funds may be used for staff salaries and expenses, as well as 
equipment purchases and other acquisitions consistent with the 
purpose of the Act to Promote the Education of the Blind.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2012....................................     $65,422,000
Budget estimate, 2013...................................      65,037,000
Committee recommendation................................      65,422,000

    The Committee recommends $65,422,000 for NTID. This level 
supports operational costs only, as in fiscal year 2012. The 
budget request includes $2,000,000 for construction expenses in 
addition to operational costs.
    NTID, located on the campus of the Rochester Institute of 
Technology in Rochester, New York, was created by Congress in 
1965 to provide a residential facility for postsecondary 
technical training and education for persons who are deaf. NTID 
also provides support services for students who are deaf, 
trains professionals in the field of deafness, and conducts 
applied research.

                          GALLAUDET UNIVERSITY

Appropriations, 2012....................................    $125,516,000
Budget estimate, 2013...................................     117,541,000
Committee recommendation................................     125,000,000

    The Committee recommends $125,000,000 for Gallaudet 
University.
    Gallaudet University is a private, nonprofit institution 
offering undergraduate and continuing education programs for 
students who are deaf, as well as graduate programs in fields 
related to deafness for students who are hearing and deaf. The 
university conducts basic and applied research related to 
hearing impairments and provides public service programs for 
the deaf community.
    Federal funding also supports the Model Secondary School 
for the Deaf, which serves as a laboratory for educational 
experimentation and development; disseminates curricula, 
materials, and models of instruction for students who are deaf; 
and prepares adolescents who are deaf for postsecondary 
academic or vocational education or the workplace. The Kendall 
Demonstration Elementary School develops and provides 
instruction for children from infancy through age 15.
    The Committee bill includes $7,000,000 for construction-
related activities at Gallaudet University. The administration 
does not request funds specifically for construction, but 
allows up to $7,000,000 to be set aside from operations for 
construction-related activities.

                 Career, Technical, and Adult Education

Appropriations, 2012....................................  $1,737,154,000
Budget estimate, 2013...................................   1,737,154,000
Committee recommendation................................   1,737,154,000

    The Committee recommends a total of $1,737,154,000 for 
career, technical, and adult education.

Career and Technical Education

    The Committee recommends $1,130,859,000, the same as the 
comparable fiscal year 2012 level and the budget request, for 
career and technical education [CTE].
    State Grants.--The Committee recommends $1,123,030,000, the 
same as the comparable fiscal year 2012 level and budget 
request, for CTE State grants.
    Funds provided under the State grant program assist States, 
localities, and outlying areas expand and improve their CTE 
program and help ensure equal access to CTE for populations 
with special needs. Persons assisted range from secondary 
students in prevocational courses through adults who need 
retraining to adapt to changing technological and labor market 
conditions. Funds are distributed according to a formula based 
on State population and State per capita income.
    Under the Indian and Hawaiian Natives programs, competitive 
grants are awarded to federally recognized Indian tribes or 
tribal organizations and to organizations primarily serving and 
representing Hawaiian Natives for services that are additional 
to services received by these groups under other provisions of 
the Perkins Act.
    Of the funds available for this program, $332,030,000 will 
become available July 1, 2013, and $791,000,000 will become 
available on October 1, 2013. These funds will remain available 
for obligation until September 30, 2014.
    National Programs.--The Committee recommends $7,829,000 for 
national research programs and other national activities. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request.
    Funds are used to support the CTE national research center, 
as well as activities designed to improve the quality of 
performance data States collect and report to the Department.

Adult Education

    The Committee recommends $606,295,000, the same as the 
fiscal year 2012 level and the budget request, for adult 
education.
    Adult Education State Grant.--For adult basic and literacy 
education State grants, the Committee recommends $594,993,000, 
the same as the fiscal year 2012 level and the budget request. 
Funds are used by States for programs to enable adults to 
acquire basic literacy skills, to enable those who so desire to 
complete a secondary education, and to make available to adults 
the means to become more employable, productive, and 
responsible citizens.
    The Committee recommendation continues the English literacy 
and civics education State grants set-aside within the adult 
education State grants appropriation. Within the total, 
$74,709,000 is available to help States or localities affected 
significantly by immigration and large limited-English 
populations to implement programs that help immigrants acquire 
English literacy skills, gain knowledge about the rights and 
responsibilities of citizenship, and develop skills that will 
enable them to navigate key institutions of American life. This 
set-aside is the same as the fiscal year 2012 level and the 
budget request.
    The budget request also provides a $15,000,000 set-aside 
for WIF, to be jointly administered by the Department and DOL. 
The Committee does not recommend any adult education funds for 
WIF due to budget constraints. Instead, the Committee provides 
WIF funding only through DOL.
    The budget request includes a general provision that 
provides the Secretary with the authority to waive statutes and 
regulations relating to title II of WIA and title I of the 
Rehabilitation Act of 1973 when the Secretary believes waivers 
would substantially improve employment and education outcomes. 
The Committee does not include the general provision.
    National Leadership Activities.--The Committee recommends 
$11,302,000, the same amount as the fiscal year 2012 level and 
the budget request, for national leadership activities.
    The Committee urges the Department to strengthen adult 
education programs to increase the focus on adults with the 
lowest literacy and numeracy skills. A vital component of 
delivering these services to those individuals are community-
based organizations that have successfully implemented 
strategies for delivering basic adult literacy instruction 
together with employment training. The Committee encourages the 
Department to work with DOL to identify promising approaches to 
succeed in this effort, including approaches that support the 
Department's career pathways and postsecondary transition 
initiatives. In recognition of the critical role adult learners 
play in advising on successful learner outcomes, the Committee 
also requests that the Department work with national adult 
literacy organizations to identify and promote new capacity 
building initiatives on adult learner leadership and advisory 
roles in local programs.

                      Student Financial Assistance

Appropriations, 2012.................................... $24,535,281,000
Budget estimate, 2013...................................  24,685,281,000
Committee recommendation................................  24,535,281,000

    The Committee recommends an appropriation of 
$24,535,281,000 for programs under the student financial 
assistance account.

Federal Pell Grant Program

    The Committee recommends $22,824,000,000 in discretionary 
funding, the same amount as the fiscal year 2012 level and the 
budget request, for the Pell grant program. This amount will 
support an increase in the maximum Pell grant award from $5,550 
to $5,635--the first increase in the maximum award since fiscal 
year 2010.
    Pell Grants provide need-based financial assistance that 
helps undergraduate students and their families defray a 
portion of the costs of postsecondary education and vocational 
training. Awards are determined according to a statutory need-
analysis formula that takes into account a student's family 
income and assets, household size, and the number of family 
members, excluding parents, attending postsecondary 
institutions.
    More than 9.6 million students are expected to receive a 
Pell grant during the 2012-2013 academic year. Of the 9.3 
million students who relied on Pell Grants during the 2010-2011 
award year, 74 percent had incomes or came from families with 
incomes less than or equal to $30,000.
    The Pell grant program is funded partly through the 
discretionary appropriations process and partly through 
mandatory funding. The HCERA included additional mandatory 
money for the program to increase the maximum grant by the 
Consumer Price Index beginning in academic year 2013-2014 as 
long as the discretionary portion of the funding is sufficient 
to support $4,860 of the maximum award. The Committee 
recommendation for fiscal year 2013 meets that requirement, so 
it will trigger enough mandatory funding to add $775 ($85 more 
than in fiscal year 2012) to the maximum award on top of the 
discretionary portion, for a total maximum award of $5,635.
    In fiscal year 2012, Congress made several programmatic 
changes to the Pell grant program to close the $1,362,000,000 
funding gap between the estimated cost of maintaining the 
maximum award and the discretionary funding level provided the 
previous year. These changes reduced program costs in fiscal 
year 2012 and into the future, and helped improve the fiscal 
sustainability of the Pell grant program.
    Together with mandatory funding from the HCERA and BCA, 
plus discretionary funding in the fiscal year 2012 Consolidated 
Appropriations Act, as well as $2,087,000,000 in cumulative 
surplus budget authority from previous fiscal years, the fiscal 
year 2013 funding level will provide an estimated 
$1,839,000,000 more than is needed to support the discretionary 
base award of $4,860 and trigger the mandatory increase in the 
maximum award. This surplus will carry over into fiscal year 
2014.
    While the Committee's recommendation ensures there will be 
no funding gap in fiscal year 2013, the Committee is extremely 
concerned about the funding cliff expected in fiscal year 2014. 
If the discretionary funding for Pell grants were level funded 
again in fiscal year 2014, it is estimated that an additional 
$6,003,000,000 would be needed to continue supporting the 
discretionary portion of the maximum award at $4,860.
    Ignoring this looming crisis would be irresponsible. 
Therefore, the Committee recommends three reforms to the 
student financial aid programs that will provide offsets that 
will not only put a down payment on the Pell grant program's 
funding needs but also incentivize students to complete their 
education, eliminate excessive payments to guaranty agencies, 
and reduce fraud related to distance education programs. 
Together, these changes will produce $3,517,000,000 in savings 
in fiscal years 2013 and 2014, all of which will be put back 
into the Pell grant program to further reduce the funding cliff 
in fiscal year 2014. The remaining savings from these 
provisions will be applied in later years.
    First, the Committee recommendation includes bill language 
that limits the duration of a student borrower's in-school 
interest subsidy to 150 percent of the normal time required to 
complete the educational program. For example, an undergraduate 
student enrolled in a 4-year bachelor's degree program will be 
eligible to receive the in-school interest subsidy for up to 6 
years. Currently, subsidized Stafford student loan borrowers 
receive the in-school interest subsidy the entire time they 
remain enrolled. The proposal to limit the subsidy duration 
will encourage borrowers to complete their educational program 
in a timelier manner. The Committee recommendation will impact 
new borrowers only. The administration included a similar 
proposal in the budget request that would have applied to 
current borrowers as well.
    The second reform recommended by the Committee, and 
requested by the administration, will reduce the amount of loan 
rehabilitation funds that may be retained by guaranty agencies.
    A student borrower who has defaulted on his or her loan has 
the opportunity to rehabilitate it by making a series of nine 
payments over a 10-month period. The guaranty agency then sells 
the loan to an eligible lender, triggering the removal of the 
default status. Guaranty agencies are compensated in two ways 
through the rehabilitation process. First, they receive 18.5 
percent of the original defaulted amount, plus an additional 
18.5 percent collection fee that is charged to the borrower. 
This means the guaranty agency retains 37 percent of each loan 
rehabilitated.
    The Committee recommendation includes bill language that 
eliminates the guaranty agencies' retention of 18.5 percent of 
the original balance and requires the guaranty agencies to 
remit the original balance to the Department, as opposed to 
selling the remaining 81.5 percent of the original balance to 
an eligible lender. In addition, the fee charged to borrowers 
will be capped at 16 percent as opposed to 18.5 percent. The 
Department estimates this policy will reduce borrower fees by 
$58,000,000 in fiscal year 2013.
    The Committee notes that many guaranty agencies are 
affiliated with not-for-profit servicers that will benefit from 
new loan servicing contracts awarded under the HCERA. These new 
contracts will reduce or even eliminate the financial impact of 
the proposed reform to the guaranty agencies.
    Third, the Committee recommendation includes a reform to 
limit Pell Grants to cover only tuition, fees, books, and 
supplies, and not room and board, for students enrolled in 
programs provided exclusively by distance education. The 
Committee notes that, with recent statutory changes that 
removed the restrictions on the eligibility of distance 
education programs for student financial aid, there has been a 
significant increase in the number of education programs 
offered solely online and in the number of students receiving 
Pell Grants to enroll in such programs. In September 2011, the 
Department's Inspector General [IG] issued an Investigative 
Program Advisory Report alerting the Department about the 
growth of fraud in distance education programs. Specifically, 
the report noted that since 2005, 215 participants in 42 fraud 
rings have been convicted and ordered to pay $7,500,000 in 
restitution and fines and that 17 percent of the agency's open 
cases are related to distance education fraud. The IG also 
expressed concern that the cost of attendance [COA] for 
distance education students includes an allowance for room and 
board, which is in contrast to the requirement for students 
enrolled in correspondence courses. The COA for those students 
excludes room and board.
    Therefore, the Committee includes new bill language that 
will limit the COA calculation for purposes of determining Pell 
grant award amounts. Only the costs of tuition, fees, books, 
and supplies will be included in the COA used to determine the 
Pell grant award amount for an individual enrolled in an 
education program delivered exclusively online. Students 
enrolled in programs that are taught in an on-campus location, 
or taught using a mix of both on-campus instruction and 
instruction through distance education, will be unaffected by 
this reform.

Protecting Financial Aid for Students and Taxpayers

    The Committee is disturbed by recent findings that some 
colleges and universities are using Federal student financial 
assistance funding for aggressive marketing, recruitment, and 
advertising rather than for the programs' intended purpose--to 
help low- and middle-income students pursue an academic degree.
    At a time when Federal resources are scarce and students 
and families across the Nation are struggling to afford a 
college education, this practice should not be tolerated.
    To that end, the Committee includes bill language that 
prohibits all colleges and universities receiving funding 
through the HEA from spending Federal educational program 
dollars on advertising, marketing, and recruitment. Colleges 
and universities will continue to be free to spend however much 
they want on these activities; this provision simply stipulates 
that they cannot use Federal tax dollars that are intended for 
student aid and educational programs to do so. This reform will 
target Federal resources at educating students, as opposed to 
online advertisements and aggressive recruiters, and help 
ensure that taxpayers are getting a good return on their 
investment.

Federal Supplemental Educational Opportunity Grant Program

    The Committee recommends $734,599,000 for the SEOG program. 
This amount is the same as the fiscal year 2012 level and the 
budget request.
    The SEOG program provides funds to postsecondary 
institutions for need-based grants to undergraduate students. 
Institutions must contribute at least 25 percent toward SEOG 
awards. Students qualify for grants of up to $4,000 by 
demonstrating financial need. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell grant recipients with exceptional need.
    The budget request recommends reforming the SEOG allocation 
formula and redirecting SEOG funding from higher-priced and 
well-endowed institutions to lower-priced public and private 
institutions that enroll and graduate higher numbers of Pell-
eligible students and restrain tuition increases. The budget 
request does not include any specific recommendations or bill 
language on how to accomplish these goals. The Committee 
supports the proposals in principle but believes they deserve 
more deliberation in Congress.

Federal Work-Study Program

    The Committee bill provides $976,682,000 for the FWS 
program. This is the same amount as the comparable fiscal year 
2012 level. The budget request includes $1,126,682,000 and 
directs the $150,000,000 in new funds to institutions opting to 
participate in an enhanced work-study partnership with 
prospective employers.
    The budget request also recommends reforming the FWS 
allocation formula to target and incentivize funding toward 
institutions that enroll and graduate relatively high numbers 
of Pell-eligible students as well as offer lower, net tuition 
prices and fees and/or contain growth in tuition and fees. The 
budget request does not include bill language on this proposal 
and no hearings on the topic have been held in the Senate or 
House. The Committee supports the administration's goals, but 
believes the proposal deserves more deliberation in Congress.
    This program provides grants to about 3,400 institutions to 
help an estimated 700,000 undergraduate, graduate, and 
professional students meet the costs of postsecondary education 
through part-time employment. Work-study jobs must pay at least 
the Federal minimum wage and institutions must provide at least 
25 percent of student earnings. Institutions also must use at 
least 7 percent of their grants for community service jobs.
    The Committee recognizes that community service 
opportunities allow students to gain work experience and 
develop skills that they may be able to use in future careers 
and encourages the Department to bolster these opportunities at 
participating FWS institutions.
    The Committee expects the Department to provide the same 
funding from the FWS program appropriation in fiscal year 2013 
as in the prior year for the Work Colleges program authorized 
under section 448 of the HEA.

Federal Perkins Loans

    The Federal Perkins loan program supports student loan 
revolving funds built up with capital contributions to nearly 
1,700 participating institutions. Institutions use these 
revolving funds, which also include Federal capital 
contributions [FCCs], institutional contributions equal to one-
third of the FCCs, and student repayments, to provide low-
interest, subsidized loans that help financially needy students 
pay the costs of postsecondary education.
    The Committee recommends no new funds for the Perkins Loans 
program, as was the case in fiscal year 2012. The budget 
request proposes to restructure the Perkins Loan program as a 
mandatory credit program--and to expand institutional 
participation by up to an additional 2,700 postsecondary 
education institutions. The Committee bill does not include 
this proposal.

                       Student Aid Administration

Appropriations, 2012....................................  $1,043,387,000
Budget estimate, 2013...................................   1,126,363,000
Committee recommendation................................   1,126,363,000

    The Committee recommends $1,126,363,000 for the Student Aid 
Administration account. These funds are available until 
September 30, 2014, and support the Department's student aid 
management expenses.
    The HCERA terminated the authority under the HEA to make 
loans under the Federal Family Education Loan Program as of 
June 2010. Beginning July 1, 2010, 100 percent of student loans 
are now made through the William D. Ford Direct Loan Program 
and are serviced by private for-profit and not-for-profit 
servicers under contract with the Department.
    The Committee recommendation includes $726,618,000 for 
administrative costs and $399,745,000 for loan servicing 
activities. The Committee recommendation for these two 
activities represents a combined $82,976,000 increase over the 
fiscal year 2012 level. The Committee recommendation reflects 
the increased application, origination, and servicing costs 
associated with the recent legislative changes. These increases 
are necessary to manage the higher loan volume, ensure the 
operational integrity of Federal student aid systems, and 
provide high-quality service to student and parent borrowers.
    The budget request includes a general provision 
transferring the Health Education Assistance Loan program from 
HHS to the Department. The Committee recommendation includes 
new bill language authorizing the transfer and provides 
$2,807,000 for the costs of managing and servicing outstanding 
loans.
    The Committee directs the Department to continue to provide 
quarterly reports detailing its obligation plan by quarter for 
spending mandatory and discretionary funding for student aid 
administrative activities broken out by servicer, activity, and 
funding source.

                            Higher Education

Appropriations, 2012....................................  $1,869,656,000
Budget estimate, 2013...................................   2,914,064,000
Committee recommendation................................   1,911,348,000

    The Committee recommends an appropriation of $1,911,348,000 
for higher education programs.

Aid for Institutional Development

    The Committee recommends $531,076,000 for Aid for 
Institutional Development. This total and the recommended 
levels for each of the individual programs below are the same 
as the comparable levels for fiscal year 2012 and the budget 
request.
    Strengthening Institutions.--The Committee bill recommends 
$80,623,000 to provide competitive, 1-year planning and 5-year 
development grants for institutions with a significant 
percentage of financially needy students and low educational 
and general expenditures per student in comparison with similar 
institutions. Applicants may use these funds to develop 
faculty, strengthen academic programs, improve institutional 
management, and expand student services.
    Hispanic-Serving Institutions [HSIs].--The Committee 
recommends $100,432,000 for competitive grants to institutions 
at which Hispanic students make up at least 25 percent of 
enrollment. Funds may be used for acquisition, rental, or lease 
of scientific or laboratory equipment; renovation of 
instructional facilities; development of faculty; support for 
academic programs; institutional management; and purchase of 
educational materials. In addition to the Committee-recommended 
level, the HCERA provides $100,000,000 of mandatory funding in 
each fiscal year through 2019 to support HSIs in the 
development of STEM and articulation programs.
    Promoting Postbaccalaureate Opportunities for Hispanic 
Americans.--The Committee recommends $9,011,000 for competitive 
5-year grants to HSIs to help Hispanic Americans gain entry 
into and succeed in graduate study. Institutions may use 
funding to support low-income students through outreach 
programs; academic support services; mentoring and financial 
assistance; acquisition, rental, or lease of scientific or 
laboratory equipment; construction and other facilities 
improvements; and purchase of educational materials.
    Strengthening Historically Black Colleges and 
Universities.--The Committee recommends $227,980,000 for the 
strengthening HBCUs program. The program makes formula grants 
to HBCUs that may be used to purchase equipment, construct and 
renovate facilities, develop faculty, support academic 
programs, strengthen institutional management, enhance 
fundraising activities, provide tutoring and counseling 
services to students, and conduct outreach to elementary and 
secondary school students. In addition to the Committee-
recommended level, this program will receive $85,000,000 of 
mandatory funding through the HCERA in each fiscal year through 
2019.
    Strengthening Historically Black Graduate Institutions 
[HBGIs].--The Committee recommends $58,958,000 for the 
Strengthening HBGIs program. This program provides 5-year 
grants to provide scholarships for low-income students and 
academic and counseling services to improve student success. 
Funds may also be used for construction, maintenance and 
renovation activities, the purchase or lease of scientific and 
laboratory equipment, and the establishment of an endowment.
    Strengthening Predominately Black Institutions [PBIs].--The 
Committee recommends $9,262,000 for the Strengthening PBIs 
program. This program provides 5-year grants to PBIs to plan 
and implement programs to enhance the institutions' capacity to 
serve more low- and middle-income Black American students. In 
addition to the Committee-recommended level, the HCERA provides 
$15,000,000 of mandatory funding in each fiscal year through 
2019 to support programs at PBIs in the areas of STEM, health 
education, internationalization or globalization, teacher 
preparation, and improving the educational outcomes of African-
American males.
    Strengthening Asian American and Native American Pacific 
Islander-Serving Institutions [AANAPISIs].--The Committee 
recommends $3,119,000 for competitive grants to AANAPISIs that 
have an enrollment of undergraduate students that is at least 
10 percent Asian American or Native American Pacific Islander 
students. Grants may be used to improve their capacity to serve 
Asian American and Native American Pacific Islander students 
and low-income individuals. In addition to the Committee-
recommended level, AANAPISIs will receive $5,000,000 of 
mandatory funding through the HCERA in each fiscal year through 
2019 to develop faculty, strengthen academic programs, improve 
institutional management, and expand student services. 
AANAPISIs may also use mandatory funds for construction of 
classrooms, libraries, laboratories, and other instructional 
facilities.
    Strengthening Alaska Native and Native Hawaiian-Serving 
Institutions.--The Committee recommends $12,859,000 for this 
program. In addition to the Committee-recommended level, these 
institutions receive $15,000,000 of mandatory funding through 
the HCERA in each fiscal year through 2019.
    The purpose of this program is to improve and expand the 
capacity of institutions serving Alaska Native and Native 
Hawaiian students and low-income individuals. Funds may be used 
to plan, develop, and implement activities that encourage 
faculty and curriculum development, better fund administrative 
management, renovation, and improvement of educational 
facilities, enhanced student services, the purchase of library 
and other educational materials, and education or counseling 
services designed to improve the financial and economic 
literacy of students or their families.
    Strengthening Native American-Serving Nontribal 
Institutions.--The Committee recommends $3,119,000 for this 
program, which serves institutions that enroll at least 10 
percent Native American students and at least 50 percent low-
income students. In addition to the Committee-recommended 
level, these institutions receive $5,000,000 of mandatory 
funding through the HCERA in each fiscal year through 2019 to 
help institutions plan, develop, and implement activities that 
encourage faculty and curriculum development, better fund 
administrative management, renovation, and improvement of 
educational facilities, enhanced student services, and the 
purchase of library and other educational materials.
    Strengthening Tribally Controlled Colleges and 
Universities.--The Committee recommends $25,713,000 for this 
program. Tribal colleges and universities rely on a portion of 
the funds provided to address developmental needs, including 
faculty development, curriculum, and student services. In 
addition to the Committee-recommended level, this program 
receives $30,000,000 of mandatory funding through the HCERA in 
each fiscal year through 2019.

International Education and Foreign Language Studies

    The bill includes a total of $75,729,000, the same as the 
budget request, for international education and foreign 
language programs. The comparable fiscal year 2012 level is 
$74,037,000.
    Funds are used to support visits and study in foreign 
countries by individuals who plan to utilize their language 
skills in areas vital to U.S. national security in the fields 
of government, international development, and the professions.
    Domestic Programs.--The Committee recommends $68,278,000 
for domestic program activities related to international 
education and foreign language studies under title VI of the 
HEA. This amount is the same as the budget request. The fiscal 
year 2012 level is $66,586,000. Funding will support 
continuation awards in the national resource centers, foreign 
language and area studies fellowships, international business 
education projects and centers, language resource centers, and 
American overseas research centers. The Committee urges the 
Secretary to preserve the program's longstanding focus on 
activities and institutions that address the Nation's need for 
a strong training and research capacity in foreign languages 
and international studies, including increasing the pool of 
international experts in areas that are essential to national 
security and economic competitiveness.
    The increase in funds over the fiscal year 2012 level 
should be used to support new awards in the Undergraduate 
International Studies and Foreign Language program. The 
Committee recognizes that study abroad helps prepare students 
to function effectively in a global environment and recommends 
funding to expand access to study abroad, as authorized by 
section 604(b) of the HEA, particularly for underserved student 
populations and to nontraditional destinations, especially in 
developing countries.
    Overseas Programs.--The Committee recommends $7,451,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This amount is the same as the comparable 
fiscal year 2012 funding level and the budget request. Funding 
is provided for group, faculty, or doctoral dissertation 
research abroad as well as special bilateral projects. Grants 
focus on training American instructors and students in order to 
improve foreign language and area studies education in the 
United States.

Fund for the Improvement of Postsecondary Education

    The Committee recommends $43,494,000 for FIPSE. The 
comparable fiscal year 2012 funding level is $3,494,000 and the 
budget request for this program is $70,000,000.
    The Committee includes $39,000,000 to create the First in 
the World initiative, which will be modeled after the Investing 
in Innovation program. The budget request includes $55,500,000 
for this new program. The initiative will help ensure 
institutions of higher education have access to and implement 
innovative strategies and practices that have been shown to be 
effective in improving educational outcomes and making college 
more affordable for students and families. The Committee 
recommends that up to $14,000,000 be set aside for minority-
serving institutions to improve their students' persistence and 
completion rates while keeping costs under control. The 
Committee is particularly interested in supporting programs 
that target innovative strategies at low-income students.
    Training for Realtime Writers.--Within the total for FIPSE, 
the Committee recommendation includes $1,128,000 for the 
Training for Realtime Writers program authorized by section 872 
of the HEA. This amount is the same as the fiscal year 2012 
level. The budget request does not include funding for this 
program, which provides grants to institutions of higher 
education to establish programs to train realtime writers. 
Eligible activities include curriculum development, student 
recruitment, distance learning, mentoring, and scholarships. 
The program places a priority on encouraging individuals with 
disabilities to pursue careers in realtime writing. More than 
30 million Americans are considered deaf or hard of hearing, 
and many require captioning services to participate in 
mainstream activities and gain access to emergency broadcasts. 
Federal law requires that all television broadcasts be closed 
captioned, yet a shortage of trained captioners is contributing 
to the barrier to full-quality captioning of realtime 
television programming such as news, weather, and emergency 
messaging.
    Low-Income Single Parents.--The Committee recognizes the 
importance of providing targeted, supportive services to low-
income, single-parent students, such as on-campus housing, 
child care, counseling, advising, internship opportunities, 
financial aid, and financial aid counseling and assistance. The 
Committee continues to encourage the Department to promote 
replication of best practices that have proven to successfully 
provide postsecondary degree completion opportunities for low-
income single parents.
    The Committee includes new bill language, as proposed in 
the budget, allowing any funds from title III (Institutional 
Aid), title V (Developing Institutions), and part AA of title 
VIII (Masters and Postbaccalaureate Programs) of the HEA that 
would otherwise lapse to carry out an initiative to improve 
college completion rates at minority-serving institutions.
    Analysis of Federal Regulations and Reporting Requirements 
on Institutions of Higher Education.--The Committee directs 
$1,000,000 for the Secretary to enter into an agreement with 
the National Research Council of the National Academy of 
Sciences to conduct a study on the impacts of Federal 
regulations and reporting requirements on institutions of 
higher education as authorized under section 1106 of the Higher 
Education Opportunity Act of 2008. The study shall include 
information describing, by agency, the number of Federal 
regulations and reporting requirements affecting institutions 
of higher education, the estimated time required and costs to 
institutions of higher education (disaggregated by types of 
institutions) to comply with the regulations and reporting 
requirements affecting institutions of higher education, and 
recommendations for consolidating, streamlining, and 
eliminating redundant and burdensome Federal regulations and 
reporting requirements affecting institutions of higher 
education. The study shall be submitted to the Senate and House 
Committees on Appropriations, as well as the Committee on HELP 
and the Committee on Education and the Workforce not later than 
1 year after the date of enactment of this act.

Model Comprehensive Transition and Postsecondary Programs for Students 
        With Intellectual Disabilities

    The Committee recommendation includes $10,957,000 for this 
program as authorized by section 769 of the HEA. This is the 
same level that was provided in fiscal year 2012. The budget 
request includes $10,978,000 for this purpose within FIPSE 
rather than as a distinct program.
    These funds provide competitive grants to postsecondary 
institutions to establish model programs to help students with 
intellectual disabilities transition to and complete college. 
Funds may be used for student support services; academic 
enrichment, socialization, or independent living; integrated 
work experiences; and partnerships with LEAs to support 
students with intellectual disabilities participating in the 
model program who are still eligible for special education and 
related services under the IDEA.
    Funds also support a national coordinating center that is 
charged with conducting and disseminating research on 
strategies to promote positive academic, social, employment, 
and independent living outcomes for students with intellectual 
disabilities.
    The Committee is aware that the national coordinating 
center has been unable to collect data about the 
characteristics of students served, course access, employment, 
and costs associated with creating these services because its 
evaluation system has yet to be approved. It is important for 
the Committee to learn which supports are successful in 
improving educational and employment outcomes for students with 
intellectual disabilities. Therefore, the Committee urges the 
Department, in coordination with OMB, to finalize the national 
coordinating center's evaluation system, so that data can be 
captured in a timely manner.

Minority Science and Engineering Improvement

    The Committee recommends $9,466,000 for the Minority 
Science and Engineering Improvement program. This amount is the 
same as the comparable fiscal year 2012 funding level and the 
budget request. Funds are used to provide discretionary grants 
to institutions with minority enrollments greater than 50 
percent to purchase equipment, develop curricula, and support 
advanced faculty training. Grants are intended to improve 
science and engineering education programs and increase the 
number of minority students in the fields of science, 
mathematics, and engineering.

Tribally Controlled Postsecondary Career and Technical Institutions

    The Committee recommends $8,131,000 for tribally controlled 
postsecondary vocational institutions. This amount is the same 
as the comparable fiscal year 2012 funding level and the budget 
request. This program provides grants for the operation and 
improvement of tribally controlled postsecondary vocational 
institutions to ensure continued and expanding opportunities 
for Indian students.

Federal TRIO Programs

    The Committee recommends $839,932,000, the same amount as 
the fiscal year 2012 level and budget request, for Federal TRIO 
programs.
    TRIO programs provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students. Upward Bound 
offers disadvantaged high school students academic services to 
develop the skills and motivation needed to pursue and complete 
a postsecondary education; Student Support Services provides 
developmental instruction, counseling, summer programs, and 
grant aid to disadvantaged college students to help them 
complete their postsecondary education; Talent Search 
identifies and counsels individuals between ages 11 and 27 
regarding opportunities for completing high school and 
enrolling in postsecondary education; Educational Opportunity 
Centers provide information and counseling on available 
financial and academic assistance to low-income adults who are 
first-generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in doctoral 
programs.
    The Committee is aware that the Department plans to 
reallocate fiscal year 2012 funds from the McNair 
Postbaccalaureate Achievement program to the Upward Bound Math-
Science program. Recognizing the importance of increasing 
attainment of doctoral degrees by students from disadvantaged 
backgrounds, the Committee directs the Department to submit a 
report, not later than 90 days after enactment of this act, on 
the impact of any proposed reduction on preparing and assisting 
students in the pursuit of doctoral degrees. Additionally, the 
Committee expects to be notified in advance of the obligation 
of any Federal TRIO funds for fiscal year 2013 and urges the 
Department to restore any proposed reduction in funding to the 
McNair Postbaccalaureate Achievement program within available 
resources.

Gaining Early Awareness and Readiness for Undergraduate Programs

    The Committee recommends $302,244,000 for GEAR UP. This 
amount is the same as the comparable fiscal year 2012 funding 
level and the budget request. GEAR UP funds are used by States 
and partnerships of colleges, middle and high schools, and 
community organizations to assist cohorts or students in middle 
and high schools serving a high percentage of low-income 
students. Services provided help students prepare for and 
pursue a postsecondary education.

Graduate Assistance in Areas of National Need and Javits Fellowships

    The Committee recommends $30,909,000, the same amount as 
the fiscal year 2012 level and the budget request, to support 
the GAANN and Javits Fellowships programs.
    GAANN awards competitive grants to graduate academic 
departments and programs for fellowship support in areas of 
national need as determined by the Secretary. Javits 
Fellowships are awarded to students of superior ability who are 
pursuing doctoral degrees in the arts, humanities, and social 
sciences. Each fellowship consists of a student stipend to 
cover living costs and an institutional payment to cover each 
fellow's tuition and other expenses.
    In fiscal year 2012, Congress consolidated the GAANN and 
Javits Fellowships programs, as proposed by the administration. 
The Committee recommendation for fiscal year 2013 includes new 
bill language allowing funds awarded under GAANN to be used to 
fund continuation costs for the Javits Fellowships program.
    The Committee urges the Department to ensure that the arts, 
humanities, and social science disciplines supported by the 
current Javits program are eligible fields for new and 
continuing grant competitions under the consolidated GAANN and 
Javits programs. The Committee requests that the Department 
provide a plan for the implementation of the consolidation. The 
report should be submitted to the Committee within 30 days of 
the enactment of this act.

Teacher Quality Partnership Program

    The Committee recommends $42,833,000, the same as the 
fiscal year 2012 level, for the teacher quality partnership 
program. The budget request consolidates this program into a 
proposed new Teacher and Leader Pathways authority as part of 
the administration's plan for reauthorizing the ESEA. The 
Teacher Quality Partnership Program helps improve the quality 
of teachers working in high-need schools and early childhood 
education programs by creating model teacher preparation and 
residency programs.

Child Care Access Means Parents in Schools

    The Committee recommends an appropriation of $15,970,000 
for CCAMPIS. This amount is the same as the comparable fiscal 
year 2012 funding level and the budget request. CCAMPIS 
supports the efforts of a growing number of nontraditional 
students who are struggling to complete their college degrees 
at the same time that they take care of their children. 
Discretionary grants of up to 4 years are made to institutions 
of higher education to support or establish a campus-based 
child care program primarily serving the needs of low-income 
students enrolled at the institution.

GPRA/Higher Education Act Program Evaluation

    The Committee recommends $607,000 to collect data 
associated with the Government Performance and Results Act and 
to evaluate programs authorized by the HEA. This amount is the 
same as the comparable fiscal year 2012 funding level and the 
budget request.

Hawkins Centers of Excellence

    Because of budget constraints, the Committee does not 
recommend funding for the proposed new Hawkins Centers of 
Excellence. The budget request includes $30,000,000 for this 
program as a way to increase the talent pool of effective 
minority educators by expanding and reforming teacher education 
programs at minority-serving institutions.

Race to the Top: College Affordability and Completion

    The budget request includes $1,000,000,000 to create the 
proposed Race to the Top: College Affordability and Completion 
initiative, which would provide competitive grants to States 
with strong records of, and commitments to, increasing college 
affordability, quality, and value. The Committee recognizes the 
importance of addressing rapidly increasing college costs and 
encouraging State-level reform of higher education policies, 
but it does not include funding for this program because of 
budget constraints. The Committee also notes that the Senate 
and House authorizing committees have held no hearings on this 
proposed initiative.
    The Committee notes that the concerns the administration 
has raised about rising college costs are very serious ones, 
and agrees that action is needed to reduce burdens on families 
and improve outcomes for students. The Committee bill funds the 
First in the World competition requested in the President's 
budget as a first step toward tackling the challenges of 
college affordability and completion at the State and 
institution level. While the administration's request for a new 
Race to the Top cannot be accommodated in this year's bill, the 
Committee believes it is important for States to adopt reforms 
to higher education policies and practices that will reduce 
college costs for students. The Committee will continue to 
support these efforts and consider the Race to the Top proposal 
in the future, after additional deliberation in Congress.

                           Howard University

Appropriations, 2012....................................    $234,064,000
Budget estimate, 2013...................................     234,064,000
Committee recommendation................................     234,064,000

    The Committee recommends an appropriation of $234,064,000 
for Howard University. Howard is located in the District of 
Columbia and offers undergraduate, graduate, and professional 
degrees through 12 schools and colleges. The university also 
administers the Howard University Hospital. Federal funds from 
this account support approximately 43 percent of the 
university's projected educational and general expenditures, 
excluding the hospital. The Committee recommends, within the 
funds provided, not less than $3,593,000 for the endowment 
program.
    Howard University Hospital.--Within the funds provided, the 
Committee recommends $28,834,000 for the Howard University 
Hospital. The hospital provides inpatient and outpatient care, 
as well as training in the health professions. It also serves 
as a major acute and ambulatory care center for the District of 
Columbia and functions as a major teaching facility attached to 
the university. The Federal appropriation provides partial 
funding for the hospital's operations.

         College Housing and Academic Facilities Loans Program

Appropriations, 2012....................................        $459,000
Budget estimate, 2013...................................         459,000
Committee recommendation................................         459,000

    Federal Administration.--The Committee bill includes 
$459,000 for Federal administration of the CHAFL program. These 
funds will be used to reimburse the Department for expenses 
incurred in managing the existing CHAFL loan portfolio during 
fiscal year 2013. These expenses include salaries and benefits, 
travel, printing, contracts, and other expenses directly 
related to the administration of the CHAFL program.

  Historically Black College and University Capital Financing Program 
                                Account

Appropriations, 2012....................................     $20,502,000
Budget estimate, 2013...................................      20,502,000
Committee recommendation................................      20,502,000

    The Committee recommends $20,502,000 for the HBCU Capital 
Financing Program.
    The Committee recommendation includes $20,150,000 to pay 
the loan subsidy costs in guaranteed loan authority under this 
program. This amount will support $320,350,000 in new loan 
volume in fiscal year 2013. The remaining $352,000 will be used 
for administrative expenses.
    The HBCU Capital Financing Program makes capital available 
to HBCUs for construction, renovation, and repair of academic 
facilities by providing a Federal guarantee for private sector 
construction bonds. Construction loans will be made from the 
proceeds of the sale of the bonds. As requested by the 
administration, the Committee retains bill language allowing 
the program to make loans to public and private HBCUs without 
regard to the limitations within section 344(a) of the HEA.
    The Committee recommendation includes new bill language, as 
proposed in the budget request, that allows the loan subsidy 
funding to be available for 2 fiscal years. The Department has 
found that the 1-year timeframe to insure loans constrains the 
planning process for new program loans, decreasing the number 
of projects that can be considered for funding and limiting the 
Department's ability to achieve the statutory mandate of 
ensuring that loans are fairly allocated among as many eligible 
institutions as possible.

                    Institute of Education Sciences

Appropriations, 2012....................................    $593,664,000
Budget estimate, 2013...................................     621,150,000
Committee recommendation................................     618,661,000

    The Committee recommends $618,661,000 for IES. This account 
supports education research, development, dissemination, and 
evaluation; data collection and analysis activities; and the 
assessment of student progress.
    The Committee commends IES's attempts to improve the rigor, 
relevance, and utilization of education research that leads to 
enhanced education policy and classroom practices. The 
Committee urges IES to continue its efforts in these areas, 
particularly through the regional educational laboratories and 
the research, development, and dissemination program.

                RESEARCH, DEVELOPMENT, AND DISSEMINATION

    The Committee recommends $189,787,000, the same as the 
fiscal year 2012 level, for education research, development, 
and national dissemination activities. The budget request is 
$202,273,000. Funds are available for obligation for 2 fiscal 
years. These funds support activities that are aimed at 
expanding fundamental knowledge of education and promoting the 
use of research and development findings in the design of 
efforts to improve education.
    The Committee directs IES to continue support for research 
and development activities related to gifted and talented 
education that directly support learning and improve the 
academic achievement of gifted and talented students, including 
those who may not be formally identified as gifted and those 
who are from underrepresented populations. The Committee also 
directs IES to support a National Research Center on the Gifted 
and Talented and to ensure that gifted and talented education 
is reported in national reports produced by IES.
    The Committee is particularly supportive of IES' research 
partnership work, which seeks to leverage investments in 
statewide, longitudinal data systems in supporting reform and 
data-based decisionmaking. The Committee believes that this 
work should include local partnerships that seek to integrate 
these statewide systems with local and State health and human 
service data systems for policy- and practice-relevant research 
on educational risk and resilience among disadvantaged 
students.
    The Committee continues to support IES research 
announcements that provide an opportunity for researchers to 
explore how closed captions could be best used to increase 
literacy and to evaluate whether changes to closed captions 
might enhance their effect.

                               STATISTICS

    The Committee recommends $114,745,000 for data gathering 
and statistical analysis activities at NCES. The increase of 
$5,997,000 provided above the fiscal year 2012 level will allow 
NCES to provide partial support to States that would like to 
benchmark their student performance against countries that 
participate in the Program for International Student 
Assessment. The budget request includes $114,745,000 for NCES.
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
NCES also provides technical assistance to SEAs, LEAs, and 
postsecondary institutions.

                   REGIONAL EDUCATIONAL LABORATORIES

    The Committee recommends $57,426,000 to continue support 
for the regional educational laboratories. This amount is the 
same as the fiscal year 2012 level and the budget request. 
Funds available in this bill will continue to support a network 
of 10 laboratories. The laboratories are responsible for 
promoting the use and development of knowledge and evidence in 
broad-based systemic strategies to increase student learning 
and further school improvement efforts. The Committee 
appreciates the efforts of IES to strengthen the connections 
between practitioners and the research community, so that 
federally supported research is practical and meets the needs 
of the field.

              RESEARCH AND INNOVATION IN SPECIAL EDUCATION

    The Committee recommends $59,905,000, an increase of 
$10,000,000 over the fiscal year 2012 funding level and the 
budget request, for research and innovation in special 
education conducted by the National Center for Special 
Education Research [NCSER]. At the Committee-recommended 
funding level, NCSER should be able to fund roughly $20,000,000 
in new awards in fiscal year 2013.
    The Center addresses gaps in scientific knowledge in order 
to improve special education and early intervention services 
and outcomes for infants, toddlers, and children with 
disabilities. Funds provided to the center are available for 
obligation for 2 fiscal years.
    Under the Individuals with Disabilities Education 
Improvement Act of 2004, Congress established NCSER to improve 
the overall quality and rigor of the special education research 
conducted by the Department, and to ensure that the needs of 
children with disabilities are included throughout other 
research programs, data collection efforts, and related 
activities conducted at IES, OSEP, and other offices of the 
Department. The Committee therefore directs the Director to 
submit a report within 90 days of enactment on the Institute's 
plans for a comprehensive research agenda for special 
education.

               SPECIAL EDUCATION STUDIES AND EVALUATIONS

    The Committee recommends $11,415,000 for special education 
studies and evaluations. This amount is the same as the fiscal 
year 2012 level and the budget request.
    This program supports competitive grants, contracts, and 
cooperative agreements to assess the implementation of IDEA. 
Funds are also used to evaluate the effectiveness of State and 
local efforts to deliver special education services and early 
intervention programs. Funds are available for obligation for 2 
fiscal years.

                         STATEWIDE DATA SYSTEMS

    The Committee recommendation includes $53,077,000, the same 
amount as the budget request, for statewide data systems. The 
fiscal year 2012 level is $38,077,000.
    This program supports competitive grants to SEAs to enable 
such agencies to design, develop, and implement statewide, 
longitudinal data systems to manage, analyze, disaggregate, and 
use individual data for students of all ages. Early childhood, 
postsecondary, and workforce information systems may be linked 
to such systems or developed with program funds. The Committee 
believes the Department should continue its efforts to ensure 
every State has the base support necessary to develop effective 
systems. Funds are available for obligation for 2 fiscal years.
    The Committee bill allows up to $20,000,000 to be used for 
awards to public or private agencies or organizations to 
support activities to improve data coordination, quality, and 
use at the local, State, and national levels. The Committee 
requests that, prior to obligating any funds for this purpose, 
the Department provide to the Committee an operating plan 
describing the proposed purpose and use of such funds.

                               ASSESSMENT

    The Committee recommends $132,306,000, the same amount as 
the budget request, to provide support for NAEP, a 
congressionally mandated assessment created to measure and 
report the educational achievement of American students in a 
range of subjects and analyze trends over time. The comparable 
fiscal year 2012 amount is $138,306,000.
    Within the funds appropriated, the Committee recommends 
$7,690,000, the same amount as the budget request, for NAGB. 
The comparable fiscal year 2012 level is $8,690,000. NAGB is 
responsible for formulating policy for NAEP.

                        Departmental Management


                         PROGRAM ADMINISTRATION

Appropriations, 2012....................................    $446,259,000
Budget estimate, 2013...................................     463,815,000
Committee recommendation................................     448,470,000

    The Committee recommends $448,470,000 for program 
administration.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing, and other services 
required to award, administer, and monitor Federal education 
programs. Support for program evaluation and studies and 
advisory councils also is provided under this account.
    The Committee recommendation includes $2,211,000, the same 
amount as the budget request, for building modernization 
activities for the Department. The fiscal year 2012 bill did 
not provide any resources for this purpose.
    The Committee is concerned with deficiencies in geography 
education at the elementary and secondary education levels and 
geographic education research in the United States. The 
Committee recognizes that a sound understanding of geography is 
critical to ensuring that the American workforce is qualified 
for jobs in geospatial technologies and other emerging 
industries. The Committee directs GAO to conduct a study on the 
status of geographic education and the ability of U.S. 
graduates to fill and retain skilled jobs, particularly in 
geospatial technologies. Additionally, recognizing fiscal 
constraints on States and LEAs, the Committee requests GAO to 
report on the challenges elementary and secondary schools face 
in providing geographic education within limited resources.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2012....................................    $102,624,000
Budget estimate, 2013...................................     105,318,000
Committee recommendation................................     102,624,000

    The Committee recommends $102,624,000 for OCR.
    OCR is responsible for the enforcement of laws that 
prohibit discrimination on the basis of race, color, national 
origin, sex, disability, and age in all programs and 
institutions that receive financial assistance from the 
Department. To carry out this responsibility, OCR investigates 
and resolves discrimination complaints, monitors desegregation 
and equal educational opportunity plans, reviews possible 
discriminatory practices by recipients of Federal education 
funds, and provides technical assistance to recipients of funds 
to help them meet these civil rights requirements.
    The Committee finds troubling the continued high rates of 
out-of-school suspension and expulsion evidenced in the Civil 
Rights Data Collection [CRDC]. Research demonstrates that over-
reliance on suspension and expulsion does not improve school 
safety, does little to correct misbehavior, is associated with 
worse school-wide educational outcomes, and increases the 
likelihood of a student dropping out and having contact with 
the juvenile justice system. However, as the CRDC shows, some 
schools have successfully lowered suspension and expulsion 
rates and have demonstrated academic improvement in the 
process.
    The Committee applauds the Department for its recent 
expansion of the CRDC to include more data related to school 
discipline and climate. The Committee recommends further 
expansion of the CRDC to include a comprehensive set of school 
discipline data indicators such as: the grade level of students 
subject to discipline, the length of time of any exclusionary 
discipline action, and disaggregation by the general types of 
incidents giving rise to disciplinary action. Adequate 
collection and reporting of this information will engender the 
implementation of the types of evidence-based approaches to 
improving school discipline and climate that improve academic 
performance, student attendance, and perceptions of school 
safety while lowering disciplinary rates.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012....................................     $59,820,000
Budget estimate, 2013...................................      62,401,000
Committee recommendation................................      59,820,000

    The Committee recommends $59,820,000 for OIG.
    OIG has the authority to investigate all departmental 
programs and administrative activities, including those under 
contract or grant, to prevent and detect fraud and abuse, and 
to ensure the quality and integrity of those programs. The 
Office investigates alleged misuse of Federal funds and 
conducts audits to determine compliance with laws and 
regulations, efficiency of operations, and effectiveness in 
achieving program goals.

                           GENERAL PROVISIONS

    Section 301. The bill continues a provision prohibiting the 
use of funds for the transportation of students or teachers in 
order to overcome racial imbalance.
    Section 302. The bill continues a provision prohibiting the 
involuntary transportation of students other than to the school 
nearest to the student's home.
    Section 303. The bill continues a provision prohibiting the 
use of funds to prevent the implementation of programs of 
voluntary prayer and meditation in public schools.
    Section 304. The bill continues a provision giving the 
Secretary authority to transfer up to 1 percent of any 
discretionary funds between appropriations.
    Section 305. The bill continues a provision that allows the 
outlying areas to consolidate funds under title V of the ESEA.
    Section 306. The bill continues a provision that allows the 
Republic of Palau to receive certain Federal funds.
    Section 307. The bill includes a new provision changing the 
name of the Office of Vocational and Adult Education to the 
Office of Career, Technical, and Adult Education.
    Section 308. The bill contains a new provision that 
clarifies the Department's authority to reserve up to 0.5 
percent of each ESEA appropriation in the bill for evaluation 
of ESEA programs funded in this act. These resources are in 
addition to any funds specifically provided for evaluation 
purposes. The Department shall provide the Committees on 
Appropriations and HELP with an evaluation plan not later than 
10 days before any funds are obligated under the provision.
    Section 309. The bill includes a new provision prohibiting 
all colleges and universities that receive funding through HEA 
from spending Federal educational program dollars on 
advertising, marketing, and recruitment.
    Section 310. The bill includes a new provision that reforms 
the student aid programs by eliminating the interest subsidy 
for new borrowers who remain in-school beyond 150 percent of 
their program length, reducing subsidies for guaranty agencies 
that rehabilitate defaulted loans, and reducing fraud related 
to distance education programs. The savings from these reforms 
are reappropriated into the Pell grant program. The provision 
will also allow certain students to become eligible for Pell 
grants through the ability to benefit option and to limit the 
number of not-for-profit student loan servicers.

                                TITLE IV

                            RELATED AGENCIES

 Committee for Purchase From People Who Are Blind or Severely Disabled

                         SALARIES AND EXPENSES

Appropriations, 2012....................................      $5,375,000
Budget estimate, 2013...................................       5,396,000
Committee recommendation................................       5,375,000

    The Committee recommends $5,375,000 for the Committee for 
Purchase from People Who Are Blind or Severely Disabled.
    The primary purpose of this program is to increase the 
employment opportunities for people who are blind or have other 
severe disabilities and, whenever possible, to prepare them to 
engage in competitive employment.

             Corporation for National and Community Service


                           OPERATING EXPENSES

Appropriations, 2012....................................    $750,252,000
Budget estimate, 2013...................................     760,498,000
Committee recommendation................................     760,498,000

    The Committee recommends $760,498,000 for the operating 
expenses of CNCS.
    The Committee recommendation is sufficient to maintain the 
number of AmeriCorps members at over 82,000.
    The Committee bill includes a consolidation of the Training 
and Technical Assistance grants into the State Commission 
grants. The Committee believes that this consolidation will 
create efficiencies at both the Federal and State levels of 
government by combining two State grants with overlapping 
purposes.
    CNCS, a corporation owned by the Federal Government, was 
established to enhance opportunities for national and community 
service. The Corporation makes grants to States, institutions 
of higher education, public and private nonprofit 
organizations, and others to create service opportunities for 
students, out-of-school youth, and adults.
    CNCS administers programs authorized under the Domestic 
Volunteer Service Act, the National and Community Service Trust 
Act, and the SERVE America Act.

                                 VISTA

    The Committee recommends $95,300,000, the same as the 
budget request, for VISTA. The fiscal year 2012 level is 
$94,820,000.
    VISTA provides capacity building for small, community-based 
organizations with a mission of combating poverty. VISTA 
members raise resources, recruit and organize volunteers, and 
establish and expand programs in housing, employment, health, 
and economic development activities.

                    NATIONAL SENIOR VOLUNTEER CORPS

    The Committee recommends $208,883,000 for the National 
Senior Volunteer Corps Programs. The fiscal year 2012 
comparable level is $207,491,000 and the budget request is 
$207,883,000.
    Senior Corps is a collection of programs that connect 
Americans older than the age of 55 with opportunities to 
contribute their job skills and expertise to community projects 
and organizations. Programs include the Retired Senior 
Volunteer Program, the Foster Grandparent Program, and the 
Senior Companion Program.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2012         Fiscal year      Committee
                                                                    comparable     2013 request   recommendation
----------------------------------------------------------------------------------------------------------------
Retired Senior Volunteer Program................................          50,204          50,299          51,299
Foster Grandparent Program......................................         110,565         110,774         110,774
Senior Companion Program........................................          46,722          46,810          46,810
----------------------------------------------------------------------------------------------------------------

    The Committee includes $1,000,000 above the request in the 
Retired Senior Volunteer Program [RSVP] to provide training and 
technical assistance to grantees as they begin to undergo the 
grant competition process set out in the SERVE America Act, 
scheduled to begin in fiscal year 2013.

                  AMERICORPS STATE AND NATIONAL GRANTS

    The Committee recommends $346,368,000 for AmeriCorps State 
and National Grants. The fiscal year 2012 level is 
$344,348,000. The budget request is $345,000,000.
    AmeriCorps State and National Grants provide funds to local 
and national organizations and agencies to address community 
needs in education, public safety, health, and the environment. 
Each of these organizations and agencies, in turn, uses its 
AmeriCorps funding to recruit, place, and supervise AmeriCorps 
members. AmeriCorps members receive a modest living allowance 
and other benefits proportional to their level of time 
commitment.
    In fiscal year 2009, Congress removed a long-standing 
provision capping the amount of funding that could be awarded 
as national direct grants. Fiscal year 2012 was the fourth year 
in which CNCS determined the funding balance between State and 
national direct awardees. The Committee requests a report, no 
later than 60 days after the beginning of fiscal year 2013, on 
the balance of awards between national direct grants, State 
competitive grants, and State formula awards for the 4 years 
prior to and the 4 years subsequent to the elimination of the 
statutory cap. The report should include a State-by-State 
analysis that includes number of members, number of grants, and 
dollar amounts for each State.
    The Committee is very supportive of the work being done by 
members supported by the national direct program; however, the 
Committee is concerned by the lack of support for rural America 
in this program. The Committee directs CNCS to develop an 
action plan for how to create a more appropriate balance 
between urban and rural communities in the national direct 
program. The Committee encourages CNCS to engage organizations 
that specialize in addressing rural needs to determine the type 
of technical assistance that might increase their participation 
in this important program.

National Civilian Community Corps [NCCC]

    The Committee recommendation includes $30,742,000 for NCCC. 
The comparable fiscal year 2012 level is $31,882,000 and the 
budget request is $30,110,000. The recommended reduction 
reflects the completion of one-time relocation activities 
related to the loss of the Perry Point campus.
    NCCC is a full-time, team-based residential program for men 
and women ages 18 to 24. Members are assigned to 1 of 5 
campuses for a 10-month service commitment.
    The Committee is pleased by the creation of FEMA Corps, a 
new partnership between CNCS and the Federal Emergency 
Management Agency [FEMA]. This partnership is a welcome 
recognition of the significant contribution that NCCC teams 
have made to communities hardest hit by natural disasters. FEMA 
Corps will broaden this traditional mission of NCCC by creating 
a new Corps with additional responsibilities and training. 
Given that NCCC has routinely executed task orders from FEMA in 
the past, the Committee believes that allowing FEMA to deploy 
NCCC members directly will create sorely needed efficiencies in 
times of crisis.

          INNOVATION, DEMONSTRATION, AND ASSISTANCE ACTIVITIES

    The Committee recommendation includes $54,215,000 for 
Innovation, Demonstration, and Assistance Activities. The 
comparable fiscal year 2012 level is $53,280,000. The budget 
request is $53,215,000.
    Within the funds provided for the Innovation account, the 
Committee includes $45,000,000 for the Social Innovation fund 
authorized under section 1807 of the SERVE America Act. The 
fiscal year 2012 comparable level is $44,815,000. The budget 
request is $50,000,000.
    In addition, $5,000,000 is included for the Volunteer 
Generation Fund authorized under section 198P of the SERVE 
America Act, and $1,000,000 for MLK Service Day. The fiscal 
year 2012 comparable levels are $3,984,000 and $992,000, 
respectively. The budget request does not include funds for 
either activity.

                               EVALUATION

    The Committee recommendation includes $5,000,000, the same 
as the budget request, for CNCS evaluation activities. The 
fiscal year 2012 level is $2,994,000.
    The Committee intends that part of the increase in 
evaluation funds be used to continue the Civic Health 
Assessment, which is funded in Training and Technical 
Assistance in fiscal year 2012.

                        STATE COMMISSION GRANTS

    The Committee includes $19,990,000 for State Commission 
grants. The fiscal year 2012 level is $15,437,000 and the 
budget request is $20,990,000.
    The recommended increase over the budget request reflects 
the Committee's intention to consolidate the training and 
technical assistance grants into the State Commission Grants. 
The Committee believes that this consolidation will create 
efficiencies at both the Federal and State levels of government 
by combining two State grants with overlapping purposes. The 
Committee expects CNCS to develop measures to ensure that 
States adequately train new applicants and newly awarded 
grantees in accountability procedures.
    The Committee does not continue a provision in the fiscal 
year 2012 bill that lowered the State minimum award to $200,000 
from the $250,000 level prescribed in the SERVE America Act.
    The Committee is concerned that Commission grants are 
awarded based on a formula that does not take into account 
either the number of grants, the number of members, or the 
dollar amounts administered by any of the State commissions. As 
CNCS moves to consolidate training and technical assistance 
into this funding stream, the Committee encourages CNCS to 
consider linking the State Commission Grants more closely to 
their federally mandated workload.

                 PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2012....................................    $211,797,000
Budget estimate, 2013...................................     208,744,000
Committee recommendation................................     208,744,000

    The Committee recommends an appropriation of $208,744,000 
for making payments to the National Service Trust.
    The National Service Trust makes payments of Segal 
education awards, pays interest that accrues on qualified 
student loans for AmeriCorps participants during terms of 
service in approved national service positions, and makes other 
payments entitled to members who serve in the programs of CNCS.
    The recommended funding level is sufficient to support no 
less than the same number of servicemembers as were enrolled in 
fiscal year 2012.
    The Committee is aware that some institutions of higher 
education, in recognition and appreciation of members' service, 
have agreed to match the Segal educational award either 
financially or through some other inducement. This is a 
practice that the Committee applauds and would like to 
encourage due to the increasing costs of higher education and 
limited resources for financial aid. To that end, the Committee 
directs CNCS to include in members' end-of-service packet of 
information a list of all institutions and programs in the 
country that match the educational award. The Committee further 
directs CNCS to make a current list available on its Web site 
and in the AmeriCorps portal.

                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $82,843,000
Budget estimate, 2013...................................      88,000,000
Committee recommendation................................      88,000,000

    The Committee recommends an appropriation of $88,000,000 
for CNCS salaries and expenses.
    The salaries and expenses appropriation provides funds for 
staff salaries, benefits, travel, training, rent, equipment, 
and other operating expenses necessary for management of CNCS 
programs and activities.
    The Committee strongly supports efforts to redesign the 
outreach activities meant to recruit and support national 
service members with disabilities. The program should build on 
successful models of integration of persons with disabilities. 
The Committee notes that section 129(k) of the National and 
Community Service Act of 1990 requires CNCS to reserve 2 
percent of funds for disability training and support 
activities. Though flexibility exists to use excess funds in 
other ways, the Congress clearly intended this effort to be 
robust. Therefore, the Committee requests that CNCS begin to 
report in the annual congressional budget justification the 
amount for disability training and support activities proposed 
for the current fiscal year and the amount obligated in the 5 
prior fiscal years.
    The Committee remains strongly supportive of service 
learning. The Committee encourages CNCS to work with the heads 
of State service commissions, former Learn and Serve America 
grantees, SEAs, and other relevant stakeholders to formulate a 
plan to advance service learning. The Committee further 
encourages CNCS to become a national resource on service 
learning by collecting and disseminating model curricula and 
public information on school districts that provide service 
learning opportunities for school-aged children.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2012....................................      $3,992,000
Budget estimate, 2013...................................       5,400,000
Committee recommendation................................       5,400,000

    The Committee recommends an appropriation of $5,400,000 for 
the CNCS OIG.
    The OIG's goals are to increase organizational efficiency 
and effectiveness within the Corporation and to prevent fraud, 
waste, and abuse.
    The recommended level of funding should allow the IG to 
hire three new criminal investigators, one criminal analyst, 
two auditors and an audit manager.

                       ADMINISTRATIVE PROVISIONS

    The Committee retains language in previous bills concerning 
four administrative provisions: requiring the Corporation to 
make any significant changes to program requirements or policy 
through rule-making (section 401), stipulating minimum share 
requirements (section 402), requiring that donations supplement 
and not supplant operations (section 403), and aligning 
requirements regarding the use of Education Awards at GI bill-
eligible institutions (section 404). The Committee bill does 
not include language requested by the administration to modify 
the SERVE America Act with respect to the Senior Corps grant 
award process.

                  Corporation for Public Broadcasting

Appropriations, 2012....................................    $444,159,000
Appropriations, 2013....................................     445,000,000
Appropriations, 2014....................................     445,000,000
Budget estimate, 2015...................................     445,000,000
Committee recommendation, 2015..........................     445,000,000

    The Committee recommends $445,000,000 for CPB as an advance 
appropriation for fiscal year 2015. Two-year advance funding 
has been in place since 1975 to ensure the independence of 
public broadcasting programming.
    The majority of these funds go directly to local public 
television and radio stations to support their programming. CPB 
funds also support the creation of content for radio, 
television, and other platforms; system support activities that 
benefit the entire public broadcasting community; and CPB's 
administrative costs.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $46,163,000
Budget estimate, 2013...................................      47,045,000
Committee recommendation................................      46,163,000

    The Committee recommends $46,163,000 for the Federal 
Mediation and Conciliation Service [FMCS]. FMCS provides 
mediation, conciliation, and arbitration services to labor and 
management organizations to prevent and minimize work stoppages 
and promote stable labor-management relationships. FMCS is also 
authorized to provide dispute resolution consultation and 
training to all Federal agencies.
    Within the total, the Committee recommendation includes up 
to $400,000, the same amount as the budget request, for labor-
management partnership grants. This program was not funded in 
fiscal year 2012. These grants support innovative approaches to 
collaborative labor-management relationships to resolve 
potential problems, explore ways to improve productivity, and 
avert serious work stoppages.

            Federal Mine Safety and Health Review Commission


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $17,604,000
Budget estimate, 2013...................................      16,000,000
Committee recommendation................................      17,000,000

    The Committee recommends $17,000,000 for FMSHRC. FMSHRC 
provides administrative trial and appellate review of legal 
disputes under the Federal Mine Safety and Health Act of 1977. 
Most cases involve civil penalties proposed by MSHA. FMSHRC's 
administrative law judges [ALJs] decide cases at the trial 
level and the five-member Commission provides review of the ALJ 
decisions.
    The comparable fiscal year 2012 funding level includes 
$2,680,000 in one-time costs associated with developing an 
electronic case management system and moving FMSHRC to new 
office space. Excluding these one-time costs, the Committee 
recommendation represents a $2,076,000 increase over the 
comparable fiscal year 2012 operating level.
    This increase in funding, and corresponding increases at 
DOL, supports continued Federal efforts to reduce the backlog 
of appealed cases up for review at FMSHRC. The rate of 
contested MSHA citations has more than quadrupled since 2006, 
resulting in a corresponding fourfold increase in the number of 
cases appealed to FMSHRC annually. For many years FMSHRC's 
funding did not keep up with this added workload resulting in a 
significant increase in the number of backlogged cases awaiting 
review and the time it takes to process cases. This has created 
a dangerous incentive for mine operators to contest violations 
solely to delay enforcement. Congress provided additional 
resources over the last several years to increase capacity to 
process contested cases but at current funding levels FMSRHC is 
still only able to keep up with incoming cases. As a result, 
pending cases and processing times are expected to remain at 
approximately their current levels. The Committee 
recommendation allows FMSHRC to decrease the number of pending 
cases and the time it takes to process cases.

                Institute of Museum and Library Services


       OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2012....................................    $231,954,000
Budget estimate, 2013...................................     231,954,000
Committee recommendation................................     231,954,000

    The Committee recommends $231,954,000 for IMLS. IMLS 
supports programs for museums and libraries that encourage 
innovation, provide lifelong learning opportunities, promote 
cultural and civic engagement, and improve access to a variety 
of services and information.
    The budget request proposes to consolidate the Conservation 
Project Support program with the Museums for America program 
and the 21st Century Museum Professionals program with the 
National Leadership program, for the purpose of simplifying and 
streamlining the grantee application process and IMLS' 
management of these programs. The Committee supports these 
consolidations.
    The Committee encourages IMLS to consider allowing museums, 
as appropriate, to be considered as organizations that 
primarily serve and represent Native Hawaiians for eligibility 
purposes under the Native American/Native Hawaiian Museum 
Services program.
    Within the total for IMLS, the Committee recommendation 
includes the amounts below:

                                            [in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                                    Fiscal year
                                                                    Fiscal year     Fiscal year   2013 Committee
                         Budget activity                               2012         2013 budget
                                                                    comparable        request     recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
    Grants to States............................................         156,365         156,365         156,365
    Native American Library Services............................           3,869           3,869           3,869
    National Leadership: Libraries..............................          11,946          12,000          12,000
    Laura Bush 21st Century Librarian...........................          12,524          12,470          12,470
                                                                 -----------------------------------------------
      Subtotal, LSTA............................................         184,704         184,704         184,704
                                                                 -----------------------------------------------
Museums Services Act:
    Museums for America.........................................          18,030          20,643          20,643
    21st Century Museum Professionals...........................           1,969  ..............  ..............
    Conservation Project Support................................           2,675  ..............  ..............
    Native American/Hawaiian Museum Services....................             926             926             926
    National Leadership: Museums................................           5,911           7,880           7,880
                                                                 -----------------------------------------------
      Subtotal, MSA.............................................          29,449          29,449          29,449
                                                                 -----------------------------------------------
African American History and Culture Act........................           1,410           1,410           1,410
Administration..................................................          14,505          14,505          14,505
Research, Analysis, and Data Collection.........................           1,886           1,886           1,886
----------------------------------------------------------------------------------------------------------------

            Medicaid and CHIP Payment and Access Commission


                         SALARIES AND EXPENSES

Appropriations, 2012....................................      $5,989,000
Budget estimate, 2013...................................      11,000,000
Committee recommendation................................       9,500,000

    The Committee recommends $9,500,000 for MACPAC. MACPAC was 
established in the Children's Health Insurance Program 
Reauthorization Act of 2009 and is tasked with reviewing State 
and Federal Medicaid and Children's Health Insurance Program 
access and payment policies and making recommendations to 
Congress, the Secretary of HHS, and the States on a wide range 
of issues affecting those programs. The Committee 
recommendation will allow MACPAC to continue to build capacity 
to carry out these activities.

                  Medicare Payment Advisory Commission


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $11,778,000
Budget estimate, 2013...................................      12,210,000
Committee recommendation................................      11,778,000

    The Committee recommends $11,778,000 for MedPAC, which 
provides independent policy and technical advice on issues 
affecting the Medicare program.

                     National Council on Disability


                         SALARIES AND EXPENSES

Appropriations, 2012....................................      $3,258,000
Budget estimate, 2013...................................       3,258,000
Committee recommendation................................       3,258,000

    The Committee recommends $3,258,000 for the National 
Council on Disability [NCD]. NCD is mandated to make 
recommendations to the President, Congress, the RSA, and NIDRR 
on issues of concern to individuals with disabilities. The 
Council gathers information on the implementation, 
effectiveness, and impact of the Americans with Disabilities 
Act and examines emerging policy issues as they affect persons 
with disabilities and their ability to enter or re-enter the 
Nation's workforce and to live independently.

               National Health Care Workforce Commission


                         SALARIES AND EXPENSES

Appropriations, 2012....................................................
Budget estimate, 2013...................................      $3,000,000
Committee recommendation................................       3,000,000

    The Committee recommendation includes $3,000,000 for the 
National Health Care Workforce Commission, which was authorized 
in PPACA but has not yet been funded.
    The Commission will serve as a resource to Congress, the 
President, and State and local entities in evaluating 
healthcare workforce needs, including assessing education and 
training activities to determine to what extent the demand for 
health workers is being met; identifying barriers to improved 
coordination at the Federal, State and local levels; and 
recommending changes to address those barriers.

                     National Labor Relations Board


                         SALARIES AND EXPENSES

Appropriations, 2012....................................    $278,306,000
Budget estimate, 2013...................................     292,800,000
Committee recommendation................................     288,306,000

    The Committee recommends $288,306,000 for NLRB, which 
administers and enforces the National Labor Relations Act and 
protects employee and employer rights provided under that act.
    The Committee recommends an increase of $10,000,000 for 
planned relocation costs in fiscal year 2013. The General 
Services Administration has recommended that NLRB reduce its 
headquarters space and estimates that $10,000,000 will be 
needed for those associated costs. In future years this 
reduction in space is expected to reduce NLRB's rent costs by 
approximately 30 percent, or $4,600,000 annually.

                        National Mediation Board


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $13,411,000
Budget estimate, 2013...................................      13,530,000
Committee recommendation................................      14,411,000

    The Committee recommends $14,411,000 for the National 
Mediation Board [NMB], which mediates labor-management 
relations in the railroad and airline industries under the 
Railway Labor Act. The NMB mediates collective bargaining 
disputes, conducts elections to determine the choice of 
employee bargaining representatives, and administers 
arbitration of employee grievances. The Committee 
recommendation includes an increase over the comparable fiscal 
year 2012 funding level to prevent backlogs of key workloads 
and to respond to oversight and reporting requirements included 
in the FAA Modernization and Reform Act of 2012.

            Occupational Safety and Health Review Commission


                         SALARIES AND EXPENSES

Appropriations, 2012....................................     $11,667,000
Budget estimate, 2013...................................      11,965,000
Committee recommendation................................      11,667,000

    The Committee recommends $11,667,000 for the Occupational 
Safety and Health Review Commission [OSHRC]. OSHRC serves as a 
court to resolve disputes between OSHA and employers charged 
with violations of health and safety standards enforced by 
OSHA.

                       Railroad Retirement Board

    The Railroad Retirement Board [RRB] administers the 
retirement/survivor and unemployment/sickness insurance benefit 
programs for railroad workers and their families under the 
Railroad Retirement Act and Railroad Unemployment Insurance 
Act.

                     DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2012....................................     $50,904,000
Budget estimate, 2013...................................      45,000,000
Committee recommendation................................      45,000,000

    The Committee recommends $45,000,000 for the Dual Benefits 
Payments Account. This amount includes an estimated $3,000,000 
derived from income taxes on vested dual benefits. This 
appropriation provides for vested dual benefit payments to 
beneficiaries covered under both the railroad retirement and 
Social Security systems.

          FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2012....................................        $150,000
Budget estimate, 2013...................................         150,000
Committee recommendation................................         150,000

    The Committee recommends $150,000 for Federal payments to 
the railroad retirement account. These funds reimburse the 
railroad retirement trust funds for interest earned on non-
negotiated checks.

                      LIMITATION ON ADMINISTRATION

Appropriations, 2012....................................    $108,649,000
Budget estimate, 2013...................................     112,415,000
Committee recommendation................................     111,649,000

    The Committee recommends $111,649,000 for RRB's costs 
associated with the administration of railroad retirement/
survivor and unemployment/sickness benefit programs. This 
account limits the amount of funds in the railroad retirement 
and railroad unemployment insurance trust funds that may be 
used by the Board for administrative expenses. The Committee 
recommendation includes an increase over the comparable fiscal 
year 2012 funding level to support RRB's transition to a new 
financial management system.

           LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012....................................      $8,155,000
Budget estimate, 2013...................................       8,820,000
Committee recommendation................................       8,155,000

    The Committee recommends $8,155,000 for the RRB OIG. This 
Office conducts audits and investigations to protect the 
integrity of the RRB trust funds and provides comprehensive 
oversight of all RRB operations and programs.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2012....................................     $20,404,000
Budget estimate, 2013...................................      20,402,000
Committee recommendation................................      20,402,000

    The Committee recommends $20,402,000 in mandatory funds for 
payments to Social Security trust funds. This account 
reimburses the Old Age and Survivors Insurance [OASI] and 
Disability Insurance [DI] trust funds for special payments to 
certain uninsured persons, costs incurred administering pension 
reform activities, and the value of the interest for benefit 
checks issued but not negotiated. This appropriation restores 
the trust funds to the same financial position they would have 
been in had they not borne these costs and they were properly 
charged to general revenues.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2012.................................... $37,823,550,000
Budget estimate, 2013...................................  40,043,000,000
Committee recommendation................................  40,043,000,000

    The Committee recommends $40,043,000,000 in fiscal year 
2013 mandatory funds for the SSI program. In addition, the 
Committee recommends $19,300,000,000, the same as the budget 
request, in advance funding for the first quarter of fiscal 
year 2014. The comparable advance provided last year for the 
first quarter of fiscal year 2013 is $18,200,000,000. The SSI 
program guarantees a minimum level of income to individuals who 
are disabled, blind, or older than age 65, and meet certain 
income and resource limitations.

Federal Benefit Payments

    The Committee recommendation includes a fiscal year 2013 
program level of $54,245,000,000, the same as the budget 
request, for Federal benefit payments. This includes a regular 
fiscal year 2013 mandatory appropriation of $36,045,000,000 and 
a mandatory advance appropriation provided last year for the 
first quarter of fiscal year 2013 of $18,200,000,000. The 
comparable fiscal year 2012 program level is $47,557,000,000. 
The increase in fiscal year 2013 is largely the result of 
having 13 Federal monthly benefit payments compared with 11 in 
fiscal year 2012. Monthly SSI benefit payments are typically 
made on the first day of the month. But if the first day of the 
month falls on a weekend or holiday, the payment is accelerated 
to the previous business day. As a result, the number of 
monthly payments in some fiscal years can vary. In fiscal year 
2013 the SSI program will provide an average monthly benefit of 
$544 to 8.2 million recipients.

Beneficiary Services

    As in the budget request, the Committee recommendation does 
not include new mandatory budget authority for beneficiary 
services. The comparable fiscal year 2012 funding level is 
$47,000,000. Carryover of prior year unobligated balances will 
be sufficient to fund these activities in fiscal year 2013 and 
will support a fiscal year 2013 program level of $59,000,000. 
The comparable fiscal year 2012 program level is $52,000,000.
    These funds reimburse VR agencies for successfully 
rehabilitating disabled SSI recipients by helping them achieve 
and sustain productive, self-supporting work activity. Funds 
also support the Ticket to Work program that provides SSI 
recipients with a ticket to offer employment networks [ENs], 
including VR agencies, in exchange for employment and support 
services. Instead of reimbursing ENs for specific services, the 
Ticket to Work program pays ENs based on recipients achieving 
certain milestones and outcomes.

Research and Demonstration

    The Committee recommendation includes $48,000,000, the same 
as the budget request, in mandatory funds for research and 
demonstration projects conducted under sections 1110, 1115, and 
1144 of the Social Security Act. The comparable fiscal year 
2012 funding level is $7,998,000. Because of the availability 
of unobligated balances, these funds will support a fiscal year 
2013 program level of $57,270,000, compared to $51,422,000 in 
fiscal year 2012.
    These funds support a variety of research and demonstration 
projects designed to improve the disability process, promote 
self-sufficiency and assist individuals in returning to work, 
encourage savings and retirement planning through financial 
literacy, and generally provide analytical and data resources 
for use in preparing and reviewing policy proposals.
    Within the total for research and demonstration, the 
Committee recommends $7,200,000, the same amount as the budget 
request, for the PROMISE program. The comparable fiscal year 
2012 funding level is $2,800,000. This demonstration program is 
jointly administered by SSA and the Department of Education and 
includes interagency collaboration with the Departments of HHS 
and Labor. The goal of the PROMISE program is to test 
interventions that improve health, education, postsecondary, 
employment, and family outcomes for children receiving SSI by 
encouraging innovation and improving coordination between 
existing programs and services. In fiscal year 2013, the 
Department of Education expects to award competitive grants to 
a small number of States to test promising strategies. These 
funds at SSA will support program design and evaluation 
activities.
    Within the total for research and demonstration the 
Committee recommends $3,000,000 for a new demonstration program 
to test the impact of providing financial literacy information 
on the OASI, DI, and SSI programs to high school-aged youth.

Administrative Expenses

    The Committee recommendation includes $3,950,000,000, the 
same as the budget request, for SSI program administrative 
expenses. The comparable fiscal year 2012 funding level is 
$3,611,552,000. This appropriation funds the SSI program's 
share of administrative expenses incurred through the 
Limitation on Administrative Expenses [LAE] account.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2012.................................... $11,445,192,000
Budget estimate, 2013...................................  11,755,000,000
Committee recommendation................................  11,735,544,000

    The Committee recommends $11,735,544,000 for SSA's LAE 
account. This account provides resources for SSA to administer 
the OASI, DI, and SSI programs, and to support CMS in 
administering the Medicare program. The LAE account is funded 
by the Social Security and Medicare trust funds for their share 
of administrative expenses, the general fund for the SSI 
program's share of administrative expenses, and applicable user 
fees. The majority of these funds are used to process 
retirement and disability claims, which SSA expects will stay 
at near-record levels in fiscal year 2013.
    The Committee applauds the work SSA has done in recent 
years to reduce the disability hearings backlog and the time it 
takes to process disability hearings. SSA has reduced the 
average time it takes to process a disability hearing from 532 
days in 2008 to 354 days in 2012, despite a record increase in 
disability hearings over that period. SSA has also greatly 
improved the parity of processing times across the country. In 
fiscal year 2008 some hearing offices had average processing 
times over 900 days but this year no hearing office has a 
processing time over 475 days.
    Work Incentives Planning and Assistance [WIPA] and 
Protection and Advocacy for Beneficiaries of Social Security 
[PABSS].--The WIPA and PABSS programs provide valuable services 
to disabled beneficiaries, particularly in helping them return 
to work. However, because of a delay in the reauthorization 
process, WIPA grantees have been told they will have to shut 
down at the end of June 2012 and PABSS grantees at the end of 
September 2012. The Committee strongly encourages SSA to use 
fiscal year 2012 funds, and the broad authority provided in 
annual appropriations language, to continue these programs. 
Specifically, the Committee encourages SSA to extend current 
WIPA and PABSS grants as soon as possible for a short period of 
time, up to 1 year, to prevent any disruption in services. If 
there are subsequent changes to the programs, through 
reauthorization or otherwise, this would give the Agency ample 
time to run a new competition and make new awards without 
unnecessarily creating a gap in services. In addition, the 
Committee recommendation for fiscal year 2013 includes 
$23,000,000 for WIPA and $7,000,000 for PABSS.
    Representative Payee Oversight.--The Committee 
recommendation includes not less than $2,500,000 for SSA to 
continue to partner with outside organizations to improve 
representative payee oversight. SSA assigns representative 
payees when beneficiaries are unable to financially manage 
their own benefit payments. These funds support activities to 
identify and prevent fraud and abuse within the program.
    Social Security Advisory Board.--The Committee 
recommendation includes not less than $2,150,000, the same as 
the budget request, for the Social Security Advisory Board. The 
comparable fiscal year 2012 funding level is $2,146,000. The 
Social Security Advisory Board advises the Commissioner of 
Social Security and makes recommendations to Congress and the 
President on policies relating to the OASI, DI, and SSI 
programs.
    Social Security Annual Statements.--The Committee believes 
that Social Security Annual Statements, required by statute to 
be provided to everyone older than age 25, provide valuable 
information to workers on their benefits under the OASI and DI 
programs. In addition, they allow workers to check their 
earnings history and notify SSA of any errors in a timely 
fashion. Earnings discrepancies identified years later can 
often be complicated and time-consuming to resolve. Therefore, 
the Committee directs SSA to resume the mailing of annual 
Social Security Account Statements in accordance with section 
1143(c)(2) of the Social Security Act.
    Field Office Closings.--The Committee directs SSA to submit 
a report to the Committee on Appropriations of the Senate 
within 90 days of enactment of this act on its policies and 
procedures for closing and consolidating field offices. The 
report should include a detailed description of the process SSA 
uses and the factors it considers when deciding which offices 
to close, and its process for notifying the public of such 
closures. It should also include an analysis of the offices 
closed in fiscal year 2012 based on those factors. Finally, the 
Committee directs SSA to provide a readily available public 
notice of proposed field office closures. Such notice should be 
provided not less than 90 days prior to closing any field 
office.
    Adminstrative Law Judge Disclosure Policy.--The Committee 
is concerned about SSA's new policy to not disclose the name of 
the ALJ who will preside over a disability appeal until the day 
of the hearing. The Committee notes SSA's concern with the 
possibility of claimant representatives abusing the process, 
specifically as it relates to declining a video hearing or 
postponing other hearings simply to search for judges they 
believe are more likely to allow a case. This abuse challenges 
the integrity of the process and can cause administrative 
delays. However, such a broad policy change could have 
unintended consequences. The Committee strongly encourages SSA 
to consider policies more targeted at suspected abuse, such as 
sanctions against individual representatives or changes to 
regulations to prevent representatives from canceling a video 
hearing close to the hearing date without due cause. The 
Committee directs SSA to submit a report to the Committee on 
Appropriations of the Senate no later than November 1, 2012, 
detailing the type and scope of abuse under the previous policy 
and alternative policies that were considered or could 
otherwise be used to address the issue.

Program Integrity

    Within the total for LAE, the Committee recommendation 
includes $1,024,000,000, the same as the budget request, for 
program integrity activities. This includes $273,000,000 in 
base funding and $751,000,000 in cap adjustment funding allowed 
under the Budget Control Act of 2011. The comparable fiscal 
year 2012 funding level is $756,052,000. These funds support 
program integrity activities such as continuing disability 
reviews [CDRs] and redeterminations of nonmedical eligibility 
under the SSI program. This increase in funding in fiscal year 
2013 will allow SSA to conduct approximately 650,000 full 
medical CDRs, 215,000 more than in fiscal year 2012, and 
2,622,000 SSI redeterminations, the same amount as in fiscal 
year 2012. In total, these activities are projected to save 
approximately $8,100,000,000 over 10 years to the Social 
Security, Medicare, and Medicaid programs.

User Fees

    Within the total for LAE, the Committee recommendation 
includes up to $166,500,000 for administrative activities 
funded from user fees. This includes $166,000,000 in fees paid 
to SSA by States that request SSA to administer State SSI 
supplementary payments and up to $500,000 from a fee payment 
process for nonattorney representatives of claimants.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2012....................................    $102,283,000
Budget estimate, 2013...................................     107,600,000
Committee recommendation................................     102,283,000

    The Committee recommends $102,283,000, the same as the 
comparable fiscal year 2012 funding level, for OIG. The budget 
request is $107,600,000. The recommendation includes 
$73,396,000 funded from the OASI and DI trust funds for those 
programs' share of inspector general expenses and $28,887,000 
funded from general revenues for the SSI program's share of 
expenses.

                      TITLE V--GENERAL PROVISIONS

    Section 501. The bill continues a provision authorizing 
transfers of unexpended balances.
    Section 502. The bill continues a provision limiting 
funding to 1-year availability unless otherwise specified.
    Section 503. The bill modifies a provision limiting 
lobbying and related activities.
    Section 504. The bill continues a provision limiting 
official representation expenses.
    Section 505. The bill continues a provision clarifying 
Federal funding as a component of State and local grant funds.
    Sections 506 and 507. The bill continues provisions 
limiting the use of funds for abortion.
    Section 508. The bill continues a provision restricting 
human embryo research.
    Section 509. The bill continues a provision limiting the 
use of funds for promotion of legalization of controlled 
substances.
    Section 510. The bill continues a provision prohibiting the 
use of funds to promulgate regulations regarding the individual 
health identifier.
    Section 511. The bill continues a provision limiting the 
use of funds to enter into or review contracts with entities 
subject to the requirement in section 4212(d) of title 38, 
United States Code, if the report required by that section has 
not been submitted.
    Section 512. The bill continues a provision prohibiting the 
transfer of funds made available in this act to any department, 
agency, or instrumentality of the U.S. Government, except as 
otherwise provided by this or any other act.
    Section 513. The bill continues a provision prohibiting 
Federal funding in this act for libraries unless they are in 
compliance with the Children's Internet Protection Act.
    Section 514. The bill continues a provision maintaining a 
procedure for reprogramming of funds.
    Section 515. The bill continues a provision prohibiting 
candidates for scientific advisory committees from having to 
disclose their political activities.
    Section 516. The bill continues a provision requiring each 
department and related agency to submit an operating plan.
    Section 517. The bill continues a provision requiring the 
Secretaries of Labor, Health and Human Services, and Education 
to submit a report on the number and amounts of contracts, 
grants, and cooperative agreements awarded by the Departments 
on a noncompetitive basis.
    Section 518. The bill continues a provision prohibiting the 
use of funds for a grant or contract exceeding $5,000,000 
unless the prospective contractor or grantee makes certain 
certifications regarding Federal tax liability.
    Section 519. The bill modifies a provision rescinding funds 
from the State Children's Health Insurance Program performance 
bonus fund.
    Section 520. The bill modifies a provision regarding 
funding for programs that carry out distribution of sterile 
needles or syringes.
    Section 521. The bill continues a provision requiring each 
department and SSA to provide quarterly reports on the status 
of balances of appropriations.
    Section 522. The bill adds a new provision authorizing the 
transfer of the Health Education Assistance Loan program from 
the Department of Health and Human Services to the Department 
of Education.
    Section 523. The bill adds a new provision establishing 
Performance Partnership Pilots related to discretionary funds 
available in this act.
    Section 524. The bill adds a new provision requiring 
departments, agencies, boards, and commissions funded in this 
act to submit quarterly reports regarding conferences.
    Section 525. The bill adds a new provision limiting the 
attendance of Federal employees at any single international 
conference.

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

    Paragraph 7 of rule XVI requires that Committee reports on 
general appropriations bills identify each Committee amendment 
to the House bill ``which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.''
    The Committee is filing an original bill, which is not 
covered under this rule, but reports this information in the 
spirit of full disclosure.
    The Committee recommends funding for the following programs 
and activities which currently lack authorization: Elementary 
and Secondary Education Act; National Center for Special 
Education Research; parts C and D of the Individuals with 
Disabilities Education Act; Education Sciences Reform Act; 
Special Olympics Sport and Empowerment Act of 2004; Workforce 
Investment Act; Homeless Veterans Reintegration Program; 
Universal Newborn Hearing Screening; Organ Transplantation; 
Family Planning; Rural Health programs; Traumatic Brain Injury 
programs; Combating Autism Act; Public Health Improvement Act; 
Healthy Start; Telehealth; Health Professions Education 
Partnership Act; Children's Health Act; Women's Health Research 
and Prevention Amendments of 1998; Birth Defects Prevention, 
Preventive Health Amendments of 1993; Substance Abuse and 
Mental Health Services programs, except for Depression Centers 
of Excellence and grants for Primary and Behavioral Healthcare 
Integration; Low Income Home Energy Assistance Program; Refugee 
and Entrant Assistance programs; Adoption Opportunities; Child 
Welfare Services and Research; Child Care and Development Block 
Grant; Developmental Disabilities programs; Voting Access for 
Individuals with Disabilities; Native American Programs; 
Community Services Block Grant; Rural Facilities; Individual 
Development Accounts; Community Economic Development; 
Alzheimer's Disease Demonstration Grants; Adolescent Family 
Life; Office of Disease Prevention and Health Promotion; 
Rehabilitation Services and Disability Research, except 
sections 4, 5, and 6 of the Assistive Technology Program; 
Institute of Education Sciences; Corporation for Public 
Broadcasting; Museum and Library Services Act programs; 
National Council on Disability; and Older Americans Act.

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

    Pursuant to paragraph 7(c) of rule XXVI, on June 14, 2012, 
the Committee ordered favorably reported favorably an original 
bill (S. 3301) making appropriations for the Departments of 
Labor, Health and Human Services, and Education, and related 
agencies for the fiscal year ending September 30, 2013, subject 
to amendment and subject to its spending allocations, by a 
recorded vote of 16-14, a quorum being present. The vote was as 
follows:
        Yeas                          Nays
Chairman Inouye                     Mr. Cochran
Mr. Leahy                           Mr. McConnell
Mr. Harkin                          Mr. Shelby
Ms. Mikulski                        Mrs. Hutchison
Mr. Kohl                            Mr. Alexander
Mrs. Murray                         Ms. Collins
Mrs. Feinstein                      Ms. Murkowski
Mr. Durbin                          Mr. Graham
Mr. Johnson (SD)                    Mr. Kirk
Ms. Landrieu                        Mr. Coats
Mr. Reed                            Mr. Blunt
Mr. Lautenberg                      Mr. Moran
Mr. Nelson                          Mr. Hoeven
Mr. Pryor                           Mr. Johnson (WI)
Mr. Tester
Mr. Brown

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

    Paragraph 12 of rule XXVI requires that Committee reports 
on a bill or a joint resolution repealing or amending any 
statute include ``(a) the text of the statute or part thereof 
which is proposed to be repealed; and (b) a comparative print 
of that part of the bill or joint resolution making the 
amendment and of the statute or part thereof proposed to be 
amended, showing by stricken through type and italics, parallel 
columns, or other appropriate typographical devices the 
omissions and insertions which would be made by the bill or 
joint resolution if enacted in the form recommended by the 
committee.''
    In compliance with this rule, changes in existing law 
proposed to be made by the bill are shown as follows: existing 
law to be omitted is enclosed in black brackets; new matter is 
printed in italic; and existing law in which no change is 
proposed is shown in roman.

                          TITLE 20--EDUCATION


     CHAPTER 28--HIGHER EDUCATION RESOURCES AND STUDENT ASSISTANCE


                    SUBCHAPTER I--GENERAL PROVISIONS


                          Part A--Definitions


Sec. 1011m. Certification regarding the use of certain Federal funds 
                    and restrictions on sources of funds for recruiting 
                    and marketing activities

(a) Prohibition

           *       *       *       *       *       *       *

(d) Certification

    Each institution of higher education or other postsecondary 
educational institution receiving Federal funding under the 
Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) [and 42 
U.S.C. 2751 et seq.], as a condition for receiving such 
funding, shall annually certify to the Secretary of Education 
that the requirements of [subsections (a) through (c)] 
subsections (a), (b), (c), and (e) have been met.

    (e) Restrictions on Sources of Funds for Recruiting and 
Marketing Activities.--
            (1) In general.--An institution of higher 
        education, or other postsecondary educational 
        institution, may not use revenues derived from Federal 
        educational assistance funds for recruiting or 
        marketing activities described in paragraph (2).
            (2) Covered activities.--Except as provided in 
        paragraph (3), the recruiting and marketing activities 
        subject to paragraph (1) shall include the following:
                    (A) Advertising and promotion activities, 
                including paid announcements in newspapers, 
                magazines, radio, television, billboards, 
                electronic media, naming rights, or any other 
                public medium of communication, including 
                paying for displays or promotions at job fairs, 
                military installations, or college recruiting 
                events.
                    (B) Efforts to identify and attract 
                prospective students, either directly or 
                through a contractor or other third party, 
                including contact concerning a prospective 
                student's potential enrollment or application 
                for grant, loan, or work assistance under title 
                IV of the Higher Education Act of 1965 (20 
                U.S.C. 1070 et seq.) or participation in 
                preadmission or advising activities, 
                including--
                            (i) paying employees responsible 
                        for overseeing enrollment and for 
                        contacting potential students in-
                        person, by phone, by email, or by other 
                        internet communications regarding 
                        enrollment; and
                            (ii) soliciting an individual to 
                        provide contact information to an 
                        institution of higher education, 
                        including websites established for such 
                        purpose and funds paid to third parties 
                        for such purpose.
                    (C) Such other activities as the Secretary 
                of Education may prescribe, including paying 
                for promotion or sponsorship of education or 
                military-related associations.
            (3) Exceptions.--Any activity that is required as a 
        condition of receipt of funds by an institution under 
        title IV of the Higher Education Act of 1965 (20 U.S.C. 
        1070 et seq.), is specifically authorized under such 
        title, or is otherwise specified by the Secretary of 
        Education, shall not be considered to be a covered 
        activity under paragraph (2).
            (4) Federal educational assistance funds.--In this 
        subsection, the term ``Federal educational assistance 
        funds'' means any Federal financial assistance provided 
        under any Federal law, through a grant, contract, 
        subsidy, loan, guarantee, insurance or other means, 
        including Federal financial assistance that is 
        disbursed or delivered to an institution on behalf of a 
        student or to a student to be used to attend the 
        institution.
            (5) Rule of construction.--Nothing in this section 
        shall be construed as a limitation on the use by an 
        institution of revenues derived from sources other than 
        Federal educational assistance funds.
            (6) Reporting.--Each institution of higher 
        education, or other postsecondary educational 
        institution, that receives revenues derived from 
        Federal educational assistance funds shall report 
        annually to the Secretary of Education and to Congress 
        the institution's expenditures on advertising, 
        marketing, and recruiting.

[(e)] (f) Actions to implement and enforce

    The Secretary of Education shall take such actions as are 
necessary to ensure that the provisions of this section are 
implemented and enforced.

           *       *       *       *       *       *       *


                   SUBCHAPTER IV--STUDENT ASSISTANCE


  Part A--Grants To Students in Attendance at Institutions of Higher 
                               Education


                     SUBPART 1--FEDERAL PELL GRANTS

Sec. 1070a. Federal Pell Grants: amount and determinations; 
                    applications

(a) Program authority and method of distribution

           *       *       *       *       *       *       *

(b) Purpose and amount of grants

        (1) * * *

           *       *       *       *       *       *       *

            (7) Additional funds.--
                    (A) In general.-- * * *
                            (i) * * *

           *       *       *       *       *       *       *

                            [(iv) to carry out this section-
                                    [(I) $13,500,000,000 for 
                                fiscal year 2011;
                                    [(II) $13,795,000,000 for 
                                fiscal year 2012;
                                    [(III) $7,587,000,000 for 
                                fiscal year 2013;
                                    [(IV) $588,000,000 for 
                                fiscal year 2014;
                                    [(V) $0 for fiscal year 
                                2015;
                                    [(VI) $0 for fiscal year 
                                2016;
                                    [(VII) $1,574,000,000 for 
                                fiscal year 2017;
                                    [(VIII) $1,382,000,000 for 
                                fiscal year 2018;
                                    [(IX) $1,409,000,000 for 
                                fiscal year 2019;
                                    [(X) $1,430,000,000 for 
                                fiscal year 2020; and
                                    [(XI) $1,145,000,000 for 
                                fiscal year 2021 and each 
                                succeeding fiscal year.]
                            (iv) to carry out this section--
                                    (I) $13,500,000,000 for 
                                fiscal year 2011;
                                    (II) $13,795,000,000 for 
                                fiscal year 2012;
                                    (III) $10,683,000,000 for 
                                fiscal year 2013;
                                    (IV) $1,009,000,000 for 
                                fiscal year 2014;
                                    (V) $0 for fiscal year 
                                2015;
                                    (VI) $0 for fiscal year 
                                2016;
                                    (VII) $1,574,000,000 for 
                                fiscal year 2017;
                                    (VIII) $1,595,000,000 for 
                                fiscal year 2018;
                                    (IX) $1,622,000,000 for 
                                fiscal year 2019;
                                    (X) $1,643,000,000 for 
                                fiscal year 2020;
                                    (XI) $1,358,000,000 for 
                                fiscal year 2021 and each 
                                succeeding fiscal year.

           *       *       *       *       *       *       *


             Part B--Federal Family Education Loan Program


Sec. 1078-6. Default reduction program

(a) Other repayment incentives

        (1) Sale or assignment of loan

                (A) In general

                    Each guaranty agency, upon securing 9 
                payments made within 20 days of the due date 
                during 10 consecutive months of amounts owed on 
                a loan for which the Secretary has made a 
                payment under paragraph (1) of section 1078(c) 
                of this title, shall--
                            (i) * * *
                            [(ii) on or before September 30, 
                        2011, assignthe loan to the Secretary 
                        if--]
                            (ii) on or after October 1, 2012, 
                        assign the loan to the Secretary if the 
                        guaranty agency has been unable to sell 
                        the loan under clause (i).

           *       *       *       *       *       *       *

                (D) Duties upon sale

                With respect to a loan sold under subparagraph 
                (A)(i)--
                        [(i) the guaranty agency--
                                [(I) shall repay the Secretary 
                                81.5 percent of the amount of 
                                the principal balance 
                                outstanding at the time of such 
                                sale, multiplied by the 
                                reinsurance percentage in 
                                effect when payment under the 
                                guaranty agreement was made 
                                with respect to the loan; and]
                            (i) the guaranty agency--
                                    (I) shall, in the case of a 
                                sale made on or after October 
                                1, 2012, repay the Secretary 
                                100 percent of the amount of 
                                the principal balance 
                                outstanding at the time of such 
                                sale, multiplied by the 
                                reinsurance percentage in 
                                effect when payment under the 
                                guaranty agreement was made 
                                with respect to the loan; and
                                    (II) may, in the case of a 
                                sale made on or after October 
                                1, 2012, in order to defray 
                                collection costs--
                                            (aa) charge to the 
                                        borrower an amount not 
                                        to exceed 16 percent of 
                                        the outstanding 
                                        principal and interest 
                                        at the time of the loan 
                                        sale; and
                                            (bb) retain such 
                                        amount from the 
                                        proceeds of the loan 
                                        sale; and

           *       *       *       *       *       *       *


          Part C--William D. Ford Federal Direct Loan Program


Sec. 1087e. Terms and conditions of loans

(a) In general

           *       *       *       *       *       *       *

(p) Disclosures

    Each institution of higher education with which the 
Secretary has an agreement under section 1087c of this title, 
and each contractor with which the Secretary has a contract 
under section 1087f of this title, shall, with respect to loans 
under this part and in accordance with such regulations as the 
Secretary shall prescribe, comply with each of the requirements 
under section 1083 of this title that apply to a lender with 
respect to a loan under part B.

    (q) Eligibility for, and Interest Charges on, Federal 
Direct Stafford Loans for New Borrowers on or After July 1, 
2013.--
            (1) In general.--Notwithstanding subsection (a) or 
        any other provision of this title, any borrower who was 
        a new borrower on or after July 1, 2013, shall not be 
        eligible for a Federal Direct Stafford Loan if the 
        period of time for which the borrower has received 
        Federal Direct Stafford loans, in the aggregate, 
        exceeds the period of enrollment described in paragraph 
        (3). Such borrower may still receive any Federal Direct 
        Unsubsidized Stafford Loan for which such borrower is 
        otherwise eligible.
            (2) Payment of interest on federal direct stafford 
        loans.--Notwithstanding subsection (f)(1)(A) or any 
        other provision of this title and beginning on the date 
        upon which a borrower who is in school becomes 
        ineligible for a Federal Direct Stafford Loan as a 
        result of paragraph (1), interest on all Federal Direct 
        Stafford Loans that were disbursed to such borrower on 
        or after July 1, 2013, shall accrue. Such interest 
        shall be paid or capitalized in the same manner as 
        interest on a Federal Direct Unsubsidized Stafford Loan 
        is paid or capitalized under section 428H(e)(2).
            (3) Period of enrollment.--
                    (A) In general.--The aggregate period of 
                enrollment referred to in paragraph (1) shall 
                not exceed the lesser of--
                            (i) a period equal to 150 percent 
                        of the published length of the 
                        educational program in which the 
                        student is enrolled; or
                            (ii) in the case of a borrower who 
                        was previously enrolled in one or more 
                        other educational programs that began 
                        after July 1, 2013, a period of time 
                        equal to the difference between--
                                    (I) 150 percent of the 
                                published length of the longest 
                                educational program in which 
                                the borrower was, or is, 
                                enrolled; and
                                    (II) any periods of 
                                enrollment in which the 
                                borrower received a Federal 
                                Direct Stafford Loan.
                    (B) Less than full-time basis.--The 
                Secretary shall specify in regulation how the 
                aggregate period described in subparagraph (A) 
                shall be calculated with respect to a borrower 
                who was or is enrolled on a less than full-time 
                basis.

           *       *       *       *       *       *       *


Sec. 1087f. Contracts

(a) Contracts for supplies and services

    (1) In general

           *       *       *       *       *       *       *

    (4) Servicing by eligible not-for-profit servicers

            (A) Servicing contracts

                    (i) In general

                            The Secretary shall contract with 
                        each eligible not-for-profit servicer 
                        to service loans originated under this 
                        part, if the servicer--''

           *       *       *       *       *       *       *

            (B) Allocations

                    (i) In general

                            The Secretary shall (except as 
                        provided in clause (ii)) allocate to an 
                        eligible not-for-profit servicer, 
                        subject to the contract of such 
                        servicer described in subparagraph (A), 
                        the servicing rights for the loan 
                        accounts of 100,000 borrowers 
                        (including borrowers who borrowed loans 
                        in a prior year that were serviced by 
                        the servicer).

                    (ii) Servicer allocation

                            The Secretary may reallocate, 
                        increase, reduce, or terminate an 
                        eligible not-for-profit servicer's 
                        allocation of servicing rights under 
                        clause (i) based on the performance of 
                        such servicer, on the same terms as 
                        loan allocations provided by contracts 
                        awarded pursuant to paragraph (1).
            (5) Special rule for not-for-profit servicers with 
        affiliates.--Notwithstanding any other provision of 
        this section, only an eligible not-for-profit servicer 
        described in clause (i) or (ii) of subsection (c)(1)(B) 
        shall receive a contract with the Secretary under 
        paragraph (4)(A), and an allocation under paragraph 
        (4)(B), except that, if an eligible not-for-profit 
        servicer so described is also a corporation described 
        in subparagraphs (A) and (B) of section 150(d)(2) of 
        the Internal Revenue Code of 1986, then the affiliated 
        entity of that servicer (described in subsection 
        (c)(1)(B)(ii)) shall receive the contract with the 
        Secretary under paragraph (4)(A), and an allocation 
        under paragraph (4)(B), rather than the eligible not-
        for-profit servicer described in clause (i) or (ii) of 
        subsection (c)(1)(B).
            (6) Special rule for not-for-profit servicers with 
        shared management or common control.--Notwithstanding 
        any other provision of this section, in the case of 
        entities that otherwise meet the definition of an 
        eligible not-for-profit servicer under this section but 
        2 or more of the same individuals serve as part of the 
        management, board of directors, or other governing body 
        of more than one such entity, or the Secretary 
        determines that one entity controls, is controlled by, 
        or is under common control with, another such entity, 
        all such entities with that shared management or 
        control shall receive one aggregate allocation under 
        paragraph (4)(B) and be treated for purposes of 
        paragraph (4) as though all of such entities were a 
        single eligible not-for-profit servicer.

           *       *       *       *       *       *       *


                         Part E--Need Analysis


Sec. 1087ll. Cost of attendance

For the purpose of this subchapter and part C of subchapter I 
of chapter 34 of title 42, the term ``cost of attendance'' 
means--
            (1) * * *

           *       *       *       *       *       *       *

            (3) except as provided in paragraph (10)(A)(i), an 
        allowance (as determined by the institution) for room 
        and board costs incurred by the student which--

           *       *       *       *       *       *       *

            [(10) for a student receiving all or part of the 
        student's instruction by means of telecommunications 
        technology, no distinction shall be made with respect 
        to the mode of instruction in determining costs;]
            (10)(A) with respect to the determination of a 
        student's need for a Federal Pell Grant, in the case of 
        a student who is receiving--
                    (i) all instruction (excluding limited 
                periods in which the student is required to be 
                physically present at the institution for 
                noninstructional purposes, such as orientation 
                or the administration of examinations) by means 
                of telecommunications technology, only tuition 
                and fees, books and supplies; or
                    (ii) part of the student's instruction by 
                means of telecommunications technology, no 
                distinction shall be made with respect to the 
                mode of instruction in determining costs; and
            (B) with respect to the determination of a 
        student's need for assistance under this title other 
        than a Federal Pell Grant, in the case of a student who 
        is receiving all or part of the student's instruction 
        by means of telecommunications technology, no 
        distinction shall be made with respect to the mode of 
        instruction in determining costs;

           *       *       *       *       *       *       *


   Part F--General Provisions Relating to Student Assistance Programs


Sec. 1091. Student eligibility

(a) * * *

           *       *       *       *       *       *       *

[(d) Students who are not high school graduates

    [In order for a student who does not have a certificate of 
graduation from a school providing secondary education, or the 
recognized equivalent of such certificate, to be eligible for 
any assistance under subparts 1, 3, and 4 of part A and parts 
B, C, and D of this subchapter and part C of subchapter I of 
chapter 34 of title 42, the student shall have completed a 
secondary school education in a home school setting that is 
treated as a home school or private school under State law.]
    (d) Students Who Are Not High School Graduates.--
            (1) Student eligibility.--In order for a student 
        who does not have a certificate of graduation from a 
        school providing secondary education, or the recognized 
        equivalent of such certificate, to be eligible for any 
        assistance under subparts 1, 3, and 4 of part A and 
        parts B, C, D, and E of this title, the student shall 
        meet the requirements of one of the following 
        subparagraphs:
                    (A) The student is enrolled in an eligible 
                career pathway program and meets one of the 
                following standards:
                            (i) The student shall take an 
                        independently administered examination 
                        and shall achieve a score, specified by 
                        the Secretary, demonstrating that such 
                        student can benefit from the education 
                        or training being offered. Such 
                        examination shall be approved by the 
                        Secretary on the basis of compliance 
                        with such standards for development, 
                        administration, and scoring as the 
                        Secretary may prescribe in regulations.
                            (ii) The student shall be 
                        determined as having the ability to 
                        benefit from the education or training 
                        in accordance with such process as the 
                        State shall prescribe. Any such process 
                        described or approved by a State for 
                        the purposes of this section shall be 
                        effective 6 months after the date of 
                        submission to the Secretary unless the 
                        Secretary disapproves such process. In 
                        determining whether to approve or 
                        disapprove such process, the Secretary 
                        shall take into account the 
                        effectiveness of such process in 
                        enabling students without high school 
                        diplomas or the equivalent thereof to 
                        benefit from the instruction offered by 
                        institutions utilizing such process, 
                        and shall also take into account the 
                        cultural diversity, economic 
                        circumstances, and educational 
                        preparation of the populations served 
                        by the institutions.
                            (iii) The student shall be 
                        determined by the institution of higher 
                        education as having the ability to 
                        benefit from the education or training 
                        offered by the institution of higher 
                        education upon satisfactory completion 
                        of 6 credit hours or the equivalent 
                        coursework that are applicable toward a 
                        degree or certificate offered by the 
                        institution of higher education.
                    (B) The student has completed a secondary 
                school education in a home school setting that 
                is treated as a home school or private school 
                under State law.
            (2) Eligible career pathway program.--In this 
        subsection, the term ``eligible career pathway 
        program'' means a program that--
                    (A) concurrently enrolls participants in 
                connected adult education and eligible 
                postsecondary programs;
                    (B) provides counseling and supportive 
                services to identify and attain academic and 
                career goals;
                    (C) provides structured course sequences 
                that--
                            (i) are articulated and 
                        contextualized; and
                            (ii) allow students to advance to 
                        higher levels of education and 
                        employment;
                    (D) provides opportunities for acceleration 
                to attain recognized postsecondary credentials, 
                including degrees, industry relevant 
                certifications, and certificates of completion 
                of apprenticeship programs;
                    (E) is organized to meet the needs of 
                adults;
                    (F) is aligned with the education and skill 
                needs of the regional economy; and
                    (G) has been developed and implemented in 
                collaboration with partners in business, 
                workforce development, and economic 
                development.

           *       *       *       *       *       *       *


               CHAPTER 44--CAREER AND TECHNICAL EDUCATION


 SUBCHAPTER I--CAREER AND TECHNICAL EDUCATION ASSISTANCE TO THE STATES


                    Part A--Allotment and Allocation


Sec. 2324. National activities

(a) Program performance information

           *       *       *       *       *       *       *

(b) Miscellaneous provisions

        (1) Collection of information at reasonable cost

            The Secretary shall take such action as may be 
        necessary to secure at reasonable cost the information 
        required by this subchapter. To ensure reasonable cost, 
        the Secretary, in consultation with the National Center 
        for Education Statistics, the [Office of Vocational and 
        Adult Education] Office of Career, Technical, and Adult 
        Education, and an entity assisted under section 2328 of 
        this title (if applicable), shall determine the 
        methodology to be used and the frequency with which 
        information is to be collected.

           *       *       *       *       *       *       *


                  CHAPTER 48--DEPARTMENT OF EDUCATION


             SUBCHAPTER II--ESTABLISHMENT OF THE DEPARTMENT


Sec. 3412. Principal officers

(a) Deputy Secretary of Education

           *       *       *       *       *       *       *

(b) Assistant Secretaries and General Counsel

        (1) There shall be in the Department--
                (A) * * *

           *       *       *       *       *       *       *

                (C) an [Assistant Secretary for Vocational and 
                Adult Education] Assistant Secretary for 
                Career, Technical, and Adult Education;

           *       *       *       *       *       *       *

(h) Coordination of literacy related functions by [Assistant 
            Secretary for Vocational and Adult Education] 
            Assistant Secretary for Career, Technical, and 
            Adult Education

    The [Assistant Secretary for Vocational and Adult 
Education] Assistant Secretary for Career, Technical, and Adult 
Education, in addition to performing such functions as the 
Secretary may prescribe, shall have responsibility for 
coordination of all literacy related programs and policy 
initiatives in the Department. The [Assistant Secretary for 
Vocational and Adult Education] Assistant Secretary for Career, 
Technical, and Adult Education shall assist in coordinating the 
related activities and programs of other Federal departments 
and agencies.

           *       *       *       *       *       *       *


Sec. 3416. [Office of Vocational and Adult Education] Office of Career, 
                    Technical, and Adult Education

    There shall be in the Department an [Office of Vocational 
and Adult Education] Office of Career, Technical, and Adult 
Education, to be administered by the [Assistant Secretary for 
Vocational and Adult Education] Assistant Secretary for Career, 
Technical, and Adult Education appointed under section 3412(b) 
of this title. The Assistant Secretary shall administer such 
functions affecting [vocational and adult education] career, 
technical, and adult education as the Secretary shall delegate, 
and shall serve as principal adviser to the Secretary on 
matters affecting [vocational and adult education] career, 
technical, and adult education. The Secretary, through the 
Assistant Secretary, shall also provide a unified approach to 
rural education and rural family education through the 
coordination of programs within the Department and shall work 
with the Federal Interagency Committee on Education to 
coordinate related activities and programs of other Federal 
departments and agencies.
                                ------                                


            TITLE 40--PUBLIC BUILDINGS, PROPERTY, AND WORKS


                            Part A--General


                          CHAPTER 31--GENERAL


                 SUBCHAPTER IV--WAGE RATE REQUIREMENTS


Sec. 3144. Authority [of Comptroller General] to pay wages and list 
                    contractors violating contracts

    (a) Payment of Wages.--
            (1) In general.--[The Comptroller General] The 
        Secretary of Labor shall pay directly to laborers and 
        mechanics from any accrued payments withheld under the 
        terms of a contract any wages found to be due laborers 
        and mechanics under this subchapter.

           *       *       *       *       *       *       *


          CHAPTER 37--CONTRACT WORK HOURS AND SAFETY STANDARDS


Sec. 3703. Report of violations and withholding of amounts for unpaid 
                    wages and liquidated damages

    (a) Reports of Inspectors.-- * * *

           *       *       *       *       *       *       *

    (b) Withholding Amounts.--
            (1) Determining amount.-- * * *

           *       *       *       *       *       *       *

            (3) Payment.--[The Comptroller General] The 
        Secretary of Labor shall pay the amount 
        administratively determined to be due directly to the 
        laborers and mechanics from amounts withheld on account 
        of underpayments of wages if the amount withheld is 
        adequate. If the amount withheld is not adequate, [the 
        Comptroller General] the Secretary of Labor shall pay 
        an equitable proportion of the amount due.
                                ------                                


                TITLE 42--THE PUBLIC HEALTH AND WELFARE


                   CHAPTER 6A--PUBLIC HEALTH SERVICE


               SUBCHAPTER V--HEALTH PROFESSIONS EDUCATION


                         Part A--Student Loans


   SUBPART I--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE 
                                STUDENTS


Sec. 292o. Definitions

For purposes of this subpart:
    (1) The term ``eligible institution'' means, with respect 
to a fiscal year, a school of medicine, osteopathic medicine, 
dentistry, veterinary medicine, optometry, podiatric medicine, 
pharmacy, public health, allied health, or chiropractic, or a 
graduate program in health administration or behavioral and 
mental health practice, including clinical psychology.

           *       *       *       *       *       *       *

        (5)(A) The term ``default rate'', in the case of an 
        eligible entity, means the percentage constituted by 
        the ratio of--
                    (i) the principal amount of loans 
                insuredunder this subpart--
                            (I) that are made with respect to 
                        the entity and that enter repayment 
                        status after April 7, 1987; and
                            (II) for which amounts have been 
                        paid under section 292f(a) of this 
                        title to insurance beneficiaries, 
                        exclusive of any loan for which amounts 
                        have been so paid as a result of the 
                        death or total and permanent disability 
                        of the borrower; exclusive of any loan 
                        for which the borrower begins payments 
                        to the Secretary on the loan pursuant 
                        to section 292f(b) of this title and 
                        maintains payments for 12 consecutive 
                        months in accordance with the agreement 
                        involved (with the loan subsequently 
                        being included or excluded, as the case 
                        may be, as amounts paid under section 
                        292f(a) of this title according to 
                        whether further defaults occur and 
                        whether with respect to the default 
                        involved compliance with such 
                        requirement regarding 12 consecutive 
                        months occurs); and exclusive of any 
                        loan on which payments may not be 
                        recovered by reason of the obligation 
                        under the loan being discharged in 
                        bankruptcy under title 11; to
                    (ii) the total principal amount of loans 
                insured under this subpart that are made with 
                respect to the entity and that enter repayment 
                status after April 7, 1987.
            (B) For purposes of subparagraph (A), a loan 
        insured under this subpart shall be considered to have 
        entered repayment status if the applicable period 
        described in subparagraph (B) of section 292d(a)(2) of 
        this title regarding the loan has expired (without 
        regard to whether any period described in subparagraph 
        (C) of such section is applicable regarding the loan).
            (C) For purposes of subparagraph (A), the term 
        ``eligible entity'' means an eligible institution, an 
        eligible lender, or a holder, as the case may be.
            (D) For purposes of subparagraph (A), a loan is 
        made with respect to an eligible entity if--
                    (i) in the case of an eligible institution, 
                the loan was made to students of the 
                institution;
                    (ii) in the case of an eligible lender, the 
                loan was made by the lender; and
                    (iii) in the case of a holder, the loan was 
                purchased by the holder.
            (6) The term ``Secretary'' means the Secretary of 
        Education.
                                ------                                


             TITLE 48--TERRITORIES AND INSULAR POSSESSIONS


          CHAPTER 18--MICRONESIA, MARSHALL ISLANDS, AND PALAU


             SUBCHAPTER I--MICRONESIA AND MARSHALL ISLANDS


      Part B--Approval and Implementation of Compacts, as Amended


Sec. 1921d. Supplemental provisions

(a) Domestic program requirements

           *       *       *       *       *       *       *

(f) Continuing programs and laws

        (1) Federated States of Micronesia and Republic of the
            Marshall Islands

           *       *       *       *       *       *       *

                (A) Emergency and disaster assistance

           *       *       *       *       *       *       *

                (B) Treatment of additional programs

                        (i) Consultation

           *       *       *       *       *       *       *

                        (ix) Applicability

                            The government, institutions, and 
                        people of Palau shall remain eligible 
                        for appropriations and to receive 
                        grants under the provisions of law 
                        specified in clauses (ii) and (iii) 
                        until the end of fiscal year [2009] 
                        2013, to the extent the government, 
                        institutions, and people of Palau were 
                        so eligible under such provisions in 
                        fiscal year 2003.
                                ------                                


    DEPARTMENT OF EDUCATION ORGANIZATION ACT, 1980, PUBLIC LAW 96-88

    Section 1. This Act may be cited as the ``Department of 
Education Organization Act''.

                           TABLE OF CONTENTS


               TITLE II--ESTABLISHMENT OF THE DEPARTMENT

Sec. 201. Establishment.
     * * * * * * *
[Sec. 206. Office of Vocational and Adult Education]
Sec. 206. Office of Career, Technical, and Adult Education

                        BUDGETARY IMPACT OF BILL


  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays
                                                             ---------------------------------------------------
                                                               Committee    Amount  in   Committee    Amount  in
                                                               allocation      bill      allocation      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
 to its subcommittees of amounts in the Budget Resolution
 for 2013: Subcommittee on Labor, Health and Human Services,
 Education, and Related Agencies:
    Mandatory...............................................      594,910      594,910      594,481   \1\594,481
    Discretionary...........................................      157,722      158,772      168,600   \1\165,542
        Security............................................  ...........  ...........           NA           NA
        Nonsecurity.........................................      157,722      158,722           NA           NA
Projections of outlays associated with the recommendation:
    2013....................................................  ...........  ...........  ...........   \2\663,774
    2014....................................................  ...........  ...........  ...........       73,446
    2015....................................................  ...........  ...........  ...........       17,804
    2016....................................................  ...........  ...........  ...........        2,919
    2017 and future years...................................  ...........  ...........  ...........          642
Financial assistance to State and local governments for                NA      323,132           NA      305,979
 2013.......................................................

----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.

NA: Not applicable.

Note.--Consistent with the funding recommended in the bill for continuing disability reviews and
  redeterminations and for healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C)
  of section 251(b)(2) of the BBEDCA of 1985 and section 106 of the Deficit Control Act of 2011, the Committee
  anticipates that the Budget Committee will file a revised section 302(a) allocation for the Committee on
  Appropriations reflecting an upward adjustment of $1,050,000,000 in budget authority plus associated outlays.


  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2012 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2013
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation
                                                                                                                            compared with (+ or -)
                             Item                                     2011         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         2012
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
                 TITLE I--DEPARTMENT OF LABOR

            EMPLOYMENT AND TRAINING ADMINISTRATION

               TRAINING AND EMPLOYMENT SERVICES

Grants to States:
    Adult Training, current year..............................           58,811            57,465            58,811   ................           +1,346
        Advance from prior year...............................         (710,654)         (712,000)         (712,000)          (+1,346)  ................
        Fiscal year 2014......................................          712,000           712,000           712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          770,811           769,465           770,811   ................           +1,346

    Youth Training............................................          824,353           824,353           824,353   ................  ................

    Dislocated Worker Assistance, current year................          148,151           146,526           148,151   ................           +1,625
        Advance from prior year...............................         (858,375)         (860,000)         (860,000)          (+1,625)  ................
        Fiscal year 2014......................................          860,000           860,000           860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        1,008,151         1,006,526         1,008,151   ................           +1,625
                                                               =========================================================================================
          Subtotal, Grants to States..........................        2,603,315         2,600,344         2,603,315   ................           +2,971
            Current Year......................................       (1,031,315)       (1,028,344)       (1,031,315)  ................          (+2,971)
            Fiscal year 2014..................................       (1,572,000)       (1,572,000)       (1,572,000)  ................  ................

Federally Administered Programs:
    Dislocated Worker Assistance National Reserve:
        Current year..........................................           24,066            23,688            24,066   ................             +378
        Advance from prior year...............................         (199,622)         (200,000)         (200,000)            (+378)  ................
        Fiscal year 2014......................................          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          224,066           223,688           224,066   ................             +378
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Dislocated Worker Assistance..............        1,232,217         1,230,214         1,232,217   ................           +2,003

    Native Americans..........................................           47,562            52,562            47,562   ................           -5,000
    Migrant and Seasonal Farmworker programs..................           84,291            84,291            84,291   ................  ................
    Women in Apprenticeship...................................              996   ................              996   ................             +996
    YouthBuild activities.....................................           79,689            79,689            79,689   ................  ................
    Workforce Innovation Fund.................................           49,906           100,000            49,906   ................          -50,094
                                                               =========================================================================================
      Subtotal, Federally Administered Programs [FAP].........          486,510           540,230           486,510   ................          -53,720
          Current Year........................................         (286,510)         (340,230)         (286,510)  ................         (-53,720)
          Fiscal year 2014....................................         (200,000)         (200,000)         (200,000)  ................  ................

    National Activities:
        Pilots, Demonstrations, and Research..................            6,603   ................  ................           -6,603   ................
        Reintegration of Ex-Offenders.........................           80,238            85,238            80,238   ................           -5,000
        Evaluation............................................            9,563   ................  ................           -9,563   ................
        Workforce Data Quality Initiative.....................            6,463             6,000             6,000              -463   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          102,867            91,238            86,238           -16,629            -5,000
                                                               =========================================================================================
          Total, Training and Employment Services [TES].......        3,192,692         3,231,812         3,176,063           -16,629           -55,749
            Current Year......................................       (1,420,692)       (1,459,812)       (1,404,063)         (-16,629)         (-55,749)
            Fiscal year 2014..................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................

                      OFFICE OF JOB CORPS

Administration................................................           29,077            29,132            29,132               +55   ................
Operations....................................................        1,569,078         1,545,872         1,569,078   ................          +23,206
    Advance from prior year...................................         (589,883)  ................  ................        (-589,883)  ................
Construction, Rehabilitation and Acquisition..................          104,792            75,000            75,000           -29,792   ................
    Advance from prior year...................................          (99,811)  ................  ................         (-99,811)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Job Corps..............................        1,702,947         1,650,004         1,673,210           -29,737           +23,206
          Current Year........................................       (1,702,947)       (1,650,004)       (1,673,210)         (-29,737)         (+23,206)

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\...........          448,251   ................          448,251   ................         +448,251
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES..................        1,100,100         1,421,000         1,421,000          +320,900   ................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Unemployment Compensation [UI]:
    State Operations..........................................        3,209,172         3,004,912         3,004,912          -204,260   ................
    National Activities.......................................           11,266            11,297            11,297               +31   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Unemployment Compensation.....................        3,220,438         3,016,209         3,016,209          -204,229   ................

Employment Service [ES]:
    Allotments to States:
        Federal Funds.........................................           22,595            22,638            22,638               +43   ................
        Trust Funds...........................................          678,247           708,204           708,204           +29,957   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          700,842           730,842           730,842           +30,000   ................

    ES National Activities....................................           20,912            20,952            20,952               +40   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Employment Service............................          721,754           751,794           751,794           +30,040   ................
          Federal Funds.......................................          (22,595)          (22,638)          (22,638)             (+43)  ................
          Trust Funds.........................................         (699,159)         (729,156)         (729,156)         (+29,997)  ................

Foreign Labor Certification:
    Federal Administration....................................           50,323            50,418            50,418               +95   ................
    Grants to States..........................................           15,070            15,099            15,099               +29   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Foreign Labor Certification...................           65,393            65,517            65,517              +124   ................

One-Stop Career Centers/Labor Market Information..............           63,473           115,720            63,473   ................          -52,247
                                                               =========================================================================================
      Total, State UI and ES..................................        4,071,058         3,949,240         3,896,993          -174,065           -52,247
          Federal Funds.......................................          (86,068)         (138,358)          (86,111)             (+43)         (-52,247)
          Trust Funds.........................................       (3,984,990)       (3,810,882)       (3,810,882)        (-174,108)  ................

STATE PAID LEAVE FUND.........................................  ................            5,000   ................  ................           -5,000

ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\...................          171,000   ................  ................         -171,000   ................

                    PROGRAM ADMINISTRATION

Adult Employment and Training.................................           46,677            47,015            46,677   ................             -338
    Trust Funds...............................................            8,518             8,536             8,518   ................              -18
Youth Employment and Training.................................           12,260            12,283            12,260   ................              -23
Employment Security...........................................            3,476             3,483             3,476   ................               -7
    Trust Funds...............................................           39,343            39,417            39,343   ................              -74
Apprenticeship Services.......................................           27,676            27,728            27,676   ................              -52
Executive Direction...........................................            7,048             7,062             7,048   ................              -14
    Trust Funds...............................................            2,083             2,087             2,083   ................               -4
                                                               -----------------------------------------------------------------------------------------
      Total, Program Administration...........................          147,081           147,611           147,081   ................             -530
          Federal Funds.......................................          (97,137)          (97,571)          (97,137)  ................            (-434)
          Trust Funds.........................................          (49,944)          (50,040)          (49,944)  ................             (-96)
                                                               =========================================================================================
      Total, Employment and Training Admin. [ETA].............       10,833,129        10,404,667        10,762,598           -70,531          +357,931
          Federal Funds.......................................        6,798,195         6,543,745         6,901,772          +103,577          +358,027
              Current Year....................................       (5,026,195)       (4,771,745)       (5,129,772)        (+103,577)        (+358,027)
              Fiscal year 2014................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
          Trust Funds.........................................        4,034,934         3,860,922         3,860,826          -174,108               -96

       EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]

                     SALARIES AND EXPENSES

Enforcement and Participant Assistance........................          145,243           145,243           145,243   ................  ................
Policy and Compliance Assistance..............................           31,205            31,205            31,205   ................  ................
Executive Leadership, Program Oversight and Admin.............            6,705             6,705             6,705   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, EBSA.............................................          183,153           183,153           183,153   ................  ................

          PENSION BENEFIT GUARANTY CORPORATION [PBGC]

Pension Insurance Activities..................................          (84,219)          (75,943)          (75,943)          (-8,276)  ................
Pension Plan Termination......................................         (238,993)         (240,611)         (240,611)          (+1,618)  ................
Operational Support...........................................         (153,689)         (162,459)         (162,459)          (+8,770)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, PBGC (program level).............................         (476,901)         (479,013)         (479,013)          (+2,112)  ................

Enforcement of Wage & Hour Standards..........................          227,061           237,730           237,730           +10,669   ................
OFFICE OF LABOR-MANAGEMENT STANDARDS..........................           41,289            41,771            41,289   ................             -482
Feeral Contractor EEO Standards Enforcement...................          105,187           106,415           105,187   ................           -1,228

          FEDERAL PROGRAMS FOR WORKERS' COMPENSATION

Salaries and Expenses.........................................          115,720           120,056           115,720   ................           -4,336
    Trust Funds...............................................            2,120             2,134             2,120   ................              -14
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and Expenses............................          117,840           122,190           117,840   ................           -4,350
          Federal Funds.......................................         (115,720)         (120,056)         (115,720)  ................          (-4,336)
          Trust Funds.........................................           (2,120)           (2,134)           (2,120)  ................             (-14)

                       SPECIAL BENEFITS

Federal Employees' Compensation Benefits......................          347,000           393,000           393,000           +46,000   ................
Longshore and Harbor Workers' Benefits........................            3,000             3,000             3,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits.................................          350,000           396,000           396,000           +46,000   ................

           SPECIAL BENEFITS FOR DISABLED COAL MINERS

Benefit Payments..............................................          177,000           158,000           158,000           -19,000   ................
Administration................................................            5,227             5,220             5,220                -7   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, fiscal year 2014 program level................          182,227           163,220           163,220           -19,007   ................
          Less funds advanced in prior year...................          -41,000           -40,000           -40,000            +1,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Current Year, fiscal year 2014...................          141,227           123,220           123,220           -18,007   ................
          New advances, 1st quarter fiscal year 2014..........           40,000            35,000            35,000            -5,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits for Disabled Coal Miners........          181,227           158,220           158,220           -23,007   ................

    ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND

Part B Administrative Expenses................................           52,147            54,962            54,962            +2,815   ................

               BLACK LUNG DISABILITY TRUST FUND

Benefit Payments and Interest on Advances.....................          242,609           250,043           250,043            +7,434   ................
Workers' Compensation Programs, Salaries and Expenses.........           32,906            32,906            32,906   ................  ................
Departmental Management, Salaries and Expenses................           25,217            25,217            25,217   ................  ................
Departmental Management, Inspector General....................              327               327               327   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Black Lung Disability.........................          301,059           308,493           308,493            +7,434   ................

Treasury Department Administrative Costs......................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Black Lung Disability Trust Fund.................          301,415           308,849           308,849            +7,434   ................
                                                               =========================================================================================
      Total, Federal Programs for Workers' Compensation.......        1,002,629         1,040,221         1,035,871           +33,242            -4,350
          Federal Funds.......................................        1,000,509         1,038,087         1,033,751           +33,242            -4,336
              Current year....................................         (960,509)       (1,003,087)         (998,751)         (+38,242)          (-4,336)
              Fiscal year 2014................................          (40,000)          (35,000)          (35,000)          (-5,000)  ................
          Trust Funds.........................................            2,120             2,134             2,120   ................              -14

     OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA]

                     SALARIES AND EXPENSES

Safety and Health Standards...................................           19,962            21,008            20,964            +1,002               -44
Federal Enforcement...........................................          207,753           207,075           207,075              -678   ................
Whistleblower enforcement.....................................           15,873            20,739            18,650            +2,777            -2,089
State Programs................................................          104,196           104,196           104,196   ................  ................
Technical Support.............................................           25,820            24,880            24,880              -940   ................

Compliance Assistance:
    Federal Assistance........................................           76,355            73,131            75,000            -1,355            +1,869
    State Consultation Grants.................................           57,890            57,890            57,890   ................  ................
    Training Grants...........................................           10,709            10,709            11,000              +291              +291
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Compliance Assistance.........................          144,954           141,730           143,890            -1,064            +2,160

Safety and Health Statistics..................................           34,739            34,313            34,313              -426   ................
Executive Direction and Administration........................           11,491            11,527            11,500                +9               -27
                                                               =========================================================================================
      Total, OSHA.............................................          564,788           565,468           565,468              +680   ................

             MINE SAFETY AND HEALTH ADMINISTRATION

                     SALARIES AND EXPENSES

Coal Enforcement..............................................          164,500           167,859           167,859            +3,359   ................
Metal/Non-Metal Enforcement...................................           89,063            91,697            91,697            +2,634   ................
Standards Development.........................................            4,764             5,416             5,416              +652   ................
Assessments...................................................            7,103             6,732             7,000              -103              +268
Educational Policy and Development............................           38,325            31,682            33,555            -4,770            +1,873
Technical Support.............................................           33,613            33,791            33,791              +178   ................
Program Evaluation and Information Resources [PEIR]...........           18,157            17,990            17,990              -167   ................
Program Administration........................................           16,998            16,729            18,962            +1,964            +2,233
                                                               =========================================================================================
      Total, Mine Safety and Health Administration............          372,523           371,896           376,270            +3,747            +4,374
                                                               =========================================================================================
      Total, Worker Protection Agencies.......................        1,611,841         1,628,623         1,626,937           +15,096            -1,686
          Federal Funds.......................................       (1,609,721)       (1,626,489)       (1,624,817)         (+15,096)          (-1,672)
          Trust Funds.........................................           (2,120)           (2,134)           (2,120)  ................             (-14)

                  BUREAU OF LABOR STATISTICS

                     SALARIES AND EXPENSES

Employment and Unemployment Statistics........................          209,367           213,219           214,367            +5,000            +1,148
Labor Market Information......................................           67,176            67,176            67,176   ................  ................
Prices and Cost of Living.....................................          205,888           211,084           210,860            +4,972              -224
Compensation and Working Conditions...........................           80,391            81,545            80,391   ................           -1,154
Productivity and Technology...................................           12,013            10,205            12,013   ................           +1,808
Executive Direction and Staff Services........................           34,236            34,978            34,236   ................             -742
                                                               =========================================================================================
      Total, Bureau of Labor Statistics.......................          609,071           618,207           619,043            +9,972              +836
          Federal Funds.......................................          541,895           551,031           551,867            +9,972              +836
          Trust Funds.........................................           67,176            67,176            67,176   ................  ................

            OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES.........................................           38,879            38,953            38,953               +74   ................

                    DEPARTMENTAL MANAGEMENT

                     SALARIES AND EXPENSES

Executive Direction...........................................           32,722            32,722            32,722   ................  ................
Departmental Program Evaluation...............................           24,360             9,000             9,000           -15,360   ................
Legal Services................................................          129,647           130,938           130,938            +1,291   ................
    Trust Funds...............................................              325               326               326                +1   ................
International Labor Affairs...................................           92,309            94,984            94,984            +2,675   ................
Administration and Management.................................           29,982            29,614            29,614              -368   ................
Adjudication..................................................           29,495            29,639            29,639              +144   ................
Women's Bureau................................................           11,559             9,081             9,081            -2,478   ................
Civil Rights Activities.......................................            7,260             7,273             7,273               +13   ................
Chief Financial Officer.......................................            5,340             5,350             5,350               +10   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and expenses............................          362,999           348,927           348,927           -14,072   ................
          Federal Funds.......................................         (362,674)         (348,601)         (348,601)         (-14,073)  ................
          Trust Funds.........................................             (325)             (326)             (326)              (+1)  ................

               VETERANS EMPLOYMENT AND TRAINING

State Administration, Grants..................................          165,081           170,049           172,000            +6,919            +1,951
Transition Assistance Program.................................            8,983            12,000            14,000            +5,017            +2,000
Federal Administration........................................           35,155            35,222            35,222               +67   ................
National Veterans Training Institute..........................            2,439             3,414             3,414              +975   ................
Homeless Veterans Program.....................................           38,185            38,185            38,185   ................  ................
Veterans Workforce Investment Programs........................           14,594   ................  ................          -14,594   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Veterans Employment and Training.................          264,437           258,870           262,821            -1,616            +3,951
          Federal Funds.......................................           52,779            38,185            38,185           -14,594   ................
          Trust Funds.........................................          211,658           220,685           224,636           +12,978            +3,951

            INFRASTRUCTURE TECHNOLOGY MODERNIZATION

Departmental support systems..................................           11,829             8,000             7,985            -3,844               -15
Infrastructure technology modernization.......................            7,985            13,852            11,829            +3,844            -2,023
                                                               -----------------------------------------------------------------------------------------
      Total, IT Modernization.................................           19,814            21,852            19,814   ................           -2,038

                  OFFICE OF INSPECTOR GENERAL

Program Activities............................................           77,790            79,199            77,790   ................           -1,409
    Trust Funds...............................................            5,898             5,909             5,898   ................              -11
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Inspector General......................           83,688            85,108            83,688   ................           -1,420
                                                               =========================================================================================
      Total, Departmental Management..........................          730,938           714,757           715,250           -15,688              +493
          Federal Funds.......................................          513,057           487,837           484,390           -28,667            -3,447
              Current Year....................................         (513,057)         (487,837)         (484,390)         (-28,667)          (-3,447)
          Trust Funds.........................................          217,881           226,920           230,860           +12,979            +3,940
                                                               =========================================================================================
      Total, Title I, Department of Labor.....................       14,708,647        14,323,238        14,680,812           -27,835          +357,574
          Federal Funds.......................................       10,386,536        10,166,086        10,519,830          +133,294          +353,744
              Current Year....................................       (8,574,536)       (8,359,086)       (8,712,830)        (+138,294)        (+353,744)
              Fiscal year 2014................................       (1,812,000)       (1,807,000)       (1,807,000)          (-5,000)  ................
          Trust Funds.........................................        4,322,111         4,157,152         4,160,982          -161,129            +3,830

       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

      HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]

                 HEALTH RESOURCES AND SERVICES

                      Primary Health Care

Community Health Centers......................................        1,566,892         1,561,803         1,566,892   ................           +5,089
Free Clinics Medical Malpractice..............................               40                40                40   ................  ................
National Hansen's Disease Program.............................           16,045            16,045            16,045   ................  ................
Hansen's Disease Program Buildings and Facilities.............              127               127               127   ................  ................
Payment to Hawaii, Treatment of Hansen's......................            1,960             1,960             1,960   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Primary Health Care...........................        1,585,064         1,579,975         1,585,064   ................           +5,089

              Bureau of Health Professions [BHP]

                       Health Workforce

Health Professions, Training for Diversity:
    Centers of Excellence.....................................           22,909            22,909            22,909   ................  ................
    Health Careers Opportunity Program........................           14,822   ................  ................          -14,822   ................
    Faculty Loan Repayment....................................            1,243             1,243             1,243   ................  ................
    Scholarships for Disadvantaged Students...................           47,452            47,452            47,452   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Training for Diversity........................           86,426            71,604            71,604           -14,822   ................

Training in Primary Care Medicine.............................           38,962            50,962            48,962           +10,000            -2,000
Pediatric Loan Repayment......................................  ................            5,000   ................  ................           -5,000
Oral Health Training..........................................           32,392            32,392            32,392   ................  ................

Interdisciplinary Community-Based Linkages:
    Area Health Education Centers.............................           27,220   ................           27,220   ................          +27,220
    Geriatric Programs........................................           30,629            30,629            30,629   ................  ................
    Mental and Behavorial Health..............................            2,892             2,892             2,892   ................  ................
        Evaluation Tap Funding................................  ................           (5,000)  ................  ................          (-5,000)
        Prevention and Public Health Fund\3\..................          (10,000)  ................  ................         (-10,000)  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Interdisciplinary Community Linkages......           60,741            33,521            60,741   ................          +27,220
              Subtotal, Evaluation Tap Funding................  ................            5,000   ................  ................           -5,000
              Subtotal, Prevention and Public Health Fund\3\..           10,000   ................  ................          -10,000   ................
                                                               -----------------------------------------------------------------------------------------
          Total, Interdisciplinary Community Linkages.........           70,741            38,521            60,741           -10,000           +22,220

Workforce Information and Analysis............................            2,782   ................            7,782            +5,000            +7,782
    Evaluation Tap Funding....................................  ................          (10,000)  ................  ................         (-10,000)

Public Health and Preventive Medicine programs................            8,111             9,609            10,111            +2,000              +502
    Prevention and Public Health Fund\3\......................          (25,000)          (10,000)          (25,000)  ................         (+15,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................           33,111            19,609            35,111            +2,000           +15,502

Nursing Programs:
    Advanced Education Nursing................................           63,925            63,925            63,925   ................  ................
        Evaluation Tap Funding................................  ................          (20,000)  ................  ................         (-20,000)
    Nurse Education, Practice, and Retention..................           39,182            39,182            39,182   ................  ................
    Nursing Workforce Diversity...............................           15,819            15,819            15,819   ................  ................
    Loan Repayment and Scholarship Program....................           83,135            83,135            83,135   ................  ................
    Comprehensive Geriatric Education.........................            4,485             4,485             4,485   ................  ................
    Nursing Faculty Loan Program..............................           24,553            24,553            24,553   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Nursing programs..............................          231,099           231,099           231,099   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Evaluation Tap Funding........................  ................          (20,000)  ................  ................         (-20,000)

Children's Hospitals Graduate Medical Education...............          265,171            88,000           265,171   ................         +177,171
National Practitioner Data Bank...............................           28,016            28,016            28,016   ................  ................
    User Fees.................................................          -28,016           -28,016           -28,016   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Bureau of Health Professions..................          725,684           522,187           727,862            +2,178          +205,675
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Evaluation Tap Funding........................  ................          (35,000)  ................  ................         (-35,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Prevention and Public Health Fund.............          (35,000)          (10,000)          (25,000)         (-10,000)         (+15,000)
                                                               -----------------------------------------------------------------------------------------
      Total, Health Professions Program Level.................          760,684           567,187           752,862            -7,822          +185,675

                   Maternal and Child Health

Maternal and Child Health Block Grant.........................          638,646           640,098           640,098            +1,452   ................
Sickle Cell Anemia Demonstration Program......................            4,665             4,665             4,665   ................  ................
Traumatic Brain Injury........................................            9,760             9,760             9,760   ................  ................
Autism and Other Developmental Disorders......................           47,142            47,142            47,142   ................  ................
Heritable Disorders...........................................            9,834             9,834             9,834   ................  ................
Healthy Start.................................................          103,532           103,532           103,532   ................  ................
Universal Newborn Hearing.....................................           18,660            18,660            18,660   ................  ................
Emergency Medical Services for Children.......................           21,116            21,116            21,116   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Maternal and Child Health.....................          853,355           854,807           854,807            +1,452   ................

                  Ryan White HIV/AIDS Program

Ryan White AIDS Programs:
    Emergency Assistance......................................          666,071           671,258           666,071   ................           -5,187
    Comprehensive Care Programs...............................        1,360,827         1,422,341         1,390,827           +30,000           -31,514
        AIDS Drug Assistance Program [ADAP] (NA)..............         (933,299)       (1,000,000)         (963,299)         (+30,000)         (-36,701)
    Early Intervention Program................................          215,086           235,564           215,086   ................          -20,478
    Children, Youth, Women, and Families......................           77,167            69,582            77,167   ................           +7,585
    AIDS Dental Services......................................           13,485            13,485            13,485   ................  ................
    Education and Training Centers............................           34,542            34,542            34,542   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDS programs......................        2,367,178         2,446,772         2,397,178           +30,000           -49,594
    Evaluation Tap Funding (NA)...............................          (25,000)          (25,000)          (25,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDs program level.................       (2,392,178)       (2,471,772)       (2,422,178)         (+30,000)         (-49,594)

                      Health Care Systems

Organ Transplantation.........................................           24,015            24,015            24,015   ................  ................
National Cord Blood Inventory.................................           11,887            11,887            11,887   ................  ................
Bone Marrow Program...........................................           23,330            23,330            23,330   ................  ................
Office of Pharmacy Affairs....................................            4,472             4,472             4,472   ................  ................
340B Drug Pricing User Fees...................................  ................            6,000             6,000            +6,000   ................
    User Fees.................................................  ................           -6,000            -6,000            -6,000   ................
Poison Control................................................           18,830            18,830            18,830   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health Care Systems...........................           82,534            82,534            82,534   ................  ................

                         Rural Health

Rural Outreach Grants.........................................           55,553            55,553            57,553            +2,000            +2,000
Rural Health Research/Policy Development......................            9,866             9,866             9,866   ................  ................
Rural Hospital Flexibility Grants.............................           41,040            26,200            41,040   ................          +14,840
Rural and Community Access to Emergency Devices...............            1,100   ................            5,000            +3,900            +5,000
State Offices of Rural Health.................................           10,036            10,036            10,036   ................  ................
Black Lung Clinics............................................            7,140             7,140             7,140   ................  ................
Radiation Exposure Screening and Education Program............            1,935             1,935             1,935   ................  ................
Telehealth....................................................           11,502            11,502            11,502   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Rural Health..................................          138,172           122,232           144,072            +5,900           +21,840

Family Planning...............................................          293,870           296,838           293,870   ................           -2,968
Program Management............................................          159,894           162,517           162,517            +2,623   ................
      Total, Health resources & services program level........       (6,265,751)       (6,137,862)       (6,297,904)         (+32,153)        (+160,042)

       HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT

HEAL Liquidating Account......................................           (1,000)           (1,000)           (1,000)  ................  ................
HEAL Program Management.......................................            2,807             2,807             2,807   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, HEAL.............................................            2,807             2,807             2,807   ................  ................

        VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Post-fiscal year 1988 Claims..................................          235,000           235,000           235,000   ................  ................
HRSA Administration...........................................            6,477             6,477             6,477   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Vaccine Injury Compensation Trust Fund...........          241,477           241,477           241,477   ................  ................
                                                               =========================================================================================
      Total, Health Resources & Services Administration.......        6,450,035         6,312,146         6,492,188           +42,153          +180,042
          Total, Evaluation tap funding.......................          (25,000)          (60,000)          (25,000)  ................         (-35,000)

    Prevention and Public Health Fund\3\......................          (35,000)          (10,000)          (25,000)         (-10,000)         (+15,000)
      Total, HRSA program level...............................       (6,510,035)       (6,382,146)       (6,542,188)         (+32,153)        (+160,042)

          CENTERS FOR DISEASE CONTROL AND PREVENTION

            DISEASE CONTROL, RESEARCH, AND TRAINING

Immunization and Respiratory Diseases.........................          576,083           583,855           576,083   ................           -7,772
    Evaluation Tap Funding....................................          (12,864)          (13,765)          (12,864)  ................            (-901)
    Pandemic Flu balances (Public Law 111-32).................  ................          (51,049)  ................  ................         (-51,049)
    Prevention and Public Health Fund\3\......................         (190,000)          (72,460)         (190,000)  ................        (+117,540)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (778,947)         (721,129)         (778,947)  ................         (+57,818)

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.............        1,099,934         1,145,678         1,101,934            +2,000           -43,744
    Prevention and Public Health Fund\3\......................          (10,000)  ................          (10,000)  ................         (+10,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, HIV/AIDS, Viral Hepathitis, STD & TB..........        1,109,934         1,145,678         1,111,934            +2,000           -33,744

Emerging and Zoonotic Infectious Diseases.....................          252,476           279,477           269,274           +16,798           -10,203
    Prevention and Public Health Fund\3\......................          (51,750)          (51,750)          (51,750)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Emerging and Zoonotic Infectious..............          304,226           331,227           321,024           +16,798           -10,203

Chronic Disease Prevention and Health Promotion...............          756,377           608,019           798,445           +42,068          +190,426
    Evaluation Tap Funding....................................  ................          (25,000)  ................  ................         (-25,000)
    Prevention and Public Health Fund\3\......................         (427,050)         (511,711)         (457,050)         (+30,000)         (-54,661)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Chronic Disiease Prevention...................       (1,183,427)       (1,144,730)       (1,255,495)         (+72,068)        (+110,765)

Birth Defects and Developmental Disabilities..................          137,287            18,476           134,500            -2,787          +116,024
    Prevention and Public Health Fund\3\......................  ................         (107,089)  ................  ................        (-107,089)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Birth Defects.................................         (137,287)         (125,565)         (134,500)          (-2,787)          (+8,935)

Public Health Scientific Services.............................          143,972            35,695           143,972   ................         +108,277
    Evaluation Tap Funding....................................         (247,769)         (379,374)         (247,769)  ................        (-131,605)
    Prevention and Public Health Fund\3\......................          (70,000)          (90,000)          (70,000)  ................         (-20,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (461,741)         (505,069)         (461,741)  ................         (-43,328)

Environmental Health..........................................          104,998           103,672           114,667            +9,669           +10,995
    Prevention and Public Health Fund\3\......................          (35,000)          (29,000)          (35,000)  ................          (+6,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (139,998)         (132,672)         (149,667)          (+9,669)         (+16,995)

Injury Prevention and Control.................................          137,693           137,754           137,693   ................              -61
    Prevention and Public Health Fund\3\......................  ................  ................           (3,000)          (+3,000)          (+3,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (137,693)         (137,754)         (140,693)          (+3,000)          (+2,939)

National Institute for Occupational Safety & Health\3\........          181,864   ................          181,864   ................         +181,864
    Evaluation Tap Funding....................................         (110,724)         (249,364)         (110,724)  ................        (-138,640)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (292,588)         (249,364)         (292,588)  ................         (+43,224)

Energy Employees Occupational Illness Compensation Program....           55,358            55,358            55,358   ................  ................
Global Health.................................................          347,594           362,889           362,594           +15,000              -295
Public Health Preparedness and Response.......................        1,299,479         1,228,360         1,299,479   ................          +71,119
    Pandemic Flu balances (Public Law 111-32).................          (30,000)          (46,776)  ................         (-30,000)         (-46,776)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,329,479         1,275,136         1,299,479           -30,000           +24,343

CDC-Wide Activities...........................................          617,913           487,648           593,193           -24,720          +105,545
Prevention and Public Health Fund\3\..........................          (41,200)          (41,200)          (41,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, CDC-Wide Activities...........................         (659,113)         (528,848)         (634,393)         (-24,720)        (+105,545)

      Total, Centers for Disease Control......................        6,536,028         5,950,091         6,627,056           +91,028          +676,965
          Discretionary.......................................        5,655,670         4,991,523         5,713,698           +58,028          +722,175
          Evaluation Tap Funding (NA).........................         (371,357)         (667,503)         (371,357)  ................        (-296,146)
          Pandemic Flu balances (Public Law 111-32)...........          (30,000)          (97,825)  ................         (-30,000)         (-97,825)
                                                               -----------------------------------------------------------------------------------------
          Prevention and Public Health Fund\3\................         (825,000)         (903,210)         (858,000)         (+33,000)         (-45,210)
                                                               =========================================================================================
      Total, Centers for Disease Control Program Level........       (6,937,385)       (6,715,419)       (6,998,413)         (+61,028)        (+282,994)

                 NATIONAL INSTITUTES OF HEALTH

National Cancer Institute.....................................        5,067,396         5,068,864         5,084,227           +16,831           +15,363
National Heart, Lung, and Blood Institute.....................        3,076,115         3,076,067         3,085,390            +9,275            +9,323
National Institute of Dental & Craniofacial Research..........          410,322           408,212           409,449              -873            +1,237
National Institute of Diabetes and Digestive and Kidney               1,795,348         1,792,107         1,797,539            +2,191            +5,432
 Diseases [NIDDK].............................................
National Institute of Neurological Disorders & Stroke.........        1,624,830         1,624,707         1,629,631            +4,801            +4,924
National Institute of Allergy and Infectious Diseases.........        4,486,473         4,495,307         4,508,932           +22,459           +13,625
    Global HIV/AIDS Fund Transfer.............................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NIAID program level...........................        4,486,473         4,495,307         4,508,932           +22,459           +13,625

National Institute of General Medical Sciences................        2,427,742         2,378,835         2,387,112           -40,630            +8,277
National Institute of Child Health & Human Development........        1,320,151         1,320,600         1,324,603            +4,452            +4,003
National Eye Institute........................................          702,049           693,015           695,115            -6,934            +2,100
National Institute of Environmental Health Sciences...........          684,923           684,030           686,103            +1,180            +2,073
National Institute on Aging...................................        1,121,400         1,102,650         1,124,265            +2,865           +21,615
National Institute of Arthritis and Musculoskeletal and Skin            535,280           535,610           537,233            +1,953            +1,623
 Diseases.....................................................
National Institute on Deafness and Other Communication                  415,880           417,297           418,562            +2,682            +1,265
 Disorders....................................................
National Institute of Nursing Research........................          144,633           144,153           144,590               -43              +437
National Institute on Alcohol Abuse and Alcoholism............          459,085           457,104           458,489              -596            +1,385
National Institute on Drug Abuse..............................        1,052,373         1,054,001         1,057,196            +4,823            +3,195
National Institute of Mental Health...........................        1,478,868         1,479,204         1,483,687            +4,819            +4,483
National Human Genome Research Institute......................          512,727           511,370           512,920              +193            +1,550
National Institute of Biomedical Imaging and Bioengineering...          338,038           336,896           337,917              -121            +1,021
National Center for Complementary and Alternative Medicine....          127,937           127,930           128,318              +381              +388
National Institute on Minority Health and Health Disparities..          276,179           279,389           280,236            +4,057              +847
John E. Fogarty International Center..........................           69,556            69,758            69,969              +413              +211
National Center for Advancing Translation Sciences............          574,823           639,033           631,346           +56,523            -7,687
National Library of Medicine [NLM]............................          337,322           372,651           373,781           +36,459            +1,130
    Evaluation Tap Funding....................................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          345,522           380,851           381,981           +36,459            +1,130

Office of the Director........................................        1,458,501         1,429,161         1,431,341           -27,160            +2,180
    Common fund...............................................         (544,930)         (544,930)         (544,930)  ................  ................
Buildings and Facilities......................................          125,308           125,308           125,308   ................  ................
                                                               =========================================================================================
      Total, National Institutes of Health [NIH]..............       30,623,259        30,623,259        30,723,259          +100,000          +100,000
          Evaluation Tap Funding..............................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, NIH Program Level................................      (30,631,459)      (30,631,459)      (30,731,459)        (+100,000)        (+100,000)

   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
                           [SAMHSA]

          SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Mental Health:
    Programs of Regional and National Significance............          275,756           219,550           270,394            -5,362           +50,844
    Prevention and Public Health Fund\3\......................          (45,000)          (28,000)          (45,000)  ................         (+17,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, PRNS..........................................         (320,756)         (247,550)         (315,394)          (-5,362)         (+67,844)

    Mental Health block grant.................................          438,717           438,717           458,717           +20,000           +20,000
        Evaluation Tap Funding................................          (21,039)          (21,039)          (21,039)  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, MHBG Program level........................         (459,756)         (459,756)         (479,756)         (+20,000)         (+20,000)

    Children's Mental Health..................................          117,315            88,557           117,315   ................          +28,758
    Grants to States for the Homeless (PATH)..................           64,794            64,794            64,794   ................  ................
    Protection and Advocacy...................................           36,238            36,238            36,238   ................  ................
    State prevention grants...................................  ................           55,000   ................  ................          -55,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental Health.................................          932,820           902,856           947,458           +14,638           +44,602
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental health program level...................         (998,859)         (951,895)       (1,013,497)         (+14,638)         (+61,602)

Substance Abuse Treatment:
    Programs of Regional and National Significance............          398,242           334,139           368,813           -29,429           +34,674
    Prevention and Public Health Fund\3\......................          (25,000)          (30,000)          (25,000)  ................          (-5,000)
        Evaluation Tap Funding................................           (2,000)  ................           (2,000)  ................          (+2,000)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................         (425,242)         (364,139)         (395,813)         (-29,429)         (+31,674)

    Substance Abuse block grant...............................        1,721,132         1,376,906         1,741,132           +20,000          +364,226
        Evaluation Tap Funding................................          (79,200)          (71,724)          (79,200)  ................          (+7,476)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................       (1,800,332)       (1,448,630)       (1,820,332)         (+20,000)        (+371,702)

    Substance abuse prevention grants.........................  ................          404,501   ................  ................         -404,501
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Substance Abuse Treatment.....................        2,119,374         2,115,546         2,109,945            -9,429            -5,601
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program level.................................       (2,225,574)       (2,217,270)       (2,216,145)          (-9,429)          (-1,125)

Substance Abuse Prevention:
    Programs of Regional and National Significance............          185,956            58,877           184,433            -1,523          +125,556
    Prevention and Public Health Fund\3\......................  ................           (7,000)  ................  ................          (-7,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          185,956            58,877           184,433            -1,523          +125,556
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program Level.................................         (185,956)          (65,877)         (184,433)          (-1,523)        (+118,556)

Health Surveillance and Program Support:
    Program Management........................................           76,891            72,229            72,229            -4,662   ................
    Health Surveillance.......................................            1,996             2,000             1,996   ................               -4
        Prevention and Public Health Fund\3\..................          (18,000)  ................          (18,000)  ................         (+18,000)
        Evaluation Tap Funding................................          (27,428)          (45,428)          (27,428)  ................         (-18,000)
                                                               -----------------------------------------------------------------------------------------
          Surveillance, Program level.........................          (47,424)          (47,428)          (47,424)  ................              (-4)

Military Families.............................................            3,493   ................  ................           -3,493   ................
Data Requests and Publications................................  ................            1,500             1,500            +1,500   ................
    User Fees.................................................  ................           -1,500            -1,500            -1,500   ................
Public Awareness and Support..................................           13,545   ................           13,545   ................          +13,545
    Evaluation Tap Funding....................................  ................          (13,571)  ................  ................         (-13,571)
Performance and Quality Information Systems...................           12,940   ................           12,940   ................          +12,940
    Evaluation Tap Funding....................................  ................          (12,996)  ................  ................         (-12,996)
Tribal Prevention Grants [PPHF]...............................  ................          (40,000)  ................  ................         (-40,000)
                                                               -----------------------------------------------------------------------------------------
      Total, Health Surveillance..............................          108,865            74,229           100,710            -8,155           +26,481
                                                               -----------------------------------------------------------------------------------------
      Total, Health Surveillance Program Level................          154,293           186,224           146,138            -8,155           -40,086
                                                               =========================================================================================
      Total, SAMHSA...........................................        3,347,015         3,151,508         3,342,546            -4,469          +191,038
          Evaluation Tap Funding..............................         (129,667)         (164,758)         (129,667)  ................         (-35,091)
          Prevention and Public Health Fund\3\................          (88,000)         (105,000)          (88,000)  ................         (-17,000)
                                                               -----------------------------------------------------------------------------------------
      Total, SAMHSA Program Level.............................       (3,564,682)       (3,421,266)       (3,560,213)          (-4,469)        (+138,947)

       AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]

                HEALTHCARE RESEARCH AND QUALITY

Research on Health Costs, Quality, and Outcomes:
    Evaluation Tap funding....................................         (235,768)         (206,635)         (236,331)            (+563)         (+29,696)
    Prevention and Public Health Fund\3\......................          (12,000)          (12,000)          (12,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health Costs, Quality, and Outcomes...........         (247,768)         (218,635)         (248,331)            (+563)         (+29,696)

Medical Expenditures Panel Surveys:
    Evaluation Tap Funding (NA)...............................          (59,300)          (59,300)          (59,300)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medical Expenditures Panel Surveys............          (59,300)          (59,300)          (59,300)  ................  ................

Program Support:
    Evaluation Tap Funding (NA)...............................          (73,985)          (68,422)          (68,422)          (-5,563)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (73,985)          (68,422)          (68,422)          (-5,563)  ................
          Evaluation Tap Funding (NA).........................         (369,053)         (334,357)         (364,053)          (-5,000)         (+29,696)
          AHRQ, Prevention and Public Health Fund\3\..........          (12,000)          (12,000)          (12,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, AHRQ Program Level...............................         (381,053)         (346,357)         (376,053)          (-5,000)         (+29,696)
                                                               =========================================================================================
      Total, Public Health Service (PHS) appropriation........       46,131,337        45,133,794        46,327,049          +195,712        +1,193,255
      Total, Public Health Service Program Level..............      (48,148,614)      (47,612,647)      (48,322,326)        (+173,712)        (+709,679)

          CENTERS FOR MEDICARE AND MEDICAID SERVICES

                 GRANTS TO STATES FOR MEDICAID

Medicaid Current Law Benefits.................................      253,884,907       250,398,918       250,398,918        -3,485,989   ................
State and Local Administration................................       12,808,496        14,735,346        14,735,346        +1,926,850   ................
Vaccines for Children.........................................        4,030,996         4,271,015         4,271,015          +240,019   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medicaid Program Level........................      270,724,399       269,405,279       269,405,279        -1,319,120   ................
          Less funds advanced in prior year...................      -86,445,289       -90,614,082       -90,614,082        -4,168,793   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Grants to States for Medicaid....................      184,279,110       178,791,197       178,791,197        -5,487,913   ................
          New advance, 1st quarter............................       90,614,082       106,335,631       106,335,631       +15,721,549   ................

              PAYMENTS TO HEALTH CARE TRUST FUNDS

Supplemental Medical Insurance................................      178,041,000       189,520,000       189,520,000       +11,479,000   ................
Federal Uninsured Payment.....................................          262,000           228,000           228,000           -34,000   ................
Program Management............................................          222,000           192,000           192,000           -30,000   ................
General Revenue for Part D Benefit............................       51,431,000        60,744,000        60,744,000        +9,313,000   ................
General Revenue for Part D Administration.....................          475,000           424,000           424,000           -51,000   ................
HCFAC Reimbursement...........................................          310,378           610,000           610,000          +299,622   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to Trust Funds, Program Level...........      230,741,378       251,718,000       251,718,000       +20,976,622   ................

                      PROGRAM MANAGEMENT

Research, Demonstration, Evaluation...........................           21,160   ................           23,900            +2,740           +23,900
Program operations............................................        2,608,785         3,618,487         3,156,045          +547,260          -462,442
State Survey and Certification................................          375,203           387,353           375,203   ................          -12,150
High Risk Insurance Pools.....................................           44,000            22,004            44,000   ................          +21,996
Federal Administration........................................          770,964           792,964           770,964   ................          -22,000
                                                               =========================================================================================
      Total, Program management, Limitation on new BA.........        3,820,112         4,820,808         4,370,112          +550,000          -450,696

              HEALTH CARE FRAUD AND ABUSE CONTROL

Part D Drug Benefit/Medicare Advantage [MIP]..................          219,463           362,792           362,792          +143,329   ................
HHS Office of Inspector General...............................           29,674           102,500           102,500           +72,826   ................
Medicaid/CHIP.................................................           30,979            46,906            46,906           +15,927   ................
Department of Justice.........................................           29,674            97,802            97,802           +68,128   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Fraud and Abuse Control..............          309,790           610,000           610,000          +300,210   ................
                                                               =========================================================================================
      Total, Centers for Medicare and Medicaid Services.......      509,764,472       542,275,636       541,824,940       +32,060,468          -450,696
          Federal funds.......................................      505,634,570       536,844,828       536,844,828       +31,210,258   ................
              Current year....................................     (415,020,488)     (430,509,197)     (430,509,197)     (+15,488,709)  ................
              New advance, fiscal year 2014...................      (90,614,082)     (106,335,631)     (106,335,631)     (+15,721,549)  ................
          Trust Funds.........................................        4,129,902         5,430,808         4,980,112          +850,210          -450,696

           ADMINISTRATION FOR CHILDREN AND FAMILIES

  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY
                       SUPPORT PROGRAMS

Payments to Territories.......................................           33,000            33,000            33,000   ................  ................
Repatriation..................................................            1,000             1,000             1,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Welfare payments..............................           34,000            34,000            34,000   ................  ................

Child Support Enforcement:
    State and Local Administration............................        3,484,514         3,272,647         3,272,647          -211,867   ................
    Federal Incentive Payments................................          519,000           539,838           539,838           +20,838   ................
    Access and Visitation.....................................           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Child Support Enforcement.....................        4,013,514         3,822,485         3,822,485          -191,029   ................
                                                               =========================================================================================
      Total, Family Support Payments Program Level............        4,047,514         3,856,485         3,856,485          -191,029   ................
          Less funds advanced in previous years...............       -1,200,000        -1,100,000        -1,100,000          +100,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Family Support Payments, current year............        2,847,514         2,756,485         2,756,485           -91,029   ................
          New advance, 1st quarter, fiscal year 2014..........        1,100,000         1,100,000         1,100,000   ................  ................
                                                               =========================================================================================
          LOW-INCOME HOME ENERGY ASSISTANCE [LIHEAP]

Formula Grants................................................        3,471,672         2,820,000         3,371,672          -100,000          +551,672
Contingency Fund..............................................  ................          200,000           100,000          +100,000          -100,000
                                                               -----------------------------------------------------------------------------------------
      Total, LIHEAP, Program Level............................        3,471,672         3,020,000         3,471,672   ................         +451,672

                REFUGEE AND ENTRANT ASSISTANCE

Transitional and Medical Services.............................          323,195           403,000           343,000           +19,805           -60,000
Victims of Trafficking........................................            9,775             9,775             9,775   ................  ................
Social Services...............................................          115,107           153,407           153,407           +38,300   ................
Preventive Health.............................................            4,730             4,730             4,730   ................  ................
Targeted Assistance...........................................           20,201            48,401            48,401           +28,200   ................
Unaccompanied Minors..........................................          284,281           175,000           235,000           -49,281           +60,000
Victims of Torture............................................           11,045            11,045            11,045   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Refugee and Entrant Assistance...................          768,334           805,358           805,358           +37,024   ................

  PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
                             GRANT

Child Care and Development Block Grant........................        2,278,313         2,603,313         2,438,313          +160,000          -165,000

SOCIAL SERVICES BLOCK GRANT (TITLE XX)........................        1,700,000         1,700,000         1,700,000   ................  ................

            CHILDREN AND FAMILIES SERVICES PROGRAMS

Programs for Children, Youth and Families:
    Head Start, current funded................................        7,968,544         8,054,000         8,038,544           +70,000           -15,456
    Consolidated Runaway, Homeless Youth Program..............           97,355            97,355            97,355   ................  ................
    Prevention Grants to Reduce Abuse of Runaway Youth........           17,901            17,901            17,901   ................  ................
    Child Abuse State Grants..................................           26,432            26,432            26,432   ................  ................
    Child Abuse Discretionary Activities......................           25,744            25,744            25,744   ................  ................
    Community Based Child Abuse Prevention....................           41,527            41,527            41,527   ................  ................
    Abandoned Infants Assistance..............................           11,553            11,553            11,553   ................  ................
    Child Welfare Services....................................          280,650           280,650           280,650   ................  ................
    Child Welfare Training/Innovative Approaches to Foster               26,092            31,092            31,092            +5,000   ................
     Care.....................................................
    Adoption Opportunities....................................           39,179            39,179            39,179   ................  ................
    Adoption Incentive........................................           39,346            39,346            39,346   ................  ................

Social Services and Income Maintenance Research...............  ................            8,000   ................  ................           -8,000
    Evaluation Tap Funding....................................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program Level.................................           (5,762)          (13,762)           (5,762)  ................          (-8,000)

Native American Programs......................................           48,583            48,583            48,583   ................  ................

Community Services:
    Community Services Block Grant Act programs:
        Grants to States for Community Services...............          677,358           350,000           677,358   ................         +327,358
        Economic Development..................................           29,943            29,943            29,943   ................  ................
        Rural Community Facilities............................            4,981   ................            5,981            +1,000            +5,981
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          712,282           379,943           713,282            +1,000          +333,339

        Individual Development Account Initiative.............           19,869            19,869            19,869   ................  ................