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Calendar No. 178
112th Congress Report
SENATE
1st Session 112-84
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2012
_______
September 22, 2011.--Ordered to be printed
_______
Mr. Harkin, from the Committee on Appropriations,
submitted the following
REPORT
[To accompany S. 1599]
The Committee on Appropriations reports the bill (S. 1599)
making appropriations for Departments of Labor, Health and
Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2012, 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............. $742,432,508,000
Amount of 2011 appropriations....................... 722,738,724,000
Amount of 2012 budget estimate...................... 758,715,002,000
Bill as recommended to Senate compared to--
2011 appropriations............................. +19,693,784,000
2012 budget estimate............................ -16,282,494,000
CONTENTS
----------
Page
Summary of Budget Estimates and Committee Recommendations........ 4
Overview..................................................... 4
Fiscal Accountability........................................ 5
Leveraging Reform............................................ 6
Investing in the Future...................................... 8
Other Highlights of the Bill................................. 8
Reprogramming and Transfer Authority......................... 10
Title I: Department of Labor:
Employment and Training Administration....................... 12
Employee Benefits Security Administration.................... 22
Pension Benefit Guaranty Corporation......................... 23
Wage and Hour Division....................................... 23
Office of Labor-Management Standards......................... 24
Office of Federal Contract Compliance Programs............... 24
Office of Workers' Compensation Programs..................... 25
Occupational Safety and Health Administration................ 28
Mine Safety and Health Administration........................ 29
Bureau of Labor Statistics................................... 30
Office of Disability Employment Policy....................... 32
Departmental Management...................................... 33
General Provisions........................................... 36
Title II: Department of Health and Human Services:
Health Resources and Services Administration................. 36
Centers for Disease Control and Prevention................... 59
National Institutes of Health................................ 84
Substance Abuse and Mental Health Services Administration.... 116
Agency for Healthcare Research and Quality................... 126
Centers for Medicare and Medicaid Services................... 129
Administration for Children and Families..................... 134
Administration on Aging...................................... 149
Office of the Secretary...................................... 153
General Provisions........................................... 164
Title III: Department of Education:
Education for the Disadvantaged.............................. 166
Impact Aid................................................... 170
School Improvement Programs.................................. 171
Indian Education............................................. 177
Innovation and Improvement................................... 177
Safe Schools and Citizenship Education....................... 184
English Language Acquisition................................. 186
Special Education............................................ 187
Rehabilitation Services and Disability Research.............. 191
Special Institutions for Persons With Disabilities:
American Printing House for the Blind.................... 196
National Technical Institute for the Deaf................ 197
Gallaudet University..................................... 197
Career, Technical, and Adult Education....................... 197
Student Financial Assistance................................. 199
Student Aid Administration................................... 202
Higher Education............................................. 203
Howard University............................................ 210
College Housing and Academic Facilities Loans................ 211
Historically Black College and University Capital Financing
Program Account............................................ 211
Institute of Education Sciences.............................. 212
Departmental Management:
Program Administration................................... 214
Office for Civil Rights.................................. 215
Office of the Inspector General.......................... 215
General Provisions........................................... 215
Title IV: Related Agencies:
Committee for Purchase From People Who Are Blind or Severely
Disabled................................................... 217
Corporation for National and Community Service............... 217
Corporation for Public Broadcasting.......................... 220
Federal Mediation and Conciliation Service................... 221
Federal Mine Safety and Health Review Commission............. 221
Institute of Museum and Library Services..................... 222
Medicaid and CHIP Payment and Access Commission.............. 223
Medicare Payment Advisory Commission......................... 223
National Council on Disability............................... 224
National Health Care Workforce Commission.................... 224
National Labor Relations Board............................... 224
National Mediation Board..................................... 225
Occupational Safety and Health Review Commission............. 225
Railroad Retirement Board.................................... 225
Social Security Administration............................... 226
Title V: General Provisions...................................... 231
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the Sen-
ate............................................................ 232
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules
of the Senate.................................................. 232
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 233
Budgetary Impact of Bill......................................... 236
Comparative Statement of New Budget Authority.................... 237
SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS
For fiscal year 2012, the Committee recommends total budget
authority of $742,432,508,000 for the Departments of Labor,
Health and Human Services [HHS], and Education, and Related
Agencies. Of this amount, $158,027,000,000 is current year
discretionary funding, including offsets and $893,000,000 in
cap adjustments for healthcare fraud and abuse and for program
integrity at the Social Security Administration, in accordance
with the 302(b) allocation for this bill. Not counting cap
adjustments, the 302(b) allocation provided by the Committee
for this bill is $308,000,000 below the fiscal year 2011 level.
The Committee recommendation reflects a program level of
$165,384,183,000 for fiscal year 2012. (Program level is
current year discretionary funding plus additional spending
that is offset by savings in mandatory programs and other
adjustments to discretionary funding.) Within this total, the
Committee included an additional $409,000,000 in spending
necessary to receive the two cap adjustments. When program
level is adjusted for this additional program integrity
spending, the program level is $308,000,000 below the 2011
comparable level of $165,283,184,000. This difference mirrors
the reduction in the Committee 302(b) allocation for this bill,
before cap adjustments, from the fiscal year 2011 enacted level
to fiscal year 2012.
The bill provides discretionary program level funding of
$12,687,502,000 for the Department of Labor, $70,183,059,000
for the Department of HHS, $68,425,775,000 for the Department
of Education and $14,087,847,000 for related agencies. The
comparable fiscal year 2011 levels were $12,662,505,000 for
Labor, $70,444,321,000 for HHS, $68,345,327,000 for Education
and $13,831,031,000 for related agencies.
Overview
It has been said that while the Defense appropriations bill
defends America, the Labor, HHS, and Education, and Related
Agencies appropriations bill defines America.
This bill is made up of over 300 programs, spanning three
Federal departments and numerous related agencies. But the bill
is more than its component parts. Virtually every element of
this bill reflects the traditional ideal of democracy: that
every citizen deserves the right to a basic education and job
skills training; protection from illness and want; and an equal
opportunity to reach one's highest potential.
This year, the Committee has been asked to help Americans
achieve those ideals with less funding than was available the
year before. That constraint has forced the Committee to make
difficult cuts, some of which may be unpopular, or eliminate
programs altogether. In other cases, the Committee has
recommended targeted increases to address needs that are
particularly pressing in today's struggling economy.
Three themes permeate the Committee's recommendation.
First, the Committee recognizes that every taxpayer dollar
should be used wisely; efforts to root out waste are bolstered,
and duplicative and inefficient programs are eliminated.
Second, just because times are lean doesn't mean that
innovation should cease. This bill launches or continues
several new initiatives that will leverage reform and transform
key Federal services. Finally, the Committee invests in the
future of this Nation by helping ensure that our young people
receive a strong education and are prepared to compete in a
global economy.
Each theme is described more fully below.
Fiscal Accountability
For fiscal year 2012, the Committee increases funding for
key activities aimed at reducing fraud, waste and abuse of
taxpayer dollars. These program integrity initiatives have
proven to be a wise Federal investment, resulting in billions
of dollars of savings in Federal entitlement programs.
Health Care Program Integrity.--Fraud committed against
Federal healthcare programs puts Americans at increased risk
and diverts critical resources from providing necessary health
services to some of the Nation's most vulnerable populations.
The Committee includes $581,000,000 for Health Care Fraud and
Abuse Control activities at the Centers for Medicare and
Medicaid Services. This amount is a $270,623,000 increase over
the fiscal year 2011 level of $310,377,000. The historical
return on investment for the life of 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 $896,000,000, an increase of
$139,516,000 over the fiscal year 2011 level, for the Social
Security Administration to conduct continuing disability
reviews and redeterminations of non-medical eligibility under
the Supplemental Security Income program. This investment will
save approximately $8,900,000,000 over 10 years for the Social
Security, Medicare, and Medicaid programs, almost $10 for every
$1 spent.
340B User Fee.--The Committee has included a provision,
requested by the administration, to institute a 0.1 percent
user fee on 340B discount drugs. The fee is expected to
generate $5,000,000 in fiscal year 2012, which will be used to
implement program integrity work recommended by the Government
Accountability Office and mandated by the Patient Protection
and Affordable Care Act.
Unemployment Insurance Program Integrity.--The Committee
recommendation includes $59,900,000 to conduct re-employment
and eligibility assessments and unemployment insurance [UI]
improper payment reviews. The recommendation will support the
continuation of this initiative in approximately 40 States and
will save State UI Trust funds by helping claimants exit the UI
program faster and avoid exhausting UI benefits. These
activities have a return on investment of more than $3 for
every $1 spent.
Program Eliminations.--Lean economic times require tough
choices and a critical look at all programs in the bill, even
those that have been funded for decades. The fiscal year 2011
appropriations bill eliminated 46 programs, totaling
$1,336,540,000, within the jurisdiction of this bill. In fiscal
year 2012, the Committee recommendation eliminates another 15
programs totaling $263,383,000.
Leveraging Reform
Accelerating Cures.--The Committee bill includes
$582,362,000 to create the National Center for Advancing
Translational Sciences [NCATS] within the National Institutes
of Health [NIH]. The new Center is part of a broader
restructuring at NIH that also includes the termination of the
National Center for Research Resources. The mission of NCATS is
to transform the way NIH pursues the translation of basic
science into treatments and cures. Too often, basic biomedical
research will suggest a promising path for a treatment or cure,
but funding falls short to pursue the idea to its fullest
potential. A new program within NCATS--the Cures Acceleration
Network [CAN]--will 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, for which
the Committee provides $20,000,000, 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. The other programs within NCATS
will be transferred from other Institutes and Centers.
Race to the Top.--The Committee includes $698,600,000, the
same as the fiscal year 2011 level, for the administration's
signature education reform program. Race to the Top was created
in the American Recovery and Reinvestment Act and continued in
the fiscal year 2011 appropriations bill. This competitive
program has achieved enormous success in spurring States to
change their practices for the purposes of closing the
achievement gap and making other needed improvements. Thus far,
11 States and the District of Columbia have been awarded funds
and are now implementing their Race to the Top plans. This bill
will offer additional opportunities to support reform,
including new authority to award grants directly to local
educational agencies interested in pursuing ambitious education
reform in their local communities.
The bill also continues to support the Race to the Top--
Early Learning Challenge program, which was first funded in the
fiscal year 2011 appropriations bill. More than 30 States and
the District of Columbia have signaled an interest in applying
for $500,000,000 available in that bill. There is robust
evidence that high-quality early learning programs help
children develop the cognitive, social, and emotional skills
needed to succeed in school and later in life. Yet quality
varies greatly across settings, within States, and across the
Nation. The fiscal year 2012 bill provides the Department with
authority to further support States' plans for raising the bar
for early childhood programs, particularly disadvantaged
children, and ensure that more children enter kindergarten
ready to succeed.
Investing in Innovation.--The Committee bill includes
$149,700,000, the same as the fiscal year 2011 level, to
replicate education programs that have high levels of
effectiveness as established under rigorous research and to
develop and test promising new ideas. Like Race to the Top,
Investing in Innovation was created in the Recovery Act and
continued in the fiscal year 2011 bill.
Workforce Innovation Fund.--In an increasingly competitive
economy, America's strength depends on the education and skills
of our workforce. To that end, the Committee includes
$100,000,000 to continue the Workforce Innovation Fund, which
will help reform the Nation's workforce investment system and
improve the delivery of training programs to workers. Created
in the fiscal year 2011 appropriations bill, WIF will support
innovative, systemic and evidence-based reforms and help
determine which strategies are cost-effective and have the
greatest impact.
Community Transformation Grants.--The Committee recommends
dedicating $280,000,000 of the Prevention and Public Health
Fund, an increase of $135,000,000 over the fiscal year 2011
level, for implementing evidence-based public health
interventions to reduce obesity and smoking and make preventive
services more accessible. The Committee believes this program
offers enormous potential to turn the environment in which
Americans work, live and raise their families into one that
offers a much greater array of healthy choices.
Promoting School Readiness for Minors in SSI.--The
Committee includes $4,000,000 and the authority to allocate
unspent vocational rehabilitation State grant funds within the
Department of Education and $10,000,000 at the Social Security
Administration [SSA] for a new Promoting School Readiness for
Minors in SSI [PROMISE] program. PROMISE will bring together
these agencies with the Departments of HHS and Labor in
unprecedented interagency effort to improve outcomes for
children, and the families of children, receiving Supplemental
Security Income benefits. Almost 60 percent of child SSI
recipients who turn 18, and become ineligible for child
benefits, immediately continue receiving benefits as an adult.
Those who do enter the workforce have average earnings that are
only one-third the level as their peers. This program will
improve services for these transition-aged youth by encouraging
State-level innovation and facilitating better coordination
between existing programs serving disabled youth. To the extent
that this initiative can help young people with disabilities
eventually support themselves, it will also reduce SSI program
costs.
Social Innovation Fund.--The Committee recommendation
provides $49,900,000, the same as the fiscal year 2011 level,
for the Social Innovation Fund at the Corporation for National
and Community Service. 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.
Investing in the Future
Pell Grants.--One of the Committee's highest priorities in
the bill is maintaining the maximum Pell Grant award. Now more
than ever, students need affordable, quality education
opportunities to help make our economy strong and competitive.
Pell Grants, the foundation of Federal postsecondary student
aid, are essential to helping students enter college and gain
the education and skills needed for jobs in the 21st century
economy.
The Committee bill maintains the discretionary portion of
the maximum Pell Grant award level at $4,860 for the 2012-2013
school year. Combined with mandatory funding, the total maximum
award is maintained at $5,550. The Pell Grant program supports
an estimated 9.4 million low- and middle-income students.
Head Start.--Quality early childhood education has been
proven to have lasting effects for low-income children and
their families. Investments in early childhood education not
only improve outcomes for low-income children and families, but
save taxpayer dollars in the long-run through lower Federal and
State welfare, special education, and criminal justice costs.
The Committee recommendation includes a $340,000,000 increase
for Head Start, maintaining the recent expansion of 61,000 Head
Start slots funded with Recovery Act funding in fiscal years
2009 and 2010. In total, Head Start will provide comprehensive
early childhood services to 968,000 low-income children and
families.
Striving Readers.--The Committee includes $183,000,000 for
this comprehensive, competitive literacy program. Funds will be
used by States to implement their statewide literacy plans,
which address activities from birth through 12th grade and will
support programs that advance literacy skills through
professional development, screening and assessment, targeted
interventions for students reading below grade level and other
research-based methods of improving classroom instruction and
practice.
Promise Neighborhoods.--The Committee recommends
$60,000,000--a doubling of the fiscal year 2011 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. Funds provided in this bill will allow a third
group of communities to develop their Promise Neighborhood
plans and enable communities that are farther along to
implement their plans. Hundreds of communities from across the
country have applied for Promise planning grants--evidence of
the great interest in comprehensive solutions for our Nation's
most challenged communities.
Other Highlights of the Bill
Mine Safety Appeals.--The number of violations appealed
annually to the Federal Mine Safety and Health Review
Commission has quadrupled since 2006. Because staffing at the
Commission has not kept pace with this increase, the number of
pending cases has skyrocketed and it now takes over 500 days to
issue a final decision. These delays undermine mine safety and
ultimately put miners at risk. The Committee recommendation
includes a combined $26,656,000 increase at the Commission and
the Department of Labor, building off of supplemental funding
provided in fiscal year 2010, to continue efforts to reduce the
backlog of cases, decrease case processing time, and improve
the safety of American miners.
Centers for Medicare and Medicaid Services [CMS].--The
Committee recommends $4,044,876,000 for operations of CMS. The
fiscal year 2011 level was $3,586,855,000. Additional funding
is needed to continue implementation of the Patient Protection
and Affordable Care Act and to accommodate an increase in the
Medicare population, as 2011-2012 are the first years that the
baby boom generation will begin enrolling in this program.
National Institutes of Health [NIH].--The bill provides
$30,498,289,000, a decrease of $190,000,000, to fund biomedical
research at the 27 institutes and centers that comprise the
NIH.
Community Health Centers [CHCs].--The Committee bill
includes $1,580,749,000 for CHCs. Combined with mandatory
funding provided in the health reform law, the fiscal year 2012
program level for CHCs is $2,780,749,000--an increase of
$200,000,000. This level will allow for base grant adjustments
for all existing CHCs and the expansion of the national network
of clinics.
Low Income Home Energy Assistance.--The Committee
recommendation includes $3,600,580,000 for the Low Income Home
Energy Assistance Program. The fiscal year 2011 level was
$4,700,580,000. The recommended level, while a significant cut,
is $1,031,029,000 more than the administration's budget request
and $1,030,252,000 more than the comparable fiscal year 2008
funding level.
Child Care and Development Block Grant.--The Committee
recommendation includes $2,222,627,000 for the Child Care and
Development Block Grant, including $283,592,000 specified for
child care quality improvement activities. This recommendation
maintains funding at the fiscal year 2011 level and, including
mandatory funding, will allow States to provide child care
subsidies to an estimated 1.6 million low-income children and
their working families.
Senior Nutrition.--The Committee recommendation includes
$817,835,000 for senior nutrition programs, including
congregate meals, home-delivered meals and the nutrition
services incentive program. These programs provide seniors with
the meals they need to stay healthy and remain independent in
their community. The Committee recommendation maintains funding
at the fiscal year 2011 level.
Homelessness.--The Committee recommendation includes
$14,576,000 for a new initiative targeting mental health and
substance abuse treatment services to homeless and at-risk
families. This initiative, in collaboration with the Department
of Housing and Urban Development, aims to provide permanent
supportive housing to those who experience chronic, long-term
homelessness.
Community Services Block Grant [CSBG].--The Committee
recommendation includes $678,640,000, the same as the fiscal
year 2011 funding level, for CSBG. This block grant provides
critical funding for community action agencies across the
country to help ensure a safety net at the local level for the
most vulnerable Americans.
AIDS Drug Assistance Program [ADAP].--The Committee
recommends $900,000,000 for ADAP, an increase of $15,000,000
over the fiscal year 2011 level.
Polio Eradication.--The Committee bill provides
$111,597,000, an increase of $10,000,000 over the fiscal year
2011 level, for CDC efforts to eradicate polio.
Education for Individuals With Disabilities.--The Committee
bill provides $11,482,200,000, the same amount as the fiscal
year 2011 level, under section 611 of part B grants to States
for educating students with disabilities.
Title I (Education for the Disadvantaged).--The Committee
bill includes $14,463,417,000, the same amount as the fiscal
year 2011 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--an important contribution given the
reductions to education spending by State and local
governments.
Corporation for Public Broadcasting.--The Committee
recommendation includes $445,000,000 in fiscal year 2014
advanced funding for the Corporation for Public Broadcasting,
the same as the advance provided last year for fiscal year
2013. The Committee maintains 2-year advance funding, which has
been in place since 1975 to ensure the independence of public
broadcasting programming. The Committee recommendation also
includes $5,988,000 in fiscal year 2012 funding for digital
broadcasting equipment and programming related to the
transition from analog to digital broadcasting.
Social Security Administration [SSA].--The Committee
recommendation includes $11,631,948,000, an increase of
$208,342,000 over the fiscal year 2011 level, for the SSA's
administrative expenses. This increase includes $139,516,000
for program integrity activities and $68,826,000 in base
administrative expenses. As SSA faces sustained record levels
of core workloads, the increase for base administrative
expenses will allow SSA to provide targeted increases to parts
of the agency facing the highest demand for services while
maintaining the goal of eliminating the disability hearings
backlog by the end of 2013.
Corporation for National and Community Service.--The
Committee recommendation includes $1,092,578,000 for the
Corporation for National and Community Service, an increase of
$17,000,000. The additional funds are necessary to offer over
82,000 Americans the opportunity to join AmeriCorps. AmeriCorps
places members in settings where they can provide a service to
the community while they gain valuable experience. Other
programs of the Corporation engage seniors in part-time
volunteerism, work with nonprofit organizations to improve
their management, and link volunteers to programs of need.
Reprogramming and Transfer Authority
The Committee includes bill language delineating
permissible transfer authority in general provisions for each
of the Departments of Labor, Health and Human Services, and
Education, as well as specifying reprogramming authority in a
general provision applying to all funds provided under this
act, available for obligation from previous appropriations
acts, or derived from fees collected.
TITLE I
DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
Appropriations, 2011.................................... $3,344,497,000
Budget estimate, 2012................................... 3,626,947,000
Committee recommendation................................ 3,310,247,000
The Committee recommends $3,310,247,000 for this account,
which provides funding primarily for activities under the
Workforce Investment Act [WIA]. The fiscal year 2011 comparable
amount is $3,344,497,000 and the budget request provides
$3,626,947,000 for this purpose.
The training and employment services 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 2012 will support the
program from July 1, 2012, through June 30, 2013. A portion of
this account's funding, $1,772,000,000, is available on October
1, 2012, for the 2012 program year.
Pending reauthorization of WIA, the Committee is acting on
the basis of current law.
The Committee recommendation includes bill language
requiring that the Department take no action to amend, through
regulatory or other administrative action, the definition
established in 20 CFR 677.220 for functions and activities
under title I of WIA until such time as legislation
reauthorizing the act is enacted.
Grants to States
The Committee recommends $2,660,268,000 for Training and
Employment Services Grants to States. The fiscal year 2011
level for these grants is $2,785,018,000 and includes funding
for the Workforce Innovation Fund [WIF]. The budget request is
$2,959,043,000. Funding for WIF in fiscal year 2012 is provided
under federally administered programs.
The bill includes legislative 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. This language was
proposed in the budget request. In addition, the bill includes
language that allows a local board to award a contract to an
institution of higher education or other eligible training
provider if the local board determines that it would facilitate
the training of multiple individuals in high-demand
occupations, if such contract does not limit customer choice.
This language was also included in the budget request.
Adult Employment and Training.--For Adult Employment and
Training activities, the Committee recommends $770,922,000.
This is the same amount provided in fiscal year 2011. The
budget request provides $860,527,000 for this purpose and
includes an 8 percent set-aside, $68,842,000, for WIF.
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. Most customers receiving a training service
will use their individual training accounts to determine which
programs and providers fit their needs.
The Committee commends the Employment and Training
Administration for its collaborative work with the Institute
for Museum and Library Services [IMLS] to integrate the
education, employment and training services provided by and/or
supported through public libraries into the workforce
investment system. According to a survey conducted by IMLS and
the Gates Foundation, 30 million people used public library
computers to help address their career and employment needs and
an estimated 3.7 million Americans found work with the support
of their public libraries in 2009. The Committee encourages the
Department to continue to invest in building and strengthening
partnerships between the one-stop system and public libraries.
The Committee is greatly concerned about the low level of
literacy and numeracy skills among adult workers, as 1 in 7
adults do not have basic literacy skills to succeed in
tomorrow's industries and jobs. The Committee encourages the
Department to work with the Department of Education to examine
and publish best practices from local organizations that
integrate adult literacy and workforce development skills to
help adults with the lowest literacy levels improve their
overall skills and employment opportunities.
Funds made available in this bill support program year 2012
activities that occur from July 1, 2012, through June 30, 2013.
The bill provides that $58,922,000 is available for obligation
on July 1, 2012, and that $712,000,000 is available on October
1, 2012. Both categories of funding are available for
obligation through June 30, 2013.
Youth Training.--For youth training programs, the Committee
recommends $825,914,000, the same as the fiscal year 2011
comparable amount. The budget request provides $923,913,000 for
this purpose and includes an 8 percent set-aside, $73,913,000,
for WIF.
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 2012
activities, which occur from April 1, 2012, through June 30,
2013.
Dislocated Worker Assistance.--For Dislocated Worker
Assistance, the Committee recommends $1,063,432,000, the same
as the fiscal year 2011 comparable amount. The budget request
provides $1,174,603,000 for this purpose and includes an 8
percent set-aside, $93,968,000, for WIF.
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. Also, States must
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 2012
activities, which occur from July 1, 2012, through June 30,
2013. The bill provides that $203,432,000 is available for
obligation on July 1, 2012, and that $860,000,000 is available
on October 1, 2012. Both categories of funding are available
for obligation through June 30, 2013.
Federally Administered Programs
Dislocated Worker Assistance National Reserve.--The
Committee recommends $224,112,000 for the Dislocated Worker
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 2011 level. The budget request includes
$229,160,000.
Funds made available in this bill support activities in
program year 2012, which occurs from July 1, 2012, through June
30, 2013. The bill provides that $24,112,000 is available for
obligation on July 1, 2012, and that $200,000,000 is available
on October 1, 2012. Both categories of funding are available
for obligation through June 30, 2013.
The Committee bill includes language 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.
This language was included in the budget request.
Native American Programs.--The Committee recommends
$52,652,000, the same amount provided in fiscal year 2011, for
Native American programs. The budget request is $54,158,000.
This program is designed to improve the economic well-being of
Native Americans (Indians, Eskimos, Aleuts, and Native
Hawaiians) through the provision of training, work experience
and other employment-related services and opportunities that
are intended to aid the participants in securing permanent,
unsubsidized employment.
Migrant and Seasonal Farmworker Programs.--The Committee
recommends $84,451,000, the same amount as fiscal year 2011,
for migrant and seasonal farmworkers. The budget request is
$86,620,000 for this program. Authorized by WIA, this program
is designed to 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 $78,253,000 be
used for State service area grants. The Committee
recommendation also includes bill language directing that
$5,689,000 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
$509,000 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 $998,000
for program year 2012 activities as authorized under the Women
in Apprenticeship and Non-Traditional Occupations [WANTO] Act
of 1992. This amount is the same as the fiscal year 2011 level.
The budget request includes $1,000,000. 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 $79,840,000, the same
as the fiscal year 2011 level, for the YouthBuild program. The
budget request includes $115,000,000 for this purpose.
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
$100,000,000 in fiscal year 2012 funding for WIF to make
competitive awards for workforce innovation activities. The
comparable fiscal year 2011 level is $124,750,000. The budget
request includes $378,704,000 for this initiative by
designating a portion of funds from the WIA formula programs
and Department of Education Rehabilitation Services and Adult
Education States Grants accounts.
The Committee provided initial support for this initiative
in fiscal year 2011 and requests that the Department brief the
Committee not less than 30 days prior to the release of a
solicitation of grant applications for this program. The
Committee also encourages the Department to implement WIF in a
manner consistent with the bipartisan framework that the Senate
Health, Education, Labor and Pensions Committee developed for
WIA reauthorization.
The Committee continues its support for activities within
the WIF that are intended to test innovative strategies,
replicate proven practices or promote workforce system reform.
Among those activities are those that will improve services for
youth who are transitioning from school to post-school
activities, with the goal of improving employment outcomes.
Within activities for youth, the Committee is particularly
interested in addressing services to youth with disabilities.
WIF awards should 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 should be given to applicants
that demonstrate significant alignment across workforce
development 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. Awards should also prioritize
applicants that demonstrate comprehensive strategic planning
and coordination at the State, regional or local level.
In addition, the Committee believes that a component of the
WIF should include the promising results of pay-for-performance
models. These models have been particularly successful at
reaching populations with the most significant barriers to
employment. The Committee encourages the Secretary to use
innovation funds to replicate pay-for-performance models with
proven track records of helping hard-to-serve workers in
additional sites.
National Activities
Pilots, Demonstrations and Research.--The Committee
recommends $10,480,000 for pilots, demonstrations and research
authorized by section 171 of WIA. The comparable fiscal year
2011 amount is $9,980,000. The budget request includes
$6,616,000 for this purpose. These funds support grants or
contracts to conduct research, pilots or demonstrations that
foster promising practices for national policy application or
launch pilot projects on a broader scale.
The Committee recognizes the importance of building
stronger linkages between title I job training programs and
title II adult education and literacy programs in WIA in order
to create career pathways that enhance participants' long-term
economic success. The Committee urges the Department to expand
funding to programs that have successfully implemented
strategies for delivering basic literacy instruction together
with employment training so that they may document and
disseminate best practices related to this goal.
The Committee recommends $500,000 for a competitive grant
to a national intermediary to support local initiatives that
improve mobility and promote employment by improving
transportation assistance. Lack of mobility is an obstacle for
people living in small towns and farming communities as well as
low-income people living in small cities and people with
disabilities who are looking for work or seeking employment and
training assistance. The grant award should allow for the
demonstration of the effectiveness of specialized methods and
activities that address employment and training needs of
individuals by improving coordination between local government,
employment and training agencies, and transit providers;
providing technical assistance on revising routes and
schedules; and conducting demonstration programs that encourage
partnerships between community-based transportation
organizations and local job training and welfare departments.
Green Jobs Innovation Fund.--The Committee does not
recommend funding for the Green Jobs Innovation Fund, which was
eliminated in fiscal year 2011. The budget request includes
$60,000,000 for competitive grants to help workers access green
training and green career pathways.
Reintegration of Ex-offenders.--The Committee recommends
$75,390,000 for the Reintegration of Ex-offenders program. The
comparable fiscal year 2011 level is $85,390,000 and the budget
request includes $90,000,000 for this program. The
Reintegration of Ex-offenders 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,
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.
The Committee recommendation includes $20,000,000 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. The budget request also
includes this set-aside.
Evaluation.--The Committee recommends $9,581,000, the same
as the fiscal year 2011 level, to provide for new and
continuing rigorous evaluations of programs conducted under
WIA, as well as of federally funded employment-related
activities under other provisions of law. The budget requests
$11,600,000 for this purpose.
Workforce Data Quality Initiative.--The Committee
recommends $12,475,000, the same as the fiscal year 2011 level,
for the Workforce Data Quality Initiative. The budget request
includes $13,750,000. 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.
OFFICE OF JOB CORPS
Appropriations, 2011.................................... $1,706,171,000
Budget estimate, 2012................................... 1,699,747,000
Committee recommendation................................ 1,706,171,000
For Job Corps, the Committee recommends $1,706,171,000.
This is the same level provided in fiscal year 2011. The budget
request includes $1,699,747,000 for Job Corps.
The recommendation for operations of Job Corps centers is
$1,572,049,000, comprised of $981,049,000 in fiscal year 2012
funds and $591,000,000 in advance appropriations provided in
fiscal year 2011. The Committee also recommends fiscal year
2013 advance funding of $591,000,000, which will become
available on October 1, 2012. The budget request provides
$1,589,817,000, comprised of $998,817,000 in fiscal year 2012
funds and $591,000,000 in advance appropriations provided in
fiscal year 2011. The budget request also includes $591,000,000
for fiscal year 2013 advance funding.
The Committee recommendation for administration costs is
$29,132,000, the same amount as the fiscal year 2011 level. The
budget request includes $31,430,000.
The Committee also recommends a total of $104,990,000 in
construction, renovation and acquisition [CRA] funds. Of this
amount, $4,990,000 is available from July 1, 2012, to June 30,
2015. In addition, the Committee recommends $100,000,000 in
advance appropriations, which will become available on October
1, 2012, through June 30, 2015.
As requested by the administration, the Committee again
includes bill language allowing the Secretary to transfer up to
15 percent of CRA funds, if necessary, to meet the operational
needs of Job Corps centers or to achieve administrative
efficiencies.
Since fiscal year 2008, the Committee has highlighted the
fact that a number of large metropolitan areas remain
underserved by Job Corps and has called on the Department to
establish a process for opening new centers. In fiscal year
2011, as a first step in initiating a competition for a new Job
Corps center, the Department completed a study to determine
needs around the country. The Committee urges the Department to
continue to prepare for a future competition to expand Job
Corps services in large, underserved metropolitan areas.
community service employment for older americans
Appropriations, 2011.................................... $449,100,000
Budget estimate, 2012................................... 450,000,000
Committee recommendation................................ 449,100,000
The Committee recommends $449,100,000, the same as the
fiscal year 2011 level, for the Community Service Employment
for Older Americans [CSEOA] program. The budget request is
$450,000,000.
This program, authorized by title V of the Older Americans
Act [OAA], provides part-time employment in community service
activities for unemployed, low-income persons aged 55 and over.
CSEOA provides a direct, efficient and quick means to
assist economically disadvantaged older workers. Administrative
costs for the program are low and the vast majority of the
money goes directly to low-income seniors as wages and fringe
benefits.
Senior enrollees provide necessary and valuable services at
Head Start centers, schools, hospitals, libraries, elderly
nutrition sites, senior centers and elsewhere in the community.
A large proportion of senior enrollees use their work
experience and training to obtain employment in the private
sector. This not only increases our Nation's tax base but also
enables more low-income seniors to participate in the program.
The budget proposes to transfer the program to the
Administration on Aging in the Department of Health and Human
Services. The Committee does not recommend transferring the
program. As authorized under OAA, CSEOA's purpose is to foster
individual economic self-sufficiency, which the Committee views
as an employment activity. Additionally, the Senate authorizing
committee with jurisdiction over OAA is in the process of
reauthorizing this law. As a result, the Committee
recommendation follows current law.
The Committee strongly encourages grantees to develop and
implement research-based curriculum designed specifically for
older adults.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriations, 2011.................................... $721,312,000
Budget estimate, 2012................................... 1,100,100,000
Committee recommendation................................ 1,100,100,000
The Committee recommends $1,100,100,000, the same as the
budget request, in mandatory funds for Federal unemployment
benefits and allowances. The fiscal year 2011 comparable amount
is $721,312,000.
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, 2011.................................... $4,102,672,000
Budget estimate, 2012................................... 4,202,057,000
Committee recommendation................................ 4,094,672,000
The Committee recommends $4,094,672,000 for this account.
The recommendation includes $4,008,441,000 authorized to be
drawn from the Employment Security Administration account of
the unemployment trust fund and $86,231,000 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 continues language 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; at the request of one or more States, authorizes the
Secretary to reallot funds for States to carry out activities
that benefit the administration of unemployment compensation
laws of a requesting State; and permits the Secretary to use
funds to make payments on behalf of States for the use of the
National Directory of New Hires.
The Committee recommends a total of $3,242,441,000 for
unemployment insurance activities. The fiscal year 2011 level
is $3,250,441,000 and the budget requests $3,286,920,000.
For unemployment insurance [UI] State operations, the
Committee recommends $3,231,154,000. The fiscal year 2011 level
is $3,239,154,000 and the budget request is $3,275,610,000.
These funds are available for obligation by States through
December 31, 2012. However, funds used for automation
acquisitions or for competitive grants to be awarded to States
to address worker misclassification, system improvements or
improper payments are available for obligation by States
through September 30, 2014.
The recommendation includes $59,900,000, the same as the
fiscal year 2011 level, to conduct in-person re-employment and
eligibility assessments [REAs] and unemployment insurance
improper payment reviews. The budget requests $70,000,000 for
this purpose. The recommendation will support continuation of
the REA initiative. 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 the funds to be used for additional technology-based
overpayment prevention, detection and collection activities.
The administration's budget includes $24,711,000 for a new
initiative to address the issue of employee misclassification,
allowing States to compete for grants to increase their
capacity in this area and provide funds to pilot high-
performance awards to incentivize States to improve their
misclassification efforts.
The budget request also includes $10,000,000 for a new
program to provide incentives for States to improve their UI
operations, supplementing the current system of nonmonetary
awards with grants for improved performance.
The Committee recommendation for UI State operations does
not explicitly include funds for expansion of REAs or for
either of the new initiatives requested above. However, the
projected improvement in the economy and resulting declines in
State UI workload should result in sufficient funding being
available for these activities. The Committee recommends that
funds not required for workload be used to increase REA funding
and other activities to address improper payments, to fund
State requests for technology improvement funding, and to
initiate the misclassification and performance improvement
grants proposed in the budget.
The Committee recommendation provides for a contingency
reserve amount should the unemployment workload exceed an
average weekly insured claims volume of 4,832,000, as proposed
in the budget request. This contingency amount would fund the
administrative costs of the unemployment insurance workload
over the level of 4,832,000 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
$11,287,000, the same level provided in fiscal year 2011. The
budget requests $11,310,000. These funds are directed to
activities that benefit the State/Federal unemployment
insurance 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 $702,169,000, which includes $22,638,000
in general funds together with an authorization to spend
$679,531,000 from the Employment Security Administration
account of the unemployment trust fund. This amount is the same
as the fiscal year 2011 level. The budget requests $764,757,000
and includes an 8 percent set-aside, $61,181,000, for WIF.
The Committee also recommends $20,952,000, the same as the
fiscal year 2011 level, for Employment Service national
activities. The budget request includes $20,994,000 for this
purpose. 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 amount provided in fiscal year
2011. The budget requests $65,666,000. 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 $63,593,000, the same as the fiscal
year 2011 level. The budget request includes $63,720,000. The
Committee recommendation includes $11,976,000 for ETA, in
collaboration with the Office of Disability Employment Policy
[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
improve the accessibility and accountability of the public
workforce development system for individuals with disabilities.
The Committee further expects these funds to continue promising
practices implemented by disability program navigators. Such
practices include the effective deployment of staff in selected
States to improve coordination and collaboration among
employment and training and asset development programs carried
out at a State and local level, including the Ticket to Work
program; and to build effective community partnerships that
leverage public and private resources to better serve
individuals with disabilities and improve employment outcomes.
STATE PAID LEAVE FUND
Appropriations, 2011....................................................
Budget estimate, 2012................................... $23,000,000
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. The budget
request includes $23,000,000 for this purpose.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
Appropriations, 2011.................................... $290,000,000
Budget estimate, 2012...................................................
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
2012 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, 2011.................................... $147,360,000
Budget estimate, 2012................................... 159,882,000
Committee recommendation................................ 147,360,000
The Committee recommends $97,320,000 in general funds for
the Program Administration account, as well as authority to
expend $50,040,000 from the Employment Security Administration
account of the unemployment trust fund, for a total of
$147,360,000, the same as the fiscal year 2011 level. The
budget request provides $159,882,000 for this purpose.
General funds in this account pay for the Federal staff
needed to administer employment and training programs under the
Workforce Investment Act, the Older Americans Act, the Trade
Act of 1974, the Women in Apprenticeship and Non-Traditional
Occupations Act of 1992, 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, 2011.................................... $159,363,000
Budget estimate, 2012................................... 197,528,000
Committee recommendation................................ 195,528,000
The Committee recommends $195,528,000 for the Employee
Benefits Security Administration [EBSA]. The budget request for
fiscal year 2012 is $197,528,000, and the comparable fiscal
year 2011 amount is $159,363,000.
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 the
Employee Retirement Income Security Act of 1974 [ERISA] in both
civil and criminal areas. EBSA is also responsible 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.
The Committee expects this appropriation to help EBSA
better protect pension and health benefits for workers,
retirees, and their families. These funds will provide for
increased enforcement capacity, continued investments in EBSA
education and compliance assistance programs, and enhanced
research and evaluation activities. The Committee commends EBSA
for its cost-reduction efforts, including the new paperless
participant complaint system. The Committee requests that EBSA
include in its fiscal year 2013 congressional budget
justification information on additional steps it will take to
carry out its responsibilities more cost effectively.
Pension Benefit Guaranty Corporation
The Pension Benefit Guaranty Corporation's estimated
obligations for fiscal year 2012 include single-employer
benefit payments of $6,688,000,000, multi-employer financial
assistance of $123,000,000 and administrative expenses of
$476,901,000. Administrative expenses are comprised of three
activities: (1) pension insurance activities, $86,023,000; (2)
pension plan termination expenses, $243,372,000; and (3)
operational support, $147,506,000. These expenditures are
financed by permanent authority.
The Pension Benefit Guaranty Corporation [PBGC] is a wholly
owned Government corporation established by ERISA. The law
places it within the Department of Labor and makes the
Secretary of Labor the 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 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, 2013. The Committee bill
continues these provisions to ensure that 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.
The President's budget also proposes language slightly
modified from current PBGC authority that allows 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 modification would allow PBGC to obligate
funds for extraordinary multi-employer program related
expenses. The Committee bill includes the requested language.
The single-employer program protects about 33.8 million
participants in approximately 28,000 defined benefit pension
plans. The multi-employer insurance program protects about 10
million participants in more than 1,500 plans.
Wage and Hour Division
SALARIES AND EXPENSES
Appropriations, 2011.................................... $227,491,000
Budget estimate, 2012................................... 240,937,000
Committee recommendation................................ 227,491,000
The Committee recommends $227,491,000, the same amount as
the fiscal year 2011 level, for the Wage and Hour Division
[WHD]. The budget request for fiscal year 2012 is $240,937,000.
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, employment
rights under the Family and Medical Leave Act, and the Migrant
and Seasonal Agricultural Worker Protection Act are several of
the important laws WHD is charged with administering and/or
enforcing.
The Committee strongly urges 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 Fair Labor Standards Act, in order to
protect the rights of workers with disabilities.
The Committee notes that WHD is taking steps to provide
better and timelier services to the public at a lower cost. The
Committee requests that WHD include in its fiscal year 2013
congressional budget justification information on additional
steps it will take to carry out its responsibilities more cost
effectively.
Office of Labor-Management Standards
SALARIES AND EXPENSES
Appropriations, 2011.................................... $41,367,000
Budget estimate, 2012................................... 41,367,000
Committee recommendation................................ 41,367,000
The Committee recommends $41,367,000 for the Office of
Labor-Management Standards [OLMS]. This is the same amount as
the fiscal year 2012 budget request and comparable fiscal year
2011 level.
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.
The Committee notes that OLMS is taking steps to reduce
costs and focus activities on its core mission. The Committee
requests that OLMS include in its fiscal year 2013
congressional budget justification information on additional
steps it will take to carry out its responsibilities more cost
effectively.
Office of Federal Contract Compliance Programs
SALARIES AND EXPENSES
Appropriations, 2011.................................... $105,386,000
Budget estimate, 2012................................... 109,010,000
Committee recommendation................................ 105,386,000
The Committee recommends $105,386,000, the same amount as
the fiscal year 2011 level, for the Office of Federal Contract
Compliance Programs [OFCCP]. The budget request for fiscal year
2012 is $109,010,000.
OFCCP 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 last year the Department issued an
advance notice of proposed rulemaking regarding regulations
implementing section 503 of the Rehabilitation Act. The
Committee expects the Department to issue a final rule in
fiscal year 2012, and encourages the Department to make
technical assistance available to Federal contractors regarding
the rule, and to increase Federal contractor employment
opportunities for workers with disabilities.
The Committee notes that OFCCP is taking steps to reduce
costs and focus activities on its core mission. The Committee
requests that OFCCP include in its fiscal year 2013
congressional budget justification information on additional
steps it will take to carry out its responsibilities more cost
effectively.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriations, 2011.................................... $118,063,000
Budget estimate, 2012................................... 123,538,000
Committee recommendation................................ 118,063,000
The Committee recommends $118,063,000, the same amount as
the fiscal year 2011 level, for the Office of Workers'
Compensation Programs [OWCP]. The budget request for fiscal
year 2012 is $123,538,000. The bill provides authority to
expend $2,124,000 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, the Office houses the Division of Information
Technology Management and Services.
The Committee notes that OWCP is taking steps to reduce
costs, through automation efforts and increased use of
teleconferencing among other efforts. The Committee requests
that OWCP include in its fiscal year 2013 congressional budget
justification information on additional steps it will take to
carry out its responsibilities more cost effectively.
DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION
SALARIES AND EXPENSES
Appropriations, 2011.................................... $53,778,000
Budget estimate, 2012................................... 52,147,000
Committee recommendation................................ 52,147,000
The Committee recommends $52,147,000 for the Division of
Energy Employees Occupational Illness Compensation. The budget
request for fiscal year 2012 is $52,147,000, and the comparable
fiscal year 2011 amount is $53,778,000. This is a mandatory
appropriation.
The Division administers the Energy Employees Occupational
Illness Compensation Program Act [EEIOCPA], which provides
benefits to eligible employees and former employees of the
Department of Energy [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
the Office of Workers' Compensation Programs.
In 2012, the volume of incoming claims under part B of the
EEOICPA is estimated at about 8,000 claims 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 6,600 new claims will be
received during fiscal year 2012. 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 their survivors.
SPECIAL BENEFITS
Appropriations, 2011.................................... $183,000,000
Budget estimate, 2012................................... 350,000,000
Committee recommendation................................ 350,000,000
The Committee recommends $350,000,000, the same as the
budget request for fiscal year 2012, for this account. The
comparable fiscal year 2011 amount is $183,000,000. This
mandatory appropriation primarily provides benefits under the
Federal Employees' Compensation Act [FECA]. This benefit
program is administered by the Office of Workers' Compensation
Programs.
The Committee recommends continuation of appropriation
language to provide authority to require disclosure of Social
Security account numbers by individuals filing claims under the
Federal Employees' Compensation Act or the Longshore and Harbor
Workers' Compensation Act and its extensions.
The Committee recommends continuation of appropriation
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
allowing carryover of unobligated balances to be used in the
following year.
The Committee again includes appropriation language that
retains the drawdown date of August 15. The drawdown authority
enables the agency to meet any immediate shortage of funds
without requesting supplemental appropriations. The August 15
drawdown date allows flexibility for continuation of benefit
payments without interruption.
The Committee recommends continuation of appropriation
language to provide authority to deposit into the special
benefits account of the employees' compensation fund those
funds that the Postal Service, the Tennessee Valley Authority,
and other entities are required to pay to cover their fair
share of the costs of administering the claims filed by their
employees under FECA. 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, 2011.................................... $203,220,000
Budget estimate, 2012................................... 182,227,000
Committee recommendation................................ 182,227,000
The Committee recommends a mandatory appropriation of
$141,227,000 in fiscal year 2012 for special benefits for
disabled coal miners. This is in addition to the $41,000,000
appropriated last year as an advance for the first quarter of
fiscal year 2012. 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.
This account pays for the benefits and administrative costs
of part B of the Black Lung Benefits Act. The program is
administered by the Division of Coal Mine Workers'
Compensation, which is part of the Office of Workers'
Compensation Programs.
Part B benefits are based on black lung claims filed on or
before December 31, 1973. In fiscal year 2012, an estimated
21,150 beneficiaries will receive benefits. By law, increases
in black lung benefit payments are tied directly to Federal pay
increases. The year-to-year decrease in this account reflects a
declining beneficiary population.
The Committee recommends an advance appropriation of
$40,000,000 for the first quarter of fiscal year 2013. This
amount is the same as the budget request. These funds will
ensure uninterrupted benefit payments to coal miners, their
widows, and dependents.
BLACK LUNG DISABILITY TRUST FUND
Appropriations, 2011.................................... $296,960,000
Budget estimate, 2012................................... 300,495,000
Committee recommendation................................ 300,495,000
The Committee recommends $300,495,000 for this mandatory
appropriations account. This amount is the same as the budget
request. The comparable fiscal year 2011 amount is
$296,960,000.
This benefit program is administered by the Division of
Coal Mine Workers' Compensation, which is part of the Office of
Workers' Compensation Programs.
The appropriation language continues to provide indefinite
authority for the Black Lung Disability Trust Fund to provide
for benefit payments. The recommendation assumes that
$204,490,000 for benefit payments will be paid in fiscal year
2012. In addition, the appropriation bill provides for
transfers from the trust fund for administrative expenses for
the following Department of Labor 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.
It is estimated that 22,850 individuals will receive black
lung benefits financed through the end of the fiscal year 2012.
The basic financing for the trust fund comes from a coal
excise tax for underground and surface-mined coal. Additional
funds come from reimbursement from the Advances to the
Unemployment Trust Fund and Other Funds as well as payments
from mine operators for benefit payments made by the trust fund
before the mine operator is found liable. The advances to the
fund assure availability of necessary funds when liabilities
may exceed other income. The Emergency Economic Stabilization
Act of 2008 authorized the restructuring of the Black Lung
Disability debt and extended the current tax structure until
the end of 2018.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2011.................................... $558,619,000
Budget estimate, 2012................................... 583,386,000
Committee recommendation................................ 561,119,000
The Committee recommends $561,119,000 for this account. The
budget request for fiscal year 2012 is $583,386,000 and the
fiscal year 2011 level is $558,619,000. This agency is
responsible for enforcing the Occupational Safety and Health
Act of 1970 in the Nation's workplaces.
The Committee continues bill language to allow the
Occupational Safety and Health Administration [OSHA] to retain
up to $200,000 per fiscal year of training institute course
tuition fees to be used for occupational safety and health
training and education grants in the private sector.
The Committee 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 Committee 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. These provisions have been in the
bill for many years.
The Committee recommendation supports the important mission
carried out by OSHA. The Committee notes that an average of 12
workers suffered a fatal occupational injury each day during
calendar year 2010. While an improvement from recent years,
this rate is still too high. This appropriation will help OSHA
meet its goal of securing safe and healthy workplaces,
particularly for the most dangerous workplaces. The Committee
intends these funds to help rebuild OSHA's enforcement
capacity, accelerate safety and health standards development,
and maintain robust compliance assistance programs.
The Committee recommends $104,393,000 for grants to States
under section 203(g) of the Occupational Safety and Health Act.
These funds 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
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. The Committee
recommendation includes $10,729,000 for the OSHA Susan Harwood
Training Grant Program.
The Committee notes that OSHA has reduced travel costs by
using videoconferencing technology for training and other
purposes, and taken other steps to realize cost savings. The
Committee requests that OSHA include in its fiscal year 2013
congressional budget justification information on additional
steps OSHA will take to carry out its responsibilities more
cost effectively.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2011.................................... $361,844,000
Budget estimate, 2012................................... 384,277,000
Committee recommendation................................ 371,500,000
The Committee recommendation includes $371,500,000 for the
Mine Safety and Health Administration [MSHA]. The budget
request for fiscal year 2012 is $384,277,000, and the
comparable fiscal year 2011 amount is $361,844,000.
This agency insures the safety and health of the Nation's
miners by conducting inspections and special investigations of
mine operations, promulgating mandatory safety and health
standards, cooperating with the States in developing effective
State programs, and improving training in conjunction with
States and the mining industry.
The Committee 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 of Labor
to use any funds available to the Department to provide for the
costs of mine rescue and survival operations in the event of a
major disaster. In order to prepare properly for an actual
emergency, the Committee also directs MSHA to continue to
devote additional resources toward effective emergency response
and recovery training in various types of mine conditions.
Funding for Brookwood Sago grants was increased from $500,000
in fiscal year 2010 to $1,000,000 in fiscal year 2011, and a
further increase is warranted in fiscal year 2012 given the
need to provide miners and rescue teams with opportunities for
realistic mine emergency training.
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 $1,475,000 from fees collected for the
approval and certification of equipment, materials, and
explosives for use in mines, and may utilize such sums for such
activities.
In recent years, some mine operators have challenged an
increasing share of their mine safety violations. The budget
request proposes $15,000,000 to expand the Department's effort
to reduce the backlog of contested violations, and this bill
includes sufficient funds to continue this backlog reduction
plan. This effort was initiated with funding provided in the
fiscal year 2010 supplemental appropriations bill and continued
with funding in the fiscal year 2011 full-year continuing
appropriations act. The budget proposes and the Committee bill
includes legislative language to transfer a portion of these
funds to support related activities in the Office of the
Solicitor.
The Committee recommendation also includes funding to
address other important issues at MSHA, including $3,100,000 to
purchase continuous personal dust monitors and continue the
spot inspection initiative related to respirable coal dust.
These funds should help MSHA make progress on this important
issue. Funds also are provided for the expansion and renovation
of the Mount Hope laboratory, maintenance of mine emergency
operations equipment, the operation of a new coal office
district, the continued support of the Office of Accountability
and other important priorities.
The Committee notes that MSHA's budget includes a proposal
to reduce printing and mailing costs by adopting a suggestion
made by one of MSHA's employees. This suggestion was a finalist
in the administration's 2010 SAVE (Securing Americans Value and
Efficiency) award process. The Committee appreciates this
suggestion and requests that MSHA include in its fiscal year
2013 congressional budget justification information on
additional steps the MSHA proposes to carry out its
responsibilities more cost effectively.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriations, 2011.................................... $610,224,000
Budget estimate, 2012................................... 647,030,000
Committee recommendation................................ 611,224,000
The Committee recommends $611,224,000 for this account. The
budget request for fiscal year 2012 is $647,030,000 and the
fiscal year 2011 level is $610,224,000. The recommendation
includes $67,303,000 from the Employment Security
Administration account of the unemployment trust fund, and
$542,921,000 in Federal funds. Language pertaining to the
Current Employment Survey is retained from prior-year bills.
The Bureau of Labor Statistics [BLS] is the principal fact-
finding agency in the Federal Government in the broad field of
labor economics.
The Committee recommendation also includes $1,500,000 to
continue to support the Mass Layoff Statistics Program.
As requested by the administration, the Committee does not
include bill language from prior years that requires BLS to
continue the women worker series within the current employment
statistics program. The Committee understands BLS will continue
this data collection as it currently exists; therefore, this
bill language is unnecessary.
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. This gap 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 of Labor 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 (including the
CES, QCEW, LAUS, OES, and MLS programs), particularly regarding
the appropriate roles and responsibilities of BLS, ETA, the
State labor market information agencies, and the system's
relationship with the Census Bureau, the National Center for
Education Statistics, 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, 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 of Labor to use such
sums as may be necessary for this study which shall be
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 notes that BLS has reduced travel costs by
using videoconferencing technology and Web-based services for
training and other purposes, and taken other steps to realize
cost savings. The Committee requests that the BLS include in
its fiscal year 2013 congressional budget justification
information on additional steps it will take to carry out its
responsibilities more cost effectively.
Office of Disability Employment Policy
Appropriations, 2011.................................... $38,953,000
Budget estimate, 2012................................... 39,031,000
Committee recommendation................................ 38,953,000
The Committee recommends $38,953,000, the same amount as
the fiscal year 2011 level, for this account. The budget
request for fiscal year 2012 is $39,031,000. 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.
Congress created the Office of Disability Employment Policy
[ODEP] in the Department of Labor's fiscal year 2001
appropriation. 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 is properly supported in carrying out its leadership role
with respect to Government-wide policies related to the
training and employment of individuals with disabilities. The
Committee is particularly interested in ODEP providing support
and technical assistance to Federal agencies for the
implementation of Executive Order 13548 (2010) regarding
Federal hiring of persons with disabilities.
The Committee recommendation includes $11,976,000 for ODEP,
in collaboration with the Employment and Training
Administration [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 ETA, will
improve the accessibility and accountability of the public
workforce development system for individuals with disabilities.
The Committee further expects these funds to continue promising
practices implemented by disability program navigators. Such
practices include the effective deployment of staff in selected
States to improve coordination and collaboration among
employment and training and asset development programs carried
out at a State and local level, including the Ticket to Work
program; and to build effective community partnerships that
leverage public and private resources to better serve
individuals with disabilities and improve employment outcomes.
The Committee notes that ODEP has prioritized its spending,
including shifting some financing of its activities to other
Federal agencies. The Committee requests that ODEP include in
its fiscal year 2013 congressional budget justification
information on additional steps it will take to carry out its
responsibilities more cost effectively.
Departmental Management
SALARIES AND EXPENSES
Appropriations, 2011.................................... $356,861,000
Budget estimate, 2012................................... 371,554,000
Committee recommendation................................ 366,861,000
The Committee recommendation includes $366,861,000 for the
Departmental Management account. The budget request for fiscal
year 2012 is $371,554,000, and the comparable fiscal year 2011
amount is $356,861,000. An amount of $326,000 is available by
transfer from the Black Lung Disability Trust Fund.
The primary goal of the Department of Labor is to protect
and promote the interests of American workers. The departmental
management appropriation pays the salaries 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 $10,000,000 within
the legal services activity to continue support of the
Department's efforts to reduce the backlog of cases before the
Federal Mine Safety and Health Review Commission [FMSHRC]. This
effort was initiated with funding provided in the fiscal year
2010 supplemental appropriations bill and continued with
funding in the fiscal year 2011 full-year continuing
appropriations act. The Committee remains concerned that the
backlog of cases at the FMSHRC is currently higher than
historical levels. The Committee understands that this increase
has resulted largely from the fact that the rate of contested
citations has grown from 7 percent before the enactment of the
MINER Act of 2006 to more than 25 percent last year. The
Committee is continuing its efforts to address this issue by
increasing funding for the FMSHRC, as described later in the
report, to reduce the backlog by engaging additional judges and
support staff, and to continue the transition to an electronic
case management system.
The Committee intends these funds, as well as funds
provided to MSHA, to support necessary expenses of the
Department of Labor related to an increased capacity of the
Commission to process caseloads pending before it. The
Committee expects 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.
The Committee recommendation includes $92,484,000, the same
as the fiscal year 2011 level, for the Bureau of International
Labor Affairs [ILAB]. The budget request for fiscal year 2012
is $101,504,000. 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. These funds may be used to support
microfinance programs and other livelihood activities that
contribute to a more comprehensive approach to addressing the
root causes of labor exploitation, including child and forced
labor, as provided in prior appropriations bills and proposed
in the fiscal year 2012 budget.
The budget request proposes making the appropriation for
ILAB available for obligation through December 31, 2012. The
Committee bill allows $66,500,000 to be available for
obligation for an extra quarter. The Committee will continue to
monitor ILAB's use of the extended obligation authority
provided for the current fiscal year in making a final decision
about this budget proposal.
The budget request proposes $18,400,000 for program
evaluation and requests that the funds be available for
obligation through September 30, 2013. The Committee recommends
$8,500,000, the same amount as the fiscal year 2011 level, and
allows funds to be available for obligation through September
30, 2013. The budget also proposes to continue the authority of
the Secretary to transfer these funds to any other account in
the Department for evaluation purposes. The Committee bill
continues to provide this transfer authority and supports the
mission of the Office of the Chief Evaluation Officer. The
Committee bill also includes requested authority to use up to
0.5 percent of certain Department appropriations for evaluation
activities identified by the Chief Evaluation Officer. The
Committee expects to be notified of the planned uses of funds
derived from this authority.
The budget request also proposes $11,620,000 for the
Women's Bureau and requests bill language allowing the bureau
to award grants to promote the interests of women in the
workforce. The Committee bill includes $11,581,000 for the
bureau and the requested language. The Committee believes the
bureau should sharpen its mission and demonstrate effectively
the impact of its efforts on important issues such as the wage
gap, pay discrimination and family and medical leave.
The Committee notes that agencies and offices funded within
this account have taken steps to create efficiencies and
realize cost savings by better using technology and
prioritizing agency activities. The Committee requests that the
Secretary include in the fiscal year 2013 congressional budget
justification information on additional actions related to this
account that will enable funded agencies to carry out their
responsibilities more cost effectively.
VETERANS EMPLOYMENT AND TRAINING
Appropriations, 2011.................................... $255,614,000
Budget estimate, 2012................................... 261,036,000
Committee recommendation................................ 258,614,000
The Committee recommends $258,614,000 for this account,
including $47,879,000 in general revenue funding and
$210,735,000 to be expended from the Employment Security
Administration account of the unemployment trust fund. The
budget request for fiscal year 2012 is $261,036,000, and the
comparable fiscal year 2011 amount is $255,614,000.
This account includes resources for the Veterans'
Employment and Training Services [VETS] that enable it to
maximize employment opportunities for veterans and
transitioning service members, 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 expects this appropriation to help VETS
better meet the employment and training needs and employment
rights of veterans and service members. The Committee requests
that VETS include in its fiscal year 2013 congressional budget
justification information on steps it will take to carry out
its responsibilities more cost effectively.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2011.................................... $83,846,000
Budget estimate, 2012................................... 84,445,000
Committee recommendation................................ 83,846,000
The Committee recommends $83,846,000 for the Office of the
Inspector General [OIG]. The bill includes $77,937,000 in
general funds and authority to transfer $5,909,000 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. The budget
request for the OIG for fiscal year 2012 is $84,445,000 and the
comparable fiscal year 2011 amount is $83,846,000.
The OIG was created by law to protect the integrity of
departmental programs as well as the welfare of beneficiaries
served by those programs. Through a comprehensive program of
audits, investigations, inspections, and program evaluations,
the OIG attempts to reduce the incidence of fraud, waste abuse,
and mismanagement, and to promote economy, efficiency and
effectiveness.
The Committee requests that the OIG include in its fiscal
year 2013 congressional budget justification information on
steps it will take to carry out its responsibilities more cost
effectively.
INFORMATION TECHNOLOGY [IT] MODERNIZATION
Appropriations, 2011....................................................
Budget estimate, 2012................................... $25,000,000
Committee recommendation................................................
The Committee recommends no funds for the IT Modernization
account. The budget request for fiscal year 2012 is $25,000,000
for this new account. The Departmental Management account
includes $19,852,000 in fiscal year 2011 and 2012 resources for
similar purposes.
Funds requested in the budget request would be used for two
primary activities. The first is a consolidated IT
infrastructure modernization activity. Of the requested amount,
$8,000,000 would assist in using information technology
strategically to modernize the Department's infrastructure and
supporting project-oriented investments that will demonstrably
improve program performance and contribute to achieving the
Secretary's outcome goals. The remaining $17,000,000 requested
would be allocated to the Departmental Support Systems budget
activity.
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 I (sec. 101).
Provide for general transfer authority (sec. 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 (sec. 103).
Require that funds available under section 414(c) of the
American Competitiveness and Workforce Improvement Act of 1998
may only be used for training in occupations and industries for
which employers are using H-1B visas to hire foreign workers
(sec. 104).
Require the Secretary to award competitively funds
available for section 414(c) of the American Competitiveness
and Workforce Improvement Act of 1998 (sec. 105).
Prohibit the Secretary from taking any action to alter the
procedure for redesignating local areas under subtitle B of
title I of the Workforce Investment Act (sec. 106).
Provide the Employment and Training Administration 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 (sec. 107).
Allow up to 0.5 percent of discretionary appropriations
provided in this act for all DOL agencies, except the
Employment and Training Administration, 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 (sec. 108).
Prohibit funding for the enforcement of the rule entitled
``Wage Methodology for the Temporary Non-Agricultural
Employment H-2B Program'' (76 Fed. Reg. 3452 (January 19,
2011)) (sec. 109).
TITLE II
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Activities of the Health Resources and Services
Administration [HRSA] support programs to provide healthcare
services for mothers and infants; the underserved, elderly and
homeless; migrant farm workers; and disadvantaged minorities.
This agency supports cooperative programs in community health,
AIDS care, healthcare provider training, and healthcare
delivery systems and facilities.
HEALTH RESOURCES AND SERVICES
Appropriations, 2011.................................... $6,287,241,000
Budget estimate, 2012................................... 7,081,685,000
Committee recommendation................................ 6,229,517,000
The Committee provides a program level of $6,229,517,000
for Health Resources and Services. The Committee recommendation
includes $6,204,517,000 in budget authority and an additional
$25,000,000 via transfers available under section 241 of the
Public Health Service [PHS] Act. The fiscal year 2011
comparable program level was $6,287,241,000. The budget request
for fiscal year 2012 was $7,081,685,000.
In addition, the Committee recommendation includes
$25,000,000 in transfers from the Prevention and Public Health
[PPH] Fund. The fiscal year 2011 comparable transfer was
$20,000,000, as was the budget request for transfers in fiscal
year 2012.
BUREAU OF PRIMARY HEALTH CARE
Community Health Centers
The Committee provides $1,580,749,000 in this bill for the
community health centers program. Combined with the
$1,200,000,000 in mandatory funding appropriated for fiscal
year 2012 in Public Law 111-152, the recommended fiscal year
2012 program level totals $2,780,749,000.
The fiscal year 2011 comparable program level was
$2,580,749,000. The budget request for fiscal year 2012 is
$3,317,814,000.
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.
Within the amount provided, the Committee has provided up
to $100,000,000 under the Federal Tort Claims Act [FTCA] for
the Health Centers program. The Committee has included bill
language making this funding available until expended. The
Committee intends that the fund be used to pay judgments and
settlements, occasional witness fees and expenses, and the
administrative costs of the program, which include the cost of
evaluating claims, defending claims and conducting settlement
activities. 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.
Base Grants.--The Committee recognizes the importance of
maintaining a solid foundation of stable, viable existing
health centers and urges HRSA to increase base funding to
existing health centers due to increasing demands. The
Committee also urges HRSA to use additional programmatic
funding to expand access to health centers in those areas of
the country with high need and inadequate access to services to
meet such need. The Committee expects HRSA to implement any new
expansion initiative using the existing, and statutorily
required, proportionality for urban and rural communities, as
well as migrant, homeless and public housing health centers.
Health Care for the Homeless [HCH].--HCH projects funded
under section 330(h) of the PHS Act provide essential services
to people experiencing homelessness, providing the access to
comprehensive services and the continuity of care that are
critical to establishing and maintaining housing and health
stability. Permanent supportive housing is an important step in
the process to permanent housing; however, the Committee
believes that permanent supportive housing has important
differences from truly permanent housing. Therefore the
Committee believes that it is consistent with Sec. 330(h)(4)
for HCH grantees to treat residents of permanent supportive
housing or other housing programs that are targeted to homeless
populations but do not limit tenant length of stay as persons
who are homeless.
Nurse-Managed Health Clinics.--Nurse-managed health clinics
[NMHCs] strengthen nursing workforce development efforts by
acting as clinical education sites for nursing students. The
Committee strongly encourages HRSA to prioritize funding for
NMHCs within any competition for new access points in fiscal
year 2012. Expanding services this way will help expand
coverage to underserved populations, including native and rural
communities. The Committee also believes that supporting the
nurse-managed model will facilitate the implementation the
recommendations in the Institute of Medicine's report on the
future of nursing.
Technical Assistance.--The Committee believes that adequate
funding for technical assistance and networking functions for
health centers is critical to the successful operation and
expansion of the Health Centers program. Funds are available
within the amount provided to invest in the technical
assistance necessary to support existing centers and assist
communities that currently lack, but seek, a health center
presence.
Workforce.--The Committee recognizes that the National
Health Service Corps [NHSC] is an essential tool for the
recruitment and retention of primary care health professionals
in Health Professional Shortage Areas nationwide. The Committee
applauds efforts by HRSA to enhance access to the NHSC by
streamlining the application process for health professionals
and prospective sites, implementing part-time service
arrangements, enhancing customer service and accepting
applicants with consolidated or refinanced educational loans.
The Committee encourages HRSA to continue with these
improvements, as well as collaborate with the Health Centers
program in order to maximize the investment in both programs.
Native Hawaiian Health Care
The Committee again includes the legal citation in the bill
for the Native Hawaiian Health Care Program. The Committee has
included sufficient funding so that healthcare activities
funded under the Native Hawaiian Health Care Program can be
supported under the broader community health centers line. The
Committee expects that not less than last year's level be
provided for these activities in fiscal year 2012.
The Committee is concerned by a recent letter of
clarification of Medicare payment policy that blocks
implementation of a Hawaii State law allowing advanced practice
registered nurses to practice without the physical supervision
of a physician. Given the remote locations of many of the
grantees of the Native Hawaiian Health Care program and the
barrier imposed by island geography, enforcing the physical
requirement may have the unintended consequence of reducing
access to care. The Committee urges HRSA to work with the
Centers for Medicare and Medicaid Services to find a suitable
resolution that maximizes access to care in remote locations.
Free Clinics Medical Malpractice Coverage
The Committee provides $40,000 in funding for payments of
claims under the Federal Tort Claims Act to be made available
for free clinic health professionals as authorized by section
224(o) of the PHS Act. The fiscal year 2011 comparable level
and the budget request for fiscal year 2012 both included
$40,000 for this program. This appropriation continues to
extend Federal Tort Claims Act 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 $16,077,000 for the National
Hansen's Disease Program, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$16,075,000. 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 $129,000 for the repair and
maintenance of buildings at the Gillis W. Long Hansen's Disease
Center, the same as the fiscal year 2011 comparable level and
the budget request for fiscal year 2012.
Payment to Hawaii for Hansen's Disease Treatment
The Committee provides $1,964,000 for Hansen's Disease
services, the same as the fiscal year 2011 comparable level.
The budget request for fiscal year 2012 was $1,976,000.
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
National Health Service Corps
The Committee provides $24,848,000 in this bill for
National Health Service Corps [NHSC] activities. This is the
same level as was provided in the fiscal year 2011 bill.
Together with $295,000,000 appropriated for fiscal year 2012 in
the Patient Protection and Affordable Care Act, the
recommendation for the fiscal year 2012 program level is
$319,848,000. The fiscal year 2011 comparable level was
$314,848,000. The comparable budget request for fiscal year
2012 is $431,925,000.
This program provides full-cost scholarships or sizable
loan repayments to students in exchange for an agreement to
serve as a primary care provider in a federally designated
health professional shortage area. These funds should support
multi-year, rather than single-year, commitments. Salary costs
of most new assignees are paid by the employing entity. The
Committee has modified bill language to clarify that all NHSC
funding may be used to adjust prior-year awards.
Demonstrations.--An essential component of patient-
centered, team-based care is the appropriate management of
medications. This management also improves healthcare quality
and lowers costs. The Committee has included funding in the
past to conduct demonstration programs on the benefits of
including pharmacists and chiropractic care into primary care
teams through NHSC. The Committee is impressed by the results
of those demonstrations and urges the Secretary to offer
pharmacists and chiropractors loan repayment through NHSC so
that eligible entities may be able to improve the quality of
care for underserved patients and populations.
HEALTH PROFESSIONS
The Committee recommendation includes $497,924,000 for HRSA
health professions programs. The fiscal year 2011 comparable
level was $514,922,000. The budget request for fiscal year 2012
was $823,529,000.
Training for Diversity
Centers of Excellence
The Committee provides $24,452,000, the same as the fiscal
year 2011 comparable level, for the Centers of Excellence
Program. The budget request for fiscal year 2012 was
$24,602,000.
This program was established to fund institutions that
train a significant portion of the Nation's minority health
professionals. Funds are used for the recruitment and retention
of students, faculty training and the development of plans to
achieve institutional improvements. The institutions that are
designated as centers of excellence are private institutions
whose mission is to train disadvantaged minority students for
service in underserved areas.
The Committee recognizes the longstanding commitment of
minority health professions schools to diversity in the health
professional workforce and the vital role the Minority Centers
of Excellence Program continues to play in assisting those
institutions fulfill their mission. The Committee encourages
HRSA to continue to support minority health professions
schools' work to diversify and improve the healthcare
workforce, focusing the Centers of Excellence Program on
institutions with a historic mission of promoting health
professions diversity.
Mid-Career Support.--The Committee is aware that
unemployment is particularly high among minority populations at
a time of acute shortages in health professionals. The
Committee urges HRSA to encourage health professions schools to
develop innovative programs for recruiting and supporting
individuals, particularly underrepresented minorities, who
decide to switch to a career in primary care or allied health
professions.
Health Careers Opportunity Program
The Committee has not included funding for the Health
Careers Opportunity Program. The fiscal year 2011 comparable
level was $21,998,000. The budget request for fiscal year 2012
was $22,133,000.
This program provides funds to medical and other health
professions schools for engagement of disadvantaged K-12
students in health professions education.
The Committee strongly supports the goal of this program,
but because of budget constraints and the prevalence of waiting
lists for health training programs nationwide, the Committee
has prioritized healthcare job training programs over
recruitment and youth engagement programs.
Faculty Loan Repayment
The Committee provides $1,258,000, the same as the fiscal
year 2011 comparable level, for the Faculty Loan Repayment
Program. The budget request for fiscal year 2012 was
$1,266,000.
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 $49,042,000, the same as the fiscal
year 2011 comparable level, for the Scholarships for
Disadvantaged Students Program. The budget request for fiscal
year 2012 proposed $52,921,000 in budget authority and another
$7,079,000 in transfers available under section 241 of the PHS
Act.
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 $39,036,000, the same as the fiscal
year 2011 comparable level, for Primary Care Training and
Enhancement programs. The budget request for fiscal year 2012
proposed $53,018,000 in budget authority and another
$86,914,000 in transfers available under section 241 of the PHS
Act for this program.
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 urges HRSA to prioritize the training of physician
assistants and has included bill language allowing HRSA to
determine the funding amount for this activity.
Quality Improvements.--The Committee continues to support
efforts to develop and implement national quality measures for
clinical practice. The Committee urges HRSA to require that
primary care physicians and dentists be educated and trained in
relevant quality measures in use for clinical practice.
Understanding Basic Science.--The Committee encourages HRSA
to give preference to applicants that seek to develop or expand
a research infrastructure, critical appraisal and evidence-
based curricula, and longitudinal research opportunities for
students.
Training in Oral Health Care
The Committee recommends $32,781,000, the same as the
fiscal year 2011 comparable level, for Training in Oral Health
Care programs. The budget request for fiscal year 2012 proposed
$35,419,000 in budget authority and another $14,509,000 in
transfers available under section 241 of the PHS Act.
These programs support a variety of training opportunities
in the field of oral health, authorized under sections 748 and
340G of the PHS Act. 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 supports opportunities for advanced training
for dentists and faculty loan repayment programs because it
recognizes that there is a shortage of pediatric and public
health dentists. Dentists who complete a general residency
receive additional training that allows them to take on complex
cases of patients with autoimmune or systemic diseases. The
Committee remains concerned about the growing aging population
and encourages HRSA to initiate training programs that target
vulnerable populations in risk-based clinical disease
management of all populations.
The Committee further encourages HRSA to create a grant
program to provide access to unpaid, volunteer dental services
for medically necessary but otherwise uncovered and
unaffordable dental treatment. Grant costs may include the
salaries and other employment costs of professionals who verify
the medical and financial needs, including the absence of other
insurance coverage, of individual patients potentially eligible
for such services.
Interdisciplinary, Community-based Linkages
Area Health Education Centers
The Committee provides $33,142,000, the same as the fiscal
year 2011 comparable level, for the Area Health Education
Centers [AHEC] program. The budget request for fiscal year 2012
was $33,345,000, including $1,488,000 in transfers available
under section 241 of the PHS Act.
This program links university health science centers with
community health service delivery systems to provide training
sites for students, faculty and practitioners. The program
supports three types of projects: core grants to plan and
implement programs; special initiative funding for schools that
have previously received AHEC grants; and model programs to
extend AHEC programs with 50 percent Federal funding.
Allied Health and Other Disciplines
The Committee provides $1,933,000, the same as the fiscal
year 2011 comparable level, for the Allied Health and Other
Disciplines programs. The budget for fiscal year 2012 did not
request funds for this program.
Career Pathways and Articulation Agreements.--The Committee
is concerned that many graduates of certificate and 2-year
degree programs are often unable to pursue more advanced
degrees in one of the health professions. The Committee urges
HRSA to support programs that encourage graduates of
certificate and 2-year community college programs to enroll in
baccalaureate degree-granting programs and health professions
schools and to encourage articulation agreements between
community colleges and baccalaureate-degree granting programs
and health professions schools that allow for transfer of
credits earned in the certificate and associate degree
programs.
Vacancy Rates.--The Committee remains concerned that many
allied health professions continue to experience high vacancy
rates and encourages HRSA to give priority consideration to
schools that are educating and training people in these
professions.
Mental and Behavioral Health
The Committee provides $2,927,000, the same as the fiscal
year 2011 comparable level, for Mental and Behavioral Health
programs. The budget request for fiscal year 2012 was
$17,945,000.
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 Program.--The Committee is
concerned that the Nation's mental health infrastructure will
experience increased strain for years to come as individuals
and their families increasingly turn to behavioral healthcare
professionals in local communities. The Nation's population is
rapidly aging and significant numbers of veterans are returning
from war. Ramifications of current economic conditions also are
significantly increasing the numbers of people seeking mental
health services as they struggle with unemployment, job and
income loss, and the many associated problems that result. The
Committee supports efforts by HRSA that would expand training
sites, reinstate the geropsychology component, initiate a new
focus on veterans and help integrate health service psychology
trainees at federally Qualified Health Centers to provide
behavioral and mental health services to underserved
populations.
Geriatric Education
The Committee provides $33,542,000 for Geriatric Education
programs, the same as the fiscal year 2011 comparable level.
The budget request for fiscal year 2012 was $36,907,000 in
budget authority and $6,840,000 in transfers available under
section 241 of the PHS Act.
Geriatric programs include: Geriatric Education Centers,
the Geriatric Academic Career awards program, and the Geriatric
Training program for Physicians, Dentists, and Behavioral and
Mental Health Professionals.
Innovation.--The Committee remains concerned that 7 out 10
deaths among older Americans each year are from chronic
diseases. The Committee urges HRSA to support projects that
propose innovative educational and practice techniques with
regard to treating at least one of the 10 most prevalent
chronic diseases (such as, heart disease, stroke, diabetes and
cancer) in order to improve the quality of care for that
condition and have an effect on primary care and the health of
the general public.
Reducing Hospital Readmission Rates.--Approximately 20
percent of hospitalized Medicare patients are readmitted within
30 days. The Committee urges HRSA to support curriculum
projects that examine innovative educational and practice
techniques with regard to preventing hospital readmissions
among older Americans.
State Health Care Workforce Development Grants
The Committee has not included funding for the State Health
Care Workforce Development Grant program, authorized in the
Patient Protection and Affordable Care Act. The fiscal year
2012 budget requests $51,000,000 for this new program.
The State Health Care Workforce Development Program is
designed to support State partnerships (generally the State
Workforce Investment Board) to conduct planning and
coordination among the variety of programs related to
healthcare workforce training.
Health Professions Workforce Information and Analysis
The Committee is recommending $2,815,000 for health
professions workforce information and analysis, the same as the
fiscal year 2011 comparable level. The budget request for
fiscal year 2012 did not request new budget authority but did
propose $20,000,000 in transfers available under section 241 of
the PHS Act. The program provides grants and contracts to
eligible entities to provide for the collection and analysis of
targeted information, research on high-priority workforce
questions, the development of analytic and research
infrastructure, and program evaluation and assessment.
The Committee commends HRSA for the information that the
National Center for Health Workforce Analysis has collected and
disseminated. The Committee encourages HRSA to make their Web
site ``one-stop shopping'' for any researcher or policy-maker
on health workforce issues. For that reason, the Committee
encourages HRSA to integrate data from the Bureau of Labor
Statistics and other Federal agencies to the greatest extent
possible.
Public Health and Preventive Medicine Training Programs
The Committee provides $34,609,000 for these programs,
including $9,609,000 in budget authority and $25,000,000 in
transfers from the PPH Fund. The fiscal year 2011 comparable
level was $9,609,000 in budget authority and $20,000,000 in
funding from the PPH Fund. The budget request for fiscal year
2012 did not include new budget authority, but proposed
$10,068,000 in transfers available under section 241 of the PHS
Act and $15,000,000 from the PPH Fund for these programs. The
Committee directs HRSA to fund preventive medicine residencies
at no less than last year's level.
This funding supports 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.
The Committee recommendation includes $5,000,000 from the
PPH Fund for an initiative on integrative medicine residency
[IMR] training. Of this amount, $2,500,000 is to be used for
grants of $100,000 to $150,000 to accredited residency programs
to incorporate competency-based integrative medicine curricula
in graduate medical education. The remaining funds are intended
to establish a national coordinating center responsible for
conducting data collection, providing technical assistance to
residency programs, and conducting an evaluation of the IMR
training program.
Nursing Workforce Development Programs
The Committee provides $242,387,000 for the Nursing
Workforce Development programs, the same as the fiscal year
2011 comparable level. The budget request for fiscal year 2012
was $224,550,000 in budget authority and $108,525,000 in
transfers available under section 241 of the PHS Act.
The Committee directs HRSA to maintain all Nursing
Workforce Development programs at no less than last year's
level.
Advanced Nursing Education Grants.--The Committee is
concerned that masters and doctoral programs lack the resources
necessary to keep pace with the demand for new nurse faculty.
Doctoral prepared nurse educators are in especially high
demand, as the majority of vacant faculty positions require
this level of education. The Committee notes that lack of
faculty is often cited as the reason why community colleges
turn away potential nursing students, despite severe shortages
at all levels of nursing. Therefore, the Committee encourages
the Division of Nursing to establish a priority for funding
full-time doctoral nursing students including Ph.D. or the
doctor of nursing practice [DNP]. The Committee further
encourages HRSA to give priority to nursing students who
indicate an interest in teaching.
Baccalaureate Nursing Degrees.--In recognition of the
Institute of Medicine [IOM] and the Robert Wood Johnson
Foundation report, ``The Future of Nursing: Leading Change,
Advancing Health,'' the Committee urges the Division of Nursing
to enhance programs that increase the number of nurses with
baccalaureate degrees. Research has shown that nurses who hold
a bachelor of nursing have better patient outcomes such as
lower mortality and failure to rescue rates. The Committee
further concurs with the IOM report recommendation that the
Division's programs need to encourage nurses with associate
degrees and diplomas to enter baccalaureate programs. For that
reason, the Committee encourages HRSA to focus grants in
nursing education to create and support career ladder programs.
Innovative Entry Points.--The Committee is encouraged by
various innovative models in K-12 education that allow students
to take college courses while in high school, some of which are
partnerships with nursing programs. The Committee urges HRSA to
partner with the Department of Education to promote innovative
programs that support K-12 students as they transition into
nursing education.
Nurse Practitioners.--In the presence of an acute shortage
of primary care providers, the need to prepare quality, cost
effective clinicians such as nurse practitioners continues to
be severe. Nurse practitioners are primary care providers who
can assist in meeting the needs of our communities and help to
increase access to primary care. The Committee urges HRSA to
support educational programs and traineeships for nurse
practitioners to help meet the growing health needs of the
Nation particularly in rural America.
Children's Hospitals Graduate Medical Education Program
The Committee provides $268,356,000 for the Children's
Hospitals Graduate Medical Education [GME] program, the same as
the fiscal year 2011 comparable level. The administration did
not request funds for this program for fiscal year 2012.
The program provides support for graduate medical education
training programs in freestanding children's teaching hospitals
and is intended to provide with them a similar level of Federal
GME support that other teaching hospitals receive through
Medicare. Prior to the enactment, the freestanding children's
hospitals, whose inpatients are predominantly under the age of
18, received only 0.05 percent of Federal GME funding.
Children's Hospitals GME [CHGME] payments are determined by
formula, based on a national per-resident amount. Payments
support training of resident physicians as defined by Medicare
in both ambulatory and inpatient settings.
The Committee 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, in addition to serving large
disproportionate underserved populations, such as those in
Medicaid and the State Children's Health Insurance Program
[SCHIP]. CHGME funding has enabled the hospitals to increase
their training by 35 percent, in response to State, local and
national needs, including the reversal of a prior decline in
pediatric specialty residencies. The program improves access to
healthcare by not only ensuring an adequate supply of pediatric
providers, but also by expanding the capacity of the healthcare
safety net as freestanding children's hospitals care for
underserved children in both inpatient and outpatient settings.
The program has also enabled the hospitals to increase the
diversity of their training experiences in underserved urban
and rural areas.
Patient Navigator
The Committee recommendation does not include funding for
the Patient Navigator Outreach and Chronic Disease Outreach
Program. The comparable funding level for fiscal year 2011 was
$4,990,000. The budget did not request funding for this program
in fiscal year 2012.
The program provides demonstration grants to public or
nonprofit health centers to help patients overcome barriers in
the healthcare system to prompt screening, referral, diagnosis,
and treatment services.
The Committee strongly supports efforts to reduce the
complexity of the current healthcare system and notes that the
expansion of decision support features in electronic health
records and current CMS demonstrations on accountable care
organizations and medical home models aim to reduce or even
eliminate the need for patient navigation models.
Teaching Health Centers Development Grants
The Committee has not provided funding for the Teaching
Health Centers [THC] Development Grant program in fiscal year
2012. The administration requested $10,000,000 for this new
program.
The Teaching Health Centers [THC] Development Grant Program
is designed to provide funding to cover the costs of curriculum
development, accreditation, faculty salaries, and the
recruitment, training and retention of residents and faculty.
Eligible entities include community-based clinics that intend
to operate a primary care residency program.
The Committee is aware of $230,000,000 available in
mandatory funds for graduate medical education payments to THCs
for the period of fiscal years 2011 through 2015. These funds
will cover the costs of new resident training in community-
based ambulatory primary care settings, such as health centers.
National Practitioner Data Bank
The Committee provides $28,016,000 for the National
Practitioner Data Bank, the same as the budget request. The
comparable level for fiscal year 2011 was $23,508,000. The
Committee and the budget request assume that full funding will
be provided entirely through the collection of user fees and
will cover the full cost of operating the data bank. 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
Maternal and Child Health Block Grant
The Committee provides $606,319,000 for the maternal and
child health [MCH] block grant. The fiscal year 2011 comparable
level was $656,319,000 and the budget request for fiscal year
2012 was $654,489,000.
The MCH block grant program provides a flexible source of
funding that allows States to target their most urgent maternal
and child health needs through the development of community-
based networks of preventive and primary care that coordinate
and integrate public and private sector resources and programs
for pregnant women, mothers, infants, children and adolescents.
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 for
children, adolescents and families through clinics, home visits
and school-based health programs.
The Committee has included bill language requiring that the
State grant portion of the block grant be funded at no less
than $535,748,000, compared to $556,333,000 in fiscal year 2011
and the budget request. This reduction will be more than offset
by an increase in mandatory appropriations for the Maternal,
Infant, and Early Childhood Home Visiting [MIECHV] program.
State agencies funded by the MCH block grant receive
additional mandatory funding from the MIECHV program. In fiscal
year 2012, mandatory appropriations for this program will rise
from $250,000,000 to $350,000,000, a majority of which will be
distributed to State agencies. The MIECHV program and the MCH
block grant serve the same population with overlapping goals.
Both programs include a formula-based distribution to States
and a demonstration authority to allow grants for special
projects of regional and national significance.
The Committee has included bill language identifying
$60,171,000 for the Title V Special Projects of Regional and
National Significance [SPRANS] set-aside. Within that total,
the Committee recommendation includes sufficient funding to
continue the set-asides for oral health, epilepsy and fetal
alcohol syndrome at no less than last year's level.
Global Health Strategies.--The Committee recognizes that
some global models of healthcare have been proven to be cost
effective and provide a high level of quality care. The
Committee urges the Department to consider projects that
demonstrate and pilot global health strategies in underserved
domestic healthcare markets. These projects should include
programs that improve overall community health and wellness;
increase access to primary health services; support innovative
payment models that offer affordable healthcare payment options
for low-income families; and improve access to immunizations.
Healthy Homes.--The Committee supports efforts by HRSA to
fund evidence-based maternal, infant and early childhood home
visiting programs that are consistent with the Patient
Protection and Affordable Care Act. The Committee is aware of
nurse home visiting programs in New York State, Rhode Island
and Oklahoma that have adopted healthy homes activities as part
of their programming. This integrative approach of identifying
and preventing environmental health and safety hazards in the
homes of high-risk pregnant mothers and their babies is a cost-
effective and efficient strategy for preventing disease and
injury among the Nation's most vulnerable families. The
Committee recommends that HRSA expand and incentivize the
implementation of these integrative programs in consultation
with the Centers for Disease Control and Prevention.
Hemophilia.--The Committee supports continued funding for
the network of hemophilia treatment centers supported by the
SPRANS program.
Mobile Health Messaging.--The Committee is concerned that
the United States now ranks 33rd among industrialized and
developed Nations in its infant mortality rate. The Committee
notes the successful use of mobile health outreach programs
that send cell phone text messages to low-income women to
provide advice to help keep the mothers and their babies
healthy. The Committee encourages HRSA to engage and support
mobile health messaging programs that target the goals of the
title V program in areas with the worst overall outcomes.
Oral Health.--The Committee has included sufficient funding
to continue early childhood oral health interventions and
prevention programs encompassing the medical/dental interface,
topical fluorides, school and community-based sealant programs,
and systems building with Head Start and the Women, Infants and
Children program.
Sickle Cell Anemia Program
The Committee provides $4,721,000 for the sickle cell
anemia demonstration program, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$4,740,000.
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 other efforts related to the
expansion and coordination of education, treatment, and
continuity of care programs for individuals with sickle cell
disease.
Traumatic Brain Injury Program
The Committee provides $9,878,000 for the Traumatic Brain
Injury program, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $9,918,000.
The program supports implementation and planning grants to
States for coordination and improvement of services to
individuals and families with traumatic brain injuries, as well
as protection and advocacy. Such services can include: pre-
hospital care, emergency department care, hospital care,
rehabilitation, transitional services, education, employment,
and long-term support. The Committee includes no less than last
year's funding level for protection and advocacy services, as
authorized under section 1305 of Public Law 106-310.
The Committee supports the efforts of HRSA to develop a
long-range plan for the Traumatic Brain Injury program. The
Committee encourages HRSA to collaborate with other Federal
agencies during this process and to solicit broad input from
consumers, States, professionals and care providers in order to
ensure that the program maximizes resources related to the
treatment and prevention of traumatic brain injury.
Autism and Other Developmental Disorders
The Committee provides $47,708,000 for the Autism and Other
Developmental Disorders initiative, the same as the fiscal year
2011 comparable level. The budget request for fiscal year 2012
was $55,000,000.
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.
Bill language is included to ensure that fiscal year 2012
grants may be awarded.
Newborn Screening for Heritable Disorders
The Committee provides $9,952,000, the same as the fiscal
year 2011 comparable level, 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 budget
request was $9,992,000.
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.
Congenital Disabilities Program
The Committee has not provided funding for the congenital
disabilities program. The budget request for fiscal year 2012
included $499,000 for these activities. The program was
discontinued in fiscal year 2011.
The purpose of the program is to provide information and
support services to families receiving a positive test
diagnosis for down syndrome, spina bifida, dwarfism, or other
prenatally and postnatally diagnosed conditions.
The Committee is pleased with the materials created in this
program and encourages HRSA to distribute them through the
Maternal Child Health Bureau's programs.
Healthy Start
The Committee provides $104,361,000 for the Healthy Start
infant mortality initiative, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$104,776,000.
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
largely 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 is aware that racial disparities in
stillbirth and sudden unexpected infant deaths [SUIDs] persist
and significantly contribute to the more than 25,000
stillbirths and over 4,000 SUIDs each year. The Committee
encourages HRSA to support training and assistance that will
enhance cooperative partnerships among local community health
professionals, public health officers, community advocates and
consumers to address racial disparities in SUIDs and
stillbirth. In addition, the Committee encourages Healthy Start
grantees to promote local efforts to review stillbirth and
SUIDs, especially in addressing racial disparities.
Universal Newborn Hearing Screening and Early Intervention
The Committee provides $18,884,000 for universal newborn
hearing screening and early intervention activities, the same
as the fiscal year 2011 comparable level. The budget request
for fiscal year 2012 was $18,960,000.
The Committee expects HRSA to coordinate its early hearing
detection and intervention activities with the National Center
on Birth Defects and Developmental Disabilities, the National
Institute on Deafness and Other Communication Disorders, the
National Institute on Disability and Rehabilitation Research
and the Office of Special Education and Rehabilitative
Services.
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 $21,369,000 for the Emergency
Medical Services for Children [EMSC] program, the same as the
fiscal year 2011 comparable level. The budget request for
fiscal year 2012 was $21,454,000. The program supports
demonstration grants for the delivery of emergency care to
acutely ill and seriously injured children.
The EMSC program makes funding available to every State EMS
office to improve emergency care for children and to pay for
critical research and dissemination of best practices. The
Committee commends the program's efforts to improve the
evidence base for pediatric emergency care in the pre-hospital
and emergency department settings and to drive the rapid
translation of new science into professional practice.
The Committee commends the program's efforts to improve the
evidence base for pediatric emergency care and urges HRSA to
continue creating innovative initiatives to improve evidence-
based pediatric emergency care and be cognizant of the
educational and training needs of those serving in rural
America.
HIV/AIDS BUREAU
ACQUIRED IMMUNE DEFICIENCY SYNDROME
RYAN WHITE AIDS PROGRAMS
The Committee provides $2,351,665,000 for Ryan White AIDS
programs. The recommendation includes $25,000,000 in transfers
available under section 241 of the Public Health Service Act.
The fiscal year 2011 comparable level was $2,336,665,000, and
the budget request for fiscal year 2012 was $2,400,587,000.
These programs provide 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 $672,529,000 for emergency
assistance grants to eligible metropolitan areas
disproportionately affected by the HIV/AIDS epidemic, the same
as the fiscal year 2011 comparable level. The budget request
for fiscal year 2012 was $679,074,000.
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.
The Committee has continued a statutory provision that
reduces the rate of cuts to metropolitan areas enacted in the
reauthorization of the Ryan White Care Act formula in 2006.
Comprehensive Care Programs
The Committee provides $1,323,141,000 for HIV healthcare
and support services. The fiscal year 2011 comparable level was
$1,308,141,000, and the budget request for fiscal year 2012 was
$1,358,791,000.
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 $900,000,000
for AIDS medications in the AIDS Drug Assistance Program
[ADAP]. The fiscal year 2011 comparable level was $885,000,000,
and the budget request for fiscal year 2012 was $940,000,000.
The Committee is very concerned by the vulnerability of
State funding for ADAP, the continuing increases in drug
prices, and ongoing high unemployment, which has caused spikes
in enrollment. Sufficient funding is included to continue the
emergency allocations from the past 2 fiscal years and extend
additional life-saving support in fiscal year 2012.
Early Intervention Services
The Committee provides $205,564,000 for early intervention
grants, the same as the fiscal year 2011 comparable level. The
budget request for fiscal year 2012 was $211,522,000.
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 $77,313,000 for grants for
coordinated services and access to research for women, infants,
children and youth, the same as the fiscal year 2011 comparable
level. The budget request for 2012 was $77,787,000.
Funds are awarded to community health centers, family
planning agencies, comprehensive hemophilia diagnostic and
treatment centers, federally qualified health centers under
section 1905(1)(2)(B) of the Social Security Act, 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 disease.
AIDS Dental Services
The Committee provides $13,511,000 for AIDS Dental
Services, the same as the fiscal year 2011 comparable level.
The budget request for fiscal year 2012 was $13,594,000.
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 disease.
AIDS Education and Training Centers
The Committee provides $34,607,000 for the AIDS Education
and Training Centers [AETCs], the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012
included $34,819,000.
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 diagnosis and treatment of HIV infection for health
professions schools and training organizations.
HEALTH CARE SYSTEMS BUREAU
Organ Donation and Transplantation
The Committee provides $24,896,000 for organ donation and
transplantation activities, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$25,991,000.
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 is aware of the large and growing national
organ transplantation waiting list, in part due to the
unavailability of organs. Healthcare professionals,
particularly physicians, nurse, and physician assistants, if
given enhanced knowledge and training, can positively impact
organ donation. Therefore, the Committee encourages HRSA to
develop curriculum and continuing education programs for
targeted health professionals.
Vascularized Composite Allografts Rulemaking Process.--The
Committee notes that more than 3 years ago, on March 3, 2008,
the Department published a Request for Information in the
Federal Register to assist the Department in determining
whether it should engage in a rulemaking with respect to the
growing field of transplantation referred to as vascularized
composite allografts [VCAs]. The Committee believes that this
rulemaking process is necessary to bring this growing category
of transplantation, which includes the transplantation of
hands, arms and faces, under the policy umbrella of the
National Organ Transplantation Act. The Committee therefore
urges the Department to proceed with rulemaking to place VCA
transplants under the policy oversight of the Organ Procurement
Transplant Network.
National Cord Blood Inventory
The Committee has provided $11,910,000 for the National
Cord Blood Inventory, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$13,883,000. 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 $23,374,000 for the C.W. Bill Young
Cell Transplantation Program, the same as the fiscal year 2011
comparable level. The budget request for fiscal year 2012 was
$26,544,000.
Office of Pharmacy Affairs
The Committee provides $4,480,000 for the Office of
Pharmacy Affairs, the same as the fiscal year 2011 comparable
level for this program. The budget request for fiscal year 2012
was $5,220,000.
The Office of Pharmacy Affairs promotes access to clinical
and cost-effective pharmacy services among safety-net clinics
and hospitals that participate in the 340B Drug Pricing
program. Section 340B of the Public Health Service Act requires
drug manufacturers to provide discounts or rebates to a
specified set of HHS-assisted programs and hospitals that meet
the criteria in the Social Security Act for serving a
disproportionate share of low-income patients. These funds are
used to help resolve deficiencies that could not be addressed
within resources available for the normal operations of the
office. Specifically, these deficiencies include noncompliance
with the 340B pricing requirements and errors and omissions in
the office's covered entity database.
The Committee strongly supports the efforts of the Office
of Pharmacy Affairs to ensure the integrity of the 340B
program. The Committee is particularly supportive of HRSA's
plan to develop a transparent system to verify the accuracy of
the 340B ceiling price. Therefore, the Committee has included
bill language, 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 the Patient Protection and Affordable Care Act. The
fee will be set at 0.1 percent for covered entities and is
expected to generate $5,000,000. The Committee expects HRSA to
report the expected and actual amounts generated by the fee in
HRSA's annual budget justification.
New Access Points.--The Committee is strongly supportive of
efforts to expand access to care, particularly for those who
are currently uninsured. Therefore, HRSA is encouraged to
review its application policy and guidance to find
opportunities to move more expeditiously in making 340B
available to new clinics and access points. For example, the
Committee is aware that HRSA requires a filed Medicare cost
report for all hospital-affiliated clinic applications, which
can take up to a year after the clinic opens. The Committee
encourages HRSA to explore other forms of documentation that
might be available more quickly upon the opening of a new
access point.
Outpatient Coverage.--The Committee is aware that treatment
guidelines over the last few decades have been moving to
provision of care from inpatient to outpatient. The Committee
encourages HRSA to review the definition of patient to ensure
that the 340B program continues to serve the population it was
intended to serve, even as that population accesses care in
different ways. In any guidance that HRSA might issue, the
Committee recommends that HRSA keep an eye trained on
preventing society's most vulnerable patients from losing
access to affordable drugs.
Supplanting.--The Committee remains strongly supportive of
the 340B program and its emphasis on helping hospitals, health
centers and other safety net providers extend care to those who
need it most. For that reason, the Committee is troubled by
reports of health care insurers and other third party payers
setting reimbursement rates that discriminate against 340B
covered entities and supplant the benefit of the 340B
discounts. The Committee urges HRSA to clarify to healthcare
insurers and other third party payers that discriminatory
reimbursement rates for 340B covered entities is inconsistent
with congressional intent.
Poison Control Centers
The Committee provides $21,866,000 for poison control
center activities, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $29,250,000.
The Poison Control Centers program currently supports a mix of
grantees. Most grantees serve entire States; a few grantees
serve multistate regions; and, in a handful of cases, more than
one grantee serves a single State.
HRSA estimates that $7 is saved in medical spending for
every dollar spent on Poison Control Centers because treatment
guidance for the majority of poison exposures (over 70 percent)
can be provided over the phone, thereby reducing emergency
department visits, ambulance use, and hospital admissions. For
that reason, the Committee is strongly supportive of ensuring
that all citizens have access to poison control hotlines.
RURAL HEALTH PROGRAMS
Rural Healthcare Services Outreach Grants
The Committee provides $55,658,000 for rural health
outreach grants, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $57,266,000.
This program supports projects that demonstrate new and
innovative models of outreach in rural areas, such as
integration and coordination of health services.
The Delta States Network Grant Program provides network and
rural health infrastructure development grants to the eight
States in the Mississippi River Delta region. The Committee
recognizes that residents in this region disproportionately
experience disease risk factors and show positive behavioral
change when community-based programs and infrastructure are in
place. The Committee believes that collaborative programs
offering health, education, coordination of health services
offer the best hope for breaking the cycle of poor health in
this region. Therefore, the Committee has included sufficient
funding to continue these activities at no less than last
year's level.
Mental Health Outreach.--The Committee urges HRSA to
support programs that demonstrate new and innovative models of
regional outreach to meet the behavioral and mental health
needs of rural America. In particular, HRSA is encouraged to
give priority to clinical training sites that encompass a
multicounty area; train students to use secure telemedicine
applications that result in timely triage, disposition and
treatment; and provide outreach to veterans, older Americans
and underserved populations with limited or no access to
behavioral health services.
Oral Health.--The Committee recognizes that access to oral
health providers can be particularly challenging in rural
areas. The Committee encourages HRSA to consider supporting
oral healthcare outreach to underserved communities by
accredited dental schools.
Rural Health Research
The Committee provides $9,885,000 for the Rural Health
Research program, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $9,929,000.
The funds provide support for the Office of Rural Health
Policy to be the focal point for the Department's efforts to
improve the delivery of health services to rural communities
and populations. Funds are used for rural health research
centers, the National Advisory Committee on Rural Health, and a
reference and information service.
Rural Hospital Flexibility Grants
The Committee provides $41,118,000 for rural hospital
flexibility grants, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $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 remains supportive of the collaboration
between the Department of Veterans Affairs and rural hospitals
to provide locally based care, and understands that one of the
largest barriers to this effort is the lack of electronic
medical records that are interoperable with the VISTA system.
For that reason, the Committee has again included bill language
identifying $1,000,000 for grants authorized under section
1820(g)(6) of the Social Security Act to provide telehealth
equipment and to develop electronic health records that are
compatible with the VISTA system. The Committee encourages HRSA
to coordinate with the Department of Veterans Affairs to ensure
that this equipment furthers the goal of treating the illnesses
and disabilities of our Nation's veterans. The Committee is
particularly concerned with ensuring that veterans receive
appropriate mental healthcare.
Rural Access to Emergency Devices
The Committee provides $2,500,000 for rural access to
emergency devices. The fiscal year 2011 comparable level was
$236,000. The budget for fiscal year 2012 did not request funds
for this program.
This appropriation funds the Rural Access to Emergency
Devices Act, authorized under section 413 of the Cardiac Arrest
Survival Act of 2000. Funding will be used to purchase
automated external defibrillators [AED], place them in public
areas where cardiac arrests are likely to occur and train lay
rescuers and first responders in their use.
Only an estimated 8 percent of victims who suffer a sudden
cardiac arrest outside of a hospital survive. Immediate
cardiopulmonary resuscitation and early intervention, using an
AED, can more than double a patient's chance of survival.
Communities with comprehensive AED programs, including training
of anticipated rescuers, have achieved survival rates of nearly
40 percent.
The Committee directs HRSA to prepare and submit within 90
days after the enactment of this act a report on the impact of
this program since its inception, similar to the one released
in 2005. The report should include the locations where AEDs
were placed, the grant dollars requested and awarded, and the
number of applications received and awards granted, lay
rescuers and first responders trained in their use, and an
estimate of the number of individuals saved under this program.
This information, comparable to that requested in its January
2011 Funding Opportunity Announcement, should be shown by State
and grantee as in the 2005 report.
State Offices of Rural Health
The Committee provides $10,055,000 for State Offices of
Rural Health, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was $10,075,000.
The State Offices of Rural Health program helps States
strengthen rural healthcare delivery systems by allowing them
to better coordinate care and improve support and outreach in
rural areas.
Black Lung Clinics
The Committee provides $7,153,000 for black lung clinics,
the same as the fiscal year 2011 comparable level. The budget
request for fiscal year 2012 was $7,185,000.
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 $1,939,000 for activities authorized
by the Radiation Exposure Compensation Act, the same as the
fiscal year 2011 comparable level. The budget request for
fiscal year 2012 was $1,948,000.
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 $13,524,000 for telehealth
activities. The fiscal year 2011 comparable level was
$11,524,000. The budget request for fiscal year 2012 was
$11,575,000. 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.
The Committee is aware of various telemonitoring
demonstration programs, including programs for non-homebound
patients with chronic heart failure. The Committee believes
that telemonitoring has the potential to reduce healthcare
costs and improve patient outcomes in rural and frontier areas.
The Committee encourages the Office for the Advancement of
Telehealth to develop best practices that can reduce healthcare
costs throughout the Federal Government. In particular, the
Committee encourages HRSA to examine how these programs can
scale across a large population, including patient
identification and enrollment, communications with treating
physicians, technology inventory management, customer support,
and program evaluation.
Family Planning
The Committee provides $299,400,000 for the title X family
planning program, the same as the fiscal year 2011 comparable
level. The budget request for fiscal year 2012 was
$327,356,000.
Title X grants support preventive and primary healthcare
services at clinics nationwide. Approximately 70 percent of
family planning clients are at or below 100 percent of the
poverty level. In 2009, title X health centers saw more
patients than at any time in the last decade. Title X of the
PHS Act, which established the national family planning
program, authorizes the provision of a broad range of effective
family planning methods and preventive health services to
individuals, regardless of age or marital status. This includes
all FDA-approved methods of contraception.
The Committee encourages HRSA to allocate resources from
the Patient Protection and Affordable Care Act to the Office of
Population Affairs to be used to provide technical assistance
to grantees to help them prepare for the implementation of the
Affordable Care Act, including the expansion of Medicaid,
technology upgrades and participating essential community
providers.
The Committee is aware of a 2009 Institute of Medicine
report which found that the title X family planning program
provides critically needed health services to individuals with
the most difficulty accessing family planning care. The
Committee supports the Office of Family Planning's efforts to
review and update the title X program guidance and
administrative directives.
Program Management
The Committee provides $161,815,000 for program management
activities for fiscal year 2012, the same as the fiscal year
2011 comparable level. The budget request for fiscal year 2012
was $170,808,000.
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM
Appropriations, 2011.................................... $2,841,000
Budget estimate, 2012...................................................
Committee recommendation................................ 2,841,000
The Committee has provided $2,841,000 to administer the
Health Education Assistance Loans program, the same as the
fiscal year 2011 comparable level. The Committee has rejected
the administration's proposal to transfer the this workload to
the Department of Education.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Appropriations, 2011.................................... $226,489,000
Budget estimate, 2012................................... 241,502,000
Committee recommendation................................ 241,489,000
The Committee provides that $241,489,000 be released from
the vaccine injury compensation trust fund in fiscal year 2012.
The budget request for fiscal year 2012 was $241,502,000. The
comparable level in fiscal year 2011 was $226,489,000. Of that
amount, $6,489,000 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 a death
benefit. The vaccine injury compensation trust fund is funded
by excise taxes on certain childhood vaccines.
Centers for Disease Control and Prevention
Appropriations, 2011.................................... $6,281,544,000
Budget estimate, 2012................................... 6,393,242,000
Committee recommendation................................ 6,218,450,000
The Committee recommendation for the Centers for Disease
Control and Prevention [CDC] is $6,218,450,000, including
$5,765,735,000 in discretionary budget authority and an
additional $367,357,000 via transfers available under section
241 of the Public Health Service [PHS] Act. The recommendation
also assumes $30,000,000 in balances from Public Law 111-32 in
accordance with the budget request, and $55,358,000 in
mandatory funds under the terms of the Energy Employees
Occupational Illness Compensation Program Act [EEOICPA].
The comparable level in fiscal year 2011 was
$6,281,544,000, including $352,357,000 in transfers available
under section 241 of the PHS Act, $224,859,000 in balances from
Public Law 111-32 and $55,358,000 in EEOICPA mandatory funds.
The budget recommendation for fiscal year 2012 was
$6,393,242,000, including $490,472,000 in transfers available
under section 241 of the PHS Act, and $30,000,000 in balances
from Public Law 111-32 and $55,358,000 in EEOICPA mandatory
funds.
In addition, the Committee has included statutory language
transferring $848,000,000 in mandatory funds to CDC from the
Prevention and Public Health [PPH] Fund. The fiscal year 2011
comparable level was $610,900,000 and the budget request for
fiscal year 2012 was $752,500,000.
All told, the Committee provides a program level of
$7,066,450,000 for CDC.
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
to insure our national security against bioterrorist threats;
assuring the Nation's preparedness for emerging infectious
diseases and potential pandemics; promoting women's health; and
providing leadership in the implementation of nationwide
prevention strategies to encourage responsible behavior and
adoption of lifestyles that are conducive to good health.
NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES
The Committee has included a program level of $798,257,000
for the activities of this Center in fiscal year 2012,
including $150,000,000 in transfers from the PPH Fund and
$12,864,000 in transfers available under section 241 of the PHS
Act.
The comparable level for fiscal year 2011 was $748,257,000,
including $156,344,000 in transfers from Public Law 111-32,
$100,000,000 in PPH Fund transfers and $12,864,000 in section
241 transfers.
The budget request for fiscal year 2012 included
$721,663,000 for this Center, including $61,599,000 in PPH Fund
transfers and $12,864,000 in section 241 transfers.
The Committee recommendation includes funding for the
following activities in the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Section 317 Immunization Program................................ 425,571 433,503 425,571
Section 317 Immunization Program (PPH Fund)..................... 100,000 61,599 150,000
Influenza Planning and Response................................. 159,681 159,672 159,681
Program Implementation and Accountability....................... 63,005 66,889 63,005
National Immunization Survey (non-add)...................... 12,864 12,864 12,864
----------------------------------------------------------------------------------------------------------------
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, $16.50 is saved. Therefore, the Committee has
included $150,000,000 from the PPH Fund to expand 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.
Immunization Infrastructure.--The Committee recognizes that
the Nation's immunization infrastructure is essential for
ensuring the continued high rates of childhood immunization
coverage and supports efforts to modernize this infrastructure
in making recommended immunizations more widely available. The
Committee supports CDC's decision to support these efforts out
of the PPH Fund rather than at the expense of funding used for
vaccine purchase. The Committee urges the Secretary to continue
this policy.
As investments are made to modernize the immunization
infrastructure, and as the Nation's health care delivery system
continues to evolve though enhanced health insurance coverage,
the Committee recommends that CDC develop strategies to (1)
modernize immunization information systems; (2) prepare public
health departments for changes in the health care delivery
system, including new billing procedures related to privately
insured patients; and (3) strengthen the evidence base to
inform immunization policy and program monitoring, including
vaccine-preventable disease surveillance, vaccine coverage
assessment, and laboratory training. The strategy should also
address how CDC will maintain and expand partnerships with the
healthcare sector to provide routine and emergency immunization
services.
The Committee recognizes that past cost savings from the
section 317 program that supported an at-risk adult hepatitis B
vaccine initiative have been expended. The Committee commends
CDC for its efforts to provide hepatitis vaccinations through
the section 317 program.
Immunization Report.--The Committee finds the annual report
on the estimated funding needs of the section 317 immunization
program to be vital information and requests that it be
submitted not later than February 1 of each year to reflect the
following fiscal year cost estimates. The report should include
an estimate of optimum State and local operations funding, as
well as CDC operations funding needed relative to current
levels to conduct and support childhood, adolescent, and adult
programs. In addition, the report should include a discussion
of specific strategies to improve the overall immunization
infrastructure and to reduce barriers and increase adult
immunization rates in the United States and how section 317
immunization program funds are currently used to reach
immunization goals. The report should further include a
discussion of the evolving role of the 317 program as expanded
coverage for vaccination becomes available from private and
public sources over the next several years.
NATIONAL CENTER FOR HIV, VIRAL HEPATITIS, STD, AND TB PREVENTION
The Committee recommends $1,115,995,000 for the activities
at this Center in fiscal year 2012 and an additional
$10,000,000 in transfers from the PPH Fund. The fiscal year
2011 level was $1,115,995,000. The fiscal year 2012 budget
request was $1,157,133,000 in discretionary appropriations and
an additional $30,400,000 in transfers from the PPH Fund. The
Committee has included funding for the following activities at
the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research....................... 800,445 827,208 800,445
HIV Prevention by Health Department......................... 336,912 343,318 336,912
HIV Surveillance............................................ 117,667 115,803 117,667
Enhanced HIV Testing Initiative............................. 65,401 66,043 65,401
Improving HIV Program Effectiveness......................... 102,406 120,602 102,406
Non-Governmental Organizations.............................. 138,059 141,442 138,059
School Health--HIV.......................................... 40,000 40,000 40,000
Viral Hepatitis................................................. 19,784 25,000 19,784
Viral Hepatitis Screening (PPH Fund)............................ .............. .............. 10,000
Sexually Transmitted Infections................................. 154,666 161,353 154,666
Tuberculosis.................................................... 141,100 143,572 141,100
----------------------------------------------------------------------------------------------------------------
Hepatitis Testing.--The Committee recognizes that early
diagnosis of hepatitis is a cost-effective way to reduce
morbidity and mortality rates and encourages CDC to implement
plans for risk-based hepatitis testing, including baby-boomers,
injection drug users, and ethnic minorities such as Native
Hawaiians, Native Alaskans, African Americans, and Asian and
Pacific Islanders.
HIV Prevention.--The Committee commends CDC for conducting
evaluations into a number of new locally developed and
investigator-developed interventions for men who have sex with
men [MSM], particularly African-American MSM, and conducting
research to adapt existing effective behavioral interventions
for additional populations such as women and other racial and
ethnic minorities. The Committee looks forward to the results
of this research and encourages CDC to develop a plan for
disseminating any new proven interventions, including technical
assistance and training opportunities for community-based
organizations.
HIV Testing.--The Committee commends CDC for recently
expanding the Heightened Awareness HIV Testing program to
include additional jurisdictions and risk groups. The Committee
requests an update on the implementation of this expansion in
the fiscal year 2013 congressional budget justification.
Tuberculosis [TB].--The Committee notes that TB, including
drug-resistant TB, remains a public health concern and that
there are significant barriers to optimal diagnosis and
treatment and national shortages of second-line TB drugs. The
committee urges the Federal Tuberculosis Task Force to work
with the Food and Drug Administration and other partners to
accelerate the introduction of new rapid diagnostic tests and
to alleviate national shortages of TB drugs.
TB in High-Risk Areas.--The Committee is aware that the TB
program distributes supplemental funding based on outbreaks.
The Committee is concerned that areas with persistently high
rates of TB and drug-resistant TB experience outbreak
conditions routinely. The Committee directs CDC to review the
epidemiology of TB in States and territories with more than
double the average rate of TB cases to determine if a visit
from CDC's TB outbreak response team or an outbreak
supplemental grant could jumpstart significant improvement in
TB prevention and control in these high-risk areas.
Viral Hepatitis.--The Division of Viral Hepatitis is the
centerpiece of the Federal response to controlling, reducing
and preventing the suffering and deaths resulting from viral
hepatitis. CDC is responsible for surveillance, research,
education, training and program development focusing on
activities related to hepatitis A virus, hepatitis B virus
[HBV], and hepatitis C virus [HCV].
CDC estimates that up to 5.3 million Americans have chronic
HBV and HCV infections and that each year up to 15,000
Americans die of HBV- and HCV-related disease. Because of the
asymptomatic nature of hepatitis B and hepatitis C,
approximately 65 percent and 75 percent, respectively, of the
infected population are unaware that they are infected with HBV
and HCV. The prevention of chronic hepatitis B and hepatitis C
serves to prevent liver cancer, because HBV and HCV are the
leading causes of this type of cancer throughout the world.
The Committee directs that $10,000,000 transferred from the
PPH Fund be prioritized to support Division efforts to expand
identification of those chronically infected persons who do not
know their status and their referral to medical care,
particularly focusing on groups disproportionately affected by
chronic hepatitis B and hepatitis C. In particular, 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 the Assistant Secretary
for Health, AHRQ and the U.S. Preventive Services Task Force to
develop a consistent national testing guideline by early 2012
to improve testing rates. As noted in the HHS action plan, the
effectiveness of risk-based approaches to testing is hindered
by the reluctance of providers and patients to discuss
behaviors not connected with the patient's chief complaint. The
Committee urges CDC to update and implement HHS recommendations
for viral hepatitis testing as a standard of care in CDC-
sponsored HIV/STD prevention programs, correctional health, and
other programs serving populations with high disease
prevalence. The Committee further encourages CDC to conduct
prevention research to identify and disseminate best practices
for screening and the prompt linkage to needed medical
management and treatment.
In addition, the Committee recognizes that the Adult Viral
Hepatitis Prevention Coordinator program is the only Federal
hepatitis prevention program operating in all States and
understands that the program does not include any dedicated
funding for direct services. The Committee encourages the
Division of Viral Hepatitis to maintain this program in all
previously funded jurisdictions to build the Federal response
for both low- and high-impacted areas.
The Committee further encourages CDC to continue to
validate interventions focused on mother-child transmission. As
the hepatitis B virus is the single greatest health disparity
impacting the Asian and Pacific Islander [API] populations in
the United States, the Committee urges a targeted and increased
effort to address this issue, including the funding of
replicable demonstration projects to help reach the API
populations.
Finally, the Committee encourages CDC to develop and
implement a standard curriculum to train the multiple
disciplines of the public health and clinical care workforce to
deliver viral hepatitis prevention, screening and referral for
care. CDC is also urged to help reduce health disparities by
implementing a national education campaign targeting at risk
communities, strengthening the capacity of community-based
organizations to provide viral hepatitis prevention services
and observing May 19 of each year as Viral Hepatitis Testing
Day to raise awareness of the importance of viral hepatitis
screening.
NATIONAL CENTER FOR EMERGING AND ZOONOTIC INFECTIOUS DISEASES
The Committee includes $252,443,000 for fiscal year 2012
for this Center, the same as the comparable fiscal year 2011
level. In addition, the Committee has included $51,750,000 in
transfers from the PPH Fund, the same level as was transferred
in fiscal year 2011.
The fiscal year 2012 budget request was $289,118,000 in
discretionary appropriations and an additional $60,000,000 in
PPH Fund transfers. This Center provides outbreak
investigation, infection control and scientific evaluations of
emerging zoonotic, vector-borne and infectious diseases, and
conducts food-borne illness surveillance and investigation.
PPH Fund transfers ensure that CDC can invest no less than
last year's funding for Epidemiology-Laboratory Capacity
grants. The Committee recommendation also includes funding for
the following activities in the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Lyme Disease.................................................... 8,773 .............. 8,773
Prion Disease................................................... 5,373 .............. 5,373
Chronic Fatigue Syndrome........................................ 4,737 .............. 4,737
----------------------------------------------------------------------------------------------------------------
Blood Safety Surveillance.--The Committee supports the
National Healthcare Safety Network [NHSN], a surveillance tool
used by hospitals and other health care facilities to better
understand and prevent healthcare-associated infections. With
the addition of a hemovigilance module in fiscal year 2010,
NHSN also became a tool to collect and analyze national data on
adverse events and medical errors occurring during blood
transfusions. The Committee encourages CDC to broaden its
outreach to increase hospital participation, undertake measures
to assure the quality of the data collected and disseminate the
data in ways that support the development of effective
interventions.
Food Safety.--The Committee directs that CDC spend no less
than last year's level on food safety activities. The Committee
strongly supports the CDC program to ensure food safety through
surveillance outbreak response. The Committee supports an
expansion of OutbreakNet to all 50 States in order to increase
capacity and speed of food-borne outbreak detection and
response. In addition, CDC is encouraged to support efforts to
build a faster and more comprehensive public health laboratory
and epidemiological surveillance and investigations.
Infection Control.--The Committee is concerned by ongoing
exposures and outbreaks caused by the reuse of syringes and
misuse of vials in healthcare facilities. These outbreaks are
entirely preventable when well-known infection control
practices are practiced. The Committee urges CDC to continue
its injection safety activities in three areas: provider
education and awareness, detection and tracking, and response.
Prion Disease.--The Committee has included sufficient
funding to continue prion disease research and surveillance.
The Committee recognizes the importance of surveillance and
safeguarding the Nation against prion diseases.
Vector-Borne Diseases.--As international travel becomes
more commonplace, new pathogens can be introduced into new
environments more quickly than ever before, as the Nation has
seen with SARS, avian influenza and dengue fever. Arboviruses
like chikungunya and others are a constant threat to travelers
and to Americans overall. The Committee urges CDC to continue
surveillance and monitoring of vector-borne diseases within the
agency's new structure.
NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
The Committee recommends $777,987,000 for chronic disease
prevention and health promotion. The comparable level for
fiscal year 2011 was $773,987,000 and the budget request for
fiscal year 2012 was $725,207,000. In addition, the Committee
recommends $487,050,000 in mandatory funding to be transferred
from the Prevention and Public Health [PPH] Fund, which
compares to $300,950,000 in fiscal year 2011 and $460,301,000
in the fiscal year 2012 budget request.
America's poor health is plaguing our country and taking a
severe toll on our economy. 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 cost the Nation
approximately $1,800,000,000 per year.
Many chronic diseases are preventable, so there is an
urgent need to reduce their prevalence, both for the sake of
the people affected by them and for the Nation's economy. CDC
administers numerous programs intended to prevent chronic
diseases, but the funding structure for these programs evolved
over the years in ways that were not well coordinated. In many
States, the missions for several of these programs overlap.
This Committee, CDC and States have all struggled with how
to better coordinate chronic disease programs. Pilot programs
have included giving States transfer authority and adding
program coordination staff at the State and regional levels.
The President's budget for fiscal year 2012 proposed
consolidating 27 programs in the National Center for Chronic
Disease Prevention and Health Promotion. The Committee,
meanwhile, has been particularly interested in streamlining
CDC's obesity-related programs. In fiscal year 2011, the
Committee proposed consolidating the Diabetes; Heart Disease
and Stroke; Arthritis; School Health; and Nutrition, Physical
Activity and Obesity programs, all of which include a goal of
reducing obesity.
The Committee does not recommend a consolidation in fiscal
year 2012, not because the need has gone away but because
budget constraints make it impossible to achieve without
cutting funding to numerous States.
States currently receive anywhere from 1 to 5 of the 5
obesity-related grants listed above. Without significant
additional resources, as the Committee had recommended
providing in fiscal year 2011, creating a national,
consolidated program might lead to increased funding for some
States but would certainly cause cuts in many others, some of
which might be national leaders in reducing obesity. The
Committee cannot support a consolidation without enough funding
to ensure that the new program would be effective, efficient
and fair.
In the meantime, there are numerous opportunities to reduce
inefficiencies through administrative means. All of the
obesity-related grants described above include reducing obesity
as a key priority. Yet the obesity-related performance measures
and goals in each of these programs vary. The Committee
strongly urges CDC to reevaluate the obesity-related grant
programs and take administrative steps to improve their
alignment.
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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco......................................................... 108,685 107,226 108,685
Tobacco (PPH Fund).............................................. 50,000 79,000 100,000
Nutrition, Physical Activity and Obesity........................ 34,189 (\1\) 34,189
School Health on Chronic Disease................................ 13,600 (\1\) 13,600
Food Allergies (non-add).................................... 488 (\1\) 488
Glaucoma........................................................ 3,337 (\1\) 3,337
Alzheimer's Disease............................................. 1,812 (\1\) 1,812
Inflammatory Bowel Disease...................................... .............. (\1\) 680
Interstitial Cystitis........................................... .............. (\1\) 654
Excessive Alcohol Use........................................... 2,454 (\1\) 2,454
Chronic Kidney Disease.......................................... 2,093 (\1\) 2,093
Prevention Research Centers..................................... 18,001 (\1\) 18,001
Prevention Research Centers (PPH Fund).......................... 10,000 .............. 10,000
Heart Disease and Stroke........................................ 55,284 (\1\) 55,284
Diabetes........................................................ 64,796 (\1\) 64,796
Cancer Prevention and Control................................... 345,332 (\1\) 345,332
Breast and Cervical Cancer.................................. 206,001 (\1\) 206,001
WISEWOMAN (non-add)..................................... 20,745 (\1\) 20,745
Breast Cancer Awareness for Young Women..................... 4,908 (\1\) 4,908
Cancer Registries........................................... 50,295 (\1\) 50,295
Colorectal Cancer........................................... 43,070 (\1\) 43,070
Comprehensive Cancer........................................ 20,313 (\1\) 20,313
Ovarian Cancer.............................................. 4,909 (\1\) 4,909
Prostate Cancer............................................. 13,188 (\1\) 13,188
Skin Cancer................................................. 2,150 (\1\) 2,150
Cancer Survivorship Resource Center......................... 498 (\1\) 498
Oral Health..................................................... 14,726 14,609 14,726
Safe Motherhood/Infant Health................................... 44,049 55,734 44,049
Breast-Feeding Promotion and Support grants (PPH Fund).......... .............. 2,500 7,050
Arthritis....................................................... 13,075 (\1\) 13,075
Epilepsy........................................................ 7,801 (\1\) 7,801
National Lupus Patient Registry................................. 1,886 (\1\) 4,462
Healthy Communities............................................. 22,197 (\1\) 22,197
Racial and Ethnic Approach to Community Health.................. 14,018 (\1\) 14,018
Racial and Ethnic Approach to Community Health (PPH Fund)....... 25,000 .............. 50,000
Community Transformation Grants (PPH Fund)...................... 145,000 221,061 280,000
Community Health Worker pilot (PPH Fund)........................ .............. .............. 20,000
Chronic Disease Innovation grants (PPH Fund).................... .............. .............. 10,000
Small Business Workplace Wellness (PPH Fund).................... 10,000 .............. 10,000
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.
Breastfeeding.--The Committee is aware of research showing
that suboptimal breastfeeding rates are a significant
contributor to our Nation's epidemic of obesity, increasing
risks of several acute and chronic diseases and conditions,
including diabetes and cardiovascular disease. The Committee
supports the Surgeon General's Call to Action to Support Breast
Feeding. The Committee has included funding through the PPH
Fund to support hospitals that promote breastfeeding and non-
governmental organizations that assist breastfeeding mothers.
The Committee urges CDC to collaborate with the Maternal and
Child Health Bureau's doula best practices initiative.
Cancer Registries.--The Committee is pleased that CDC has
provided 35 cancer registries with funding to transform
information technology that will improve electronic reporting
of pediatric cancer patient data and that six additional
registries will be supported in an effort to improve rapid
patient data ascertainment and case completeness of pediatric
cancer patients. These improvements will help create a national
pediatric cancer database for researchers to use in finding
pediatric cancer indicators, developing and applying
appropriate treatments, and tracking long-term health outcomes
of pediatric cancer patients.
Chronic Disease Innovation Grants.--Of the amounts provided
in the PPH Fund for Innovation grants, the Committee has
included $10,000,000 to expand the National Diabetes Prevention
program authorized in section 399V-3 of the PHS Act. The
Committee recognizes that approximately one-third of people
with diabetes do not know that they have it, while another 57
million have pre-diabetes and are at high risk for developing
this deadly disease. The Committee strongly supports efforts to
curb the growing cost of healthcare by targeting populations
known to be at risk of developing disease.
Chronic Obstructive Pulmonary Disease [COPD].--The
Committee recognizes that COPD is now the third-leading cause
of death in the United States. The Committee encourages CDC to
work with the National Heart, Lung, and Blood Institute to
prepare a national action plan to address COPD, including
public awareness and surveillance activities.
Chronic Kidney Disease [CKD].--The Committee notes that
nearly 26 million Americans suffer from CKD and that CKD has a
disproportionately high impact on minority communities such as
Native Hawaiians and Pacific Islanders. The Committee continues
to assign high priority to the CKD program, with particular
emphasis on early detection to improve health outcomes and
reduce the economic burden caused by dialysis and kidney
transplantation.
Community Health Worker Demonstration.--The Committee
recommendation includes $20,000,000 in mandatory funding to be
transferred from the PPH Fund for grants to hire community
health workers, a program newly authorized in section 399V of
the PHS Act. The Committee encourages CDC to prioritize
applications from areas that have high health disparities and
that propose increasing awareness of the new preventive
benefits covered in the Patient Protection and Affordable Care
Act.
Community Transformation Grants.--The Committee recommends
transferring $280,000,000 from the PPH Fund for Community
Transformation Grants, authorized in section 4201 of the
Patient Protection and Affordable Care Act. The Committee
believes this program offers enormous potential to turn the
environment in which Americans work, live and raise their
families into one that offers a much greater array of healthy
choices.
Within this total, the Committee assumes the continuation
of $145,000,000 in 5-year grants that will be awarded in
September 2011 in the fiscal year 2011 competition. This
competition emphasized State health department coordination and
required a wide range of activities related to chronic
diseases. Funds will be used for the implementation, evaluation
and dissemination of evidence-based community preventative
health activities in order to develop strategies and practices
that will enable States to control chronic disease and co-
morbidity health disparities. Grantees are charged with
reducing obesity and smoking rates by 5 percent within 5 years,
two goals that are strongly supported by the Committee.
In addition, the Committee has included statutory language
requiring that the $135,000,000 increase over the fiscal year
2011 level must be awarded through a new competition that will
differ from the first one in several ways. In particular, this
competition will allow applicants to propose catchment areas
that are smaller than the minimum of 500,000 people required in
the original competition. Grantees will have greater
flexibility regarding the scope of the evidence-based
interventions they wish to pursue; however, they must all
relate to the prevention of chronic diseases. The Committee
encourages the CDC to maintain the 5 percent reduction goal for
the chronic disease or diseases targeted by a grantee.
The Committee is eager to see public health interventions
being adopted by towns, counties, neighborhoods and
organizations for which public health is not their primary
mission. Therefore, the pool of eligible applicants for the new
competition will be focused on non-governmental organizations,
school districts, local housing authorities, Indian tribes and
local transportation authorities. As the authorization
requires, not less than 20 percent of grant funds will be
directed to rural and frontier areas, and eligible applicants
will be required to show strong collaboration with multi-sector
partners, such as business, government and non-profit
organizations in order to ensure a broad base of support for
changes to the community.
Crohn's and Colitis Area Registry.--A substantial Federal
investment has already been made in connecting patients and
providers to the Crohn's and Colitis Area Registry, which has
consistently improved insight into the etiology of inflammatory
bowel disease, the course of illness, and methods to improve
patient outcomes. The Committee restores funding for this
program, which was eliminated by the Department in its fiscal
year 2011 operating plan.
Diabetes in Native Americans/Native Hawaiians.--The high
incidence of diabetes and kidney disease among Native American,
Native Alaskan, Native Hawaiian and Filipino populations
persists. The Committee urges CDC to continue its efforts to
target this population within Community Transformation grants
and the REACH program.
Farm-to-School Programs.--The Committee is strongly
supportive of farm-to-school programs, which work to improve
school nutrition through partnerships with local farms. The
Committee urges CDC to give priority to applicants that propose
to establish this type of partnership through the Healthy
Communities and Community Transformation Grant programs.
Further, the Committee is aware that the U.S. Department of
Agriculture [USDA] will establish a mandatory funding stream
for these programs in fiscal year 2013. The Committee further
urges CDC to collaborate with USDA as the guidelines for this
new program are established.
Food Allergy.--The Committee encourages CDC to develop a
comprehensive plan to provide healthcare providers with better
information about food allergies. In addition, the Committee
encourages CDC to collaborate with other relevant agencies to
assure the broadest possible dissemination of the NIAID
Guidelines for the Diagnosis and Management of Food Allergy.
Healthy Communities.--The Committee strongly supports
Healthy Communities as an important entry point into community
chronic disease prevention. This program provides rural and
urban communities with the foundational knowledge to make
changes in environments that enhance healthy options, leading
to improved health outcomes. With these small, one-time grants,
communities have leveraged $3 for each Federal $1 and have
sustained their work with technical assistance and resources
they have secured.
Heart Disease and Stroke.--The Committee notes that heart
disease, stroke and other forms of cardiovascular disease
continue to be the leading cause of death in the United States.
The Committee remains supportive of CDC's Division for Heart
Disease and Stroke Prevention, which provides public health
leadership to improve cardiovascular health for all, as well as
reduce the burden and eliminate disparities associated with
heart disease and stroke. The Committee has included sufficient
resources for the Division to continue its national heart
disease and stroke evidence-based prevention and control
programs and activities. They include the Paul Coverdell
National Acute Stroke Registry and the ``ABCs'' initiative,
which promotes appropriate low-dose aspirin therapy, improved
high blood pressure and cholesterol control and prevention, and
smoking avoidance and cessation. Also, the Division conducts
prevention research and evaluation and works with communities,
other Federal agencies, and food manufacturers to reduce sodium
in food to help control heart disease and stroke. Further, the
Division continues to develop a comprehensive national
cardiovascular disease surveillance system to monitor and track
heart disease, stroke, and their risk factors.
Inflammatory Bowel Disease.--The Committee notes CDC's
history of supporting epidemiology research on inflammatory
bowel disease and encourages CDC to facilitate opportunities
for renewed support of current research in this area within the
Comprehensive Chronic Disease and Prevention Program. The
Committee requests a report on progress made on this issue in
the fiscal year 2013 congressional budget justification.
Interstitial Cystitis.--The Committee has included funding
to continue its interstitial cystitis education and awareness
activities and requests an update in the fiscal year 2013
congressional budget justification.
Lupus.--The Committee remains committed to the objective of
developing reliable epidemiological data on the incidence and
prevalence of all forms of lupus among various ethnic and
racial groups. The Committee has included sufficient funding to
continue to expand the CDC National Lupus Patient Registry and
address the epidemiological gaps among Hispanics/Latinos, Asian
Americans and Native Americans. In addition, a cohort of
registry patients will be established to further study long-
term outcomes, socioeconomic burdens and mortality associated
with the disease.
Office on Smoking and Health [OSH].--The Committee includes
$208,685,000 for OSH, including $100,000,000 in transfers from
the PPH Fund. The Committee is pleased that HHS has developed a
strategic action plan for ending the tobacco epidemic and that
CDC included tobacco as one of its priority ``winnable
battles.'' The Committee has long recognized that efforts to
reduce tobacco use are among the most effective and cost-
effective investments in prevention. Funding from OSH is
particularly important in fiscal year 2012 because States have
cut funding for tobacco prevention programs by 28 percent in
the last 3 years and declines in high school smoking rates have
slowed significantly in recent years, with 19.5 percent of high
school students still smoking.
Within the increase provided, the Committee intends that no
less than $15,000,000 be used to support a media campaign to
prevent and reduce tobacco use. In addition, the Committee has
long supported cessation counseling through quitlines. This
funding will grow in importance when the quitline number, 1-
800-QUIT-NOW, is included on the planned new, graphic warning
labels on cigarette packages, which are scheduled to be
implemented in September 2012.
The Committee is pleased with the work of the Environmental
Health Laboratory's effort to analyze tobacco products and
cigarette smoke, and believes this work will become more
important as the FDA continues to implement the Family Smoking
Prevention and Tobacco Control Act. The Committee expects OSH
to transfer no less than the amount it did in fiscal year 2011
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.
Finally, the Committee is deeply concerned by the
development and sale of new nicotine delivery products with
flavors or shapes that simulate candy in an effort to target
youth. Research by HHS has revealed that nearly 90 percent of
tobacco users began smoking at or before age 18. As of 2009,
there are 400,000 new underage daily smokers in this country
each year--and roughly one-third of them will eventually die
prematurely from smoking-caused disease. In addition to funds
for media campaigns that aim to prevent youth smoking, the
Committee has included bill language making $10,000,000
available over a 2-year period for incentive grants to
communities that succeed in reducing their youth nicotine
consumption rate or that implement an evidence-based policy
proven to reduce such rate.
Oral Health.--The Committee is deeply concerned by CDC's
plan to convert the Division of Oral Health to a branch. This
action appears to counter the recent IOM report ``Advancing
Oral Health in America,'' which recommended that oral health be
given a high priority within HHS. The Committee is concerned
that this reorganization has instead lowered the visibility and
priority of the Division of Oral Health. The Committee urges
CDC to reestablish the Division. Absent such a move, the
Committee directs CDC to report to the Committee by January 1,
2012, on how the oral health branch will be more effective in
improving oral health in America, what steps CDC is taking to
recruit and retain the high caliber staff that the Division
employed, and how CDC intends to ensure that oral health is
appropriately represented in leadership meetings at CDC.
The Committee recognizes that reducing disparities in oral
disease will require investments in proven prevention
strategies at the State and local levels. The Committee
strongly supports broad-based community programs that can
result in significant cost savings. The Committee
recommendation assumes that CDC will support grants to States
at no less than last year's level to strengthen oral health
infrastructure and community prevention programs. The Committee
remains concerned about the high incidence of tooth decay among
American Indian/Alaska Native [AI/AN] children and is pleased
by the work CDC has done to support effective oral health
messages in these communities. CDC is encouraged to continue
pursuing collaborative efforts with the Indian Health Service
and through the National Oral Health Surveillance System to
assess early childhood caries [ECC] epidemiology in AI/AN
children. The Committee encourages CDC to work with key
external stakeholders to identify and fill strategic
information gaps about age of onset, prevalence, severity and
microbiology to improve and accelerate existing and novel
approaches to prevent ECC.
Pre-school Programs.--The Committee strongly supports
efforts to build good nutrition and exercise habits early in
life, to more effectively combat rising rates of childhood
obesity. The Committee directs CDC to give priority within the
Community Transformation Grants to interventions aimed at pre-
school populations.
Prevention Research Centers.--The Committee recognizes the
importance of a focus on prevention in improving health,
especially in rural America where access to care may be
limited, and the significant contributions to research on
evidence-based approaches in health promotion by the Prevention
Research Centers network of community, academic and public
health partners. The Committee has included the resources
necessary to support the Prevention Research Centers program at
no less than last year's level so that this network of academic
institutions and organizations can continue to contribute
widely and effectively to prevention science.
Psoriasis.--Approximately 7.5 million Americans are
affected by psoriasis and/or psoriatic arthritis--chronic,
inflammatory, painful, and disfiguring autoimmune diseases for
which there are limited treatment options and no cure. The
Committee is aware of evidence showing significant and costly
co-morbidities associated with psoriasis, including heart
attack, diabetes, Crohn's disease, cancer, obesity and
cardiovascular disease. The Committee is pleased that CDC used
funding provided in fiscal year 2010 to establish a blueprint
for how to better understand psoriasis, examine the
relationship of psoriasis to other serious diseases, develop
public health strategies to reduce the burden of these diseases
and prevent the onset of co-morbid conditions, and gain insight
into the long-term impact of psoriasis and psoriatic arthritis.
Safe Motherhood and Infant Health.--The Committee commends
CDC for its research and evaluation efforts regarding
stillbirths, pre-term births and sudden unexpected infant
deaths [SUIDs]. CDC is urged to improve and expand national and
State data systems to track these conditions and to expand
epidemiological research that focuses especially on their
causes and prevention.
In addition to focusing on infant health, the Committee
commends CDC for collecting information on maternal mortality
through the Pregnancy Mortality Surveillance System.
The Committee encourages the Safe Motherhood and Infant
Health program to collaborate with the National Center for
Health Statistics to explore how the implementation of the
electronic death certificate might be used to expand the effort
to collect information on pregnancy-related deaths, information
about women's health and behaviors around pregnancy, and the
translation of findings and guidelines on preconception care
into everyday practice and healthcare policy.
Sleep Disorders.--The Committee is pleased with the
activities of the National Sleep Awareness Roundtable and
encourages CDC to continue to promote awareness of the
importance of sleep and sleep disorders.
Small Business Wellness Grants.--The Committee
recommendation transfers $10,000,000 from the PPH Fund to
continue the small business wellness grant program at no less
than last year's level. The Committee is aware of the struggle
that small businesses face meeting the rising cost of health
insurance premiums. For that reason, the Committee directs CDC
to focus this program on small businesses, as authorized in
section 10408 of the Patient Protection and Affordable Care
Act.
WISEWOMAN [Well-Integrated Screening and Evaluation for
Women Across the Nation].--The Committee includes bill language
stating that funding shall be available for making
competitively awarded grants under section 1509 of the PHS Act
to not less than 21 States, tribes or tribal organizations.
WISEWOMAN serves uninsured and under-insured low-income women
ages 40 to 64. This program helps these 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 their
identified risk factors to promote lasting, healthy behavior
modifications. From July 2008 to June 2010, WISEWOMAN reached
more than 70,000 low-income women. At their initial screening,
89 percent of these women had at least one risk factor and 28
percent had three or more risk factors for heart disease and
stroke.
NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES,
DISABILITY AND HEALTH
The Committee includes $138,072,000 for birth defects,
developmental disabilities, disability and health in fiscal
year 2012. The comparable level for fiscal year 2011 was
$136,072,000 and the fiscal year 2012 budget request was
$143,899,000.
The Committee has rejected the consolidation proposed in
the fiscal year 2012 budget for disability initiatives in the
National Center on Birth Defects and Developmental Disabilities
[NCBDDD] out of concern that the progress that has been made on
behalf of people with disabilities would be lost in the
proposed structure. Should the administration decide to put
forward a similar request in fiscal year 2013, the Committee
encourages CDC to ensure that it is accompanied by a needs
assessment that includes the categories of disabilities
currently served, validates the value of such a consolidation,
considers the input of stakeholders and establishes the basis
for any proposed efficiencies and commonalities.
Within the total provided, the following amounts are
provided for the following categories of funding:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Craniofacial Malformation....................................... 1,809 (\1\) 1,809
Fetal Death..................................................... 808 (\1\) 808
Fetal Alcohol Syndrome.......................................... 9,891 (\1\) 9,891
Folic Acid...................................................... 2,795 (\1\) 2,795
Infant Health................................................... 7,925 (\1\) 7,925
Autism.......................................................... 21,380 23,778 21,380
Limb Loss....................................................... 2,836 (\1\) 2,836
Tourette Syndrome............................................... 1,701 (\1\) 1,701
Early Hearing Detection and Intervention........................ 10,672 (\1\) 10,672
Muscular Dystrophy.............................................. 5,865 (\1\) 5,865
Paralysis Resource Center....................................... 6,739 (\1\) 6,739
Attention Deficit Hyperactivity Disorder........................ 1,718 (\1\) 1,718
Fragile X....................................................... 1,684 (\1\) 1,684
Spina Bifida.................................................... 5,812 (\1\) 5,812
Congenital Heart Failure........................................ .............. .............. 2,000
Hemophilia...................................................... 16,670 (\1\) 16,670
Thallasemia..................................................... 1,861 (\1\) 1,861
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.
Congenital Heart Disease.--Approximately 800,000 children
and 1,000,000 adults in the United States are now living with
congenital heart disease [CHD], which requires life-long
cardiac care. The Committee is concerned that there is a lack
of rigorous epidemiological and longitudinal data on
individuals of all ages with CHD and has included funding to
begin to compile this information. The Committee is
particularly interested in information on prevalence, barriers
to effective care, survival outcomes and neuro-cognitive
outcomes.
Craniofacial Malformation.--The Committee commends the work
that CDC has done on craniofacial malformation. In particular,
the Committee is pleased with the goals and scope of work
included in fiscal year 2011 grant competition and has included
funding to continue that work. In addition, the Committee is
impressed by the results of the March 2010 conference in
Atlanta and would support a follow up conference, if funds are
available.
Duchenne Muscular Dystrophy [DMD].--The Committee commends
CDC for developing the DMD Care Considerations. The Care
Considerations serve as a milestone for the DMD community, as
they provide a framework for recognizing the multisystem
primary manifestations and secondary complications of DMD and
for providing coordinated multidisciplinary care to improve the
lives of those individuals living with DMD. The Committee
encourages CDC to continue its work to enhance the Care
Considerations by convening a meeting of scientific experts to
identify what gaps still exist in the current guidelines and
additional areas where further research is critical. Following
the completion of the expert meeting, CDC is encouraged to
publish the areas of consensus from the meeting.
Fragile X-Associated Disorders [FXD].--The Committee
encourages CDC to focus its efforts on identifying ongoing
needs, effective treatments and positive outcomes for families
through epidemiological research, surveillance, screening and
the promotion of early interventions and supports for
individuals living with FXD. The Committee commends CDC for its
efforts to establish the Fragile X Clinical & Research
Consortium. The Committee encourages CDC to work with the
National Institute of Child Health and Human Development to
consolidate and coordinate Federal investments in data
collection efforts related to Fragile X. Additionally, the
Committee encourages CDC to focus on improving access to
clinical services for underserved populations and to
effectively disseminate information on promising practices
related to diagnosis and early intervention to healthcare
entities working with underserved populations.
Hemophilia.--The Committee has included sufficient funding
to maintain the Center's hemophilia programs, particularly the
surveillance, prevention and wellness activities of the
hemophilia treatment centers. The comprehensive care provided
by the network of hemophilia treatment centers has resulted in
reduced morbidity and mortality rates for individuals with
hemophilia and is a model system for caring for other high-
cost, chronic conditions.
Hereditary Angioedema [HAE].--The Committee is concerned by
the high rate of fatalities caused by undiagnosed or
misdiagnosed HAE. The Committee encourages CDC to support
efforts to increase awareness and education of HAE among
healthcare providers and the general public.
Hereditary Hemorrhagic Telangiectasia [HHT].--The Committee
encourages CDC to develop a sentinel network of surveillance
utilizing HHT Centers that are currently co-located with
Hemophilia Treatment Centers [HTCs]. The Committee hopes that
the existing infrastructure at the HTCs can be used to collect
data and conduct surveillance on HHT. The committee also
encourages CDC to increase outreach and education to the public
and health care professionals accessed by HHT patients.
Infant Health.--The Committee is concerned by the lack of
information available to pregnant women and their health care
providers about the safety of various prenatal exposures that
may be associated with birth defects or other health risks.
These exposures range from prescription medicines to daily
household products. The Committee requests a report no later
than 180 days after enactment of this act on the current state
of information and how CDC can work with States and
stakeholders to improve access to this vital information.
Intellectual Disabilities.--The Committee is aware of a
growing body of evidence concluding that children and adults
with mobility limitations and intellectual or learning
disabilities face a high risk of obesity and other harmful
health conditions. CDC is commended for its leadership in
screening, referrals, research, epidemiological, preventative
services, training, and other essential health services to the
disability community. The Committee is particularly concerned
about the lack of access to screening and preventative services
within the growing population of people with intellectual
disabilities. The Committee has included sufficient funding for
CDC to extend screening and other preventative health services
to address health disparities in this at-risk population.
Maternal Infections.--The Committee encourages CDC to
continue its activities to prevent Cytomegalovirus [CMV]
infection among women. These activities should include research
to address gaps in knowledge, and the development of tools to
prevent and reduce disease burden and disability from CMV in
infants born to mothers with CMV infection. Research directed
at congenital CMV prevention strategies will allow CDC to
better understand how to prevent CMV transmission during
pregnancy, support prenatal and newborn CMV testing and
intervention for infants born to women with CMV infection, and
work with providers on recommendations for CMV and infection
during pregnancy. The Committee encourages CDC to develop
evidence-based guidance to prevent congenital CMV and to
continue research for more effective interventions, including
longer-range options such as vaccines, aimed at preventing
congenital CMV and reducing disease burden among children born
to women with CMV infection during pregnancy.
Marfan Syndrome.--Many people affected by Marfan syndrome,
a genetic connective tissue disorder that can result in sudden
loss of life from aortic dissection, remain undiagnosed or
misdiagnosed until they experience a cardiac complication. The
Committee encourages CDC to increase awareness of this disease
among the general public and healthcare providers.
Spina Bifida.--The Committee encourages CDC to work with
the FDA to establish folic acid fortification levels of corn
products grown and consumed both domestically and
internationally to ensure that women of child-bearing age
benefit from the advantages of folic acid contained in enriched
foods. The Committee also recommends continued support of a
data collection initiative to improve the efficacy and quality
of care.
PUBLIC HEALTH SCIENTIFIC SERVICES
The Committee recommendation includes a program level of
$465,564,000 for Public Health and Scientific Services. The
budget request for fiscal year 2012 was $493,616,000. The
fiscal year 2011 comparable funding level was $467,564,000. The
Committee recommendation includes $70,000,000 in transfers from
the PPH Fund and $247,769,000 in transfers available under
section 241 of the PHS Act.
The Center for Public Health and Scientific Services
includes funding for the National Center for Health Statistics
[NCHS]; the Offices of Surveillance, Epidemiology and Public
Health Informatics; and Public Health Workforce Development.
The Committee recommendation includes funding for each of
these programs to continue at no less than last year's level.
The Committee requests a report to Congress no later than
120 days after enactment of this act that details CDC's various
internal laboratory activities and associated funding levels.
Preserving Integrity of Seminal Surveys.--The Committee
encourages NCHS to fully support its ongoing seminal health
surveys, in particular the National Health Interview Survey and
National Health and Nutrition Examination Survey. The Committee
urges NCHS to protect these core surveys without comprising
data quality or accessibility, particularly with regard to
minority populations.
Sexual and Gender Identity Inclusion in Health Data
Collection.--The Committee encourages CDC to consider expanding
the National Health Interview Survey to include questions
relating to sexual orientation and gender identity to better
enable government agencies to understand and meet the unique
health needs of lesbian, gay, bisexual, and transgender
individuals.
Standardized Obesity Measurements.--The Committee is
strongly supportive of the 2010 Institute of Medicine
recommendation in ``For the Public's Health: The Role of
Measurement in Action and Accountability'' that calls on CDC to
develop a standardized set of measurements for obesity
reduction and other public health programs. A standardized set
of measurements would provide the Federal Government and other
grant-making institutions with a consistent way to evaluate and
compare the effectiveness and outcomes of obesity-reduction
programs and other public health initiatives. The Committee
urges NCHS to undertake this effort, in consultation with State
and local health departments, medical and public health
professional associations, charitable foundations, the academic
and research communities, and other nonprofit and community-
based organizations.
Task Force on Community Preventive Services.--The Committee
recommendation includes $11,800,000 for the task force,
including $10,000,000 in transfers from the PPH Fund.
Vital Statistics.--Vital statistics provide complete and
continuous data on births, deaths and fetal deaths that are
essential for understanding our Nation's health. The Committee
encourages CDC to obtain data items currently collected by
States and territories and collect 12 months of these data
within the calendar year.
Vital Statistics Infrastructure.--The Committee understands
that not all States and territories have adopted the more
comprehensive 2003 standard certificates of births and deaths,
which have the potential to expand the scope and quality of
vital statistics collected on a national basis. The Committee
urges NCHS to sustain the National Vital Statistics System to
support States and territories in implementing these
certificates and modernizing their infrastructure to collect
these data electronically.
NATIONAL CENTER FOR ENVIRONMENTAL HEALTH
The Committee recommends $105,855,000 for Environmental
Health in fiscal year 2012. The fiscal year 2011 comparable
funding level was $134,855,000 and the budget request for
fiscal year 2012 was $128,715,000.
In addition, $35,000,000 is provided in transfers from the
PPH Fund for the Environmental Health Tracking Network, the
same level as was transferred in fiscal year 2011.
Many modern public health successes can be traced to
innovations in environmental health practices. However,
emerging pathogens and environmental toxins continue to pose
risks to our health and significant challenges to public
health. The task of protecting people's health from hazards in
their environment requires a broad set of tools. First among
these tools are surveillance and data collection to determine
which substances in the environment are getting into people and
to what degree. It also must be determined 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Volcanic Emissions Research..................................... 197 (\1\) 197
Amyotrophic Lateral Sclerosis Registry.......................... 5,903 (\1\) 5,903
Built Environment and Health Initiative......................... 2,634 (\1\) 2,634
Asthma.......................................................... 27,444 .............. 27,444
Healthy Homes/Childhood Lead Poisoning.......................... 29,257 .............. ..............
Healthy Home and Community Environments......................... .............. 32,674 ..............
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.
Amyotrophic Lateral Sclerosis [ALS].--The Committee
strongly supports the efforts of CDC and the Agency for Toxic
Substances and Disease Registry [ATSDR] to maintain and enhance
the National ALS Registry. The Committee intends the data
collected in the registry to be used by researchers to advance
the research into the cause, treatment and cure for ALS. CDC/
ATSDR is encouraged to continue to collaborate with the ALS
community in exploring additional ways in which the registry
can support the ALS scientific and patient communities. The
Committee is particularly supportive of the addition of a
biorepository component and the development of strategies that
can enhance clinical trials and clinical trial enrollment.
Asthma.--The Committee is concerned that CDC's proposal to
consolidate the asthma program with the Healthy Homes/Childhood
Lead Poisoning Program would jeopardize the Federal response to
asthma at a time when asthma rates are rising. Asthma is a
large public health problem in the country, affecting 25
million Americans, of whom 7 million are children. The
Committee supports science-based, effective asthma
interventions and management implemented by the National Asthma
Control Program. The Committee directs CDC to continue its
support of the program, its approach to asthma control, its
community partners and its successful interventions.
Biomonitoring.--The Committee strongly supports quality
assurance in current biomonitoring program efforts aimed at
ensuring that results are accurate and comparable across the
many different State programs. CDC is encouraged to explore the
feasibility of developing reference methods and materials for
several cardiovascular disease biomarkers, including
apolipoprotein B, high-sensitivity C-reactive protein, small
LDL and troponion. The Committee recognizes both the need for
reference methods for these biomarkers and the potential return
on investment in the form of cost savings for Federal health
care programs, like Medicare and Medicaid, and other programs.
Blood Lead Proficiency Testing.--The Committee encourages
CDC to collaborate with the Health Resources and Services
Administration to ensure continued support for the National
Blood Lead Proficiency Testing Program. Since 1988, this
program has played an important role in combating childhood
lead poisoning by assuring and improving the accuracy of lead
poisoning screenings.
Environmental Health Tracking Network.--The National
Tracking Network was launched in July 2009, and CDC continues
to expand the quality and quantity of health and environmental
information and data available through the network. The network
includes data for cancer, reproductive health outcomes, birth
defects, demographics, socioeconomic status, outdoor air
quality, drinking water quality, hospitalizations for asthma,
cardiovascular disease, carbon monoxide poisoning and childhood
lead poisoning.
The Committee is aware of research suggesting that many
diseases and conditions with rising rates may have
environmental triggers. The Committee directs CDC to work with
NIH and the ALS Registry to explore how the Environmental
Health Tracking Network could map and help researchers evaluate
potential environmental risk factors to autoimmune diseases,
neurodegenerative diseases and autism.
In addition, the Committee encourages CDC to develop a wide
variety of baseline community health data that will be tracked
over time. As drilling for natural gas increases across the
Nation, this information will allow communities to monitor the
impact of current and future drilling sites on the health of
individuals living nearby.
Healthy Homes and Lead Poisoning Prevention Program.--The
Committee commends CDC for preventing approximately 100,000
children from being poisoned by lead each year through the
Healthy Homes and Lead Poisoning Prevention Program. The
Committee has not included funding for this program in fiscal
year 2012. The Committee is aware of nurse home visiting
programs in New York State, Rhode Island, and Oklahoma that
have adopted healthy homes activities as part of their
programming. This integrative approach of identifying and
preventing environmental health and safety hazards in the homes
of high-risk pregnant mothers and their babies is a cost-
effective and efficient strategy for preventing disease and
injury among the Nation's most vulnerable families. The
Committee notes that $350,000,000 will be spent by DHS to
conduct home visiting programs in fiscal year 2012 through the
Maternal, Infant, and Early Childhood Home Visiting Program;
this funding appropriated by the Patient Protection and
Affordable Care Act, is $100,000,000 more than the fiscal year
2011 level. The Committee intends the Health Resources and
Services Administration and CDC to work together to ensure that
activities previously funded through Healthy Homes will be
fully incorporated into the Home Visiting Program.
Newborn Screening Quality Assurance Program.--The Committee
continues to support quality assurance efforts in the Nation's
newborn screening program. CDC is commended for providing
training, consultation, guidelines, proficiency testing and
reference materials to nearly 500 laboratories responsible for
newborn screening and conducts research on new tests.
NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL
The Committee recommends $129,714,000 for injury prevention
and control activities at CDC and an additional $3,000,000 in
transfers from the PPH Fund. The comparable fiscal year 2011
funding level was $143,714,000. The budget request for 2012 was
$147,501,000. The administration also requested $20,000,000 in
transfers from the PPH Fund.
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; lack of
bicycle helmet use; lack of seatbelt and proper baby seat use;
and other injuries. The national injury control program at CDC
encompasses non-occupational injury and applied research in
acute care and rehabilitation of the injured. Funds are
utilized for both intramural and extramural research as well as
assisting State and local health agencies in implementing
injury prevention programs.
The Committee recommendation includes $6,039,000 for
Traumatic Brain Injury programs, $10,522,000 for the Injury
Control Centers, $5,423,000 for Domestic Violence Community
Projects and $3,479,000 for the National Violent Death
Reporting System, the same as the comparable fiscal year 2011
levels. The Committee has included $44,474,000 for rape
prevention activities, compared to $39,474,000 in fiscal year
2011. The Committee has not included funding for youth violence
prevention programs, funded at $19,708,000 in fiscal year 2011.
Falls Prevention Interventions.--The Committee has included
$3,000,000 from the PPH Fund to expand older adult falls
prevention activities at CDC, in coordination with the
Administration of Aging [AOA]. The Committee intends that CDC
use the funding to conduct research to evaluate and disseminate
the most effective fall prevention interventions and that AOA
use the funding provided that agency to conduct outreach and
demonstration programs to expand the implementation of
effective interventions.
In addition, the Committee is aware that osteoporosis is a
chronic condition that puts individuals at risk for more
serious injuries in a fall. The Committee encourages CDC to
develop an education and outreach plan in consultation with the
patient and medical community to focus public health strategies
on osteoporosis.
Violence Against Women.--The Committee applauds CDC's
development of the National Institute Partner and Sexual
Violence Surveillance System to monitor State and national
trends and to inform public policies and prevention strategies.
The Committee urges more research on the psychological impact
of violence against women in order to increase and improve
evidence-based interventions to support the recovery of women
from the trauma of violence.
Youth Violence Prevention.--The Committee remains
supportive of efforts to reduce youth violence through
evidence-based prevention strategies. The Committee notes that
the Office of Juvenile Justice and Delinquency Prevention
Programs [OJJDP] at the Department of Justice conducts a
comprehensive suite of prevention programs aimed at youth in
high-risk categories and exhibiting high-risk behaviors. The
Committee urges CDC to continue providing technical assistance
to OJJDP with the data gained from the National Violent Death
Reporting System and other surveillance activities.
OCCUPATIONAL SAFETY AND HEALTH
The Committee recommends a program level of $295,079,000
for occupational safety and health programs, including
$106,724,000 in transfers available under section 241 of the
PHS Act. The comparable fiscal year 2011 program level was
$316,079,000, and the budget request for fiscal year 2012 was
$259,934,000, entirely funded through transfers available under
section 241 of the PHS Act.
The 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 spans the spectrum of activities necessary for the
prevention of work-related illness, injury, disability and
death by gathering information, conducting scientific
biomedical 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Education and Research Centers.................................. 24,321 .............. 24,321
Healthier Workforce Center...................................... 5,026 .............. 5,026
National Occupational Research Agenda [NORA].................... 111,367 101,528 111,367
Budget Authority............................................ 19,643 .............. 4,643
PHS Evaluation Transfers.................................... 91,724 101,528 106,724
Mining Research................................................. 52,687 .............. 52,687
Miners Choice................................................... 647 .............. 647
----------------------------------------------------------------------------------------------------------------
Cost Efficiency.--The Committee strongly encourages NIOSH
to continue to use existing Federal research facilities and
Federal property to conduct its existing research programs. The
Committee recognizes the advantages of using existing federally
owned property to fulfill NIOSH's mandate and believes this
approach will help NIOSH realize the most efficient use of
Federal funds possible.
Education and Research Centers [ERCs].--The Committee
directs CDC to spend no less than last year for ERCs.
National Occupational Research Agenda [NORA].--The
Committee directs CDC to spend no less than last year for the
Agriculture, Forestry and Fishing Program within the National
Occupational Research Agenda.
World Trade Center Health Program.--In the 10 years since
September 11, this Committee was responsible for appropriating
$408,000,000 in discretionary funding for the World Trade
Center Health Program. This funding made it possible to screen
56,000 workers who risked their lives after the World Trade
Center attack and treat 18,000 who required medical care.
Discretionary funds are no longer needed because of mandatory
funding appropriated in the James Zadroga 9/11 Health and
Compensation Act of 2010. From this point forward, all of the
treatment costs previously borne by the discretionary
appropriation will be funded through Zadroga Act funding.
GLOBAL HEALTH
The Committee recommends $350,265,000 for global health-
related activities at CDC in fiscal year 2012. The fiscal year
2011 comparable level was $340,265,000 and the budget request
for fiscal year 2012 was $381,245,000.
The Center for Global Health leads international programs
and coordinates CDC's global efforts funded out of other
centers with the goal of promoting health and preventing
disease in the United States and abroad, including 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Global AIDS Program............................................. 118,741 118,023 118,741
Global Immunization Program..................................... 150,854 163,602 160,854
Polio Eradication........................................... 101,597 112,441 111,597
Measles and Other Vaccine Preventable Diseases.............. 49,257 51,161 49,257
Global Disease Detection and Emergency Response................. 41,902 44,191 41,902
Parasitic Diseases and Malaria.................................. 19,467 19,643 19,467
Global Public Health Capacity Development....................... 9,301 35,786 9,301
----------------------------------------------------------------------------------------------------------------
Global Immunization Activities.--The bill provides not less
than $111,597,000 for CDC's global polio eradication
activities. The Committee strongly supports the dramatic
progress being made in the international partnership to
eradicate polio. Although resources are limited, the Committee
is well aware of the aligning of technical skill, vaccine
availability and strong country engagement taking place in the
four countries still plagued by this disease. The Committee
encourages CDC and its partners to take advantage of this
historic opportunity.
Hepatitis B.--The Committee continues to encourage CDC to
consider expanding global programs to increase the rate of
vaccination, reduce mother-child transmission and promote
educational programs to prevent hepatitis B and to reduce
discrimination targeted against individuals with the disease.
Parasitic Diseases and Malaria.--The Committee is pleased
with the CDC's ongoing efforts to fight global malaria and
neglected tropical diseases through the Center for Global
Health. Despite progress, much still needs to be done to
address malaria and neglected topical diseases [NTDs] on a
global scale. In 2009 more than 700,000 people died from
malaria. NTDs, including enteric diseases, continue to affect
more than 1 billion people worldwide. CDC research plays an
essential role in the continued progress towards control and
elimination efforts of global malaria and NTDs. The Committee
encourages CDC to continue its research, monitoring and
evaluation efforts for malaria and NTDs and its collaboration
with other agencies as part of the Global Health Initiative.
Product Development Partnerships [PDPs].--PDPs enable
critical research and development in the global health arena
while creating jobs in the United States. The Committee
encourages CDC to cultivate public-private partnerships like
PDPs and to work in collaboration with the National Institutes
of Health and U.S. Aid for Institutional Development to
identify and pursue other innovative research and development
opportunities.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
The Committee recommends $1,405,416,000 for public health
preparedness and response activities. The fiscal year 2011
level was $1,415,416,000. The amount requested by the
administration in fiscal year 2012 was $1,452,618,000. The
recommendation includes $30,000,000 in transfers from Public
Law 111-32, as requested by the administration. The comparable
fiscal year 2011 transfer level is $68,515,000. The Committee
recommendation includes funding for the following activities in
the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
State and Local Preparedness and Response Capability............ 664,294 651,048 654,294
Public Health Emergency Preparedness Cooperative Agreement 632,861 643,264 632,861
Program (non-add)..........................................
CDC Preparedness and Response Capability........................ 160,121 146,570 160,121
Strategic National Stockpile.................................... 591,001 655,000 591,001
----------------------------------------------------------------------------------------------------------------
Centers of Excellence.--The Committee supports the work of
the Preparedness and Emergency Response Learning Centers and
the Advanced Practice Centers. These centers provide training
and support for the public health system to prepare for,
respond to, and recover from public health emergencies. The
Committee encourages CDC to support these centers to the extent
of CDC's ability.
Public Health Emergency Preparedness.--The cooperative
agreement provides funding to enable public health departments
to have the capacity and capability to effectively respond to
the public health emergencies consisting of terrorist threats,
infectious disease outbreaks, natural disasters, and
biological, chemical, nuclear, and radiological emergencies.
Strategic National Stockpile.--The Committee is concerned
that prior to the 2009 H1N1 influenza pandemic, the Strategic
National Stockpile [SNS] contained only enough needles and
syringes to immunize between 5 and 10 percent of the
population. Stockpiling is an efficient means of preparedness
for drug delivery devices and other medical supplies because
these are generally low-cost products with long shelf-lives.
The Committee requests a professional judgment recommendation
as to the level of funding needed to acquire an adequate supply
of these drug delivery devices.
In addition, the Committee encourages CDC to continue
efforts to ensure that vaccines, medications, and equipment in
the SNS are replenished and upgraded as needed. In particular,
the Committee encourages CDC to review the supply of antiviral
medications remaining since the H1N1 outbreak, including a
review of the supply in light of the needs of special
populations, such as children.
PUBLIC HEALTH LEADERSHIP AND SUPPORT
The Committee provides $121,419,000 for public health
leadership and support activities at CDC, the same as the
fiscal year 2011 comparable level. The budget request for
fiscal year 2012 was $121,368,000.
In addition, the Committee includes $41,200,000 in
transfers from the PPH Fund, the same as was transferred in
fiscal year 2011.
Throughout CDC's accounts, the Committee has granted
additional flexibility for CDC to respond to challenging budget
times. The Committee does not expect that this flexibility will
be used to reduce transparency on CDC's expenditure of funds
appropriated in this bill. The Committee directs that CDC
include summaries of programmatic activities consistent with
the fiscal year 2011 operating plan level, along with the
associated funding levels in the annual congressional
justification, beginning in fiscal year 2014. These summaries
should include a short description of the nature of CDC's work
on a particular subject, the number of grants made, the average
grant size, and a State-by-State table for any formula-based
funding. The Committee understands that the fiscal year 2013
justification is already in draft form; therefore, the
Committee expects an operating plan 90 days after enactment of
this act that details spending levels for all CDC budget lines
included in the Senate Committee report accompanying the fiscal
year 2011 Appropriations Act for Labor, Health and Human
Services, and Education and Related Agencies (S. Rpt. 111-243).
Extramural Research.--The Committee requests a report from
CDC by March 1 of each year that details the breakdown of
intramural and extramural funding for each program of the
various offices and centers at CDC. The Committee believes that
the balance between intramural and extramural funding is an
important measure for assessing and understanding how the
agency is meeting its national and State responsibilities.
Institutional Research Training Grant Program.--The
Committee encourages CDC to continue the Institutional Research
Training Grant Program.
Leadership and Management Savings.--The Committee strongly
believes that as much of CDC's of funding as possible should go
to programs and initiatives that improve the health and safety
of Americans. To facilitate this goal, any savings in
leadership and management may be reallocated to the Director's
Discretionary Fund upon notification of the Committee.
Public Health Infrastructure.--The Committee recommendation
transfers $40,200,000 from the PPH fund, the same level as in
fiscal year 2011, to continue the Strengthening Public Health
Infrastructure for Improved Health Outcomes program. These
resources are intended to support State, local, tribal, and
territorial health departments to ensure that the systems
supporting public health services are robust and efficient,
including workforce capacity and competency; laboratory
systems; health information and systems, as well as health
information analysis for decisionmaking; communications; legal
authorities; financing; organizations capacity; and other
related activities.
PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT
The Committee does not provide funding for the Preventive
Health and Health Services block grant [PHHSBG], in accordance
with the administration proposal for fiscal year 2012. The
fiscal year 2011 comparable level was $80,094,000.
For over 30 years, this block grant has supported States in
improving their response to critical public health needs. The
Committee has regretfully accepted the administration's
recommendation to eliminate this program in light of the
overlap between this grant and other funds being awarded to
States throughout this bill.
The Committee is aware that over 10 percent of PHHSBG
funding has been used to support national rape prevention
activities. The Committee has included additional funding for
this purpose in the National Center for Injury Prevention and
Control.
An additional 40 percent of PHHSBG funds have been used for
activities related to chronic diseases. The Committee has
provided a total of $329,582,000 in this bill to States for
these purposes through various grant programs, including
Community Transformation State grants in the PPH Fund and CDC's
grant programs for diabetes; heart disease and stroke;
comprehensive cancer grants; and nutrition, physical activity
and obesity.
PHHSBG has also provided States with flexible funding to
shore up critical infrastructure needs of their public health
departments. The Committee has included $40,200,000 from the
PPH Fund for the Strengthening Public Health Infrastructure for
Improved Health Outcomes program, which allows States to
provide many of the same activities covered by PHHSBG. State
health departments can use this flexible funding source to
improve their systems that support public health services,
including workforce capacity and competency; laboratory
systems; health information and systems, as well as health
information analysis for decision making; communications; legal
authorities; financing; organizations capacity; and other
related activities.
BUSINESS SERVICES AND SUPPORT
The Committee provides $427,026,000 for business services
support functions including costs relating to buildings and
facilities. The administration request for fiscal year 2012 was
$447,466,000. The fiscal year 2011 comparable level was
$362,026,000. These funds will be used to support agency-wide
support functions.
Due to budgetary constraints, the Committee is unable to
provide the full President's budget request for these costs.
For that reason, the Committee has included bill language to
allow CDC to begin creating a Working Capital Fund [WCF] to
achieve greater cost efficiencies across the administrative
operations of the agency. The Committee directs CDC to create a
strong auditing system for the WCF and brief the Committee on
controls CDC will put in place to ensure that WCF funds are
used solely for administrative costs and that CDC Centers and
Offices are not over-charged for services.
National Institutes of Health
The Committee recommends an overall funding level for the
National Institutes of Health [NIH] of $30,498,288,000. The
budget request for NIH activities within the jurisdiction of
this bill is $31,747,915,000 and the fiscal year 2011 level is
$30,688,288,000.
The Committee regrets that fiscal constraints prevent a
higher recommended funding level for NIH. With tight budgets
likely to continue for the foreseeable future, the Committee
strongly urges NIH to explore creative ways to rethink the way
it allocates its funding. The alternative--continuing to nick
away, little by little, at the success rate or the size of
awards--will inevitably have a negative impact on young
investigators, who represent the Nation's future, and on high-
risk, high-reward research opportunities.
The Committee credits NIH with making significant efforts
in both of these priority areas despite relatively flat budgets
in recent years. With the help of the New Innovator Award and
Pathway to Independence Award programs, NIH funded more new
investigators in 2010 than in any year before. The
Transformative Research Projects Program, meanwhile, rewards
exceptionally innovative ideas. The Committee encourages NIH to
continue and expand on these initiatives.
The creation of the National Center for Advancing
Translational Sciences [NCATS], proposed by the administration
and endorsed in the Committee recommendation, is an even more
far-reaching example of how NIH can refocus its mission in a
difficult fiscal environment. This bill creates NCATS,
abolishes the National Center for Research Resources [NCRR] and
redistributes existing NCRR programs throughout other
Institutes and Centers [ICs]. With the exception of $20,000,000
for the new Cures Acceleration Network, all of the changes
involved in this restructuring are budget neutral.
The mission of NCATS is nothing less than fundamentally
changing the way NIH pursues the translation of basic science
into treatments and cures. The average length of time from
target discovery to FDA approval of a new drug is 14 years, a
delay that is costing lives and prolonging human suffering.
NCATS will study steps in the therapeutics development and
implementation process, consult with experts in academia and
the biotechnology and pharmaceutical industries to identify
bottlenecks in the processes that are amenable to re-
engineering, and develop new technologies and innovative
methods for streamlining the processes. In order to evaluate
these innovations and new approaches, NCATS will undertake
targeted therapeutics development and implementation projects.
In all of these efforts, the Committee expects that NCATS will
complement, not compete with, the efforts of the private
sector.
While the Committee welcomes the creation of NCATS, it was
disappointed by the way the administration requested it. The
President's proposed budget for fiscal year 2012 included a
vague description of NCATS but did not formally request funding
for the restructuring or provide any details about which
components of NIH would be consolidated into the new Center.
The failure to do so caused unnecessary uncertainty about the
proposal and contributed to the impression that it was being
rushed.
Lessons learned with NCATS should guide NIH as it considers
another proposed restructuring, one that would involve
consolidating NIDA, NIAAA and components of other ICs into a
new Institute devoted to research on substance use, abuse and
addiction. The Committee understands that NIH plans to adopt a
more deliberate approach in evaluating the need for this
Institute. The Committee strongly recommends that if the
administration ultimately decides to seek such a restructuring,
it should provide sufficient details in a formal budget request
to Congress.
NATIONAL CANCER INSTITUTE
Appropriations, 2011.................................... $5,058,577,000
Budget estimate, 2012................................... 5,196,136,000
Committee recommendation................................ 5,001,623,000
The Committee recommends an appropriation of $5,001,623,000
for the National Cancer Institute [NCI]. Of this amount,
$8,000,000 is available for repairs and improvements to the NCI
facility in Frederick, Maryland. The budget request for fiscal
year 2012 is $5,196,136,000 and the comparable level for fiscal
year 2011 is $5,058,577,000.
Breast Cancer.--The Committee notes that triple-negative
breast cancer is poorly understood and has a disproportionate
prevalence among African-American women. The Committee
encourages NCI to increase research and awareness of this
disease, and to advance prevention, detection, diagnosis, care,
and treatment. The Institute is urged to collaborate with ORWH,
NIMHD, the Office of Minority Health, and the Office of Women's
Health in these efforts.
Health Decisionmaking.--The Committee commends NCI for its
efforts to understand how the ability to comprehend and use
numerical information affects health decisionmaking, as low
numerical skills may not only distort perception of risks and
impair risk communication, but may also impede treatment.
Health Services Research.--The Committee commends NCI for
its efforts to determine how well state-of-the-art cancer care
is actually delivered. Ongoing health services data collection
and surveillance programs represent an important contribution
to cancer surveillance and the efforts to understand and
improve clinical and community practices. NCI is strongly urged
to maintain support for ongoing activities that advance cancer
prevention and early detection research, including data
collection infrastructure that can contribute to measuring the
delivery and outcome of services, and comparative effectiveness
research.
Liver Cancer.--The Committee urges NCI to increase its
efforts in the area of liver cancer, particularly by creating a
Specialized Program of Research Excellence [SPORE] for this
disease and by funding projects focusing on pathogenesis,
detection and/or therapeutics.
Lung Cancer.--The Committee remains concerned by the high
morbidity and mortality rates of lung cancer, particularly the
increased lung cancer rates among women and the high incidence
among African-American men. NCI is urged to enhance support for
research in these areas.
Melanoma.--The Committee urges more research on melanoma
that will identify and develop molecular markers to aid
accurate diagnosis of the primary tumor; prognostication that
will determine extent and type of treatment; and prediction of
treatment response. The Committee commends NCI for the
inclusion of melanoma in The Cancer Genome Atlas; however, in
view of the relative scarcity of melanoma biospecimens
available for this effort, additional resources are needed to
facilitate specimen collection. Given the rising incidence
rates of melanoma, the Committee encourages NCI to support
research directed at the biology of tumor initiation including
UV radiation as a carcinogen, host risk factors and risk
reduction strategies. The Committee continues to urge NCI to
promote mechanisms of collaboration between industry, the
extramural program and foundations that will accelerate
translational and clinical research as outlined in the
strategic action plan, including annotated specimen collection
from key trials independent of sponsorship and novel trial
designs to accommodate testing agents contributed by more than
one company. The Committee requests an update on these requests
in the fiscal year 2013 congressional budget justification.
Metastasis to Bone.--The Committee urges additional
research on how to repair bone defects caused by cancer cells.
Translational research is also needed to understand the impact
of metastasis on the biomechanical properties of bone and the
mechanisms by which bone marrow and tumor-derived cells can
influence metastatic growth, survival and therapeutic
resistance.
Pancreatic Cancer.--The Committee commends NCI on its
fiscal year 2011 Action Plan for Pancreatic Cancer, which marks
an important first step to making a targeted research
investment in this deadly disease. As the plan recommends, the
Committee urges NCI to put in place a long-term, comprehensive
strategic plan; move forward with requests for applications or
program announcements specific to pancreatic cancer; and
include more experts in pancreatic cancer on scientific review
panels in fiscal year 2012. In addition, earlier this year NCI
reported to the Committee that extramural research staff has
been empowered to propose exceptions for promising pancreatic
cancer research proposals that may not otherwise be funded, and
that the Institute has made it a priority to identify novel
research ideas. The Committee requests an update in the fiscal
year 2013 congressional budget justification on the use of
exceptions as well as a description of novel research ideas
being pursued in relation to pancreatic cancer.
Pediatric Cancer.--The Committee notes that childhood
cancer research accounts for less than 5 percent of the
Institute's annual budget and encourages NCI to increase that
amount, as cancer remains the leading cause of disease-related
death in children. More effective and less toxic treatments are
needed.
Slow-Growing Children's Brain Tumors.--Two primary
roadblocks to basic research on pediatric low-grade astrocytoma
[PLGA] brain tumors have been identified: a shortage of viable
tissue samples and the lack of a mouse model. The Committee
urges NCI to establish research priorities that address the
shortage of tissue samples by incentivizing hospitals and
medical institutions to centralize and share tissue samples.
The Committee also urges NIH to examine possible solutions to
address the lack of a mouse model for PLGA brain tumors. The
Committee requests an update on these issues in the fiscal year
2013 congressional budget justification.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2011.................................... $3,069,723,000
Budget estimate, 2012................................... 3,147,992,000
Committee recommendation................................ 3,036,189,000
The Committee recommendation includes $3,036,189,000 for
the National Heart, Lung, and Blood Institute [NHLBI]. The
budget request for fiscal year 2012 is $3,147,992,000 and the
comparable level for fiscal year 2011 is $3,069,723,000.
The Committee recommendation for NHLBI includes sufficient
funding to accommodate the transfer of gene vector grants
currently administered by NCRR.
Asthma.--NHLBI is urged to advance more effective life-
saving and life-enhancing treatments for asthma and to
collaborate with the FDA, NIAID, NICHD, NIMHD, and the Office
of Minority Health in this regard. The Committee notes that the
prevalence and burden of asthma are high among African-
Americans, Latinos and other communities of color, as well as
children. The Committee urges NHLBI to examine the impact of
long-acting medications and prescribed steroids on overall
health, growth and development of children.
Cardiovascular Disease.--The Committee continues to place a
high priority on research related to heart disease, stroke and
other forms of cardiovascular disease and remains concerned
that NIH still spends less than 8 percent of its budget on our
Nation's No. 1 and most costly killer. The Committee strongly
urges NHLBI to significantly enhance its investment and further
stimulate interest in multidisciplinary and interdisciplinary
basic, clinical, translational, and prevention cardiovascular
disease research, including its risk factors, using all
appropriate mechanisms. In addition, the Committee urges the
prompt implementation of priority initiatives outlined in its
Division of Cardiovascular Diseases Strategic Plan. NHLBI is
also encouraged to increase its attention to the impact of
cardiovascular disease on ethnic minorities such as Native
Hawaiians and Asians.
Chronic Obstructive Pulmonary Disease [COPD].--The
Committee applauds NHLBI's efforts to raise public awareness of
COPD and encourages the Institute to work with community
stakeholders and other Federal agencies, including CDC, to
develop a national action plan to respond to the growing burden
of this disease.
Jackson Heart Study.--The Committee recognizes that the
Jackson Heart Study in Jackson, Mississippi, is the largest
investigation of cardiovascular disease in the African-American
population. The Committee acknowledges the continued need for
comprehensive research to address this health disparity and the
important implications for such research to all persons
threatened by cardiovascular disease. The Committee urges
continued focus in addressing cardiovascular disease in
African-Americans at NHLBI and NIMHD.
Marfan Syndrome and Thoracic Aortic Aneurysms.--The
Committee commends NHLBI for its ongoing support of clinical
research on Marfan syndrome in the pediatric population, and it
encourages support for basic and translational research on this
complex connective tissue disorder. The Committee also notes
recent advancements in genetic research related to thoracic
aortic aneurysms and encourages the Institute to promote
additional research on this condition.
Pulmonary Hypertension [PH].--The Committee encourages
NHLBI to support the establishment of a Pulmonary Hypertension
Clinical Research Network to expand clinical trials and
facilitate collaboration and data sharing among PH
investigators. The Committee also continues to encourage the
Institute to collaborate with the PH community to raise
awareness of the disease.
RuSH Project.--The Committee supports the Registry and
Surveillance System in Hemoglobinopathies [RuSH] project, which
will determine the number of Americans with sickle cell
disease, thalassemia and hemoglobin E disease. The Committee
believes that NHLBI should retain control of the data system to
fully characterize these patient populations and use the data
to conduct research for new therapies, as well as to monitor
the implementation of Healthy People 2020 using leading health
indicators. NHLBI should also consult with HRSA concerning an
expansion of sites for treatment centers.
Sleep Disorders.--The Committee awaits the imminent release
of the National Sleep Disorders Research Plan by the National
Center on Sleep Disorders Research, which will articulate
priorities and opportunities NIH-wide for addressing the
challenge of sleep disorders and circadian disturbances. The
Committee is concerned by the growing body of knowledge
demonstrating linkages between sleep disorders and a number of
health conditions, including obesity, diabetes and
cardiovascular disease, and the impact of sleep disturbances on
safety at the workplace and in transportation. The Committee
recommends more collaboration among ICs regarding sleep
research and accelerated efforts in sleep research training.
Social Support.--NHLBI is encouraged to continue its
research on how psychosocial factors, such as social support,
may affect the course of prevention and treatment of, and
recovery from, cardiovascular illness or events.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2011.................................... $409,608,000
Budget estimate, 2012................................... 420,369,000
Committee recommendation................................ 404,997,000
The Committee recommendation includes $404,997,000 for the
National Institute of Dental and Craniofacial Research [NIDCR].
The budget request for fiscal year 2012 is $420,369,000 and the
comparable level for fiscal year 2011 is $409,608,000.
Systemic Bone Active Therapeutics.--The Committee urges
continued research on the effects of systemic bone active
therapeutics on the craniofacial skeleton, including factors
predisposing individuals to osteonecrosis of the jaw, as well
as new approaches to facilitate bone regeneration.
Temporomandibular Joint [TMJ] Disorders.--The Committee
encourages NIDCR to collaborate with other ICs regarding the
etiology and pathogenesis of TMJ disorders as well as the co-
morbid chronic pain conditions and disorders that solely or
predominantly affect women. In particular, NIDCR should work
with NIAMS and NIBIB to develop research opportunities in the
area of joint pain. Examples of topics that need more
exploration include: a basic understanding of the kinematics
and biomechanics of TMJ disorders as they relate to normal jaw
function and in disease; the development of biomarkers in bone,
muscle and cartilage that are predictive of temporomandibular
disease progression; the interactions of the TMJ
musculoskeletal system with the nervous system; and the
development of non-invasive measures of TMJ bone structure,
growth, degradation and repair. The recent scientific meeting
of the TMJ Association, co-sponsored by NIDCR and other ICs,
concluded that there needs to be a shift in research toward a
systematic exploration of common underlying root causes. The
Committee strongly urges NIH to heed the recommendations from
this meeting, which have the potential to accelerate scientific
progress not just in TMJ disorders but in the other coexisting
conditions.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2011.................................... $1,792,224,000
Budget estimate, 2012................................... 1,837,957,000
Committee recommendation................................ 1,772,045,000
The Committee recommendation includes $1,772,045,000 for
the National Institute of Diabetes and Digestive and Kidney
Diseases [NIDDK]. The budget request for fiscal year 2012 is
$1,837,957,000 and the comparable level for fiscal year 2011 is
$1,792,224,000.
Chronic Pelvic Pain.--The Committee is pleased by the
progress made in the Multidisciplinary Approach to the Study of
Chronic Pelvic Pain [MAPP] Research Network, particularly the
inclusion of male subjects, as the research plan continues to
focus on the natural history of interstitial cystitis. The
Committee encourages the MAPP Research Network to collaborate
closely with patient health organizations.
Depression and Diabetes.--NIDDK is encouraged to strengthen
collaborations with other institutes regarding research on the
links between diabetes and depression.
Diabetes Prevention Program.--The Committee recognizes the
success of the NIDDK-funded Diabetes Prevention Program, a
clinical research trial which found that modest weight loss
through dietary changes and increased physical activity could
prevent or delay the onset of type 2 diabetes significantly.
The Committee urges NIDDK to support further diabetes research
that will build upon past successes, improve prevention and
treatment, and close in on a cure.
Functional Gastrointestinal Disorders and Gulf War
Syndrome.--The Committee recognizes the direct link between
functional gastrointestinal disorders, such as irritable bowel
syndrome and functional dyspepsia, and gulf war syndrome, as
detailed in the Institute of Medicine report ``Gulf War and
Health: Volume 8. Health Effects of Serving in the Gulf War.''
The Committee urges NIDDK to collaborate with the Department of
Defense and the Department of Veterans Affairs to advance
research on the etiology, natural history and quality of
functional gastrointestinal disorders in patients with gulf war
syndrome.
Gestational Diabetes.--The Committee urges NIDDK to explore
additional opportunities for research on gestational diabetes,
particularly regarding possible long-term health consequences
such as a susceptibility to type 2 diabetes.
Glomerular Diseases.--The Committee recognizes the recent
progress made in understanding glomerular diseases, such as
focal segmental glomerulosclerosis [FSGS], including the
discovery of specific genetic factors which make African-
Americans five times more likely to develop FSGS than
Caucasians. The Committee urges NIDDK to continue to support
research on glomerular diseases and collaborate with NIMHD to
expand research on the impact these diseases have on minority
populations.
Inflammatory Bowel Disease [IBD].--The Committee commends
NIDDK for recent advancements in IBD research and encourages
continued support for the study of genetic, cellular and
environmental factors that contribute to the development of
these complex diseases. The Committee also notes the increasing
incidence of IBD in children and urges the Institute to expand
support for genetic and clinical studies of pediatric patients.
Pediatric Functional Gastrointestinal Disorders [FGIDs].--
The Committee urges NIDDK to work with NICHD to support
research on the quality of life for children suffering from
FGIDs, which often interfere with emotional, social and
professional development and can impair physical, economic and
educational well being.
Pediatric Kidney Disease.--The Committee supports NIDDK's
research emphasis on pediatric kidney disease and continues to
encourage the development of multicenter, pediatric prospective
clinical/translational trials.
Polycystic Kidney Disease [PKD].--The Committee urges 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 neo-
plastic genetic diseases. For example, the Committee
understands that cysts in PKD emulate the uncontrolled cell
growth observed in cancer. The Committee believes this analysis
will allow NIH to more effectively use Federal funds, create
and identify additional public-private partnerships to maximize
investments, and more quickly move PKD research findings to
clinical trials.
Vitamin D Deficiency and Chronic Kidney Disease.--The
Committee is pleased to note the full range of bone and mineral
research under way in both the intramural and extramural
programs at NIDDK, including the additional research emphasis
the Institute is placing on the relationship between vitamin D
deficiency and chronic kidney disease. These research findings
are expected to be particularly relevant to national efforts
aimed at reducing health disparities in diverse populations.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2011.................................... $1,622,003,000
Budget estimate, 2012................................... 1,664,253,000
Committee recommendation................................ 1,603,741,000
The Committee recommendation includes $1,603,741,000 for
the National Institute of Neurological Disorders and Stroke
[NINDS]. The budget request for fiscal year 2012 is
$1,664,253,000 and the comparable level for fiscal year 2011 is
$1,622,003,000.
Dystonia.--The Committee commends the participation of
NINDS in the Dystonia Coalition and encourages continued
investments in dystonia research.
Epilepsy.--The Committee applauds the establishment of the
Interagency Collaborative to Advance Research in Epilepsy
[ICARE], led by NINDS, which includes all Federal institutes
and centers that fund epilepsy research along with voluntary
organizations in the field. The Committee encourages ICARE's
continuation as a venue for sharing efforts and perspectives on
finding cures for epilepsy. The Committee also commends NINDS
for its plans to create the Epilepsy Centers Without Walls
program, which will promote multidisciplinary research efforts
targeted toward specific topic areas in epilepsy, including
epileptogenesis, comorbidities and mortality in epilepsy.
Muscular Dystrophy.--The Committee commends NIH for
collaborating with the Parent Project Muscular Dystrophy [PPMD]
End Duchenne Grant Award Program by referring applicants who
propose translational research on Duchenne muscular dystrophy
but miss NIH paylines to PPMD for the opportunity to seek
bridge funding. The Committee encourages additional efforts at
NIH to translate research findings on Duchenne into novel
discoveries.
Network of Excellence in Neuroscience Clinical Trials.--The
Committee commends NINDS for its leadership in creating the
Network of Excellence in Neuroscience Clinical Trials [NEXT]
program, which will create a robust, standardized and
accessible infrastructure to facilitate rapid development and
implementation of protocols in neurological disorders affecting
adult and/or pediatric populations. NINDS has indicated that
the first project to utilize the new NEXT infrastructure will
be a biomarker validation study of spinal muscular atrophy
[SMA]. Identifying one or more biomarkers for SMA would
represent a significant step towards accelerating efforts to
create effective treatments for this disease. The Committee
also urges NINDS to continue to demonstrate strong support for
translational research on SMA that will accelerate the
development of therapies for testing in the clinic and
facilitate the submittal of investigational new drug
applications to the Food and Drug Administration. The Committee
requests an update in the fiscal year 2013 congressional budget
justification on the specific goals for the NEXT SMA initiative
and its efforts relative to translational research on SMA.
Stroke.--The Committee continues to prioritize research
into the causes, diagnosis, treatment, recovery, rehabilitation
and prevention of stroke. The Committee urges NINDS to foster
innovative basic, clinical, translational and prevention stroke
research for all age groups affected by stroke, including
children and newborns, through all available mechanisms as
appropriate. Further, the Committee notes that NINDS will
manage a novel stroke planning effort beginning in 2011,
building on the work of the Stroke Progress Review Group, to
assess the current state of stroke research and develop
priorities to advance the most promising areas in prevention,
treatment, recovery, and rehabilitation research. The Committee
requests an update on this initiative in the fiscal year 2013
congressional budget justification.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Appropriations, 2011.................................... $4,775,968,000
Budget estimate, 2012................................... 4,915,970,000
Committee recommendation................................ 4,725,288,000
The Committee recommendation includes $4,725,288,000 for
the National Institute of Allergy and Infectious Diseases
[NIAID]. The budget request for fiscal year 2012 is
$4,915,970,000 and the comparable level for fiscal year 2011 is
$4,775,968,000. Included in these funds is $299,000,000 to be
transferred to the Global Fund to Fight HIV/AIDS, Malaria, and
Tuberculosis. The budget request was $300,000,000 for this
purpose and the fiscal year 2011 level was $297,300,000.
Anti-Malarial Medicines.--The Committee encourages the
Institute to continue supporting the work of institutions of
higher learning in combating the health, economic and security
impacts of malaria. The Committee encourages NIAID to increase
its investment in public-private partnerships that are involved
in research and development of anti-malarial medicines; the
development of safe and effective drugs for malaria prophylaxis
and treatment, including 8-aminoquinolines; new, effective
pediatric formulations; and alternatives to artemisinin
combination therapies in response to the rapidly emerging
threat of artemisinin resistance.
Food Allergies.--The Committee is pleased that NIAID has
convened periodic expert panels on food allergy research since
1996 to make key recommendations to investigate the natural
history of food allergy in young children who have risk factors
predisposing them to develop food allergy; resolve impediments
to clinical trials design and conduct; and perform clinical
trials using food allergens, given orally or sublingually, to
treat existing food allergy. The Committee is aware that public
and private research to develop immunotherapies is progressing
to an advanced clinical trials stage with the consensus support
of the Nation's leading food allergy research institutions.
NIAID is strongly encouraged to support this stage of the
research, which has the potential to cure food allergies.
Hepatitis B Virus [HBV].--The Committee applauds NIAID's
efforts to pursue the development of new classes of drugs that
are safe and effective in treating HBV. The Committee urges
continued HBV research on different courses of treatment as
well as ways to support efforts to identify new cellular and
antiviral targets and develop new strategies for intervention.
The Committee also urges an increased focus on pregnant women
and pediatric cases of hepatitis B.
Immunotherapy.--The Committee is aware of research showing
that broader use of immunotherapy for the treatment of allergic
rhinitis could improve clinical outcomes and significantly
reduce healthcare costs. Additional research is needed to
examine the clinical and economic impact of immunotherapy in
both children and adults. The Committee encourages NIAID to
collaborate with AHRQ and the Centers for Medicare and Medicaid
Services on the development and support of a research
initiative on this topic.
Kidney Transplantation.--As the demand for suitable kidneys
for transplantation continues to far exceed the supply, the
Committee is pleased to learn that research funded by NIAID has
resulted in the establishment of desensitization protocols that
have successfully demonstrated an increase to the suitability
of a larger number of cadaver kidneys for transplantation for
highly sensitized candidates, who are the sickest and most
difficult to match on the kidney transplant waiting list. The
Committee therefore urges NIAID to support a multi-center
initiative with a companion data collection and analysis center
to facilitate the use of this protocol at an increasing number
of transplant centers across the country.
Microbicides.--With NIH and USAID leadership, proof of
concept has been established for an antiretroviral [ARV]-based
microbicide to prevent HIV infection in women. The Committee
encourages NIAID to coordinate with USAID, the State
Department, other Federal agencies and global donors to
prioritize and expedite microbicide development efforts with
the goals of enabling regulatory approval of the first
effective microbicide and providing support for efficacy trials
of new and complementary ARV-based microbicides.
Tuberculosis [TB].--The Committee notes the recent
development of GeneXpert, the new TB diagnostic test that holds
the potential to dramatically improve TB diagnosis, treatment
and control. The Committee applauds NIAID for its continued
attention to the development of new TB diagnostics, drugs and
vaccines.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2011.................................... $2,033,782,000
Budget estimate, 2012................................... 2,102,300,000
Committee recommendation................................ 2,347,309,000
The Committee recommendation includes $2,347,309,000 for
the National Institute of General Medical Sciences [NIGMS]. The
budget request for fiscal year 2012 is $2,102,300,000 and the
comparable level for fiscal year 2011 is $2,033,782,000.
The recommended increase for NIGMS over the fiscal year
2011 level results mostly from the planned transfer of the
Institutional Development Awards [IDeA] program and the
Division of Biomedical Technology, Bioinformatics and
Computational Biology from NCRR.
Behavioral Research.--The Committee applauds the leadership
of NIGMS in the development of the OppNet collaboration on
basic behavioral and social science research, and it encourages
NIGMS to maintain its commitment to that trans-NIH initiative.
The Committee also commends NIGMS's program of research on the
efficacy of interventions to promote research careers, such as
its studies on effective mentoring and career transitions.
Institutional Development Awards [IDeA].--The Committee
recognizes the importance of the Centers of Biomedical Research
Excellence and the IDeA Networks of Biomedical Research
Excellence programs, which are essential components to the
overall success of the IDeA 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 within the IDeA States.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
Appropriations, 2011.................................... $1,317,854,000
Budget estimate, 2012................................... 1,352,189,000
Committee recommendation................................ 1,303,016,000
The Committee recommendation includes $1,303,016,000 for
the Eunice Kennedy Shriver National Institute of Child Health
and Human Development [NICHD]. The budget request for fiscal
year 2012 is $1,352,189,000 and the comparable level for fiscal
year 2011 is $1,317,854,000.
Adverse Pregnancy Outcomes.--The Committee is pleased with
the progress NICHD has made to identify women at risk for long-
term morbidity, as women with severe, early adverse pregnancy
outcomes are at increased risk for chronic health problems. The
Committee encourages NICHD to continue developing strategies to
prevent long-term adverse outcomes in these women.
Chromosome Abnormalities.--The Committee appreciates recent
accomplishments by NIH in addressing the science of dosage-
sensitive and -insensitive genes. The Committee now urges NIH
to leverage these efforts to achieve the translational science
goal of producing detailed clinical data that can both move the
science forward by being useful to researchers and assist
clinicians in working with affected individuals and their
families. The Committee also acknowledges and appreciates the
ongoing NIH activities related to genetic disorders but urges
new funding to support independent investigators whose work can
provide pilot data or insight into future directions for the
study of chromosome abnormalities, particularly those involving
chromosome 18.
Demographic and Economic Research.--The Institute's
investment in population-representative longitudinal studies,
such as the National Longitudinal Study of Adolescent Health,
the National Longitudinal Study of Youth Child Supplement and
Panel Study of Income Dynamics has yielded groundbreaking
scientific research and served as a model for making publicly
funded research data widely available, spurring cost-effective
research in numerous disciplines and across multiple
institutions. The Committee urges NICHD to continue investing
in these large-scale population data sets and to sustain
support for critical research infrastructure for demographic
and behavioral population science.
Learning and School Readiness.--The Committee recognizes
the important contribution of NICHD in establishing the
scientific foundation of the development of reading, math and
science skills that are critical to maintaining the Nation's
competitiveness in math and science achievement.
Maternal Morbidity.--Though maternal morbidity rates are
rising, the Committee understands that there are no uniform
definitions of severe maternal morbidity. The Committee
encourages NICHD to hold a consensus workshop to identify such
definitions, which would help Federal, State and local agencies
and research institutions establish standardized and
interoperable processes for surveillance, data collection and
research.
Metabolic Bone Disease.--The Committee is encouraged by
results thus far from the Bone Mineral Density in Childhood
Study, which will serve as a valuable resource for clinicians
and investigators to assess bone deficits in children and risk
factors for impaired bone health. The Committee urges the
Institute to extend the study and explore additional research
that will lead to a better understanding and prevention of
osteopenia and osteoporosis.
Preterm Birth.--The Committee notes that the preterm birth
rate has begun to decline from its peak of 12.8 percent in 2006
to 12.3 percent in 2008. The Committee urges increased Federal
investment to continue the downward trend. Specifically, the
Committee urges NICHD to expand its support of prematurity
research by creating integrated transdisciplinary research
centers on preterm birth as recommended by the Institute of
Medicine and the Surgeon General's Conference on the Prevention
of Preterm Birth. To initiate this process, the Committee
encourages NICHD to establish transdisciplinary research
centers for prematurity. The Committee also encourages NICHD to
expand its support for preterm birth-related research through
the Maternal-Fetal Medicine Units Network, the Neonatal
Research Network and the Genomic Proteomic Network for Preterm
Birth Research.
Prosthetics Research.--The Committee is aware that
increasing numbers of Americans are undergoing amputation as a
result of the growing prevalence of diabetes, cardiovascular
disease and other reasons. The Committee also understands that,
to date, little research has been done to examine prosthetic
outcomes and to link prosthetic and orthotic treatments,
devices and supports to patient outcomes. In order to support
evidence-based healthcare practice in prosthetics and
orthotics, and establish which approaches work best for which
patients, the Committee encourages NICHD to work with the
National Institute on Disability and Rehabilitation Research
and experts in the field of prosthetic research to develop a
prosthetics outcomes research agenda and implement needed
research.
Psychotropic Drugs and Children.--The Committee is aware
that NICHD has formed a special workgroup, which includes
representatives from NIMH and the FDA, to better understand the
impact of medications on developing children. The Committee
requests an update in the fiscal year 2013 congressional budget
justification on the workgroup's activities regarding
psychotropic drugs and a description of the basic and clinical
research the workgroup believes should be undertaken.
Rehabilitation Research.--The Committee commends NIH for
appointing a blue-ribbon panel to evaluate rehabilitation
research at the National Center for Medical Rehabilitation
Research [NCMRR] and across all of NIH. The Committee requests
a copy of the panel's report when it is available. The panel is
urged to identify gaps in the field of rehabilitation research
and recommend which ICs or other Federal agencies should be
responsible for addressing them. In addition, the Committee
recognizes the improvements that have been made in delineating
rehabilitation research as part of NIH reporting mechanisms
established since the passage of the NIH Reform Act. However,
the Committee encourages NIH, through the leadership of NCMRR,
to further clarify a consistent definition of rehabilitation
across all institutes and centers and to seek ways to delineate
between physical, cognitive, mental and substance abuse
rehabilitation when characterizing NIH-supported research.
Finally, the Committee encourages NCMRR to explore the broader
social, emotional and behavioral context of rehabilitation,
including effective interventions to increase social
participation and reintegrate individuals with disabilities
into their communities.
SMA Newborn Screening.--The Committee applauds NICHD for
funding a pilot study of newborn screening for spinal muscular
atrophy [SMA] that will confirm the efficacy and accuracy of
the SMA screening technology. The Committee understands that
newborn screening holds promise for assisting with early
interventions of SMA and developing improved and more
standardized care protocols for patients living with SMA, and
it may also assist in the development of potential drug
therapies. Natural history, preclinical and preliminary
clinical data all suggest that potential therapies will
demonstrate the greatest effectiveness when delivered
presymptomatically. The Committee encourages NICHD to support
the development of crucial follow-up care protocols for
children identified with SMA through the pilot study, and to
report on progress made in this area in the fiscal year 2013
budget justification.
Vulvodynia.--The Committee is encouraged by positive signs
that NICHD is devoting greater attention to this long-neglected
condition, especially with regard to stimulating interest in
both the intramural and extramural research community and
ensuring adequate representation of vulvodynia experts on peer-
review panels. The Committee expects to be updated on progress
in these areas in the fiscal year 2013 congressional budget
justification. The Committee also notes that vulvodynia often
coexists with other persistent pain conditions, including
interstitial cystitis, fibromyalgia, temporomandibular joint
and muscles disorders, irritable bowel syndrome, endometriosis,
headache, and chronic fatigue syndrome. The Committee strongly
urges the creation of a trans-NIH research initiative that will
support studies aimed at identifying common etiological
pathways among these disorders, with the goal of developing
potential therapeutic targets.
NATIONAL EYE INSTITUTE
Appropriations, 2011.................................... $700,828,000
Budget estimate, 2012................................... 719,059,000
Committee recommendation................................ 692,938,000
The Committee recommendation includes $692,938,000 for the
National Eye Institute [NEI]. The budget request for fiscal
year 2012 is $719,059,000 and the comparable level for fiscal
year 2011 is $700,828,000.
Age-Related Macular Degeneration [AMD].--The Committee
commends NEI for conducting the Comparison of AMD Treatments
Trial, a comparative effectiveness trial of the two leading
anti-angiogenic drug therapies currently used to treat the
``wet'' form of AMD.
Diabetic Eye Disease.--The Committee acknowledges the NEI
Diabetic Retinopathy Clinical Research Network's results that
laser treatment for diabetic macular edema, when combined with
anti-angiogenic drug treatment, is more effective than laser
treatment alone, and notes that this finding will revolutionize
the standard of care that has been in place for the past 25
years. With NIDDK leading a new NIH strategic plan to combat
diabetes, NEI's research through its various diabetic eye
disease networks will be more important than ever.
Genetic Basis of Eye Disease.--The Committee commends NEI
for elucidating the genetic basis of devastating eye diseases,
such as AMD, retinitis pigmentosa and glaucoma. The Committee
is pleased that, building upon the first successful use of
genome-wide association studies [GWAS] to determine the
increased risk of developing AMD from gene variants, NEI has
created a new International AMD Genetics Consortium to bring
together researchers to share and analyze GWAS results to
further determine the genetic basis of the disease.
Translational Research.--The Committee commends NEI's
translational research initiatives through partnerships with
other ICs, other agencies within HHS, and private funding
organizations. The Committee acknowledges NEI's leadership of
the human gene therapy clinical trial for neurodegenerative eye
disease Leber Congenital Amaurosis, which has indicated that
the treatment is safe and produces lasting visual improvement,
and it is pleased that NEI is expanding the trial to younger
patients with less severe disease.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
Appropriations, 2011.................................... $683,724,000
Budget estimate, 2012................................... 700,537,000
Committee recommendation................................ 676,033,000
The Committee recommendation includes $676,033,000 for the
National Institute of Environmental Health Sciences [NIEHS].
The budget request for fiscal year 2012 is $700,537,000 and the
comparable level for fiscal year 2011 is $683,724,000.
Multidisciplinary Research.--The Committee notes that
research conducted through NIEHS is steadily revealing
previously unrecognized influences of environmental exposures
on a wide range of diseases and conditions, including breast
cancer, autism, obesity, asthma and chemical sensitivities, and
has the potential to lead to novel methods of preventing,
detecting and treating disease. The Committee commends NIEHS
for its research across many disease areas, including the
Institute's translational and community-based studies, and
involving those living in rural communities.
Public Health Hazards.--The Committee recommends that NIEHS
address the public health hazards associated with exposure to
volcanoes, such as on the Big Island of Hawaii, and continue
efforts to evaluate the health impact of natural environmental
hazards.
NATIONAL INSTITUTE ON AGING
Appropriations, 2011.................................... $1,100,481,000
Budget estimate, 2012................................... 1,129,987,000
Committee recommendation................................ 1,088,091,000
The Committee recommendation includes $1,088,091,000 for
the National Institute on Aging [NIA]. The budget request for
fiscal year 2012 is $1,129,987,000 and the comparable level for
fiscal year 2011 is $1,100,481,000.
Age-Related Bone Loss.--The Committee supports the
Institute's continuing Biology of Aging Program and appreciates
the focus on developing a further understanding of aging
processes, health and longevity. Given the demographics of our
rapidly aging population, a continuing need exists for new
therapeutic approaches to prevent and treat age-related bone
loss, fractures and other metabolic bone diseases, including
osteogenesis imperfecta, glucocorticoid-induced osteoporosis
and bone loss due to kidney disease.
Basic Behavioral Research.--The Committee applauds the
Institute's leadership role in the OppNet initiative, which
will build a collective body of knowledge about the nature of
behavioral systems, deepen the understanding of basic
mechanisms of behavioral processes and emphasize the relevance
of basic behavioral science research throughout NIH's mission.
Demographic and Economic Research.--The Committee commends
NIA for prioritizing support of the Health and Retirement Study
[HRS], which includes data from a representative sample of
20,000 Americans aged 50 and over regarding their health and
healthcare needs, income and savings, and work and retirement
plans. NIA is especially encouraged to continue its successful
collaboration and co-funding agreements for the HRS with the
Social Security Administration. The Committee commends NIA's
initiative in developing comparable international surveys,
particularly in countries that have aged faster than the United
States. The Committee anticipates important research advances
regarding gene-environment interactions once the genome-wide
array study of the HRS sample is fully implemented.
Life Course Perspectives.--The Committee encourages NIA to
maintain its important emphasis on life course studies, which
focus on how transitions among family and other relationships
may affect health, healthcare and aging.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2011.................................... $534,349,000
Budget estimate, 2012................................... 547,891,000
Committee recommendation................................ 528,332,000
The Committee recommendation includes $528,332,000 for the
National Institute of Arthritis and Musculoskeletal and Skin
Diseases [NIAMS]. The budget request for fiscal year 2012 is
$547,891,000 and the comparable level for fiscal year 2011 is
$534,349,000.
Marfan Syndrome.--The Committee encourages NIAMS to expand
support for research on the multi-body system disorder Marfan
syndrome, including musculoskeletal and extracellular matrix
biology studies.
Scleroderma.--The Committee continues to prioritize
research on scleroderma and commends the Institute for its
ongoing efforts in this area. The Committee notes the high
mortality associated with pulmonary complications from
scleroderma, and it encourages NIAMS to collaborate with NHLBI
on this important issue.
Temporomandibular Joint [TMJ] Disorders.--Many people who
have TMJ disorders suffer from conditions that routinely affect
other joints in the body, such as trauma and arthritis.
Therefore, the Committee calls on NIAMS to collaborate with
NIDCR to study 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 pain and dysfunction.
The Committee also urges NIAMS to support comparative studies
of the TMJ with other joints that could document similarities
and differences at the clinical and molecular levels.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2011.................................... $415,155,000
Budget estimate, 2012................................... 426,043,000
Committee recommendation................................ 410,482,000
The Committee recommendation includes $410,482,000 for the
National Institute on Deafness and Other Communication
Disorders [NIDCD]. The budget request for fiscal year 2012 is
$426,043,000 and the comparable level for fiscal year 2011 is
$415,155,000.
Early Detection, Diagnosis and Intervention.--The Committee
urges NIDCD to continue to study the speech, language, voice,
auditory and psychosocial outcomes of children identified with
hearing loss through newborn screening, including evaluation of
different sound amplification strategies (including multiple
hearing aid fittings) on perception and understanding; the
impact of complex listening environments, such as noisy
classrooms, on hearing aid performance; and the effects of
parental engagement and delivery of services on emotional well-
being. The Committee also recommends continuing study of the
neurological basis of variability in outcomes in children with
cochlear implants.
Hair Cell Regeneration.--The Committee continues to place a
high priority on research involving inner ear hair cell
regeneration and stem cells. It applauds NIDCD's development of
a system for making what appear to be functional hair cells
from stem cells and recommends further studies in this area.
The Committee encourages continuing development of in vitro
assays to identify molecules involved in the differentiation of
adult and embryonic stem cells into specific cell types used in
communication, as well as research on how to regenerate
connections between nerve cells that project to the brain and
replacement hair cells. Also advocated are the continuation of
gene transfer studies that have shown transcription factors are
able to induce some non-sensory cells within the cochlea to
develop as neurons.
Hearing Aids and Cochlear Implants.--The Committee is
pleased that NIDCD has launched a series of research
initiatives between clinicians and researchers based on
recommendations from a 2009 NIDCD Working Group on Accessible
and Affordable Health Care for Adults with Mild to Moderate
Hearing Loss. The Committee urges continuing collaborations
between industry, scientists, clinicians and consumers in the
area of low-cost hearing aids so that more of the population
who need hearing aids can obtain them at affordable costs. The
Committee is aware that some individuals need alternative
hearing prostheses and therefore recommends additional studies
evaluating the ``bimodal'' option of an implant in one ear and
a hearing aid in the other as well as the option of implanting
a short electrode, which combines electric and acoustical
stimulation in the same ear.
Synapse Function.--The use of hearing aids and cochlear
implants may be limited by dramatic changes in synapse
connections following developmental hearing loss. Recognizing
this, the Committee supports research on genetic and cellular
mechanisms of normal synapse function and on approaches to
prevent or reverse deafness-caused disruptions that affect
one's ability to benefit from aids or implants.
Hearing Impairment Among Children and Young Adults.--The
Committee urges additional research on children and young
adults with unilateral hearing loss [UHL] from all modes of
injury. In particular, it recommends further studies on
educational and behavioral problems among children with UHL and
development of strategies to minimize this risk. The Committee
also supports additional research to understand the
susceptibility of adolescents and young adults to develop
noise-induced hearing loss. The Committee commends NIDCD for
its public education efforts about the dangers of hearing loss
from noise exposure, especially the ``It's a Noisy Planet.
Protect Their Hearing'' campaign, which was expanded to include
Spanish language publications.
Hereditary Hearing Loss.--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 Hearing Loss.--The Committee continues to put
a high priority on better understanding and preventing noise-
induced hearing loss. In particular, the Committee encourages
NIDCD to support environmental and genetics studies assessing
predisposition to noise-induced hearing loss and additional
research on the use of antioxidants and other micronutrients to
prevent cell death in the inner ear. Genetic and proteomic
studies in zebrafish concerning the effect of ototoxic drugs on
hair cells are also encouraged.
Otitis Media.--The Committee recognizes the threat to
infants' and children's health and development from ear
infection, or otitis media. The Committee therefore urges NIDCD
to accelerate its research on the pathogenesis of ear infection
and its consequences. In particular, it urges additional
studies of genetic risk factors, new treatments for chronic and
recurrent otitis media, and new methods for the delivery of
drugs to the middle ear.
Plasticity.--The Committee continues to support research on
functional changes of neurons and synapses of the central
auditory nervous system during development and following
hearing loss. Specifically, the Committee encourages the
continuation of brain-imaging research in children with severe
to profound unilateral hearing loss to understand the
reorganization that occurs to process sound, speech and
language, as well as experiments in animals to understand
perceptual and neural coding changes in the auditory cortex
during conductive hearing loss and after restoration of normal
hearing.
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 NIDCD's support of a P50
Specialized Center on Experimental and Clinical Studies of
Presbycusis. The Committee also recommends support for temporal
bone banks so that inner ear bones from individuals diagnosed
with presbycusis can be studied.
Tinnitus.--The Committee urges NIDCD to address the lack of
knowledge about the specific neural dysfunction responsible for
tinnitus. It also encourages research on the prevention,
treatment and cure of this prevalent disorder, including
identifying chemicals to prevent development of chronic
tinnitus; developing preventative delivery methods for ototoxic
drugs; and discovering treatments to suppress hearing-system
hyperactivity.
Translational Research.--The Committee recommends
additional research activities and clinical trials on the
prevention and treatment of hearing loss from noise, drugs,
aging, and genetic causes, and translation of these studies to
therapies. Clinical trials relevant to Meniere's disease,
sudden deafness and autoimmune inner ear disease are
encouraged.
Usher Syndrome.--The Committee encourages NIDCD to continue
to support genetic research into Usher syndrome, the most
common condition that affects both hearing and vision.
Vestibular Research.--The Committee continues to urge the
NIDCD to conduct vestibular research in animal models and
humans.
NATIONAL INSTITUTE OF NURSING RESEARCH
Appropriations, 2011.................................... $144,381,000
Budget estimate, 2012................................... 148,114,000
Committee recommendation................................ 142,755,000
The Committee recommendation includes $142,755,000 for the
National Institute of Nursing Research [NINR]. The budget
request for fiscal year 2012 is $148,114,000 and the comparable
level for fiscal year 2011 is $144,381,000.
Science-Driven Practice.--The Committee supports NINR's
efforts to prepare faculty researchers, who are desperately
needed to educate new nurses. NINR's continued commitment to
the science-driven practice of the nursing profession remains
vital to preventing disease, improving quality patient care,
and ensuring the proper training and development of nurse
researchers.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
Appropriations, 2011.................................... $458,286,000
Budget estimate, 2012................................... 469,197,000
Committee recommendation................................ 453,127,000
The Committee recommendation includes $453,127,000 for the
National Institute on Alcohol Abuse and Alcoholism [NIAAA]. The
budget request for fiscal year 2012 is $469,197,000 and the
comparable level for fiscal year 2011 is $458,286,000.
Underage Drinking Initiatives.--The Committee applauds
NIAAA's continued focus on underage alcohol use and college
binge drinking research. The Committee urges NIAAA to continue
research to evaluate campus-based programs that seek to reduce
drinking and related problems among college students using both
individual and environmental approaches, including mandated
intervention and/or treatment and community partnerships that
involve heavy publicity and highly visible enforcement. The
Committee recognizes the critical role of psychological
research in understanding drinking behavior and in developing
behaviorally based interventions as well as the demonstrated
effectiveness of those interventions alone or in combination
with pharmacotherapy.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2011.................................... $1,050,542,000
Budget estimate, 2012................................... 1,080,018,000
Committee recommendation................................ 1,038,714,000
The Committee recommendation includes $1,038,714,000 for
the National Institute on Drug Abuse [NIDA]. The budget request
for fiscal year 2012 is $1,080,018,000 and the comparable level
for fiscal year 2011 is $1,050,542,000.
Blending Initiative.--The Committee is concerned that NIDA
has reduced funding for activities that help State substance
abuse agencies infuse into the Nation's publicly funded
substance abuse system the knowledge gained by NIDA's research.
In particular, the Committee is concerned that NIDA reduced
funds for its Blending Initiative, which supported a dialogue
between NIDA, SAMHSA and State substance abuse agencies on
``research to practice'' and ``practice to research''
activities. The Committee urges NIDA to allocate funding to re-
engage State substance abuse agencies on this important issue.
Education.--The Committee encourages NIDA to continue its
work in the area of education to inform people of all ages of
the detriment to society that drug abuse causes in terms of
pronounced effects on health and the extensive expense to the
economy of the Nation.
Medications Development.--The Committee encourages NIDA to
use all available mechanisms, including the Small Business
Innovation in Research program, to expand support for
medications development to treat diseases of drug abuse and
addiction.
Military Personnel, Veterans, and Their Families.--The
Committee commends NIDA for its successful 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. Many military personnel need help confronting
war-related problems including traumatic brain injury, post-
traumatic stress disorder, depression, anxiety, sleep
disturbances, and substance abuse, including tobacco, alcohol
and other drugs. Many of these problems are interconnected and
contribute to individual health and family relationship crises,
yet there has been little research on how to prevent and treat
the unique characteristics of wartime-related substance abuse
issues. The Committee commends NIDA for this crucial work.
Prescription Drug Abuse.--The Committee applauds the
Committee for its continued effort to halt prescription drug
abuse. This effort requires the cooperation of many components
of the Federal Government, but NIDA should maintain its
comprehensive leadership role in this important area.
Substance Abuse by Teenagers.--The Committee urges NIDA to
concentrate its effort to reverse the recent increase in
experimentation in substance abuse by teenagers. This effort
will require innovative approaches in the education, prevention
and treatment arenas.
Translational Research.--The Committee recognizes the value
of the translational research funded by NIDA, which includes
preventive and treatment modalities directed toward a decrease
in drug experimentation and most importantly the development of
treatments for the diseases of drug dependence.
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2011.................................... $1,477,292,000
Budget estimate, 2012................................... 1,517,006,000
Committee recommendation................................ 1,460,671,000
The Committee recommendation includes $1,460,671,000 for
the National Institute of Mental Health [NIMH]. The budget
request for fiscal year 2012 is $1,517,006,000 and the
comparable level for fiscal year 2011 is $1,477,292,000.
HIV/AIDS Behavioral Research.--The Committee supports
NIMH's critical work in developing behavioral interventions to
prevent the spread of HIV/AIDS across multiple populations as
well as addressing co-morbid mental and substance abuse
disorders. The Committee recognizes that new research is needed
to ensure the long-term maintenance of behavior changes as HIV/
AIDS has become a chronic disease. Behavioral research aimed at
reducing the likelihood of HIV infection should include
structural, environmental and socioeconomic variables to ensure
that research-based interventions can be evaluated as
appropriate for racial and ethnic minority populations.
Premature Mortality.--The Committee continues to be
concerned about premature mortality and lower life expectancy
experienced by adults living with serious mental illness as
result of treatable medical conditions such as cardiovascular,
pulmonary, endocrine, and infectious diseases. The Committee
urges NIMH to collaborate with other institutes including NIDDK
and NHLBI on a focused research program into the causes and
interventions needed to address this crisis. The Committee
requests an update on this topic in the fiscal year 2013 budget
justification.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2011.................................... $511,497,000
Budget estimate, 2012................................... 524,807,000
Committee recommendation................................ 505,738,000
The Committee recommendation includes $505,738,000 for the
National Human Genome Research Institute [NHGRI]. The budget
request for fiscal year 2012 is $524,807,000 and the comparable
level for fiscal year 2011 is $511,497,000.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
Appropriations, 2011.................................... $313,802,000
Budget estimate, 2012................................... 322,106,000
Committee recommendation................................ 333,671,000
The Committee recommendation includes $333,671,000 for the
National Institute of Biomedical Imaging and Bioengineering
[NIBIB]. The budget request for fiscal year 2012 is
$322,106,000 and the comparable level for fiscal year 2011 is
$313,802,000.
The recommended increase for NIBIB over the fiscal year
2011 level results from the planned transfer of several grants
focused on point-of-care diagnostics and biomedical imaging
from NCRR.
NATIONAL CENTER FOR RESEARCH RESOURCES
Appropriations, 2011.................................... $1,257,754,000
Budget estimate, 2012................................... 1,297,900,000
Committee recommendation................................................
The Committee recommends eliminating the National Center
for Research Resources [NCRR] as part of its plan to create
NCATS. The budget request for fiscal year 2012 is
$1,297,900,000 and the comparable level for fiscal year 2011 is
$1,257,754,000.
The Committee recommendation includes sufficient funding to
accommodate the transfer of programs currently administered by
NCRR to NIGMS, NIBIB, NIMHD, NHLBI and OD.
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE
Appropriations, 2011.................................... $127,713,000
Budget estimate, 2012................................... 131,002,000
Committee recommendation................................ 126,275,000
The Committee recommendation includes $126,275,000 for the
National Center for Complementary and Alternative Medicine
[NCCAM]. The budget request for fiscal year 2012 is
$131,002,000 and the comparable level for fiscal year 2011 is
$127,713,000.
Access to Natural Product Collections.--The Committee
supports the efforts of NCCAM to increase its access to
comprehensive and professionally organized natural product
libraries, as such collections represent valuable research
resources to facilitate the efficiency and cost-effectiveness
of the Center's research program.
Behavioral Interventions.--The Committee commends NCCAM's
support of research on the cognitive and emotional effects of
mindfulness meditation, and it encourages the Center to
collaborate with other institutes and centers to explore
additional behavioral interventions.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES
Appropriations, 2011.................................... $209,713,000
Budget estimate, 2012................................... 214,608,000
Committee recommendation................................ 272,650,000
The Committee recommendation includes $272,650,000 for the
National Institute on Minority Health and Health Disparities
[NIMHD]. The budget request for fiscal year 2012 is
$214,608,000 and the comparable level for fiscal year 2011 is
$209,713,000.
The bill includes new language allowing the planned
transfer of the Research Centers in Minority Institutions
program from NCRR. This transfer accounts for most of the
recommended increase for NIMHD over the fiscal year 2011 level.
Diabetes.--The Committee urges NIMHD to expand, intensify
and support ongoing research and other activities with respect
to pre-diabetes and diabetes, particularly type 2 diabetes, in
minority populations, including research to identify clinical,
socioeconomic, geographical, cultural and organizational
factors that contribute to diabetes in such populations.
Specifically, the Committee encourages the Institute to support
research on behavior and obesity; environmental factors that
may contribute to the increase in type 2 diabetes in
minorities; environmental triggers and genetic interactions
that lead to the development of type 2 diabetes in minority
newborns; genes that may predispose individuals to the onset of
type 1 and type 2 diabetes and its complications; methods and
alternative therapies to control blood glucose; and diabetic
and gestational diabetic pregnancies in minority mothers. The
Committee also asks that NIH, through NIMHD and the National
Diabetes Education Program, mentor health professionals to be
more involved in weight counseling, obesity research and
nutrition; provide for the participation of minority health
professionals in diabetes focused research programs; and
encourage increased minority representation in diabetes-focused
health fields.
Glomerular Diseases.--The Committee notes that African-
Americans are five times more likely to develop glomerular
diseases, such as focal segmental glomerulosclerosis [FSGS],
than Caucasians. The Committee urges NIMHD to collaborate with
NIDDK on this important issue.
Obesity.--The Committee strongly urges NIH to continue to
support research to identify and reduce health disparities,
including studies focusing on populations at disproportionate
risk for obesity and its accompanying health consequences such
as, but not limited to, cancer, diabetes and cardiovascular
disease. To effectively address the problem of obesity and its
health consequences, the Committee requests that NIMHD
intensify its investment in obesity research and review the
benefits of establishing a Comprehensive Center of Excellence
for Obesity Research and Prevention. Further, the Committee
urges NIH to develop a trans-NIH strategy for obesity research
that is coordinated and has a significant health disparity
obesity research focus coordinated through NIMHD. This
comprehensive approach will critically and systematically
explore the causes and potential solutions for health
disparities in obesity. Studies should focus on regions with
populations at disproportionate risk for obesity and its health
consequences, in particular populations most affected--racial
and ethnic minorities, low-income populations and rural
populations--and include regional analysis. The Committee
requests NIH to participate in a trans-HHS working group that
sets measurable objectives based on scientific data and
information that leverages the appropriate HHS agencies like
AHRQ and CDC in order to improve dissemination and
implementation of scientific information to clinicians and
community organizations to aggressively improve obesity rates
in health disparate populations.
Scleroderma.--The Committee commends the Institute for
establishing the Exploratory Centers of Excellence Program and
is pleased that health disparities research related to
scleroderma will be prioritized.
JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH
SCIENCES
Appropriations, 2011.................................... $69,436,000
Budget estimate, 2012................................... 71,328,000
Committee recommendation................................ 68,653,000
The Committee recommendation includes $68,653,000 for the
Fogarty International Center [FIC]. The budget request for
fiscal year 2012 is $71,328,000 and the comparable level for
fiscal year 2011 is $69,436,000.
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, 2011....................................................
Budget estimate, 2012...................................................
Committee recommendation................................ $582,326,000
The Committee recommendation includes $582,326,000 to
create the National Center for Advancing Translational Sciences
[NCATS].
NCATS will house several programs that are currently
administered by and/or funded through NCRR, NHGRI or OD. They
include Clinical and Translational Science Awards [CTSAs],
Therapeutics for Rare and Neglected Diseases [TRND], Rapid
Access to Interventional Development, the Office of Rare
Diseases Research [ORDR] and the NIH-FDA Regulatory Science
Initiative.
The recommended appropriation for NCATS is sufficient to
fund the above programs at the same level at which they were
funded in fiscal year 2011. The Committee especially urges no
reduction in funding for CTSAs.
In addition, the Committee includes $20,000,000 to create
the Cures Acceleration Network [CAN], which was authorized in
the Patient Protection and Affordable Care Act. The Committee
believes this program offers exciting potential to help speed
the translation and application of promising new treatments for
diseases. CAN is authorized to make grants to biotech
companies, universities and patient advocacy groups to target
new discoveries that have shown potential at the laboratory
level but have not advanced far enough to attract significant
investments from the private sector. Specifically, CAN will
focus on funding the development of ``high need cures,'' which
are defined as drugs, biological products or medical devices
that the NIH Director determines to be a priority ``to
diagnose, mitigate, prevent, or treat harm from any disease or
condition, and for which the incentives of the commercial
market are unlikely to result in its adequate or timely
development.'' CAN is also intended to reduce the barriers
between laboratory discoveries and clinical trials for new
therapies and facilitate FDA review for the high need cures
funded by this initiative.
Two types of awards are authorized--grant awards and
partnership awards, the latter of which require a $1 to $3
match. Up to 20 percent of the appropriated funds may be used
to obligate funds through ``other transactions,'' which are
funding agreements or mechanisms that are not grants,
contracts, or cooperative agreements, and are intended to
provide additional flexibility akin to that of the Department
of Defense's Defense Advanced Research Projects Agency [DARPA].
Behavioral Research.--The Committee encourages NCATS to
include staff expertise and resources to manage research on the
translation of behavioral interventions into communities.
Clinical and Translational Science Awards [CTSAs].--The
Committee is encouraged by the success of the CTSA consortium
and strongly recommends that the program be fully funded,
consistent with professional judgment, as it nears full
implementation. As the CTSA program transitions to NCATS, the
Committee urges the NIH Director to ensure that the current
focus on the full spectrum of translational research is
maintained. The inclusion of patient-centered outcomes
research, community engagement, training, dissemination
science, and behavioral research is extremely important to the
translation and application of basic science discoveries and
success of the CTSAs.
Drug Repurposing.--There are over 11,000 commercial
compounds that are in a pool of late-stage, pre-clinical
through phase III clinical trials that have been tested in
humans, but whose development has been discontinued by
pharmaceutical companies. By leveraging existing compounds,
researchers and industry can develop new treatments for
patients. The Committee encourages NIH to work with
pharmaceutical companies to support drug repurposing and the
sharing of compounds; in particular, NIH is encouraged to
develop guidelines for drug repurposing technology transfer
agreements.
Dystonia Coalition.--The Committee commends ORDR for the
work conducted in the Rare Diseases Clinical Research Network
and requests an update on the patient registry of the Dystonia
Coalition.
Hereditary Angioedema [HAE].--The Committee encourages ORDR
and relevant Institutes and Centers to expand research on HAE,
a rare and potentially life-threatening genetic condition. In
particular, the Committee urges ORDR to support a scientific
conference on HAE, with the goal of identifying research
opportunities and priorities for this disease.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2011.................................... $336,733,000
Budget estimate, 2012................................... 387,153,000
Committee recommendation................................ 358,979,000
The Committee recommendation includes $358,979,000 for the
National Library of Medicine [NLM]. The budget request for
fiscal year 2012 is $387,153,000 and the comparable level for
fiscal year 2011 is $336,733,000. An additional $8,200,000 is
made available from program evaluation funds. Of the funds
provided, $4,000,000 is for the improvement of information
systems, to remain available until expended.
The Committee recommendation allows that additional funding
for the National Center for Biotechnology Information and
support for the Public Access program may be provided directly
to NLM. Under current practice, some of this funding is
provided to NLM through a small tap on ICs.
OFFICE OF THE DIRECTOR
Appropriations, 2011.................................... $1,166,963,000
Budget estimate, 2012................................... 1,298,412,000
Committee recommendation................................ 1,439,064,000
The Committee recommendation includes $1,439,064,000 for
the Office of the Director [OD]. The budget request for fiscal
year 2012 is $1,298,412,000 and the comparable level for fiscal
year 2011 is $1,166,963,000.
The recommended increase for OD over the fiscal year 2011
level results from several changes connected to the planned
elimination of NCRR. OD will now house the Comparative Medicine
Program, including National Primate Research Centers; shared
and high-end instrumentation; Science Education Partnership
Awards; and selected other programs that are currently
administered by NCRR.
The Committee recommendation is sufficient to allow up to
$189,215,000 to be used for continuation of the National
Children's Study.
The Committee recommends $537,811,000 for the Common Fund.
The budget request is $556,890,000 and the fiscal year 2011
level is $543,021,000.
Angiogenesis.--The Committee encourages NIH to support
research that will determine the role angiogenesis may have in
disease prevention and intervention. The Trans-Institute
Angiogenesis Research Program should implement a vigorous
agenda that examines current angiogenesis therapies in order to
improve outcomes. In particular, the Committee urges NCI to
take a leading role in examining angiogenic levels in the body
prior, during and after treatments. The Committee urges NIH to
use current population studies to determine the angiogenic
effect of medication, diet and lifestyle. 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.
Autism.--The Committee encourages NIMH, NINDS and NICHD to
expand their support for the development of clinically based
therapeutics for autistic children through the use of a variety
of mechanisms, including grants, contracts and the Small
Business Innovation in Research program.
Black Scientists.--The Committee is deeply disturbed by the
recent study which found that between 2000 and 2006, black
scientists were much less likely to win approval of R01 grants
than white scientists, even after controlling for the education
level of the applicants and the academic institution where they
work. Also of concern is the disproportionately low number of
black researchers who applied for a grant--just 1.5 percent of
all applicants. In addition, the study raises questions about
the effectiveness of NIH's graduate and postgraduate training,
as black researchers do not seem to benefit from this training
as much as white researchers do. The Committee notes that NIH
itself funded this study and that the agency appears to be
responding with significant actions designed to redress the
disparities. Ultimately, however, NIH will be judged on whether
the disparities are reduced. The Committee requests an update
on this issue in the fiscal year 2013 congressional budget
justification.
Bone Research.--The Committee urges the Director to work
with all relevant institutes to enhance interdisciplinary
research leading to targeted therapies for improving bone
density, quality and strength for all Americans. More
scientific knowledge is needed in a number of key areas
involving bone and muscle, fat and the central nervous system.
Research is also urgently needed to improve the identification
of populations who might require earlier treatment because they
are at risk of rapid bone loss due to a wide range of
conditions or diseases, including obesity, diabetes, chronic
renal failure, cancer, HIV, conditions that affect absorption
of nutrients or medications, or addiction to tobacco, alcohol
or other opiates. The Committee also encourages NIH to develop
a plan to expand genetics and other research on rare bone
diseases, including: osteogenesis imperfecta, Paget's disease
of bone, fibrous dysplasia, osteopetrosis, fibrous ossificans
progressiva, melorheostosis, X-linked hypophosphatemic rickets,
multiple hereditary exostoses and multiple osteochondroma.
Chemical Risk Assessment.--The Committee understands that
NIH supports a new approach on chemical risk assessment based
on the incorporation of advanced molecular biological and
computational methods in lieu of animal toxicity tests as
outlined in a recent National Research Council report. As part
of that effort, the Committee encourages NIH to continue to
support extramural and ``proof of concept'' studies on the use
of toxicity pathway analyses for assessing human risks to
chemical exposures. The Committee requests an update on these
efforts in the fiscal year 2013 congressional budget
justification.
Chimpanzees.--The Committee is eagerly anticipating the
release later this year of the Institute of Medicine's analysis
of whether chimpanzees should continue to be used in medical
research.
Chronic Fatigue Syndrome [CFS].--The Committee commends NIH
for holding a state of the knowledge workshop on CFS in 2011.
Within 1 year following that workshop, the Committee urges NIH
to develop a CFS research plan outlining a coordinated strategy
for intramural and extramural research on CFS and related
funding opportunity announcements. Further, the Committee
supports the development of a CFS research database to
catalogue the intramural and extramural NIH research funding
that has been awarded for CFS research to date and the
resulting advances.
Class B Animal Dealers.--The Committee is encouraged by the
steps NIH is taking to increase the capacity of Class A vendors
to supply the types of dogs that currently come from Class B
random source dealers; to notify its grant recipients that as
of 2015, the use of NIH grant funds to acquire dogs from Class
B dealers will be prohibited; and to advise its grantees to
identify new sources for such animals. The Committee urges NIH
to set 2015 as the outside target date for completing this
process. Meanwhile, NIH has informed the Committee that no
phase-out of cats from Class B vendors is needed, because
sufficient numbers of cats currently are available through
Class A vendors to support the needs of NIH-supported research.
If there is already no need for Class B cats in NIH-funded
research, the Committee sees no reason why NIH should wait
until Class B dogs are prohibited--a process that will take at
least 3 years--to prohibit the use of Class B cats as well. The
Committee therefore expects NIH to begin informing researchers
of this policy as soon as possible and requests an update in
the fiscal year 2013 congressional budget justification.
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 and acknowledges that improvements to date
have largely focused on enhanced supportive care. The Committee
cites the strong need for further research regarding treatments
that target the underlying cause of CF and recognizes that
protein structural studies may advance the understanding of the
mechanisms of action of CF drugs in clinical development. The
Committee encourages support for such protein structural
studies and 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.
Eosinophil-Associated Disorders.--The Committee urges NIH
to prioritize research on eosinophilic disorders and develop a
trans-institute strategy involving NIAID, NIDDK, NICHD and
NIMH. Multidisciplinary research efforts are needed to develop
improved methods of diagnosis and treatment in adults and
children and to assess strategies for managing depression and
emotional stress in patients with severe eosinophilic
disorders. NIH should seek opportunities to collaborate with
private sector organizations on this initiative. The Committee
requests an update on this effort in the fiscal year 2013
congressional budget justification.
Fragile X.--The Committee urges NIH, working with NICHD,
the Fragile X Clinical Research Consortium and the private
research sector, to fully implement the NIH Research Plan on
Fragile X Syndrome and Associated Disorders. NIH is encouraged
to support translational research that shows significant
promise of safer and more effective treatments for the various
Fragile X-associated disorders. The Committee requests an
update in the fiscal year 2013 congressional budget
justification regarding the status of federally funded registry
initiatives and how they might be coordinated.
Global Rare Diseases Patient Registry and Data
Repository.--The Committee commends NIH for its plans to
develop the Global Rare Diseases Patient Registry and Data
Repository [GRDR]. The Committee understands that a pilot
program of the GRDR will include the creation of an
infrastructure for an Internet-based platform to aggregate de-
identified patient data from existing and newly established
rare diseases registries and the development of a web-based
template to allow any patient group to establish its own
patient registry. The purpose of this pilot program is to
develop a resource for patient support organizations and the
scientific community, academic centers and industry in the
United States and globally to mine the de-identified, aggregate
data for various medical research studies, including clinical
trials. The Committee encourages NIH to consider Duchenne
muscular dystrophy and glomerular disease for inclusion in the
pilot program.
Hereditary Hemorrhagic Telangiectasia [HHT].--The Committee
urges the Director to bring together representatives from
NHLBI, NINDS, NIDDK, NIAMS, NICHD, NCI and ORDR to develop a
coordinated strategy for advancing research on HHT,
particularly regarding translational research and early
detection and intervention.
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 normal and rare, and
strive to translate research advances and discoveries into
treatments and cures. Furthermore, the Committee recognizes
that meeting the national demand of production of high-quality
biospecimens in a timely manner is crucial to advancing
translational research across all institutes and centers.
Therefore, the Committee urges the Director to maintain core
and trans-NIH support for its nationwide human tissue and organ
procurement network.
Inflammatory Bowel Disease [IBD].--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. The Committee
encourages NIH to expand research in this area in collaboration
with the IBD scientific community. In particular, the Committee
supports expanded genetic and clinical studies of pediatric
patients.
Interdisciplinary Research Consortia and the
NeuroTherapeutics Research Institute.--The Committee encourages
NIH to continue its initial investments in the development of
the Interdisciplinary Research Consortia, in particular the
NeuroTherapeutics Research Institute.
Lymphatic Research and Lymphatic Disease.--The Committee
commends the trans-NIH Coordinating Committee for Lymphatic
Research [CCLR] for its efforts. Nevertheless, stronger
oversight and engagement is needed from the leadership of the
Office of the Director and the ICs to help make more meaningful
advances into the lymphatic system and lymphatic diseases, as
the Committee has requested for many years. In particular, the
Committee requests explicit, prospective, actionable plans and
implementation strategies for each of the 2007 CCLR Working
Group Recommendations that detail the prospective roles that
each pertinent Institute and Center would undertake. A
particular emphasis is needed on the plans for the patient
registry/tissue bank; clinical and experimental imaging
initiatives; the incorporation of additional expertise in
lymphatic biology/disease in the pertinent CSR study sections;
and the creation of programs to train new investigators in
lymphatic research. Furthermore, the Committee urges NIAID and
NIAMS to demonstrate greater emphasis on lymphatics.
Mitochondrial Disease.--The Committee appreciates the
efforts of NIH to study mitochondrial function and primary
mitochondrial disease. Research on primary mitochondrial
disease is highly relevant to progress on a host of common
diseases and conditions where mitochondrial dysfunction is
clearly implicated. The Committee encourages NIH to expand its
mitochondrial research portfolio to support the training of
young investigators in the field and incorporate researchers
with expertise in mitochondrial structure and function into the
grants review and priority-setting process. Finally, the
Committee urges NIH to take tangible actions to implement the
recommendation from NHLBI's 2007 symposium on ``Modeling
Mitochondrial Dysfunction'' that NIH should better coordinate
and share the advances that have been made by various ICs
regarding mitochondrial disease.
Mobile Technology.--The Committee supports the new
initiative by the Office of Behavioral and Social Sciences
Research [OBSSR] in the area of mobile technology research to
enhance health. The Committee urges that research focus on
developing pilot programs to support smoking cessation, the
prevention and detection of diabetes, and maternal and child
health. The Committee also encourages OBSSR to engage in
discussions with the Department of State and USAID to evaluate
and consider global initiatives in these areas.
Mucopolysaccharidoses [MPS].--The Committee encourages
NINDS, NIDDK, NIAMS and ORDR to expand research efforts in the
development of effective treatments for MPS, a group of
genetic, progressive disorders that are caused by the absence
or malfunctioning of certain enzymes. The Committee also urges
all relevant ICs and the ORDR to fund research consortia and
support conferences on MPS and lysosomal diseases. The
Committee commends NINDS and the ORDR for sponsoring the recent
Gordon Research Conference focusing on the basic science of
lysosomal biology and function but with strong emphasis on
pathogenic mechanisms of lysosomal disease. The Committee also
encourages NIAMS to continue to support investigator-initiated
research focused on the skeletal complications associated with
MPS.
Neurofibromatosis [NF].--NF is an important research area
for multiple NIH institutes. As NF is connected to many forms
of cancer in children and adults, the Committee encourages NCI
to substantially increase its NF research portfolio in pre-
clinical and clinical trials by applying newly developed and
existing drugs. The Committee also encourages NCI to support NF
centers, clinical trials consortia, patient databases, and
biospecimen repositories. The Committee urges additional focus
from NHLBI, given NF's involvement with hypertension and
congenital heart disease. Because NF causes tumors to grow on
the nerves throughout the body, the Committee urges NINDS to
continue aggressive research on nerve damage and repair. In
addition, the Committee continues to encourage NICHD and NIMH
to expand funding of clinical trials for NF patients in the
area of learning disabilities. Children with NF1 are prone to
the development of severe bone deformities, including
scoliosis; the Committee therefore encourages NIAMS to expand
its NF1 research portfolio. The NIDCD is urged to expand its
research on NF2, which accounts for approximately 5 percent of
genetic forms of deafness. The Committee encourages the NEI to
support research on the treatment of optic gliomas, vision loss
and cataracts, major clinical problems associated with NF.
Finally, the Committee encourages NHGRI to expand its NF
portfolio, as NF represents an ideal model to study the
genomics of cancer predisposition, learning and behavior, and
bone disease.
OppNet.--The Committee encourages NIH to continue its
support of the NIH Basic Behavioral and Social Science
Opportunity Network [OppNet] and requests an update on the
network's progress in the fiscal year 2013 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, headache, interstitial
cystitis, irritable bowel syndrome, temporomandibular joint and
muscle disorders, and vulvodynia. As noted by the IOM report on
pain released in June, these poorly understood and neglected
conditions impact 50 million American women and cost the Nation
$80,000,000,000 annually, an amount that could be substantially
reduced with improved research, education and care. 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
pathways of these overlapping conditions, with the goal of
identifying potential therapeutic targets, and expects further
substantial progress to be made this fiscal year. This will
require continued and expanded efforts by all the relevant ICs.
The Committee urges NINDS to take the lead on this effort.
Pain.--The Committee has for many years encouraged a
stronger emphasis on pain research at NIH, and so it notes with
great interest the recent Institute of Medicine report
``Relieving Pain in America: A Blueprint for Transforming
Prevention, Care, Education, and Research.'' The report, which
was mandated by the Patient Protection and Affordable Care Act
and funded by NIH, estimates that chronic pain afflicts at
least 116 million adults in the United States and costs the
Nation between $560,000,000,000 and $635,000,000,000 a year, of
which $99,000,000,000 is borne by the Federal Government and
States. The report documents the growing recognition that
chronic pain can be a disease in itself, causing changes
throughout the nervous that often worsen over time.
Nevertheless, the biological and psychological aspects of pain,
as well as its diagnosis, treatment and prevention, remain
poorly understood. NIH took a first step toward addressing
these questions in a systematic way by creating the NIH Pain
Consortium in 2003. Eight years later, it is clear that NIH
must do more. Although every Institute and Center deals in some
way with pain, none of them ``owns'' this critical area of
research. If that is to be responsibility of the Pain
Consortium rather than an individual IC, then the consortium
needs more resources, more staffing and a more elevated status
within NIH. The IOM report concludes that ``there needs to be a
transformation in how pain research is conducted and that the
Pain Consortium should take an even more proactive role in
effecting that transformation.'' In addition, the report
recommends that the consortium should hold ``more frequent,
regular, structured and productive meetings'' and improve the
process for reviewing grant proposals related to pain, and that
NIH should consider the possibility of identifying a lead IC on
pain. The Committee requests a response to the IOM
recommendations in the fiscal year 2013 congressional budget
justification.
Pediatric Low-Grade Astrocytoma [PLGA].--The Committee
understands that current treatments for PLGA, a slow-growing
children's brain cancer, are invasive, toxic and largely
ineffective, and have not advanced in almost 25 years.
Therefore, the Committee urges NCI, NINDS, NIBIB, and ORDR to
accelerate the pace of expansion of the pediatric cancer
research portfolio by creating research priorities with a
sequential agenda and timeline, and facilitating the
collaboration of organizations (both public and private)
already funding related research initiatives. The Committee
further encourages the institutes to prioritize targeted
translational research projects that will help identify
chemical compounds or combination therapies for use as more
effective, less toxic treatments. The Committee requests an
update on these efforts in the fiscal year 2013 congressional
budget justification.
Primate Research.--The Committee continues to support the
National Primate Research Centers, which allow NIH-supported
scientists to conduct nonhuman primate research in the pursuit
of improving human health.
Product Development Partnerships.--Public-private
partnerships, including product development partnerships
[PDPs], can both enable critical research and development in
the global health arena and create jobs in the United States.
The Committee encourages NIH to cultivate PDPs and to work with
CDC and other agencies that have a role in advancing global
health to identify and pursue other innovative research and
development opportunities.
Rehabilitation Research.--The Committee recognizes the need
to continue to build a sustainable infrastructure and capacity
of emerging scientists in rehabilitation research. The
Committee encourages the use of career development awards for
emerging scientists, such as physical therapists, to meet this
need.
Spina Bifida.--The Committee encourages NIDDK, NICHD and
NINDS to study the causes and care of the neurogenic bladder to
improve the quality of life of children and adults with spina
bifida; to support research to address issues related to
treatment, management and associated secondary conditions, such
as hydrocephalus; and to invest in understanding the myriad co-
morbid conditions experienced by children with spina bifida,
including those associated with both paralysis and
developmental delay.
Tuberous Sclerosis Complex [TSC].--The Committee continues
to encourage additional research on TSC and related
neurological disorders. Because TSC serves as a gateway for
understanding more prevalent neurological disorders such as
autism and epilepsy, the Committee encourages NIH to focus
resources on clinical trials for new drug targets for TSC.
Vulvodynia.--The Committee notes that educational materials
developed as part of the vulvodynia educational campaign have
not been made available to key audiences and urges ORWH to
widely disseminate them to federally funded health centers and
college health clinics, as well as to the public and patient
and medical communities.
OFFICE OF AIDS RESEARCH
The 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, funding
for AIDS research is included within the appropriation for each
Institute, Center and Division of NIH. The recommendation also
includes a general provision which directs that the funding for
AIDS research, as determined by the Director of NIH and OAR, be
allocated directly to OAR for distribution to the Institutes
consistent with the AIDS research plan. The recommendation also
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 includes bill language permitting OAR to use
up to $8,000,000 for construction or renovation of National
Primate Research Centers. This is the same as the fiscal year
2011 level and the budget request.
BUILDINGS AND FACILITIES
Appropriations, 2011.................................... $49,900,000
Budget estimate, 2012................................... 125,581,000
Committee recommendation................................ 125,581,000
The Committee recommendation includes $125,581,000, the
same as the budget request, for NIH buildings and facilities.
The comparable level for fiscal year 2011 is $49,900,000.
The Committee understands that the average age of NIH's 280
buildings is 41 years and that the backlog of maintenance of
repair exceeds $1,400,000,000. The Committee recommendation
will not be sufficient to drive down the backlog, but it is
expected to prevent further degradation of NIH facilities.
Substance Abuse and Mental Health Services Administration
Appropriations, 2011.................................... $3,511,081,000
Budget estimate, 2012................................... 3,556,648,000
Committee recommendation................................ 3,484,262,000
The Committee recommends $3,484,262,000 for the Substance
Abuse and Mental Health Services Administration [SAMHSA] for
fiscal year 2012. The comparable fiscal year 2011 level is
$3,511,081,000 and the administration request is
$3,556,648,000. The recommendation includes $129,625,000 in
transfers available under section 241 of the PHS Act. 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. In addition, the Committee
recommends that $88,000,000 in mandatory funds be transferred
to SAMHSA from the Prevention and Public Health [PPH] Fund.
SAMHSA's work to improve the provision of mental health and
substance abuse services is carried out by three statutorily-
created Centers: the Center for Mental Health Services, Center
for Substance Abuse Treatment and the Center for Substance
Abuse Prevention. The Committee does not concur with the
administration proposal to reorganize the Programs of Regional
and National Significance [PRNS] function of each center into a
single agency-wide account for Innovation and Emerging Issues.
The Committee believes the proposed consolidated structure
would be detrimental to the specific programmatic and policy
expertise of each center, especially as it relates to substance
abuse prevention and substance abuse treatment. Therefore, the
Committee has provided funding for PRNS under each of the three
SAMHSA centers as it has done in previous years.
The Committee has included new bill language that creates
separate appropriations for each Center, along with a separate
appropriation for cross-cutting Health Surveillance and Program
Support activities. In previous years the Committee provided
funding to SAMHSA through one agency-wide appropriation. The
Committee believes this more detailed appropriation structure
better reflects the organization of SAMHSA's programmatic
activities and provides for greater transparency and
accountability of SAMHSA funding.
The Committee recommendation includes $154,279,000 for
grants throughout SAMHSA that fund mental health and substance
use treatment services targeted to homeless and at-risk
families. Within this total, $14,576,000 is included for a new
Homeless Initiative Program with the Department of Housing and
Urban Development to provide permanent supportive housing to
those who experience chronic, long-term homelessness.
CENTER FOR MENTAL HEALTH SERVICES
Appropriations, 2011.................................... $977,236,000
Budget estimate, 2012................................... 1,020,769,000
Committee recommendation................................ 970,640,000
The Committee recommends $970,640,000 for mental health
services. The comparable level for fiscal year 2011 is
$977,236,000 and the administration request is $1,020,769,000.
The recommendation includes $20,997,000 in transfers available
under section 241 of the PHS Act. In addition, the Committee
recommends that $45,000,000 in mandatory funds be transferred
to the Center for Mental Health Services [CMHS] from the PPH
Fund. Included in the recommendation is funding for programs of
regional and national significance, the community mental health
services block grant to the States, children's mental health
services, projects for assistance in transition from
homelessness, and protection and advocacy services for
individuals with mental illnesses.
Programs of Regional and National Significance
The Committee recommends $331,680,000 for programs of
regional and national significance [PRNS]. The comparable level
for fiscal year 2011 is $338,276,000 and the administration
request is $273,342,000. In addition, the Committee recommends
that $45,000,000 in mandatory funds be transferred to this
activity from the PPH Fund. 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Co-Occurring State Incentive Grant.......................... $2,168 $2,168 $2,168
Seclusion & Restraint....................................... 2,449 2,449 2,449
Youth Violence Prevention................................... 77,568 94,333 77,568
National Traumatic Stress Network........................... 40,718 11,300 40,800
Children and Family Programs................................ 9,194 6,486 6,486
Consumer and Family Network Grants.......................... 6,236 4,966 6,236
MH System Transformation and Health Reform.................. 26,606 10,623 10,623
Project LAUNCH.............................................. 24,706 .............. 34,706
Primary and Behavioral Health Care Integration.............. 27,807 14,000 27,807
Primary & Behavioral Health Integration [PPHF].......... 35,000 20,000 35,000
Community Resilience and Recovery Initiative................ 5,000 5,000 ..............
Suicide Lifeline............................................ 5,522 5,522 5,522
GLS--Youth Suicide Prevention--States....................... 29,374 29,738 29,738
GLS--Youth Suicide Prevention--Campus....................... 4,858 4,975 4,975
Suicide Prevention [PPHF]............................... 10,000 .............. 10,000
AI/AN Suicide Prevention Initiative......................... 2,944 2,944 2,944
Homelessness Prevention Programs............................ 30,830 39,696 39,696
Older Adult Programs........................................ 2,814 .............. ..............
Minority AIDS............................................... 9,283 9,283 9,283
Criminal and Juvenile Justice Programs...................... 6,684 6,684 6,684
SCIENCE AND SERVICE:
GLS--Suicide Prevention Resource Center..................... 4,957 4,957 4,957
Information Dissemination and Training...................... 8,168 7,878 7,878
Consumer & Consumer Support T.A. Centers.................... 1,927 1,927 1,927
Minority Fellowship Program................................. 4,279 4,279 5,099
Disaster Response........................................... 904 1,054 1,054
Homelessness................................................ 2,306 2,306 2,306
HIV/AIDS Education.......................................... 974 774 774
----------------------------------------------------------------------------------------------------------------
Child Trauma.--The Committee reiterates its strong support
for the National Child Traumatic Stress Network [NCTSN]. The
Committee has provided $40,800,000 under section 582 of the PHS
Act to support the continuance of the current model and mission
of the NCTSN. This activity provides 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 also recognizes the extraordinary value of
the core data set developed by the NCCTS, which identifies the
impact of multiple traumas on the lives of children and the
effectiveness of evidence-based treatment and services. Within
the funding provided, the Committee again provides $1,000,000
for continued data analysis and reports related to the NCCTS
core data set. Additional data collection by the NCCTS
regarding clinical processes and outcomes could enhance
evidence-based practices being utilized through the NCTSN.
Clinical Training.--The Committee is aware that a new
clinical accreditation program is being developed by the
Psychological Clinical Science Accreditation System to ground
training of practitioners in empirically supported treatments.
SAMHSA is encouraged to continue its collaboration with
relevant professional organizations regarding this program so
that those seeking services are assured of receiving
scientifically sound treatment.
Disabilities.--The Committee recognizes the important role
that SAMHSA plays relative to many Americans with disabilities.
Emerging research indicates that persons with severe mental
illness experience additional conditions that impact their
ability to function within the community. These co-occurring or
other functional disorders can include substance use disorder,
hidden traumatic brain injury, chronic medical conditions, or
other conditions. The Committee urges SAMHSA to continue making
a substantial commitment to the development of new
interventions and services for individuals with mental health
conditions who have co-occurring or multiple disabilities.
Minority Fellowship Program.--The Committee is 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 also
recognizes that professional counselors are highly trained and
well-qualified mental health professionals who deliver
culturally appropriate behavioral health services to diverse
populations. The Committee has provided an increase in funding
to allow SAMHSA to increase the pool of culturally competent
mental health professionals by granting professional counselors
eligibility to participate in the Minority Fellowship Program.
Primary and Behavioral Healthcare Integration.--The
Committee notes that adults with serious mental illness have
chronic health conditions, such as heart disease, hypertension,
diabetes and chronic respiratory conditions, at higher rates
than adults in the general population. The Committee continues
to believe aggressive action is necessary to eliminate this
disparity and has continued funding for Primary and Behavioral
Health Care Integration grants at SAMHSA. The Committee
provides $62,807,000 for this program, which includes
$27,807,000 provided in discretionary appropriations and
$35,000,000 in transfers from the PPH Fund. This is the same as
the comparable level for fiscal year 2011. The Committee
directs SAMHSA to ensure that new grants awarded for fiscal
year 2012 are funded under the authorities in section 520(k) of
the PHS Act.
Project LAUNCH.--The Committee recommendation includes
$34,706,000 for the Project LAUNCH program, which funds mental
health prevention and promotion strategies for young children
aged zero to eight. The Committee notes that many prevention
interventions that reduce risk factors and increase resilience
are funded in other agencies such as HRSA and the
Administration for Children and Families. The Committee intends
that funds provided to Project LAUNCH not duplicate activities
eligible for funding elsewhere in the Department. The Committee
requests a list of all grant awards made under this program,
along with a description of the activities undertaken by
grantees.
Suicide Prevention in Indian Populations.--The Committee
continues to be concerned about the high incidence of drug and
alcohol abuse and suicide in American Indian populations.
SAMHSA is encouraged to develop culturally competent suicide
prevention training courses to be used with selected
gatekeepers in Indian country. The Committee further urges
SAMHSA to collaborate with the Indian Health Service to
identify priority communities to pilot this gatekeeper
initiative and to develop a plan to help insure the
sustainability within American Indian and Alaska Native
communities.
Community Mental Health Services Block Grant
The Committee recommends $419,933,000 for the community
mental health services block grant. This amount is the same as
the comparable fiscal year 2011 level. The administration
request is $434,684,000. The recommendation includes
$20,997,000 in transfers available under section 241 of the PHS
Act.
The community mental health services block grant
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.
Children's Mental Health Services
The Committee recommends $117,803,000 for the children's
mental health services program. This amount is the same as the
comparable fiscal year 2011 level for this program. The
administration request is $121,316,000. 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.
Projects for Assistance in Transition From Homelessness [PATH]
The Committee recommends $64,917,000 for the PATH Program.
This amount is the same as the comparable fiscal year 2011
level. The administration request is $65,047,000. The PATH
program 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
The Committee recommends $36,307,000 for the protection and
advocacy for individuals with mental illness [PAIMI] program.
This amount is the same as the comparable fiscal year 2011
funding level. The administration request is $36,380,000. 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 for
the proposed Mental Health State Prevention Grant program. This
is a new activity that was not funded in fiscal year 2011. The
administration request is $90,000,000 for this program, which
would promote the wellness of children, youth and young adults
up to age 25. While the Committee applauds the administration
for emphasizing mental health prevention, it was not able to
provide significant resources to a new State formula program in
the current fiscal environment. The Committee also notes that
several key features of the program--such as the allocation
formula, required activities of grantees and outcome measures--
have not yet been determined.
CENTER FOR SUBSTANCE ABUSE TREATMENT
Appropriations, 2011.................................... $2,189,132,000
Budget estimate, 2012................................... 2,293,136,000
Committee recommendation................................ 2,194,227,000
The Committee recommends $2,194,227,000 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 comparable fiscal year 2011
level is $2,189,132,000 and the administration request is
$2,293,136,000. The recommendation includes $81,200,000 in
transfers available under section 241 of the PHS Act. In
addition, the Committee recommends that $25,000,000 in
mandatory funds be transferred to the Center for Substance
Abuse Treatment [CSAT] from the PPH Fund.
Programs of Regional and National Significance
The Committee recommends $411,575,000 for programs of
regional and national significance [PRNS] within CSAT. The
comparable fiscal year 2011 level is $406,480,000 and the
administration request is $403,822,000. The recommendation
includes $2,000,000 in transfers available under section 241 of
the PHS Act. In addition, the Committee recommends that
$25,000,000 in mandatory funds be transferred to PRNS from the
PPH Fund.
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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Co-occurring State Incentive Grants [SIGs].................. 4,263 4,263 4,263
Opioid Treatment Programs/Regulatory Activities............. 8,903 8,903 8,903
Screening, Brief Intervention, Referral, & Treatment [SBIRT] 28,237 29,106 28,237
SBIRT [PPHF]............................................ 25,000 .............. 25,000
TCE--General................................................ 28,033 17,411 28,033
Pregnant & Postpartum Women................................. 16,000 16,000 16,000
Strengthening Treatment Access and Retention................ 1,775 1,675 1,675
Recovery Community Services Program......................... 5,236 2,450 2,450
Access to Recovery.......................................... 98,954 98,454 98,454
Children and Families....................................... 30,678 30,678 30,678
Treatment Systems for Homeless.............................. 41,650 47,360 47,360
Minority AIDS............................................... 65,988 65,988 65,988
Criminal Justice Activities................................. 65,135 67,635 67,635
NASPER...................................................... .............. 2,000 ..............
SCIENCE AND SERVICE:
Addiction Technology Transfer Centers....................... 9,081 9,081 9,081
Minority Fellowship Program................................. 547 547 547
Special Initiatives/Outreach................................ 2,000 2,271 2,271
----------------------------------------------------------------------------------------------------------------
Addiction Services Workforce.--The Committee notes the
growing workforce crisis in the addictions field due to high
turnover rates, worker shortages, an aging workforce, stigma
and inadequate compensation. The Mental Health Parity and
Addiction Equity Act and the Patient Protection and Affordable
Care Act are anticipated to increase the number of individuals
who will seek substance use disorder services and may
exacerbate current workforce challenges. 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
expects SAMHSA to focus on developing the addiction workforce
and identify ways to address the current and future workforce
needs of the addiction field. The Committee directs SAMHSA to
submit a report by March 31, 2012, on current workforce issues
in the addiction field, as well as the status and funding of
its substance use disorder services workforce initiatives. This
report should also detail how SAMHSA is working with HRSA to
address addiction service workforce needs and should identify
the two agencies' specific roles, responsibilities, funding
streams and action steps aimed at strengthening the addiction
services workforce.
Addiction Technology Transfer Centers [ATTCs].--The
Committee directs SAMHSA to ensure that ATTCs continue to
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 is a skilled workforce able to meet
the demand in substance use disorder services.
Drug Courts.--The Committee directs SAMHSA to ensure that
all funding appropriated to CSAT for drug treatment courts is
allocated to serve people diagnosed with a substance use
disorder as their primary condition. In addition, the Committee
urges SAMHSA to ensure that State substance abuse agencies are
eligible to apply for all drug treatment court grant programs
in its portfolio. The Committee expects SAMHSA to ensure that
non-State substance abuse agency applicants for these grants
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 continues to recognize
the high incidence of hepatitis among substance abusers. The
Committee encourages SAMHSA to develop a demonstration project
on hepatitis education and testing for patients and providers.
Screening, Brief Intervention, and Referral to Treatment
[SBIRT].--The Committee recommendation includes $53,237,999 for
the SBIRT program, which includes $28,237,000 in discretionary
and evaluation tap funding, along with $25,000,000 in transfers
from the PPH Fund. The Committee directs 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 Testing.--The Committee notes the
scientific progress that has been made on alternative means of
substance abuse testing, including oral fluid testing, and
encourages SAMHSA to continue to update its drug testing
guidelines in order to take advantage of these new
opportunities.
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends $1,782,652,000 for the substance
abuse prevention and treatment [SAPT] block grant. The amount
is the same as the comparable level for fiscal year 2011. The
administration request is $1,494,314,000. 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. State plans must be submitted and
approved annually.
The Committee recommendation does not include a waiver,
requested by the administration, 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 setaside funds to a new Substance Abuse State
Prevention Grant program. The Committee is 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.
Furthermore, a 1-year waiver of the setaside is not a stable
basis for States to make long-term plans for substance abuse
prevention programming.
CENTER FOR SUBSTANCE ABUSE PREVENTION
Appropriations, 2011.................................... $186,061,000
Budget estimate, 2012................................... 74,582,000
Committee recommendation................................ 186,361,000
The Committee recommends $186,361,000 for programs to
prevent substance abuse. The comparable fiscal year 2011 level
is $186,061,000 and the administration request is $74,582,000.
The Center for Substance Abuse Prevention [CSAP] is the sole
Federal organization with responsibility for improving
accessibility and quality of substance abuse prevention
services.
Programs of Regional and National Significance
The Committee has provided $186,361,000 for programs of
regional and national significance [PRNS] within CSAP. Through
the PRNS, 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Strategic Prevention Framework/Partnerships for Success..... 110,015 .............. 110,015
Mandatory Drug Testing...................................... 4,906 5,206 5,206
Minority AIDS............................................... 41,385 41,385 41,385
Sober Truth on Preventing Underage Drinking (STOP Act)...... 7,000 7,000 7,000
National Adult-Oriented Media Public Service Campaign... 1,000 1,000 1,000
Community-based Coalition Enhancement Grants............ 5,000 5,000 5,000
Intergovernmental Coordinating Committee on the 1,000 1,000 1,000
Prevention of Underage Drinking........................
SCIENCE AND SERVICE:
Fetal Alcohol Spectrum Disorder............................. 9,821 8,000 9,821
Center for the Application of Prevention Technologies....... 8,074 8,511 8,074
Science and Service Program Coordination.................... 4,789 4,409 4,789
Minority Fellowship Program................................. 71 71 71
----------------------------------------------------------------------------------------------------------------
The Committee notes that the Strategic Prevention Framework
State Incentive Grant [SPF SIG] program promotes an evidence-
based, public health approach to substance abuse prevention.
This program utilizes a five-step, data-driven planning model
to ensure that services target areas of greatest need. Grantees
use the findings from public health research along with
evidence-based prevention programs to build State and local
capacity, which will in turn promote resilience and decrease
risk factors in individuals, families and communities. The
Partnerships for Success program builds on this model by
providing additional funding to eligible SPF SIG grantees that
achieve a quantifiable decline in statewide substance abuse
rates. Both programs are promising approaches to preventing the
onset and reducing the progression of substance abuse,
including childhood and underage drinking.
The administration proposes to eliminate funding for both
the SPF SIG and Partnerships for Success programs, terminating
many grants mid-cycle and before an assessment of program
performance is completed. While the administration proposed to
redirect funding to a new Substance Abuse State Prevention
Grant program, the Committee notes that the President's budget
would cut substance abuse prevention grants across SAMHSA by
$71,545,000 below the comparable fiscal year 2011 level. The
Committee further notes that youth drug use rates are
increasing and perceptions of harm decreasing. According to
SAMHSA's National Survey on Drug Use and Health, use of
marijuana rose among Americans aged 12 and older from 5.8
percent in 2007 to 6.9 percent in 2010. This is not the time to
cut funding for substance abuse prevention or to disrupt a
promising approach to this problem. For this reason the
Committee recommendation does not approve the administration
request and provides funding to the SPF SIG and Partnership for
Success programs at last year's levels. SAMHSA is directed to
allocate funding to the remaining cohort of SPF SIG grantees at
amounts not less than what they received in fiscal year 2011.
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 it may
have secondary effects on these goals.
Underage Drinking.--The Committee has provided $1,000,000
for the Interagency Coordinating Committee on the Prevention of
Underage Drinking [ICCPUD] and expects this interagency group
to explicitly address the issue of underage, high-risk drinking
on college campuses through an identification of best
practices, strategies and policies currently being implemented
on college campuses to deal with this persistent and pervasive
public health issue. The Committee expects to see this specific
information included in the next ICCPUD report.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriations, 2011.................................... $158,652,000
Budget estimate, 2012................................... 168,161,000
Committee recommendation................................ 133,034,000
The Committee recommends $133,034,000 for health
surveillance and program support activities. The comparable
level for fiscal year 2011 is $158,652,000 and the
administration request is $168,161,000. The recommendation
includes $27,428,000 in transfers available under section 241
of the PHS Act. In addition, the Committee recommends that
$18,000,000 in mandatory funds be transferred to this account
from the PPH Fund for surveillance activities.
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 has also provided funding in this account for
agency activities that cut across SAMHSA's three centers. The
Committee recommendation reflects the administration proposal
to consolidate funding for public awareness, performance
management and information dissemination, including SAMHSA's
Health Information Network and the National Registry of
Evidence-based Programs. These support activities were
previously funded in each Center. Combining these functions in
a single budget line will allow SAMHSA to achieve efficiencies
from the consolidation of multiple contracts. The fiscal year
2011 amounts have been adjusted for comparability.
The Committee recommendation does not include funding
requested by the administration for cross-cutting initiatives
relating to military families or behavioral health information
technology. The Committee was not able to fund either activity
due to fiscal constraints.
The Committee recommendation does not provide discretionary
funding or transfers from the PPH Fund for the administration's
proposed Prevention Prepared Communities initiative. According
to the proposed budget, this new program would implement
evidence-based programs to prevent substance abuse and mental
health issues in individuals aged 9 to 25. The Committee
believes the proposal would be duplicative of other programs,
such as the SPF SIG and Partnerships for Success. The
administration requested $22,600,000 for this new program.
Due to budget constraints, the Committee has not provided
funding or transfers from the PPH Fund for the administration's
proposed Tribal Behavioral Health Grant program. The
administration requested $50,000,000 for this new program.
The Committee is concerned by the reliance of SAMHSA on
contractors for the provision of technical assistance. The
Committee believes that dependence on contractors is
detrimental to building and maintaining specific knowledge and
expertise within SAMHSA's workforce. In addition, the Committee
notes a recent report by the Project on Government Oversight
showing that the Federal government pays billions more annually
in taxpayer dollars to hire contractors than it would to hire
Federal employees to perform comparable services. In this time
of fiscal constraint, the Committee is concerned that overuse
of contractors may not maximize the amount of agency funding
going to service provision. The Committee requests a report no
later than 3 months after enactment, detailing all agency
technical assistance contracts issued with fiscal year 2011
funding. The report should include descriptions of each
contract, the entities receiving contracts and the amount
provided.
Agency for Healthcare Research and Quality
Appropriations, 2011.................................... $372,053,000
Budget estimate, 2012................................... 366,397,000
Committee recommendation................................ 372,053,000
The Committee recommends $372,053,000 for the Agency for
Healthcare Research and Quality [AHRQ]. This amount is the same
as the comparable funding level for fiscal year 2011. The
administration request is $366,397,000 for AHRQ. The Committee
recommendation is funded entirely from transfers available
under section 241 of the PHS Act. In addition, the Committee
recommends that $12,000,000 in mandatory funds be transferred
to AHRQ from the PPH Fund.
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 $238,768,000 for research on health
costs, quality and outcomes [HCQO]. The comparable funding
level for fiscal year 2011 is $245,653,000 and the
administration request is $232,612,000 for this activity. In
addition, the Committee recommends that $12,000,000 in
mandatory funds be transferred to HCQO from the PPH Fund. 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 2011 Fiscal year Committee
comparable 2012 request recommendation
----------------------------------------------------------------------------------------------------------------
Patient-Centered Outcomes Research.............................. 21,000 21,600 19,600
Prevention/Care Management...................................... 15,904 23,304 15,904
Prevention and Public Health Fund Transfer (non-add)........ 12,000 .............. 12,000
Value........................................................... 3,730 3,730 3,730
Health Information Technology................................... 27,645 27,572 25,572
Patient Safety.................................................. 65,585 64,622 65,585
Crosscutting Activities Related to Quality, Effectiveness & 111,789 91,784 108,377
Efficiency.....................................................
----------------------------------------------------------------------------------------------------------------
Within the total for HCQO, the Committee provides
$19,600,000 for patient-centered outcomes research, also known
as comparative effectiveness research [CER]. The recommendation
provides sufficient resources to maintain existing grants and
contracts at AHRQ but does not include funding for new
research. The Committee has not funded new CER research
activity in recognition that the Patient Centered Outcomes
Research Institute, created by the Affordable Care Act, will be
responsible for managing and prioritizing CER.
Building the Next Generation of Researchers.--The Committee
is deeply concerned about declines in the number of, and
funding for, training grants for the next generation of
researchers. The Committee urges AHRQ to provide greater
support to pre- and post-doctoral training grants and
fellowships to ensure America stays competitive in the global
research market.
Clinical Preventive Services Research.--The Committee has
included $5,000,000 in transfers from the PPH Fund to continue
to build the evidence base regarding clinical preventive
services. This research will address evidence gaps in
implementation of preventive services in primary care, as well
as advance the national research agenda regarding how to
improve access, delivery and outcomes of clinical preventive
services in priority populations.
Investigator-Initiated Research.--The Committee continues
to support 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 Related to Quality,
Effectiveness and Efficiency Research portfolio, the Committee
provides $43,364,000, the same as the comparable funding level
for fiscal year 2011, for investigator-initiated research. This
funding level will allow ARHQ to support new investigator-
initiated research grants to advance discovery and the free
marketplace of ideas.
Moving Research Into Practice.--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 move the
best available research and decisionmaking tools into
healthcare practice. The Committee recommendation includes
funding for AHRQ to continue these programs.
Nurse Staffing Ratios.--The Committee notes that minimum
nurse staffing standards have been found to increase patients'
satisfaction with the care they receive and increase the number
of nurses who serve at the bedside. The Committee encourages
AHRQ to study the impact that nurse-to-patient ratios, in
conjunction with the organizational setting, have on the
quality of care and patient outcomes. AHRQ is also encouraged
to recommend further integration of these ratios into quality
measurement and quality improvement activities.
Rehabilitation Research.--The Committee is aware that
rehabilitation interventions offer potential solutions to many
health policy issues regarding cost-effective interventions
that improve the health of citizens and contribute to a higher
quality healthcare delivery system. The Committee encourages
AHRQ to seek opportunities to collaborate with CMS and the
National Center for Medical Rehabilitation Research [NCMRR]
within the Eunice Kennedy Shriver National Institute for Child
Health and Human Development [NICHD]. The Committee believes
such a partnership should advance potential opportunities to
conduct comparative investigations of rehabilitation
interventions with other healthcare treatment approaches.
Scientific Freedom in Contracted Research.--The Committee
understands that AHRQ continues to increase its use of
contracts for conducting research and that in a number of
circumstances the principal investigator is not allowed to
publish scientific findings in peer-reviewed journals in a
reasonable time due to contract clause limitations. The
Committee is concerned that such 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 directs AHRQ
to review its policies to ensure researchers have the
opportunity to publish research findings in scientific peer-
reviewed journals without unreasonable restrictions to allow
greater review and input from the scientific community.
U.S. Preventive Services Task Force [USPSTF].--The
Committee provides a program level of $11,300,000 for the
USPSTF, the same as the comparable funding level for fiscal
year 2011. The recommendation includes $4,300,000 in transfers
available from section 241 of the PHS Act and $7,000,000 in
transfers from the PPH Fund.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee provides $59,300,000, the same as the
administration request, for medical expenditures panel surveys
[MEPS]. The comparable funding level for fiscal year 2011 is
$58,800,000. MEPS collects 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. The increase
provided will support the precision of survey estimates and
analytic capacity by maintaining MEPS' sample size.
PROGRAM SUPPORT
The Committee recommends $73,985,000 for program support.
The comparable funding level for fiscal year 2011 is
$67,600,000 and the administration request is $74,485,000. The
Committee recommendation includes funding requested by the
administration for tenant improvement costs associated with a
possible relocation of staff. Funding has also been provided to
support dissemination of USPSTF recommendations and increase
transparency of USPSTF methods and processes.
Centers for Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriations, 2011....................................$173,143,799,000
Budget estimate, 2012................................... 184,279,110,000
Committee recommendation................................ 184,279,110,000
The Committee recommends $184,279,110,000 in mandatory
funding for Grants to States for Medicaid. This is the same
amount as the administration's request for fiscal year 2012.
The fiscal year 2011 comparable level was $173,143,799,000.
The fiscal year 2012 recommendation excludes
$86,445,289,000 in fiscal year 2011 advance appropriations for
fiscal year 2012. As requested by the administration,
$90,614,082,000 is provided for the first quarter of fiscal
year 2013.
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, 2011....................................$229,464,000,000
Budget estimate, 2012................................... 231,011,580,000
Committee recommendation................................ 231,012,000,000
The Committee recommends $231,012,000,000 in mandatory
funding for Payments to Healthcare Trust Funds. The
administration's request for fiscal year 2012 is
$231,011,580,000. The fiscal year 2011 comparable level was
$229,464,000,000.
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 $178,041,000,000 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
$51,451,000,000 for the general fund share of benefits paid
under Public Law 108-173, the Medicare Prescription Drug,
Improvement and Modernization Act of 2003. 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 $475,000,000 to
be transferred to the Supplementary Insurance Trust Fund as the
general fund share of part D administrative expenses. The
Committee recommendation includes $581,000,000 in
reimbursements to the Health Care Fraud and Abuse Control
[HCFAC] fund.
PROGRAM MANAGEMENT
Appropriations, 2011.................................... $3,586,855,000
Budget estimate, 2012................................... 4,396,973,000
Committee recommendation................................ 4,044,876,000
The Committee recommends $4,044,876,000 for CMS program
management. The administration requested $4,396,973,000. The
fiscal year 2011 comparable level was $3,586,855,000.
Research, Demonstrations and Evaluations
The Committee recommends $31,200,000 for research,
demonstrations and evaluation activities. The Committee
includes sufficient funding to fulfill the President's request
for the Medicare Current Beneficiaries Survey, Real Choice
Systems Change grants, other activities and continuations of
the demonstrations previously authorized under this account.
CMS research and demonstration activities expand efforts
that improve the efficiency of payment, delivery, access and
quality of the Medicare and Medicaid programs.
The Committee encourages the Center for Medicare and
Medicaid Innovation to collaborate with AHRQ to expand and
implement research that has resulted in successful strategies
to reduce waste and duplication in hospitals while improving
the quality of healthcare. The Committee believes that AHRQ's
research translation activities, such as its ACTION network,
could be used to promote these strategies to hospitals and help
with their implementation.
Atrial Fibrillation [AFib].--The Committee is aware that
AFib is the most common chronic cardiac arrhythmia, affecting
an estimated 2.3 million Americans. The number of patients with
AFib is likely to increase significantly, underscoring a
substantial public health risk. Already, the disease accounts
for approximately one-third of hospitalizations for cardiac
rhythm disturbances, costing $4,700 per patient annually. AFib
also has significant morbidity and mortality consequences,
increasing the risk of stroke approximately five-fold and
causing an estimated 15 percent of all strokes in the United
States. The Committee encourages CMS to consider targeting AFib
patients in current and planned Medicare payment and quality
improvement programs for the purpose of improving patient
outcomes and reducing avoidable healthcare costs, including
those associated with hospital admissions and readmissions for
these patients. Such programs could include those pertaining to
quality reporting, performance measurement, medication therapy
management, wellness assessments, transitions of care, support
services, and post-acute care.
Chronic Kidney Disease.--The Committee is aware that
approximately 23 million Americans have evidence of kidney
disease and another 20 million are at risk of developing it.
Therefore the Committee strongly supports efforts to prevent
kidney disease and detect symptoms early to improve treatment
outcomes. The Kidney Disease Education and Awareness program
authorized in section 152 of the Medicare Improvements for
Patients and Providers Act of 2008 is one such program. The
intent of this program is to increase awareness and screening
of chronic kidney disease and enhance surveillance systems to
better assess the incidence and prevalence of this disease. The
program would be carried out through a 5-year pilot project in
three States, with a GAO evaluation. The Committee encourages
CMS to consider implementing this demonstration to determine if
greater outreach can improve health outcomes and generate cost
savings for the Federal Government.
Program Operations
The Committee recommends $2,813,935,000 for program
operations. The comparable funding level for fiscal year 2011
was $2,397,655,000 and the fiscal year 2012 budget request was
$3,062,025,000.
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 recommendation includes $167,863,000 for
contract costs for the Healthcare Integrated General Ledger
Accounting System and includes bill language that extends the
availability of those funds until September 30, 2013.
The Committee has included additional funding within
Program Operations to help support the work required of CMS to
implement the Patient Protection and Affordable Care Act,
signed into law on March 23, 2010.
This funding will be used to support the development of
quality standards for the Medicare Shared Savings plan,
performance measures to reduce hospital acquired infections,
quality incentives on end-stage renal disease and value-based
purchasing standards.
In addition, the Patient Protection and Affordable Care Act
requires CMS in fiscal year 2012 to improve parts C and D of
Medicare by closing the ``doughnut hole,'' simplifying election
periods, reducing wasteful dispensing, and extending special
needs plans.
CMS will expand consumer assistance and education efforts,
with healthcare.gov being the primary example. CMS plans to
expand provider assistance as well, including the introduction
of additional transparency in the Medicare appeals process.
Finally, the Patient Protection and Affordable Care Act
requires CMS in fiscal year 2012 to support States as they
attempt to meet the January 1, 2013, deadline for a viable
State-based health insurance 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 the baby
boom generation is beginning to age into Medicare, with average
monthly enrollment jumping from 45.9 million in 2009 to 47.2
million in 2010. That trend will only accelerate in the coming
years, causing a dramatic increase in the need for support as
these Americans set up their Medicare benefit plans. Baby
boomers access information in different ways than previous
generations already on Medicare did and the Committee commends
CMS for modifying beneficiary materials and support systems
accordingly.
Collaboration With the Food and Drug Administration
[FDA].--The Committee encourages CMS to review information from
FDA that describes if a newly approved drug indication was
approved by FDA through either a noninferiority or a
superiority trial. A manufacturer can choose to submit a new
drug application using either a non-inferiority or a
superiority clinical trial or both.
Medicare Secondary Payer Reimbursement.--The Committee is
concerned by the delays experienced in the Medicare Secondary
Payer reimbursement system, in part caused by a lack of clear
information about the amount owed to Medicare. The Committee
expects CMS to submit a plan to the Committee within 180 days
of enactment of this act that allows Medicare beneficiaries to
obtain a final and reliable demand letter regarding how much
they must reimburse Medicare under the Medicare Secondary Payer
Act prior to reaching a settlement in the associated civil
litigation. That plan must identify any statutory of other
barriers to implementing such a process, make recommendations
related to any barriers identified and propose a timeline for
implementation.
Mobile Oxygen Therapy.--The Committee is aware of ongoing
research into mobile applications of oxygen therapy in wound
care, which might allow for less onerous and less expensive
forms of delivery. Some of these devices provide episodic
oxygen delivery, while others provide continuous streams of
oxygen. The Committee encourages CMS to review clinical data on
all forms of mobile oxygen delivery, with an eye toward
improved wound healing.
Remote Access to Care.--The Committee is concerned by a
recent letter from CMS to a grantee of the Federal Native
Hawaiian Health Care program that effectively blocks the
implementation of a Hawaii State law allowing advanced practice
registered nurses to practice without the physical supervision
of a physician. Given the barrier imposed by island geography,
blocking the State law may have the unintended consequence of
reducing access to care. The Committee urges CMS to work with
the Health Resources Services Administration to find a suitable
resolution that maximizes access to care in remote locations.
Uniformed Services Plans.--The Committee understands that
CMS may assume responsibility for future enrollees of the
Uniformed Services Family Health Plans [USFHP] past age 65
pending the final disposition of a Department of Defense [DOD]
proposal included in the fiscal year 2012 National Defense
Authorization Act. The Committee is aware of the high patient
satisfaction rates that this plan enjoys. The Committee directs
CMS to work with DOD to ensure that beneficiaries experience
the smoothest possible transition. In addition, the Committee
urges CMS to explore the quality of care, cost-effectiveness
and medical outcomes of this model to determine if a
demonstration is warranted on capitation-based payment systems.
If this proposal is enacted, the Committee requests a report in
the fiscal year 2013 justification on the steps CMS has taken
to ensure the continuity of care for beneficiaries and to
review the USFHP model for any strategies CMS might adopt
around delivering high-quality integrated care.
Vaccination.--It is estimated that the cost of the health
burden to society from vaccine preventable diseases, including
influenza, is approximately $10,000,000,000 annually. In
particular, the Committee is concerned that the majority of
healthcare workers do not get regularly recommended
vaccinations and that adult vaccination rates are particularly
low for minority groups. The Committee commends CMS for
including healthcare workers in seasonal influenza vaccination
reporting rates and performance metric. The Committee looks
forward to reviewing the data that will be collected beginning
in 2012.
State Survey and Certification
The Committee recommends $361,276,000, the same as the
fiscal year 2011 level, for Medicare State survey and
certification activities. The administration's request for
fiscal year 2012 was $400,283,000.
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.
High Risk Insurance Pools
The Committee has included $44,000,000, the same as the
budget request, for High Risk Insurance Pools. The fiscal year
2011 level was $54,890,000.
Federal Administration
The Committee recommends $794,465,000 for Federal
administration costs. The fiscal year 2011 funding level was
$737,505,000 and the budget request was $859,465,000.
Dental Disease.--The Committee notes that, although
virtually all dental disease is fully preventable, tooth decay
remains the most common chronic illness among children. With
more children expected to receive coverage for dental services,
there will be even greater pressure on an already challenged
dental delivery system. Increasing entry points into the oral
healthcare delivery system is increasingly being recognized as
essential to improving access to oral healthcare. 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 and HRSA to take steps to
facilitate expanded access to dental services in community
health centers and other public health settings. Further,
dental Medicaid regulations should be updated to reflect how
practice has evolved and dental services are currently
delivered.
Tuberculosis [TB].--The Committee is concerned about the
growth in cases of drug-resistant forms of TB, including 114
cases of multi-drug-resistant TB in the United States in 2009.
The Committee notes that timely and effective treatment
regimens are necessary to reduce transmission of drug-resistant
TB. Therefore, the Committee strongly supports the ongoing
collaboration between CMS and CDC that has thus far resulted in
multi-level communication to States about options in Medicaid.
The Committee encourages CMS to continue this collaboration.
HEALTH CARE FRAUD AND ABUSE CONTROL
Appropriations, 2011.................................... $310,377,000
Budget estimate, 2012................................... 580,580,000
Committee recommendation................................ 581,000,000
The Committee recommends $581,000,000, to be transferred
from the Medicare trust funds, for health care fraud and abuse
control activities. The comparable amount in fiscal year 2011
was $310,377,000 and the fiscal year 2012 budget request
included $580,580,000.
The Committee recommendation includes a base amount of
$311,000,000 and an additional $270,000,000 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 $1,271,930,000 in mandatory
monies for these activities, will provide a total of
$1,852,930,000 for health care fraud and abuse control
activities in fiscal year 2012.
The Committee has included $345,715,000 in discretionary
funds for the Medicare Integrity Program and intends the
remaining funds to be allocated as they were requested in the
administration's budget for fiscal year 2012.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2011.................................... $2,964,323,000
Budget estimate, 2012................................... 2,305,035,000
Committee recommendation................................ 2,305,035,000
The Committee recommends $2,305,035,000, the same as the
budget request under current law, in fiscal year 2012 mandatory
funds for payments to States for child support enforcement and
family support programs. The comparable fiscal year 2011
appropriation is $2,964,323,000. In addition, the Committee
recommends $1,100,000,000, the same as the budget request, in
advance funding for the first quarter of fiscal year 2013. The
comparable advance appropriation provided in fiscal year 2011
as an advance appropriation for fiscal year 2012 is
$1,200,000,000.
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.
The Committee notes that the budget request includes a
legislative proposal that would require that child support
payments made on behalf of youth in foster care are used in the
best interest of the child, rather than as an offset to State
and Federal child welfare costs. The Committee supports this
initiative and will work with the Committees of jurisdiction on
this proposal as necessary.
LOW INCOME HOME ENERGY ASSISTANCE PROGRAM
Appropriations, 2011.................................... $4,700,580,000
Budget estimate, 2012................................... 2,569,551,000
Committee recommendation................................ 3,600,580,000
The Committee recommends $3,600,580,000 for the low income
home energy assistance program [LIHEAP]. The comparable fiscal
year 2011 funding level is $4,700,580,000 and the fiscal year
2012 budget request is $2,569,551,000. 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 is aware of the significant continuing demand
for LIHEAP assistance and regrets that budget constraints
require a cut in funding. The Committee notes that the
recommended level for fiscal year 2012 is $1,030,252,000 higher
than the fiscal year 2008 funding level and $1,031,029,000
higher than the administration's budget request.
Within the total, the Committee recommendation includes
$3,400,653,000 for the State formula block grant. Bill language
stipulates that all of the funds should be allocated to States
based on the original LIHEAP formula. The comparable fiscal
year 2011 funding level is $4,500,653,000 and the budget
request is $1,980,000,000. LIHEAP block grants are awarded to
States, territories, Indian tribes, and tribal organizations
according to a statutory formula, based in part on each State's
share of home energy expenditures by low-income households.
Within this amount, the Committee includes up to $3,000,000 for
program integrity and oversight efforts and $27,000,000 for
leveraging incentive funds, as requested by the administration.
The Committee recommendation also includes $199,927,000,
the same as the comparable fiscal year 2011 level, for the
contingency fund. The budget request is $589,551,000. The
Committee does not include bill language making the contingency
fund available until expended, as proposed by the
administration. The contingency fund is used to provide
additional assistance to States adversely affected by extreme
heat or cold, significant price increases, or other causes of
energy-related emergencies.
REFUGEE AND ENTRANT ASSISTANCE
Appropriations, 2011.................................... $729,466,000
Budget estimate, 2012................................... 824,694,000
Committee recommendation................................ 787,639,000
The Committee recommends $787,639,000 for refugee and
entrant assistance. The comparable fiscal year 2011 funding
level is $729,466,000 and the fiscal year 2012 budget request
is $824,694,000. The refugee and entrant assistance program is
designed to assist refugees, asylees, Cuban and Haitian
entrants, trafficking victims, and torture victims (summarized
below as ``refugees'') to become employed and self-sufficient
as quickly as possible. It also funds 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 $386,625,000 for
transitional and medical assistance. The comparable fiscal year
2011 funding level is $352,625,000 and the budget request is
$394,224,000.
Transitional and medical services provide 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. 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 provide comprehensive
services, 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. 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 the Office of Refugee Resettlement [ORR]
to explore the continued expansion of this program.
While many of the costs of the transitional and medical
services program are outside of HHS' control, the Committee
remains concerned with the projected increases in these costs.
The Committee directs ACF to include actual and projected
information in their fiscal year 2013 budget justification,
broken out by refugees in State-administered, voluntary agency
matching grant, and Wilson-Fish programs where applicable, on
the number of refugees arriving in the United States,
potentially eligible for assistance and actually receiving
assistance; the average amount of time refugees receive
assistance; the average cash and medical assistance benefit;
and the total obligations of the program. The Committee also
directs ACF to separately include information on the actual and
projected costs of reimbursing States for providing foster care
for unaccompanied refugee minors [URM], including the number of
URMs in foster care.
Victims of Trafficking
The Committee recommendation includes $9,794,000, the same
amount as the comparable fiscal year 2011 funding level, for
victims of trafficking. The fiscal year 2012 budget request is
$9,814,000. This program supports a national network for
identifying, certifying and providing comprehensive services to
international victims of trafficking.
Social Services
The Committee recommendation includes $153,697,000, the
same amount as the comparable fiscal year 2011 funding level,
for social services. The fiscal year 2012 budget request is
$179,005,000. 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.
Preventive Health
The Committee recommendation includes $4,739,000, the same
amount as the comparable fiscal year 2011 funding level, for
preventive services. The budget request is $4,748,000. This
program funds grants to coordinate and promote refugees' access
to health screening, treatment and follow-up services.
Targeted Assistance
The Committee recommendation includes $48,493,000 for
targeted assistance, the same amount as the comparable fiscal
year 2011 funding level, for the targeted assistance program,
which provides additional funds to States with an influx of
refugee arrivals and a high concentration of refugees facing
difficulties achieving self-sufficiency. The budget request is
$48,590,000.
Unaccompanied Alien Children
The Committee recommendation includes $173,225,000 for
unaccompanied alien children [UAC]. The comparable fiscal year
2011 funding level is $149,052,000 and the budget request is
$177,225,000. The unaccompanied alien children program provides
shelter and support services to unaccompanied alien minors
apprehended in the United States by the Department of Homeland
Security or other law enforcement agencies. Children are taken
into ORR's care pending resolution of their claims for relief
under U.S. immigration law or release to an adult family member
or guardian.
Within the total, the Committee provides $6,100,000 to
continue the pro bono legal services initiative to ensure legal
representation for both released and detained children. These
funds should be used to train legal counsel to detect abuse,
mistreatment, labor exploitation and trafficking of these
children. In addition, a portion of these funds should be used
to train legal counsel in methods that will ensure the
appearance of children at all immigration court hearings.
Victims of Torture
The Committee recommendation includes $11,066,000, the same
amount as the comparable fiscal year 2011 funding level, for
victims of torture. The budget request is $11,088,000. 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 CHILDCARE AND DEVELOPMENT BLOCK GRANT
Appropriations, 2011.................................... $2,222,627,000
Budget estimate, 2012................................... 2,926,757,000
Committee recommendation................................ 2,222,627,000
The Committee recommends $2,222,627,000, the same amount as
the comparable fiscal year 2011 funding level, for the
childcare and development block grant [CCDBG]. The budget
request is $2,926,757,000. The CCDBG is a formula grant to
States to provide financial assistance to low-income families
to help pay for childcare and improve the quality of childcare
programs.
Within the total, the Committee recommendation includes
$18,922,000 for resource and referral programs and school-aged
childcare activities, of which $1,000,000 is specified in bill
language for a national toll-free hotline and Web site that
provides consumer education materials and assists families in
accessing local information on childcare options. The Committee
recommendation also includes $283,592,000 for childcare quality
improvement activities, of which $104,005,000 is specified for
improving infant and toddler childcare. These quality
improvement funds are in addition to the 4 percent quality
improvement set-aside established in the authorizing
legislation. Finally, the Committee recommendation includes
$9,890,000 for childcare research and evaluation activities.
The Committee notes the administration has proposed revised
reporting requirements for tribes that integrate Federal
funding, including CCDBG funding, for employment, job training
and related services into a single coordinated program, as
authorized by Public Law 102-477. While the Committee supports
an improved reporting system, any changes should be made
consistent with Public Law 102-477, which is intended to
improve efficiencies and lessen the administrative burden on
tribes. The Committee does not support the proposed requirement
that tribes under this program report separately on CCDBG,
Temporary Assistance for Needy Families, and Native Employment
Works funding. The Committee expects notification prior to ACF
implementing any changes to reporting requirements under these
programs.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2011.................................... $1,700,000,000
Budget estimate, 2012................................... 1,700,000,000
Committee recommendation................................ 1,700,000,000
The Committee recommends $1,700,000,000 in mandatory funds
for fiscal year 2012 for the social services block grant
[SSBG]. This amount is the same as the comparable fiscal year
2011 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, 2011.................................... $9,519,357,000
Budget estimate, 2012................................... 9,794,598,000
Committee recommendation................................ 9,845,685,000
The Committee recommends $9,845,685,000 for fiscal year
2012 for children and families services programs. The
comparable funding level for fiscal year 2011 is $9,519,357,000
and the budget request is $9,794,598,000. The recommendation
includes an additional $5,762,000 in transfers available under
section 241 of the Public Health Service Act.
This appropriation supports 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 recommends $7,899,633,000 for Head Start. The
comparable funding level for fiscal year 2011 is $7,559,633,000
and the budget request is $8,099,783,000.
Head Start provides comprehensive early childhood
development services for low-income children and families that
emphasize cognitive and language development, socio-emotional
development, physical and mental health and parent involvement
to enable each child to develop and function at his or her
highest potential. At least 10 percent of enrollment
opportunities in each State are made available to children with
disabilities.
The Committee recommendation maintains the expansion of the
Head Start program started with Recovery Act funding in fiscal
years 2009 and 2010. It fully supports the increase of over
61,000 Head Start slots funded through the Recovery Act and in
total will allow Head Start to provide comprehensive early
childhood services to 968,000 low-income children and their
families.
There is considerable and increasing evidence that high-
quality early childhood education has long lasting effects for
low-income children and families. Children receiving high-
quality care are more likely to graduate high school on time
and go on to college, more likely to earn higher incomes later
in life and less likely to commit a crime. The Committee's
investments in Head Start and elsewhere in HHS and the
Department of Education, as well as changes in the Improving
Head Start for School Readiness Act of 2007, will ensure that
more low-income children and families have access to high-
quality early childhood education.
Consolidated Runaway and Homeless Youth Program
The Committee recommends $97,539,000, the same as the
fiscal year 2011 level, for the consolidated runaway and
homeless youth program. The budget request includes
$102,734,000 for this purpose. This program supports basic
centers which provide 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.
Because of budget constraints, the Committee recommendation
regretfully does not include increased funding for the
administration's proposal targeted at enhancing services for
youth victims of sex trafficking.
Basic centers and transitional living programs provide
services to help address the needs of some of the estimated
1,600,000 runaway and homeless youth, many of whom are running
away from unsafe or unhealthy living environments. These
programs have been proven effective at lessening rates of
family conflict and parental abuse, as well as increasing
school participation and the employment rates of youth.
Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth
The Committee recommends $17,935,000, the same as the
fiscal year 2011 level, for education and prevention grants to
reduce sexual abuse of runaway and homeless youth. The budget
request is $17,971,000. 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 Programs
The Committee recommends $93,881,000, the same as the
fiscal year 2011 level, for child abuse prevention and
treatment programs. The budget request is $97,244,000. These
programs seek to improve and increase activities that identify,
prevent and treat child abuse and neglect through grants to
States; research and demonstrations; technical assistance; and
grants to community-based organizations.
State Formula Grants
Within the total for child abuse prevention and treatment,
the Committee recommendation includes $26,482,000 for State
formula grants, the same as the comparable fiscal year 2011
funding level. The budget request is $26,535,000. This program
provides formula grants to States to improve their child
protective service systems.
Discretionary Activities
Within the total for child abuse prevention and treatment,
the Committee recommendation includes $25,793,000 for
discretionary activities, the same as the comparable fiscal
year 2011 funding level. The budget request is $29,020,000.
This program supports discretionary grants for research,
demonstration and technical assistance to increase the
knowledge base of evidence-based practices and disseminate
information to State and local child welfare programs.
Community-Based Grants
Within the total for child abuse prevention and treatment,
the Committee recommendation includes $41,606,000 for
community-based grants, the same as the comparable fiscal year
2011 funding level. The budget request is $41,689,000. 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 recommends $11,575,000, the same as the
budget request, for the abandoned infants assistance program.
The comparable fiscal year 2011 funding level is $11,605,000.
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 recommends $281,181,000, the same as the
comparable fiscal year 2011 funding level, for child welfare
services. The budget request is $281,744,000. 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 recommends $27,153,000, the same as the
fiscal year 2011 level, for child welfare research, training
and demonstration. The budget request is $27,207,000. 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.
Within this amount, the Committee recommendation includes
$20,000,000, as requested by the administration, for innovative
approaches to foster care program. This continues funding for
5-year demonstration projects started in fiscal year 2010 to
improve the outcomes of children and families in foster care,
particularly those with long-term involvement in the foster
care system.
Adoption Opportunities
The Committee recommends $39,253,000, the same as the
comparable fiscal year 2011 funding level, for adoption
opportunities. The budget request is $39,332,000. In fiscal
year 2011 the more narrowly focused adoption awareness program
was eliminated and its funding redirected to the adoption
opportunities program. The Committee supports and maintains
this consolidation.
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. The adoption awareness program provided
grants to train health center staff to inform pregnant women
about adoption and to make referrals on request to adoption
agencies. It also funded the planning, development and
operation of a national campaign to inform the public about the
adoption of children with special needs. The adoption
opportunities program has broad authority to fund these types
of awareness activities and will continue to fund them in the
consolidated program.
Consistent with the authorization of this program, the
Committee expects that these funds will focus on facilitating
the adoption of older children, minority children, and children
with special needs, particularly infants and toddlers with
disabilities who have life-threatening conditions.
Adoption Incentives
The Committee recommends $39,421,000, the same as the
comparable fiscal year 2011 funding level, for the adoption
incentives program. The budget request is $49,875,000. 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.
Strengthening Communities Fund
The Committee recommendation does not include funding for
the strengthening communities fund. This program was first
funded in the American Recovery and Reinvestment Act but did
not receive funding in fiscal year 2011. The budget request for
fiscal year 2012 is $20,000,000. The strengthening communities
fund is designed to improve the capacity of community and
faith-based organizations to contribute to economic development
and revitalization. ACF is currently conducting an outcome-
based evaluation of this program and the Committee will
consider funding in future fiscal years pending the results of
that evaluation.
Social Services and Income Maintenance Research
The Committee recommends $5,762,000, the same as the fiscal
year 2011 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 2011. The budget request is $8,762,000, of which
$5,762,000 is from 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.
The Committee recommendation does not provide increased
funding specified for an early childhood care and education
research and evaluation study. The Committee supports this
research and the administration's initiative to strengthen
program evaluation, but notes that research and evaluation
funding for early childhood programs is set aside within Head
Start and the Child Care and Development Block Grant.
The Committee encourages ACF to continue to work with the
Administration on Aging and other HHS agencies to evaluate
intergenerational approaches aimed at improving the outcomes
for vulnerable populations. The Committee is aware of effective
neighborhood based programs that utilize older volunteers to
foster permanency and improved outcomes for at risk youth.
Developmental Disabilities
The Committee recommends $163,056,000 for developmental
disabilities programs. The comparable fiscal year 2011 funding
level is $168,857,000 and the budget request is $163,366,000.
These programs support community-based delivery of services
that promote the rights of persons of all ages with
developmental disabilities. Developmental disability is defined
as severe, chronic disability attributed to mental or physical
impairments manifested before age 22, which causes substantial
limitations in major life activities.
State Councils
Within the total for developmental disabilities, the
Committee recommendation includes $74,916,000 for State
councils, the same as the comparable fiscal year 2011 funding
level. The budget request is $75,066,000. State developmental
disability 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.
Protection and Advocacy
Within the total for developmental disabilities, the
Committee recommendation includes $40,942,000 for protection
and advocacy programs, the same as the comparable fiscal year
2011 funding level. The budget request is $41,024,000. 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.
Projects of National Significance
Within the total for developmental disabilities, the
Committee recommendation includes $8,333,000, the same as the
budget request, for projects of national significance to assist
persons with developmental disabilities. The comparable fiscal
year 2011 funding level is $14,134,000. 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.
The Committee recommendation supports the continuation of
current grants, including initiatives on youth transition to
employment, family support, technical assistance and data
collection, as well as continued support of the Autism Research
Center.
University Centers for Excellence
Within the total for developmental disabilities, the
Committee recommendation includes $38,865,000 for the
University Centers for Excellence in Developmental Disabilities
[UCEDDs], the same as the comparable fiscal year 2011 funding
level. The budget request is $38,943,000. The UCCEDD 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.
Voting Access for Individuals With Disabilities
The Committee recommendation includes $5,245,000 for voting
access for individuals with disabilities. The budget request
did not include funding for this program. The comparable fiscal
year 2011 funding level is $17,375,000. This program supports
formula grants to States for the Secretary of State or chief
election official to make polling places more accessible and
increase individuals with disabilities' participation in the
voting process, as well as a separate formula grant to States
for protection and advocacy organizations to do the same.
The Committee recommendation does not provide formula
funding for Secretaries of State but maintains funding for
protection and advocacy programs. States have over $33,000,000
in fiscal year 2007 to fiscal year 2010 unexpended funds
available to their Secretaries of State under this program, and
States may still use those funds for these activities. In
addition, the Committee encourages ACF to work with States and
protection and advocacy organizations to ensure that these
funds are used in a timely manner. The Committee also
encourages ACF, in consultation with the National Council on
Disability, to monitor the implementation of the Help America
Vote Act for voters with disabilities during the 2012 election
cycle.
Native American Programs
The Committee recommends $48,675,000, the same as the
fiscal year 2011 level, for Native American programs. The
budget request is $48,773,000. The Administration for Native
Americans [ANA] assists tribal and village governments and
Native Indian institutions and organizations to support and
develop stable, diversified local economies. In promoting
social and economic self-sufficiency, ANA provides financial
assistance through direct grants for individual projects,
training and technical assistance, and research and
demonstration programs.
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 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 strongly encourages ANA to give priority to grantees
with rigorous immersion programs.
Community Services Programs
The Committee recommends $731,501,000 for community
services programs. The comparable fiscal year 2011 funding
level is $727,212,000 and the budget request is $393,907,000.
Community Services Block Grant
Within the total for community services programs, the
Committee recommendation includes $678,640,000 for the
community services block grant [CSBG], the same as the
comparable fiscal year 2011 funding level. 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, that vast
majority of which are community action agencies.
The Committee strongly supports the CSBG, 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, LIHEAP and the Weatherization
Assistance Program. 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. The Committee
supports efforts to improve accountability and transparency,
but within the current framework of the program.
Community Economic Development
Within the total for community services programs, the
Committee recommendation includes $21,964,000 for the community
economic development program. The comparable fiscal year 2011
funding level was $17,964,000. The budget request is
$20,000,000. This program provides grants to community
development corporations to support employment and business
development opportunities for low-income individuals.
Within this total for community economic development, the
Committee recommendation includes up to $10,000,000, including
any related program support and evaluation costs, for the
Healthy Foods Financing Initiative [HFFI]. A recent study by
the Department of Agriculture found that over 23 million
Americans, including 6.5 million children, live in low-income
areas without ready access to grocery stores. 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 these low-income and underserved areas.
Rural Community Facilities
Within the total for community services programs, the
Committee recommendation includes $6,990,000 for the rural
community facilities program. The comparable fiscal year 2011
funding level was $4,990,000. The budget request did not
include 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.
Job Opportunities for Low-Income Individuals
Within the total for community services programs the
Committee recommendation does not include funding for the job
opportunities for low-income individuals [JOLI] program. The
comparable fiscal year 2011 funding level is $1,641,000. The
budget request did not include funding for this program. JOLI
provides grants to nonprofit organizations to support
employment and business opportunities for Temporary Assistance
for Needy Families [TANF] recipients and other low-income
individuals, focusing on micro-enterprise and self-employment.
This small discretionary grant program has never been evaluated
and duplicates activities funded in the TANF program.
Individual Development Accounts
Within the total for community services programs, the
Committee recommendation includes $23,907,000, the same as the
budget request, for individual development accounts. The
comparable fiscal year 2011 funding level is $23,977,000. This
program funds activities to encourage and help low-income
individuals and families accumulate savings for dedicated
purposes, including buying a home, paying for college or
starting a business.
Domestic Violence Hotline
The Committee recommends $3,203,000, the same as the
comparable fiscal year 2011 funding level, for the national
domestic violence hotline. 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 recommends $129,792,000, the same as the
comparable fiscal year 2011 funding level, for the family
violence prevention and services program. The budget request is
$135,052,000. 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 encourages ACF to provide funding for State
resource centers to reduce disparities in domestic violence in
States with high proportions of Indian (including Alaskan
Native) or Native Hawaiian populations, as authorized by
section (a)(2)(B)(i) of the Family Violence Prevention and
Services Act.
Mentoring Children of Prisoners
The Committee does not include funding for the mentoring
children of prisoners program, which was eliminated in fiscal
year 2011. The budget request is $25,000,000. This program
provided grants to community organizations to create and
sustain mentoring relationships between children of prisoners
and adults in their community. Program data showed that the
majority of the mentoring relationships established through the
program lasted fewer than 12 months.
Independent Living Training Vouchers
The Committee recommends $45,260,000, the same as the
comparable fiscal year 2011 funding level, for independent
living training vouchers. The budget request is $45,351,000.
This program supports vouchers of up to $5,000 per year for
postsecondary education and training for foster care youth up
to 21 years of age. This program increases the likelihood that
individuals who age out of the foster care system will be
better prepared to live independently and contribute
productively to society.
Disaster Human Services Case Management
The Committee recommends $1,996,000, the same as the
comparable fiscal year 2011 funding level, for the disaster
human services case management program. The budget request is
$2,000,000. 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 recommends $209,386,000, the same as the
comparable fiscal year 2011 funding level, for program
administration. The budget request is $226,184,000. Within this
amount, the Committee includes $1,376,000 for the Center for
Faith-based and Community Initiatives.
SUPPORTING HEALTHY FAMILIES AND ADOLESCENT DEVELOPMENT
Appropriations, 2011.................................... $428,184,000
Budget estimate, 2012................................... 428,311,000
Committee recommendation................................ 428,184,000
The Committee recommends $428,184,000, the same as the
comparable fiscal year 2011 funding level, for supporting
healthy families and adolescent development. The budget request
is $428,311,000. The recommendation consists of $365,000,000 in
mandatory funds authorized by the Social Security Act and
$63,184,000 in discretionary appropriations. This account was
previously named Promoting Safe and Stable Families and has
been revised to better describe the activities funded within
it.
This program supports activities that can prevent the
emergence of family crises which might require the temporary or
permanent removal of a child from his or her own 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, 2011.................................... $4,769,000,000
Budget estimate, 2012................................... 5,153,000,000
Committee recommendation................................ 5,153,000,000
The Committee recommends $5,153,000,000 in mandatory funds
for payments for foster care and permanency, an appropriated
entitlement that includes funding for the foster care, adoption
assistance, guardianship assistance and independent living
programs. This is in addition to the $1,850,000,000
appropriated last year as an advance appropriation for the
first quarter of fiscal year 2012. The comparable funding level
for fiscal year 2011 is $4,769,000,000, in addition to the
$1,850,000,000 provided as an advance appropriation the
previous year. The Committee recommends $2,100,000,000, the
same as the budget request, for an advance appropriation for
the first quarter of fiscal year 2013. The Committee
recommendation provides the full amount requested under current
law.
The foster care program, authorized under title IV-E of the
Social Security Act, provides Federal reimbursement to States
and tribes for maintenance payments to families and
institutions caring for eligible foster children. Funds are
matched at the Federal medical assistance percentage [FMAP]
rate for each State. Funding is also provided for
administrative costs for the management of the foster care
program, as well as training costs for foster care workers and
parents.
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. As in the foster care program, State administrative and
training costs are eligible under this program for Federal
reimbursement subject to a matching rate.
The Fostering Connections to Success and Increasing
Adoptions Act of 2008 created a new IV-E guardianship
assistance program. This program gives States and tribes an
option under their IV-E foster care programs to provide
assistance payments to relatives taking legal guardianship of
eligible children who have been in foster care.
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.
Administration on Aging
AGING SERVICES PROGRAMS
Appropriations, 2011.................................... $1,549,322,000
Budget estimate, 2012................................... 1,787,944,000
Committee recommendation................................ 1,534,701,000
The Committee recommends an appropriation of $1,534,701,000
for the Administration on Aging [AoA], which includes
$52,000,000 in Medicare trust funds. The comparable fiscal year
2011 level is $1,549,322,000. The administration request is
$1,787,944,000 for AoA. In addition, the Committee recommends
that $17,000,000 in mandatory funds be transferred to AoA from
the PPH Fund. The AoA is charged with administering programs
through the national aging network that promote the development
of comprehensive, coordinated home- and community-based care
for seniors.
Supportive Services and Senior Centers
The Committee recommends an appropriation of $367,611,000
for supportive services and senior centers. This amount is the
same as the comparable funding level for fiscal year 2011. The
administration request is $416,476,000. The supportive services
program provides formula grants to States and territories to
fund a wide range of social services such as multipurpose
senior centers, adult day care, transportation and in-home
assistance such as personal care and homemaker assistance.
State agencies on aging award funds to designated area agencies
on aging that, in turn, make awards to local services
providers.
Preventive Health Services
The Committee recommends $20,984,000 for preventive health
services. This amount is the same as the comparable funding
level for fiscal year 2011. The administration request is
$21,026,000 for this activity. The preventive health services
program funds activities that help seniors stay healthy and
avoid chronic disease, thus reducing the need for more costly
medical interventions. The Committee has included bill language
requiring States to use these funds for evidence-based
interventions, 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 $21,839,000 for grants to States
for protection of vulnerable older Americans. This is the same
as the comparable fiscal year 2011 funding level. The
administration request is $26,880,000. 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 elder abuse prevention targets its message to the elderly
community at large.
National Family Caregiver Support Program
The Committee recommends $153,912,000 for the national
family caregiver support program. This amount is the same as
the comparable funding level for fiscal year 2011. The
administration request for this program is $192,220,000. 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 include the following five components
into their program: 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 $6,376,000, the same
as the fiscal year 2011 level, to carry out the Native American
caregiver support program. The administration request is
$8,388,000 for this activity. This program assists tribes in
providing multifaceted systems of support services for family
caregivers and for grandparents or older individuals who are
relative caregivers.
Congregate and Home-Delivered Nutrition Services
For congregate nutrition services, the Committee recommends
an appropriation of $439,901,000, which is the same as the
comparable fiscal year 2011 level. The administration request
is $440,718,000 for this activity. For home-delivered meals,
the Committee recommends a funding level of $217,241,000. This
is the same as the comparable fiscal year 2011 level. The
administration request is $217,644,000 for this activity.
These programs address the nutritional needs of older
individuals. Projects funded must make home-delivered and
congregate meals available at least once a day, 5 days a week,
and each meal must meet 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 $160,693,000 for the
nutrition services incentives program [NSIP]. This amount is
the same as the comparable funding level for fiscal year 2011.
The administration request is $160,991,000. This program
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 $27,653,000 for grants to Native
Americans. This amount is the same as the comparable fiscal
year 2011 level. The administration request is $27,704,000.
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.
Program Innovations
The Committee recommends $12,728,000 for program
innovations. The comparable fiscal year 2011 level is
$13,023,000. The administration request is $18,705,000 for this
activity. 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 to serve older individuals, and provide technical
assistance to agencies that administer the Older Americans Act.
Older Adults and Mental Health.--The Committee urges AoA to
expand its efforts to address the mental and behavioral health
needs of older adults, including an emphasis on mental health
screening, treatment services for older individuals and
programs to increase public awareness and reduce the stigma
associated with mental disorders in older individuals. The
Committee is pleased with AoA efforts to implement the mental
and behavioral health aspects of the Older American Act
Amendments of 2006 and continues to urge AoA to designate an
officer to focus on the mental health needs of older Americans.
Within funding for Program Innovations, the Committee has
provided $1,000,000 to continue the 24-hour call center that
provides Alzheimer family caregivers with professional care
consultation and crisis intervention.
Aging Network Support Activities
The Committee recommends $24,143,000 for aging network
support activities. The comparable fiscal year 2011 funding
level is $34,214,000. The administration request is
$17,727,000. These funds provide support for the national aging
services network and also allow seniors and their families to
obtain information about their care options and benefits.
Programs funded include the Eldercare Locator, the Pension
Information and Counseling program and Senior Medicare Patrols.
Alzheimer's Disease Demonstration Grants to States
The Committee recommendation includes $4,018,000 for the
Alzheimer's disease demonstration grants to States program. The
comparable fiscal year 2011 funding level for this program is
$11,441,000 and the administration request is $11,462,000. Due
to budget constraints, the Committee recommendation includes
funding only for the continuation costs of existing grants.
This program was started in 1992 with the goal of testing and
implementing new models of care for individuals with
Alzheimer's disease. The Committee notes that all States have
received funding for one or more demonstrations. States should
incorporate the successful models created as a result of these
demonstrations into other funding streams, such as the Family
Caregiver Support Services program.
Lifespan Respite Care
The Committee recommends $2,495,000 for the Lifespan
Respite Care program. This amount is the same as the comparable
fiscal year 2011 level. The administration request is
$10,000,000 for this program. 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 and quality of respite care
services thereby reducing family caregiver strain. The
Committee recognizes that respite care can provide family
caregivers with relief necessary to maintain their own health,
bolster family stability and avoid or delay more costly nursing
home or foster care placements. The Committee commends AoA
efforts to ensure that grantees use the 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 in mandatory funding,
provided through a transfer from the PPH Fund, for the Chronic
Disease Self-Management Program [CDSMP]. The administration
requested $10,000,000 in discretionary funds for this activity.
This program was not funded in fiscal year 2011 but did receive
funding through the American Recovery and Reinvestment Act of
2009. CDSMP 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 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 rooms 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 AoA, in coordination with CDC. This is
a new activity that was not funded in fiscal year 2011. The
administration did not request funding. The Committee notes
that falls are the leading cause of fatal and nonfatal injuries
for those 65 and older. Among older adults who sustain hip
fractures in falls, 25 percent remain institutionalized for at
least 1 year and 50 percent cannot return home or live
independently. The Committee intends that funds provided to AoA
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
Due to budget constraints, the Committee recommendation
does not include funding for Adult Protective Services
demonstrations. The administration requested $16,500,000 for
this new program, which would test and evaluate innovative
approaches to preventing and responding to elder abuse.
State Health Insurance Assistance Program
The Committee recommendation includes $52,000,000 for State
Health Insurance Assistance Programs [SHIPs]. This amount is
the same as the comparable funding level for fiscal year 2011.
The administration request is $46,960,000 for this program.
SHIPs provide accurate and understandable health insurance
information to Medicare beneficiaries and their families. The
Committee concurs with the administration's proposal to
transfer this grant program to AoA from the Centers for
Medicare and Medicaid Services. 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 AoA's mission to develop a comprehensive system of home
and community-based services to help seniors maintain their
health and independence.
Community Living Assistance Services and Supports
The Committee recommendation does not include funding for
the Community Living Assistance Services and Supports [CLASS]
program, a new long-term care insurance program created by the
Affordable Care Act. The administration requested $120,000,000
to fund an education campaign, information technology and other
administrative costs. The Committee has not provided funding
for this activity in recognition that its implementation has
been delayed and the Congressional Budget Office estimates that
AoA will not begin collecting premiums for CLASS until fiscal
year 2013.
Program Administration
The Committee recommends $23,107,000 for program
administration. The comparable fiscal year 2011 funding level
is $19,939,000 and the administration request is $24,543,000.
These funds support salaries and related expenses for program
management and oversight activities. The Committee
recommendation includes funding for tenant improvement and
other costs related to the expiration of AoA's lease and a
possible office relocation.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriations, 2011.................................... $544,981,000
Budget estimate, 2012................................... 490,346,000
Committee recommendation................................ 549,032,000
The Committee recommends $549,032,000 for general
departmental management [GDM]. The comparable fiscal year 2011
funding level is $544,981,000. The administration request is
$490,346,000 for this activity. The recommendation includes
$72,811,000 in transfers available under section 241 of the PHS
Act. In addition, the Committee recommends that $10,000,000 in
mandatory funds be transferred to this account from the PPH
Fund.
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 Public Health and Science [OPHS], 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 $250,000 for the
Advisory Council on Alzheimer's Research, Care, and Services.
This Advisory Council, as created by the National Alzheimer's
Project Act (Public Law 111-375), will coordinate the activity
of Federal agencies conducting Alzheimer's-related care,
services and research.
Antideficiency Act.--The Committee is aware that the
Department recently reported 47 violations of the
Antideficiency Act which involved several agencies and occurred
over multiple fiscal years dating back at least to 2002.
Contributing causes of the problems were inconsistent
acquisition guidance regarding multi-year contracts and the
lack of a legal review process for large contracts. While the
Department has taken corrective action, including revising its
guidance and providing appropriations law training, the
Committee remains deeply concerned that these violations
indicate a widespread lack of understanding of appropriations
law by departmental staff. Accordingly, the Committee directs
the Secretary to institute a process by which all large
contracts above a certain dollar threshold are sent to the
Office of the General Counsel for legal review to ensure
sufficiency of available funds and compliance with
appropriations law. The thresholds may vary from agency to
agency. The Committee directs the Department to perform follow-
up sampling of contracts to ensure that improper funding
practices have been corrected.
Blood Donor Policy.--The Committee commends the Department
for releasing a research agenda that will yield the data
necessary to re-evaluate FDA's existing donor deferral policy
and develop alternative policies that maintain the safety of
blood and blood products. The Committee encourages the
Secretary, working in collaboration with NIH, CDC and FDA, to
move forward with this research agenda and to devote resources
toward an evaluation of a screening strategy that assures blood
safety and allows for the development of alternative deferral
criteria. The Committee requests an update on the Department's
progress toward meeting the research agenda by April 1, 2012.
Hearing Loss.--The Committee is aware that loud and
prolonged noise can permanently damage hearing. The Committee
continues to encourage the Department to educate the public
about the importance of protecting their hearing, through
public service announcements or other means, as there is no
cure for deafness caused by exposure to loud noise.
Human Services Transportation.--The Committee recognizes
the importance of community providers that ensure safe,
efficient and cost-effective transportation for older
Americans, children, people with disabilities, and those with
lower incomes. The Committee recommendation includes $1,000,000
for a competitive grant to provide assistance to local
government and nonprofit transportation providers on the most
cost-effective ways to provide transportation assistance and
information and technical assistance to persons with
disabilities.
Nursing.--The Committee is aware that the Institute of
Medicine [IOM] report ``The Future of Nursing: Leading Change,
Advancing Health'' made a series of important recommendations
to advance nursing practice, education, leadership and
workforce data as well as promote inter-professional education
and collaboration. The Committee encourages the Secretary to
develop an implementation plan regarding these recommendations,
in collaboration with CMS and HRSA, and provide the Committee
with an update on its progress in the fiscal year 2013
congressional budget justification.
Oral Health Research.--The Committee notes that the recent
IOM report ``Advancing Oral Health in America'' highlights the
important role that the Department can play in improving oral
health and oral healthcare in the United States. The Committee
encourages the Secretary to place a high priority on efforts to
advance oral health research, as recommended by IOM.
Urban-Based Network.--The Committee encourages the
Secretary and other agencies within the Department, such as
HRSA and the Office of Minority Health, to partner with the
NIH's 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.
Viral Hepatitis.--The Committee commends the Secretary for
developing the HHS Action Plan for the Prevention, Care and
Treatment of Viral Hepatitis and urges her to increase the
staff capacity at the Office of the Assistant Secretary for
Health [OASH] to implement the plan. The Committee notes that
hepatitis B and hepatitis C testing guidelines are not aligned
across HHS operating divisions, and expects OASH to work
expeditiously with CDC, AHRQ and the U.S. Preventive Services
Task Force to develop a consistent national testing guideline
by early 2012 to improve testing rates.
Teen Pregnancy Prevention
The Committee recommendation includes $113,245,000 for the
Teenage Pregnancy Prevention [TPP] program. The recommendation
includes $8,455,000 in transfers available under section 241 of
the PHS Act. The administration requested $118,445,000 for the
TPP program, with $110,000,000 funded through transfers from
the PPH Fund. The comparable funding level for fiscal year 2011
is $109,245,000. The Committee recommendation includes
$4,000,000 for a Federal evaluation of the projects funded by
this program. This program supports competitive grants to
public and private entities to replicate evidence-based teen
pregnancy prevention approaches.
Adolescent Family Life
The Committee recommendation does not include funding for
the Adolescent Family Life [AFL] program. The comparable fiscal
year 2011 level is $12,474,000 and the administration did not
request funding for this program. AFL is duplicative of the
Pregnancy Assistance Fund, a mandatory program created by the
Patient Protection and Affordable Care Act, which provides
similar support services to pregnancy and parenting teens.
Minority Health
The Committee recommends $55,888,000 for the Office of
Minority Health. This amount is the same as the comparable
fiscal year 2011 funding level. The administration requested
$57,980,000. The Office of Minority Health [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 recommendation includes $1,000,000 to
continue the national health education program on lupus for
healthcare providers. The Committee notes that this
debilitating autoimmune disease is up to three times more
common among African Americans, Hispanics and Native Americans
and affects over 1.5 million persons, 90 percent of whom are
women. The Committee continues to support this important
national education effort 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 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 this population.
Chronic Kidney Disease [CKD].--The Committee recognizes
that African-Americans represent nearly 29 percent of all those
treated for kidney failure and have an end-stage renal disease
rate nearly three times that of their non-minority
counterparts. Asian and Pacific Islanders experience a higher
than average rate of CKD, with Filipinos having one of the
highest rates of incidence per capita. The Committee encourages
OMH to prioritize the early detection of CKD in minority
communities in order to improve health outcomes and eliminate
these disparities.
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.
The Committee also understands that continued and expanded
collection of data capturing racial and ethnic information is
essential in understanding and reducing disparities.
Hepatitis B.--The Committee notes that Asian Americans,
Native Hawaiians and other Pacific Islanders comprise more than
1.5 million of the 2 million estimated hepatitis B carriers in
the United States and consequently have the highest rate of
liver cancer among all ethnic groups. The Committee urges OMH
to expand outreach and preventive hepatitis B programs specific
to Asian and Pacific Islanders and other groups
disproportionately affected by hepatitis B. The Committee
believes that the recently completed HHS Action Plan for the
Prevention and Treatment of Viral Hepatitis will inform and
guide this expanded effort.
Offices of Minority Health.--The Committee is encouraged by
the implementation of the HHS 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, to end longstanding and costly disparities.
Office of Women's Health
The Committee recommends $33,746,000 for the Office of
Women's Health [OWH]. This amount is the same as the comparable
fiscal year 2011 level and the administration request. 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 $53,783,000 for this activity,
which addresses high-priority HIV prevention and treatment
needs of minority communities heavily impacted by HIV/AIDS.
This amount is the same as the comparable fiscal year 2011
level. The administration request is $53,891,000. The Committee
has provided 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.
Transformation of the Commissioned Corps
The Committee request does not include funding for this
activity. The comparable fiscal year 2011 level is $8,071,000
and the administration request is $7,013,000. The Committee has
provided funding since fiscal year 2007 for an initiative to
train and provide career development programs for Corps
officers so that the Corps can respond more quickly and
effectively to public health emergencies. The Committee has
eliminated funding for this activity in recognition that this
transformation initiative has been completed.
Embryo Donation and Adoption
The Committee has not provided funding for embryo donation
and adoption awareness activities. The comparable fiscal year
2011 funding level is $2,004,000 and the administration
requested $2,000,000 for this activity. This program has had a
limited number of applicants since its inception and has been
unable to demonstrate its effectiveness.
Acquisition Reform
The Committee recommendation does not include funding
requested by the administration for an acquisition reform
initiative. The administration request is $7,000,000 for this
activity. While the Committee supports the Secretary's efforts
to improve the capability of the Department's acquisition
workforce and contracting systems, funding was not provided due
to budget constraints.
OFFICE OF MEDICARE HEARINGS AND APPEALS
Appropriations, 2011.................................... $71,147,000
Budget estimate, 2012................................... 81,019,000
Committee recommendation................................ 71,147,000
The Committee provides $71,147,000 for the Office of
Medicare Hearings and Appeals [OMHA]. This amount is the same
as the comparable level for fiscal year 2011. The
administration request for OMHA is $81,019,000.
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.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
Appropriations, 2011.................................... $61,257,000
Budget estimate, 2012................................... 78,413,000
Committee recommendation................................ 61,257,000
The Committee makes available $61,257,000 to the Office of
the National Coordinator for Health Information Technology
[ONC]. This amount is the same as the comparable fiscal year
2011 funding level. The administration request for ONC is
$78,413,000. The Committee recommendation includes $19,011,000
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. ONC was
permanently established under the Health Information Technology
for Economic and Clinical Health [HITECH] Act, which was
intended to promote not only the adoption of health information
technology, but its meaningful use.
The Committee recognizes the importance of widespread
adoption of health information technology and encourages ONC to
more aggressively assist providers not eligible for meaningful
use incentives under Medicare and Medicaid. The Committee notes
that ONC could assist these providers, many of which are in
small towns and rural areas, in affording meaningful health IT
options by building upon existing open source platforms such as
the Veterans Health Administration's VistA software and the
Indian Health Services' Resource and Patient Management System.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2011.................................... $50,178,000
Budget estimate, 2012................................... 63,329,000
Committee recommendation................................ 50,178,000
The Committee recommends an appropriation of $50,178,000
for the Office of Inspector General [OIG]. This amount is the
same as the comparable level for fiscal year 2011. The
administration request is $63,329,000 for this activity,
including $10,000,000 in funds transferred under section 241 of
the PHS Act. In addition to discretionary funds provided in
this act, the Health Insurance Portability and Accountability
Act of 1996 provides a permanent appropriation of $193,387,000
for the Office of Inspector General.
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, the OIG addresses issues of
waste, fraud and abuse and makes recommendations to improve the
efficiency and effectiveness of the Department's programs and
operations.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2011.................................... $41,016,000
Budget estimate, 2012................................... 46,717,000
Committee recommendation................................ 41,016,000
The Committee recommends $41,016,000 for the Office for
Civil Rights [OCR]. This amount is the same as the comparable
funding level for fiscal year 2011. The administration request
is $46,717,000. OCR 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. This office also has responsibility
for implementing and enforcing privacy protections under the
HITECH Act.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriations, 2011.................................... $517,537,000
Budget estimate, 2012................................... 564,505,000
Committee recommendation................................ 564,505,000
The Committee provides an estimated $564,505,000 in
mandatory funds for retirement pay and medical benefits for
commissioned officers of the U.S. Public Health Service [PHS].
This amount is the same as the administration request. 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, 2011.................................... $1,089,829,000
Budget estimate, 2012................................... 1,360,023,000
Committee recommendation................................ 989,452,000
The Committee recommends $989,452,000 for the Public Health
and Social Services Emergency Fund. The administration
requested $1,360,023,000 and the comparable fiscal year 2011
level is $1,089,829,000. This appropriation supports the
activities of the Office of the Assistant Secretary for
Preparedness and Response and other activities within the
Office of the Secretary to prepare for the health consequences
of bioterrorism and other public health emergencies, including
pandemic influenza, and to support the Department's
cybersecurity efforts.
Office of the Assistant Secretary for Preparedness and Response [ASPR]
The Office of the Assistant Secretary for Preparedness and
Response [ASPR] was created by the Pandemic and All-Hazards
Preparedness Act to lead the Federal Government's activities
regarding preventing, preparing for and responding to public
health emergencies and disasters. The Committee recommendation
includes $931,724,000 for activities administered by ASPR. The
administration requested $1,302,295,000 and the comparable
funding level for fiscal year 2011 is $913,419,000. These funds
will support the Department's efforts to prepare for and
respond to public health emergencies, including acts of
terrorism.
Virtual Training.--The Committee notes the need to provide
major medical emergency preparedness and response training for
doctors, nurses and paramedics using today's enabling training
technologies. There is also a need to develop a standardized
competency-based simulation curriculum. Virtual training tools
have the potential to revolutionize medical emergency response
training with a corresponding reduction in costs. The
Department is encouraged to explore developing and
standardizing medical emergency training using state-of-the-art
medical response simulation.
Hospital Preparedness
The Committee's recommendation includes $375,466,000, the
same as the budget request, for the hospital preparedness
program. The comparable funding level for fiscal year 2011 is
$377,997,000. This program provides grants to States and
localities to enhance hospital preparedness and improve overall
surge capacity in public health emergencies. These preparedness
activities strengthen the capabilities of hospitals throughout
the country to respond to floods, hurricanes, wildfires or
infrastructure collapse, and also include training for a
potential influenza pandemic or terrorist attack. Given the
significant tornado devastation and flooding seen this year
across the United States, the Committee believes this funding
is vital to providing our Nation's hospitals and emergency
responders the necessary tools to respond quickly and
collaboratively to these and other public health emergencies.
Emergency System for Advance Registration of Volunteer
Health Professionals
The Committee recommendation includes $5,000,000, the same
as the administration request, for the Emergency System for
Advance Registration of Volunteer Health Professionals. This
program is a national network of State-based registries that
allows health professionals to volunteer in public health
emergencies and disasters. The comparable funding level for
fiscal year 2011 is $5,861,000.
Biomedical Advanced Research and Development
The Committee has included bill language, proposed by the
administration, to transfer $415,000,000 from the Project
BioShield Special Reserve Fund [SRF] advance appropriation to
fund advanced research and development of medical
countermeasures. This amount is the same as the comparable
level from fiscal year 2011. The administration requested
$665,000,000 for this activity. The Committee is concerned that
the administration has proposed to greatly increase the amount
of transfers from the Project BioShield SRF to fund advanced
research and development. While the Committee strongly supports
the efforts of the Biomedical Advanced Research and Development
Authority [BARDA] to develop the countermeasures necessary to
protect against public health threats, the Committee has not
provided funding at the level requested by the administration.
The Committee notes that after the award of a smallpox anti-
viral contract in May, approximately $1,500,000,000 in SRF
balances remain available. The SRF was intended to serve as a
signal to the private sector that the Federal Government will
purchase countermeasures for the Strategic National Stockpile.
The Committee is concerned that increased transfers will
further deplete the SRF and significantly weaken the private
sector's confidence that the SRF will remain a stable funding
source.
Advanced Research and Development.--The Committee is aware
that in order to adequately prepare for and respond to public
health emergencies, including those caused by acts of
terrorism, there is a need by first responders to identify
quickly and accurately potentially dangerous pathogens in
complex samples. The Committee encourages 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.
Manufacturing Surge Capacity.--The Committee remains
concerned that during its response to the 2009 H1N1 influenza
pandemic, the Department relied disproportionately on
manufacturing surge capacity to produce the needles and
syringes required to administer the vaccine. The Committee
believes that the manufacturing surge capacity for these
products may not be sufficient to respond to the next global
public health emergency as well as support routine care. ASPR
should conduct a review of the existing manufacturing surge
capacity for drug-delivery devices as well as assess the
adequacy of the Strategic National Stockpile's current
inventory of drug-delivery devices.
Medical Countermeasures.--The Committee commends the
Department for the release of the Public Health Emergency
Medical Countermeasures Enterprise Review Report in August
2010. The Committee urges increased coordination between FDA,
NIH, BARDA and CDC in the development of medical
countermeasures for public health emergencies. The Committee
requests that the Department provide additional detail about
implementation strategy for medical countermeasures, including
a multiyear professional judgment budget. The implementation
strategy should not simply focus on initial investments, but
also on advanced development, procurement, distribution,
dispensing and surveillance.
Next Generation Anthrax Vaccine.--The Committee remains
concerned about the country's level of preparedness against
biological threats. Anthrax remains the number one biological
terrorist threat facing this country. However, nearly 10 years
after 9/11, and 6 years after the requirement for a recombinant
anthrax vaccine was issued, the Nation still lacks a
recombinant anthrax vaccine. The Committee directs BARDA, no
later than 60 days after enactment of this act, to brief the
Committee on its plans to deliver recombinant anthrax vaccine
to the Strategic National Stockpile by 2015.
Strategic Investor
The Committee recommendation does not include funding or
bill language requested by the administration for a Strategic
Investor initiative. The purpose of this initiative is to
provide financial support and business expertise to emerging
biodefense companies that will develop Government-required
countermeasures. The administration proposed to fund this
activity through a transfer of $100,000,000 from the Project
BioShield SRF. The Committee does not support additional SRF
transfers for this purpose.
Facilities Project
The Committee recommendation does not include funding for
the ASPR Facilities project. The administration requested
$10,000,000 to co-locate ASPR staff in a new facility. Funds
were not provided for this activity in fiscal year 2011.
Other Activities
The Committee recommendation includes the following amounts
for the following activities within the Office of the Assistant
Secretary for Preparedness and Response:
--Operations--$33,053,000;
--Preparedness and Emergency Operations--$34,647,000;
--National Disaster Medical System--$52,850,000; and
--Policy, Strategic Planning and Communications--$15,708,000.
Office of the Assistant Secretary for Administration
The Committee recommendation for the Office of the
Assistant Secretary for Administration includes $40,000,000 for
information technology cybersecurity, the same as the
administration request. The comparable funding level for fiscal
year 2011 is $56,680,000. These funds provide for continuous
monitoring and security incident response coordination for the
Department's computer systems and networks.
Office of Public Health and Science
The Committee recommendation includes $11,268,000 for the
medical reserve corps program, a national network of local
volunteers that work to strengthen the public health
infrastructure and preparedness capabilities of their
communities. This amount is the same as the administration
request. The comparable level for fiscal year 2011 is
$11,925,000.
Office of the Secretary
The Committee recommendation includes $6,460,000 for
activities within the Office of the Secretary. This amount is
the same as the administration request. The comparable fiscal
year 2011 level is $107,805,000.
Pandemic Influenza Preparedness
The Committee has not provided funding for pandemic
influenza preparedness activities, consistent with the
administration request. The Committee notes that the
administration plans to use $47,000,000 in balances from Public
Law 111-32, the fiscal year 2009 emergency supplemental, for
additional pandemic preparedness investments in fiscal year
2012. The comparable fiscal year 2011 level is $65,447,000.
Office of Security and Strategic Information
The Committee has included $6,460,000 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
2011 is $7,428,000.
PREVENTION AND PUBLIC HEALTH FUND
The Prevention and Public Health Fund was created in
section 4002 of the Patient Protection and Affordable Care Act
[PPACA]. The fund provides $17,750,000,000 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, the PPACA specifically gives the
Committee authority to transfer funds into Federal programs
that support the goal of making America healthier.
The PPACA provided $750,000,000 for the fund in fiscal year
2011. In fiscal year 2012, the level appropriated for the fund
is $1,000,000,000. The Committee includes bill language in
section 219 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:
------------------------------------------------------------------------
Account Activity Amount
------------------------------------------------------------------------
Aging Services Programs........... Chronic Disease Self $10,000,000
Management program
authorized under
section 411 of the
Older Americans Act.
Aging Services Programs........... Elder falls $7,000,000
prevention
activities
authorized under
section 393D of the
PHS Act.
Disease Control, Research, and Activities of the $100,000,000
Training. Office of Smoking
and Health.
Disease Control, Research, and Breastfeeding $7,050,000
Training. promotion and
support grants.
Disease Control, Research, and Chronic Disease $10,000,000
Training. Innovation Grants.
Disease Control, Research, and Community Health $20,000,000
Training. Worker program
authorized under
section 399V of the
PHS Act.
Disease Control, Research, and Community $280,000,000
Training. Transformation
Grants authorized
under section 4201
of the Patient
Protection and
Affordable Care Act.
Disease Control, Research, and Elder falls $3,000,000
Training. prevention research
authorized under
section 393D of the
PHS Act.
Disease Control, Research, and Environmental and $35,000,000
Training. Health Outcome
Tracking Network.
Disease Control, Research, and Epidemiology and $40,000,000
Training. Laboratory Capacity
Grants authorized
under section 2821
of the PHS Act.
Disease Control, Research, and National Center for $35,000,000
Training. Health Statistics.
Disease Control, Research, and National Prevention, $1,000,000
Training. Health Promotion &
Public Health
Council authorized
under section 4001
of the Patient
Protection and
Affordable Care Act.
Disease Control, Research, and Prevention of $11,750,000
Training. healthcare
associated
infections.
Disease Control, Research, and Prevention Research $10,000,000
Training. Centers.
Disease Control, Research, and Public Health $40,200,000
Training. Infrastructure
grants.
Disease Control, Research, and Public Health $25,000,000
Training. Workforce.
Disease Control, Research, and Racial and Ethnic $50,000,000
Training. Approaches to
Community Health.
Disease Control, Research, and Immunization program $150,000,000
Training. authorized under
Section 317 of the
PHS Act.
Disease Control, Research, and Task Force on $10,000,000
Training. Community
Preventive Services.
Disease Control, Research, and Infectious disease $10,000,000
Training. screening
activities.
Disease Control, Research, and Small Business $10,000,000
Training. Workplace Wellness
grants authorized
under section 10408
of the Patient
Protection and
Affordable Care Act.
General Departmental Management... Tobacco prevention $10,000,000
and cessation
activities.
Health Resources and Services..... Public Health and $25,000,000
Preventive Medicine
training programs.
Healthcare Costs, Quality and Clinical preventive $5,000,000
Outcomes. services research.
Healthcare Costs, Quality and U.S. Preventive $7,000,000
Outcomes. Services Task Force.
Substance Abuse and Mental Health Primary and $35,000,000
Services. Behavioral Health
Integration grants.
Substance Abuse and Mental Health Screening, Brief $25,000,000
Services. Intervention and
Referral to
Treatment.
Substance Abuse and Mental Health Suicide Prevention.. $10,000,000
Services.
Substance Abuse and Mental Health Surveillance $18,000,000
Services. activities.
------------------------------------------------------------------------
Not later than 90 days after enactment of this act, the
Secretary shall submit to the Chairman and Ranking Members of
the Committees on Appropriations, and Health, Education, Labor
and Pensions a report identifying all recipients of funds
provided pursuant to sections 4002 and 4201 of Public Law 111-
148. The report should identify each individual recipient of
funds, how much they received, the specific prevention,
wellness and public health activities they will perform and how
these activities will restrain the rate of growth in private
and public sector health care costs.
General Provisions
The Committee recommendation continues a provision placing
a $50,000 ceiling on official representation expenses (sec.
201).
The Committee recommendation continues a provision which
limits the assignment of certain public health personnel (sec.
202).
The Committee recommendation continues a provision limiting
the use of certain grant funds to pay individuals more than an
annual rate of executive level I (sec. 203).
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
(sec. 204).
The Committee recommendation continues a provision
authorizing the transfer of up to 2.5 percent of Public Health
Service funds for evaluation activities (sec. 205).
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 (sec. 206).
The Committee recommendation continues a provision
permitting the transfer of up to 3 percent of AIDS funds among
Institutes and Centers by the Director of NIH and the Director
of the Office of AIDS Research at NIH (sec. 207).
The Committee recommendation retains language which
requires that the use of AIDS research funds be determined
jointly by the Director of the National Institutes of Health
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 (sec. 208).
The Committee recommendation continues a provision
regarding requirements for family planning applicants (sec.
209).
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 (sec. 210).
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 (sec. 211).
The Committee recommendation modifies a provision which
facilitates the expenditure of funds for international health
activities (sec. 212).
The Committee recommendation continues a provision
authorizing the Director of the National Institutes of Health
to enter into certain transactions to carry out research in
support of the NIH Common Fund (sec. 213).
The Committee continues a provision that permits the
Centers for Disease Control and Prevention and the Agency for
Toxic Substances and Disease Registry to transfer funds that
are available for Individual Learning Accounts to ``Disease
Control, Research, and Training'' (sec. 214).
The Committee recommendation includes bill language
allowing use of funds to continue operating the Council on
Graduate Medical Education (sec. 215).
The Committee recommendation continues a provision
permitting the National Institutes of Health to use up to
$2,500,000 per project for improvements and repairs of
facilities (sec. 216).
The Committee recommendation includes a provision that
transfers funds from NIH to HRSA and AHRQ, to be used for
National Research Service Awards (sec. 217).
The Committee recommendation includes a provision
transferring mandatory funds 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 (sec.
218).
TITLE III
DEPARTMENT OF EDUCATION
Education for the Disadvantaged
Appropriations, 2011.................................... $15,535,934,000
Budget estimate, 2012................................... 16,224,267,000
Committee recommendation................................ 15,714,934,000
The Committee recommends an appropriation of
$15,714,934,000 for education for the disadvantaged. The budget
request for fiscal year 2012 is $16,224,267,000 and the
comparable fiscal year 2011 amount is $15,535,934,000.
The President's budget for fiscal year 2012 was based on
the administration's proposal to reauthorize the Elementary and
Secondary Education Act [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 2012-2013 school year.
Grants to Local Educational Agencies
Title I grants to local educational agencies [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 $14,463,417,000, the same amount
as the fiscal year 2011 level, for the title I grants to LEAs
program. The budget request for fiscal year 2012 is
$14,792,401,000.
Title I grants are distributed through four formulas:
basic, concentration, targeted and education finance incentive
grant [EFIG]. The budget request also proposes a new
distribution mechanism and authority called Title I Rewards.
For title I basic grants, including up to $3,992,000
transferred to the Census Bureau for poverty updates, the
Committee recommends an appropriation of $6,584,750,000, the
same amount as the fiscal year 2011 level. The budget request
for fiscal year 2012 is $6,597,946,000.
For concentration grants, the Committee recommends
$1,362,301,000, the same amount as the fiscal year 2011 level.
The budget request for fiscal year 2012 is $1,365,031,000.
For grants through the targeted formula, the Committee
recommends $3,258,183,000, the same amount as the fiscal year
2011 level. The budget request for fiscal year 2012 is
$3,264,712,000.
For grants through the EFIG formula, the Committee
recommends $3,258,183,000, the same amount as the fiscal year
2011 level. The budget request for fiscal year 2012 is
$3,264,712,000.
For grants for Title I Rewards, the Committee recommends no
funds. The budget request for fiscal year 2012 is $300,000,000
for this proposed activity. This new authority would provide
formula grants to States that would in turn allocate financial
and other awards to high-poverty LEAs and schools that are
highest-achieving and making the most progress in raising
student achievement.
Of the funds available for title I grants to LEAs, up to
$3,992,000 shall be available on October 1, 2011, not less than
$3,618,248,000 will become available on July 1, 2012 and
$10,841,177,000 will become available on October 1, 2012. The
funds that become available on July 1, 2012 and October 1,
2012, will remain available for obligation through September
30, 2013.
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 language clarifying that title I funds may be used to
address this transportation issue, as well as support homeless
liaisons.
Early Learning Challenge Fund
The Committee does not recommend resources for a separate
Early Learning Challenge Fund. The budget request includes
$350,000,000 for this activity. The fiscal year 2011 bill
includes $500,000,000 for a new Race to the Top-Early Learning
Challenge [RTT-ELC] program.
The Committee will continue the effort to improve early
learning and development programs for young children through
the RTT-ELC program. The Early Learning Challenge Fund proposes
to achieve the same goal.
School Improvement Grants
The Committee recommendation includes $534,562,000, the
same amount as the fiscal year 2011 level, for the School
Improvement Grants [SIG] program. The budget request for fiscal
year 2012 is $600,000,000.
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. Funds made available in the fiscal year 2012 bill will
pay for the continuation costs of awards made previously.
The Committee continues to have concerns about
implementation challenges related to the SIG program. A recent
Government Accountability Office interim report on the program
noted that some States have implemented SIG more rigorously
than others and that limited capacity, challenges in rural
areas and short timeframes affected school reform efforts.
Also, the Department's monitoring reports have found
significant implementation issues related to SIG that require
corrective action. The Committee strongly urges the Department
to help build the capacity of States to carry out their
responsibilities under the SIG program; make more timely
awards, so States can run competitions that effectively
identify the schools with the highest-quality plans for turning
around; help engage communities and families in school
turnaround planning and implementation; support the effective
use of time in schools, including through the adoption of
effective, extended learning time activities, and support the
effective utilization of the knowledge available for turning
around low-performing schools. To aid in this effort, the
Committee bill includes language providing the Department with
a set-aside of up to 5 percent of the SIG appropriation for
national activities designed to address implementation issues
identified through Department monitoring and other sources.
Prior to obligating any of these national activities funds, the
Committee requests a multi-year strategic vision and operating
plan for how it will utilize this new authority and coordinate
these new efforts with existing technical assistance and
related efforts that the Department supports.
Striving Readers
The Committee recommends $183,000,000 to continue the
Striving Readers initiative. The budget proposes to consolidate
this funding within a new Effective Teaching and Learning
program under its reauthorization proposal. The fiscal year
2011 bill did not include funds for Striving Readers, but
fiscal year 2010 funding of $200,000,000 allowed the Department
to make $180,500,000 in 3- and 5-year awards to States in
September 2011 and support other activities.
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, including
language development, reading and writing for all students,
including English language learners and students with
disabilities, from birth through grade 12.
Funds provided by the 2012 appropriations bill will be used
for the second-year costs of awards made in September 2011.
States will be required to distribute not less than 95 percent
of their funds as subgrants to LEAs or, in the case of early
literacy, to LEAs or other entities providing early childhood
care and education. State subgrants must first be prioritized
to such agencies or other entities serving greater percentages
or numbers of disadvantaged students and ensure that: at least
15 percent go to serve children from birth through age 5, 40
percent to serve students in kindergarten through grade 5, and
40 percent to serve students in middle and high school, through
grade 12. States also must equitably distribute funds between
middle and high schools.
Migrant Education Program
The Committee recommends $393,981,000, the same as the
fiscal year 2011 level, for the migrant education program. The
budget request for fiscal year 2012 is $394,771,000.
The title I migrant education program authorizes grants to
State educational agencies 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 $50,326,000, the same amount as
the fiscal year 2011 level, for the title I neglected and
delinquent program. The budget request for fiscal year 2012 is
$50,427,000.
This program provides financial assistance to State
educational agencies for education services to neglected and
delinquent children and youth in State-run institutions and for
juveniles 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 $4,151,000 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 2011 amount is $8,151,000.
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.
Funds provided will support costs associated with studies
of the implementation of title I and title II program
initiatives, Early Childhood Language Development activities
and School Turnaround.
High School Graduation Initiative
The Committee recommends $48,902,000, the same amount as
the fiscal year 2011 level, for the High School Graduation
Initiative under title I, part H of the ESEA. The budget
request funds related activities through a broader College
Pathways and Accelerated Learning program.
The High School Graduation Initiative provides competitive
grants to LEAs or State educational agencies 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 $36,595,000, the same as the
fiscal year 2011 level, for Special Programs for Migrant
Students. The budget request for fiscal year 2012 is
$36,668,000.
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 over and provide the academic and support
services needed to help them obtain a high school equivalency
certificate and subsequently gain employment, win admission to
a post-secondary institution or a job-training program, or join
the military. Projects provide counseling, health services,
stipends, and placement assistance.
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, 2011.................................... $1,273,631,000
Budget estimate, 2012................................... 1,276,183,000
Committee recommendation................................ 1,273,631,000
The Committee recommends $1,273,631,000, the same amount as
the fiscal year 2011 level, for impact aid. The budget request
for fiscal year 2012 is $1,276,183,000.
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
$1,135,724,000, the same amount as the fiscal year 2011 level,
for basic support payments. The budget request for fiscal year
2012 is $1,138,000,000. 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.
The Department shall continue to make heavily impacted
payments to qualifying school districts that are affected by
ongoing military housing privatization projects, as required
under section 8003(b)(2)(H) of title VIII of the ESEA,
including if the completion of these projects has been
postponed due to economic conditions.
Payments for Children With Disabilities.--The Committee
bill includes $48,505,000, the same amount as the fiscal year
2011 level, for payments for children with disabilities. The
budget request for fiscal year 2012 is $48,602,000. Under this
program, additional payments are made for certain federally
connected children eligible for services under the Individuals
with Disabilities Education Act.
Facilities Maintenance.--The Committee recommends
$4,854,000, the same amount as the fiscal year 2011 level, for
facilities maintenance. The budget request for fiscal year 2012
is $4,864,000. This activity provides funding for emergency
repairs and comprehensive capital improvements to certain
school facilities owned by the Department of Education and used
by local educational agencies to serve federally connected
military dependent students. Funds appropriated for this
purpose are available until expended.
Construction.--The Committee recommends $17,474,000, the
same amount as the fiscal year 2011 level, for the construction
program. The budget request for fiscal year 2012 is
$17,509,000. 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 a
competitive process, as proposed in the budget request. Funds
also are available for obligation through September 30, 2013.
Last year's bill provided these funds entirely through formula
allocations.
Payments for Federal Property.--The Committee recommends
$67,074,000, the same amount as the fiscal year 2011 level, for
payments for Federal property. The budget request for fiscal
year 2012 is $67,208,000. These payments compensate LEAs in
part for revenue lost due to the removal of Federal property
from local tax rolls.
School Improvement Programs
Appropriations, 2011.................................... $4,597,019,000
Budget estimate, 2012................................... 2,996,572,000
Committee recommendation................................ 4,570,145,000
The Committee recommendation includes $4,570,145,000 for
school improvement programs. The budget request for fiscal year
2012 is $2,996,572,000 and the comparable fiscal year 2011
amount is $4,597,019,000.
The President's budget for fiscal year 2012 was based on
the administration's proposal to reauthorize the Elementary and
Secondary Education Act [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 for fiscal year 2012 is $383,348,000. Activities
supported under this proposed program are instead funded under
current law.
The Effective Teaching and Learning: Literacy program would
provide competitive grants to State educational agencies
[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 [STEM]
The Committee recommends no funds for the proposed
Effective Teaching and Learning: STEM program. The budget
request for fiscal year 2012 is $206,046,000. 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.
The budget request for fiscal year 2012 is $246,084,000.
Activities supported under this proposed program are instead
funded under current law.
The Effective Teaching and Learning for a Well-Rounded
Education would provide competitive grants to high-need local
educational agencies [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
for fiscal year 2012 is $86,000,000. 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 $2,468,054,000, the same amount as
the fiscal year 2011 level, for State grants for improving
teacher quality. The budget request proposes $2,500,000,000 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 2012-2013 academic year. Of the
funds provided, $786,613,000 will become available on July 1,
2012, and $1,681,441,000 will become available on October 1,
2012. These funds will remain available for obligation through
September 30, 2013.
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 continues a set-aside established in the
fiscal year 2011 bill for competitive awards to national not-
for-profit organizations for teacher training or professional
enhancement activities. Up to 5 percent of funds available for
the State grants for improving teacher quality program shall be
used for this purpose. In fiscal year 2011, the set-aside was 1
percent.
Mathematics and Science Partnerships
The Committee recommends $175,127,000, the same amount as
the fiscal year 2011 level, for the mathematics and science
partnerships program. The budget proposes $206,046,000 for a
new Effective Teaching and Learning: Science, Technology,
Engineering, and Mathematics program.
These funds will be used to improve the performance of
students in the areas of math and science 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 Department awards grants to States by a formula
based on the number of children aged 5 to 17 who are from
families with incomes below the poverty line. States then are
required to make grants competitively to eligible partnerships,
which must include an engineering, math or science department
of an institution of higher learning and a high-need LEA.
Supplemental Education Grants
The Committee recommendation includes $17,652,000, the same
amount as the fiscal year 2011 level, for supplemental
education grants to the Republic of Marshall Islands [RMI] and
the Federated States of Micronesia [FSM]. The budget request
for fiscal year 2012 is $17,687,000.
This grant program was authorized by the Compact of Free
Association Amendments Act of 2003. These funds will be
transferred from the Department of Education to the Secretary
of the Interior for grants to these entities. The Committee
bill includes 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, Health and Human Services, and Education for such
services.
21st Century Community Learning Centers
The Committee recommends an appropriation of
$1,153,854,000, the same amount as the fiscal year 2011 level,
for the 21st Century Community Learning Centers program. The
budget request for fiscal year 2012 is $1,266,166,000.
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 after-school programs, recreational activities, drug and
violence prevention and family literacy programs for students
and related services to their families. Centers must target
their services on 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 believes State educational agencies should
award grants to high-quality programs that address individual
student learning needs and student well-being. Funded programs
should (1) deliver services through a variety of high-quality
and effective strategies for boosting learning and enrichment
including after school, before school, summer school, and
extended school day, week or year opportunities; and (2) 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
include activities that promote good health. The Committee
directs the Department to provide guidance and support
technical assistance on how to form and maintain strong
community-school partnerships, promote continuous quality
improvement and ensure that funded programs meet the needs of
individual students.
State Assessments and Enhanced Assessment Instruments
The Committee recommends $389,951,000, the same amount as
the fiscal year 2011 level, for State assessments and enhanced
assessment instruments. The budget request for fiscal year 2012
is $420,000,000.
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 Elementary and
Secondary Education Act. 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 fairness
of their assessment systems. The Committee recommendation for
the second component is $9,951,000.
The Committee urges the Department to continue to place a
high priority on grant applications that aim to improve 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.
Foreign Language Assistance
The Committee recommends no funds for the foreign language
assistance program. The comparable fiscal year 2011 amount is
$26,874,000.
The budget request proposes to fund similar activities
under Effective Teaching and Learning for a Well-Rounded
Education. Funds from this program have supported competitive
grants to increase the quality and quantity of foreign language
instruction.
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 $65,296,000. The budget request
for fiscal year 2012 is $65,427,000 and the comparable fiscal
year 2011 amount is $65,296,000.
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 Youths
Program, State educational agencies 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.
Training and Advisory Services
For training and advisory services authorized by title IV
of the Civil Rights Act, the Committee recommends $6,975,000.
The budget request for fiscal year 2012 is $6,989,000 and the
comparable fiscal year 2011 amount is $6,975,000.
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 $34,246,000. The budget request for fiscal
year 2012 is $34,315,000 and the comparable fiscal year 2011
amount is $34,246,000.
The Committee bill includes language that allows funding
provided by this program to be used for construction.
Alaska Native Educational Equity
The Committee recommends $33,248,000, the same amount as
the fiscal year 2011 level, for the Alaska Native educational
equity assistance program. The budget request for fiscal year
2012 is $33,315,000.
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 includes language that
allows funding provided by this program to be used for
construction. The Committee expects the Department to use some
of these funds to address the construction needs of rural
schools.
The Committee bill also includes language overriding the
authorizing statute's requirement to make non-competitive
awards to certain organizations.
Rural Education
The Committee recommends $174,532,000, the same amount as
the fiscal year 2011 level, for rural education programs. The
budget request for fiscal year 2012 is $174,882,000.
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 $51,210,000, the same amount as
the fiscal year 2011 level, for the comprehensive centers
program. The budget request for fiscal year 2012 is
$56,313,000.
These funds provide support to a network of 21
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 also currently includes 16 regional centers, which
are charged with providing intensive technical assistance to
State educational agencies to increase their capacity to assist
LEAs and schools with meeting the goals of the Elementary and
Secondary Education Act, and five content centers, which are
organized by topic area.
Indian Education
Appropriations, 2011.................................... $127,027,000
Budget estimate, 2012................................... 127,282,000
Committee recommendation................................ 128,027,000
The Committee recommends $128,027,000 for Indian education
programs. The budget request for fiscal year 2012 is
$127,282,000 and the comparable fiscal year 2011 amount is
$127,027,000.
Grants to Local Educational Agencies
For grants to local educational agencies, the Committee
recommends $104,122,000, the same amount as the fiscal year
2011 level. The budget request for fiscal year 2012 is
$104,331,000.
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
local educational agencies, 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 $19,022,000, the same amount as
the fiscal year 2011 level, for special programs for Indian
children. The budget request for fiscal year 2012 is
$19,060,000.
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 $4,883,000 for national
activities. The budget request for fiscal year 2012 is
$3,891,000 and the comparable fiscal year 2011 amount is
$3,883,000.
Funds will be used to expand efforts to improve research,
evaluation, and data collection on the status and effectiveness
of Indian education programs. The $1,000,000 increase over the
fiscal year 2011 level shall be used for grants to tribes for
education administration and planning.
Innovation and Improvement
Appropriations, 2011.................................... $1,856,179,000
Budget estimate, 2012................................... 4,995,000,000
Committee recommendation................................ 1,740,212,000
The Committee recommendation includes $1,740,212,000 for
programs within the innovation and improvement account. The
budget request for fiscal year 2012 is $4,995,000,000 for
related activities and the fiscal year 2011 appropriation is
$1,856,179,000 for programs in this account.
The President's budget for fiscal year 2012 was based on
the administration's proposal to reauthorize the Elementary and
Secondary Education Act [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.
Race to the Top
The Committee recommends $698,600,000, the same amount as
the fiscal year 2011 level, for the Race to the Top [RTT]
program. The budget request for fiscal year 2012 includes
$900,000,000 for this program. These funds are available for
obligation on July 1, 2012, and will remain available through
September 30, 2013.
RTT was established in the American Recovery and
Reinvestment Act and continued in the fiscal year 2011
appropriations bill. It has supported and incentivized reforms
that are designed to reduce achievement gaps, significantly
improve student achievement, graduation rates and college
enrollments, and encourage the broad replication of effective
practices. The Committee bill includes new language allowing
local school districts to be eligible for RTT grants. With
funds provided in this appropriations bill, the Department may
make awards to SEAs and/or LEAs based on their commitment to
and plan for innovation and reform that will improve student
achievement. States receiving awards must use not less than 50
percent of their funds to local educational agencies
participating in the State's RTT plan.
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 are made to States,
which may make subgrants to appropriate entities so they can
help achieve the goals of States' plans.
The Committee bill includes new language providing up to 5
percent of the appropriation for this program to be used for
evaluation and technical assistance. These funds may be used to
continue to collect implementation data, possibly to expand the
implementation study to include more districts or to conduct
impact evaluations of interventions supported by RTT including
impact studies of the RTT-ELC. The Committee expects to be
notified in advance of the proposed uses of these funds.
Investing in Innovation
The Committee recommends $149,700,000, the same amount as
the fiscal year 2011 level, for the Investing in Innovation
program. The budget request for fiscal year 2012 is
$300,000,000 for this purpose.
Investing in Innovation was established in the American
Recovery and Reinvestment Act and continued in the fiscal year
2011 appropriations bill. The program 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 fiscal year 2011
competition and believes that this priority should continue to
be used in the fiscal year 2012 competition. The Committee
expects the Department to equally distribute grants among the
absolute priority categories unless there are an insufficient
number of qualified grants for a priority category.
The Committee bill includes new language providing up to 5
percent of the appropriation for this program to be used for
evaluation and technical assistance. These funds may be used to
provide technical assistance and to summarize the evaluations
from 2011 grantees. The Committee expects to be notified in
advance of the proposed uses of these funds.
Effective Teachers and Leaders
The Committee recommends no funding for the Effective
Teachers and Leaders State grant program. The budget request
for fiscal year 2012 includes $2,500,000,000 for this new
program based on the administration's reauthorization proposal.
The Committee has provided $2,468,054,000 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 new program.
Effective Teachers and Leaders Innovation Fund
The Committee recommends no funding for the Effective
Teachers and Leaders Innovation Fund. The budget request for
fiscal year 2012 includes $500,000,000 for this new program
based on the administration's reauthorization proposal.
The Committee has provided $300,000,000 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 new program.
Teacher and Leader Pathways
The Committee recommends no funding for the Teacher and
Leader Pathways program. The budget request for fiscal year
2012 includes $250,000,000 for this new program based on the
administration's reauthorization proposal.
The Committee has provided 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 for the Expanding
Educational Options program. The budget request for fiscal year
2012 includes $372,000,000 for this new program based on the
administration's reauthorization proposal.
The Committee has provided 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 $20,125,000 for the Transition to
Teaching program. The budget request for fiscal year 2012
proposes an Excellent Instructional Teams initiative that could
support activities carried out under this program. The fiscal
year 2011 level is $41,125,000 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.
The level recommended by the Committee is sufficient to pay
the continuation costs for existing grants.
Teaching of Traditional American History
The Committee recommends $45,908,000, the same amount as
the fiscal year 2011 level, for the Teaching of Traditional
American History program. The budget request for fiscal year
2012 proposes an Effective Teaching and Learning for a Well-
Rounded Education program that could support activities carried
out under this program.
The Teaching of Traditional American History program
supports competitive grants to LEAs. Funds may be used only to
undertake activities that are related to American history and
cannot be used for social studies coursework. Grant awards are
designed to augment the quality of American history instruction
and to provide professional development activities and teacher
education in the area of American history. Grants are awarded
for 3 years, with 2 additional years allowed for grantees that
are performing effectively.
The Committee bill retains language that allows the
Department to reserve up to 3 percent of funds appropriated for
this program for national activities. The Committee continues
to believe that the Department should use these funds to help
grantees reach those teachers most in need of services
supported by these grant funds.
School Leadership
The Committee recommends $29,162,000, the same amount as
the fiscal year 2011 level, for the school leadership program.
The budget request for fiscal year 2012 proposes a Teacher and
Leader Pathways program that could support activities funded
through this program.
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.
Charter Schools
The Committee recommends a total of $255,519,000, the same
amount as the fiscal year 2011 level, for the support of
charter schools. The budget request for fiscal year 2012
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:
up to $221,519,000 for charter school grants, not less than
$23,000,000 for the State facilities, and credit enhancement
for charter schools facilities programs, 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.
State educational agencies [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 language initiated with the fiscal
year 2010 bill that allows the Secretary to reserve up to
$55,000,000 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.
The Committee is particularly interested in the Department
using a portion of the $11,000,000 available for national
activities to help 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.
Voluntary Public School Choice
The Committee recommends no funds for the voluntary public
school choice program. The comparable fiscal year 2011 level is
$25,767,000. The budget request for fiscal year 2012 includes
no funds for this program, but instead consolidates them within
the proposed Expanding Educational Options program.
This program has supported efforts by States and school
districts to establish or expand State- or district-wide public
school choice programs, especially for parents whose children
attend low-performing public schools.
Magnet Schools Assistance
The Committee recommends $99,800,000, the same amount as
the fiscal year 2011 appropriation, for the magnet schools
assistance program. The budget request for fiscal year 2012
includes $110,000,000 for this purpose.
This program supports grants to local educational agencies
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, teacher salaries and the purchase of
computers and other educational materials and equipment.
Fund for the Improvement of Education
The Committee recommends an appropriation of $70,900,000
for the Fund for the Improvement of Education [FIE]. The fiscal
year 2011 appropriation is $40,900,000 and the budget request
for fiscal year 2012 is $63,000,000 for this purpose.
Within programs of national significance, the Committee
includes $30,000,000 for 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 competition
should be designed so that funds are awarded to entities that
have evidence of effectiveness or high-quality plans for
addressing childhood literacy activities for the target
population. 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.
Funds for programs of national significance also support
$1,000,000 to continue the educational facilities
clearinghouse, which provides information on planning,
designing, financing, building, maintaining and operating safe,
healthy, high-performance educational facilities, including
early learning centers, and $9,750,000 to continue awards for
full service community schools. The Committee also provides
$2,600,000 for data quality and evaluation initiatives and peer
review.
Within the amount for FIE, the Committee also includes
$27,550,000 for arts in education. The budget request includes
funds for similar activities under its proposed Effective
Teaching and Learning for a Well-Rounded Education program. The
fiscal year 2011 appropriation is $27,447,000 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 recommends no funds for activities authorized
by the Excellence in Economic Education Act. The Department
used $1,444,000 from the fiscal year 2011 appropriation for
this purpose. The budget proposes to support similar activities
under its proposed Effective Teaching and Learning for a Well-
Rounded Education program. Funds support a grant to a nonprofit
educational organization to promote economic and financial
literacy among kindergarten through 12th grade students.
Teacher Incentive Fund
The Committee recommendation includes $300,000,000 for the
Teacher Incentive Fund [TIF] program. The comparable fiscal
year 2011 level is $399,200,000. The budget proposal supports
the program through a broader Teacher and Leader Innovation
Fund based on the administration's reauthorization proposal.
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.
The Committee-recommended funding level provides robust
support for activities designed to support reforms in
evaluation, compensation, hiring and advancement in order to
increase the effectiveness of teachers, principals and other
personnel in high-need schools. Grants funded under this
program may continue to address reform of compensation, but the
Committee bill now will allow applicants to propose additional
activities designed to increase teacher and principal
effectiveness. The Committee bill includes language broadening
the TIF program because of the rigorous research released over
the past year showing that performance-based compensation
systems had no effect in increasing student achievement.
At the Committee-recommended level, the Department will
have more than $290,000,000 to make new awards.
Ready-to-Learn Television
The Committee recommendation includes $27,245,000, the same
amount as the fiscal year 2011 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.
The Ready-to-Learn program was created by Congress in 1992
to use the power and reach of public television to help prepare
children, especially disadvantaged children, enter and succeed
in school. The Elementary and Secondary Education Act 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 [AP]
The Committee recommends $43,253,000, the same amount as
the fiscal year 2011 appropriation, for AP programs. The budget
request proposes to fund similar activities through its College
Pathways and Accelerated Learning program.
These funds support two programs, the Advanced Placement
Test Fee program and the Advanced Placement 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 State educational
agencies 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
State educational agencies, 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, 2011.................................... $288,465,000
Budget estimate, 2012................................... 514,966,000
Committee recommendation................................ 270,463,000
The Committee recommends a total of $270,463,000 for
activities to promote safe schools, healthy students and
citizenship education. The budget request for fiscal year 2012
is $514,966,000 and the comparable fiscal year 2011 amount is
$288,465,000.
The President's budget for fiscal year 2012 was based on
the administration's proposal to reauthorize the Elementary and
Secondary Education Act [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 $60,000,000 for the Promise
Neighborhoods program. The budget request for fiscal year 2012
is $150,000,000 and the comparable fiscal year 2011 amount is
$29,940,000.
Funds are available for obligation through December 31,
2012. By providing an extra quarter to obligate these funds,
the Committee gives fiscal year 2011 planning grantees
sufficient time to develop implementation plans that could be
funded by this bill and provides the Department ample time to
evaluate whether fiscal year 2011 implementation grantees are
making significant progress required to justify the receipt of
continuation awards in fiscal year 2012.
Competitive grants will be 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 will serve a high-poverty urban neighborhood or rural
community.
Two types of awards will be 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 more than $45,000,000 to support
implementation grants for prior planning grant recipients or
communities with high-quality plans for achieving the goals of
the program. Approximately $10,000,000 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
State educational agencies, 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 $79,226,000 for the
national activities portion of the Safe and Drug-Free Schools
and Communities program. The fiscal year 2011 appropriation is
$119,226,000 for this purpose. The budget request proposes to
fund related activities within the proposed Successful, Safe
and Healthy Students program.
The Committee recognizes the need to address the problems
of bullying, harassment, threats of violence and other types of
behavior that detract from the learning environment in our
Nation's schools, and urges the Department to increase support
for research-based programs, such as bullying prevention,
threat assessment protocols, social and emotional learning, and
positive behavioral supports and interventions.
The Committee recommends no funds for Project SERV (School
Emergency Response to Violence), which provides education-
related services to LEAs and institutions of higher education
in which the learning environment has been disrupted due to a
violent or traumatic crisis. Project SERV funds are available
until expended. The budget request includes $5,000,000 for this
purpose. No funds were appropriated for Project SERV in fiscal
year 2011. The Committee believes that no additional funds are
required in fiscal year 2012, given the amount of unobligated
funds that have been carried over from previous years.
The Committee recommendation includes funds for
continuation costs related to safe and supportive schools, Safe
Schools/Healthy Students, and other activities.
Alcohol Abuse Reduction
The Committee recommends no funds for grants to LEAs to
develop and implement programs to reduce underage drinking in
secondary schools. The comparable fiscal year 2011 amount is
$6,907,000. The budget recommended consolidating this program
into its proposed Successful, Safe and Healthy Students
program.
Elementary and Secondary School Counseling
The Committee recommends $52,395,000, the same as the
fiscal year 2011 level, to establish or expand counseling
programs in elementary and secondary schools. The budget
request recommended consolidating this program into its
proposed Successful, Safe and Healthy Students program. As
currently 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 $78,842,000, the same
as the fiscal year 2011 level, to help LEAs and community-based
organizations initiate, expand and improve physical education
programs for students in grades K-12. The budget request
proposed to consolidate this program into its proposed
Successful, Safe and Healthy Students program. 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.
Civic Education
The Committee recommends no funds for the civic education
program, which is intended to improve the quality of civics and
government education, foster civic competence and
responsibility, and improve the quality of civic and economic
education through exchange programs with emerging democracies.
The fiscal year 2011 appropriation is $1,155,000 for this
purpose. The budget request proposes to fund similar activities
through the Effective Teaching and Learning for a Well-Rounded
Education program.
English Language Acquisition
Appropriations, 2011.................................... $733,530,000
Budget estimate, 2012................................... 750,000,000
Committee recommendation................................ 733,530,000
The Committee recommends an appropriation of $733,530,000,
the same amount as the fiscal year 2011 level, for English
language acquisition. The budget request for fiscal year 2012
is $750,000,000.
The President's budget for fiscal year 2012 was based on
the administration's proposal to reauthorize the Elementary and
Secondary Education Act [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 Committee includes bill
language requiring 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 the English Language
Acquisition State Grants program. Under the authorizing
statute, the Department would use 1-year estimates, which are
not as reliable and produce more volatility in the allocations
from year to year.
Special Education
Appropriations, 2011.................................... $12,542,912,000
Budget estimate, 2012................................... 12,861,351,000
Committee recommendation................................ 12,553,066,000
The Committee recommends an appropriation of
$12,553,066,000 for special education programs. The fiscal year
2011 funding level is $12,542,912,000 and the budget request
includes $12,861,351,000 for special education.
Grants to States
The Committee recommends $11,482,200,000, the same amount
as the fiscal year 2011 level, for special education grants to
States, as authorized under section 611 of part B of the IDEA.
The budget request proposes $11,705,211,000 under this
authority.
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
local educational agencies, but may reserve some for program
monitoring, enforcement, technical assistance, and other
activities.
The appropriation for this program primarily supports
activities associated with the 2012-2013 academic year. Of the
funds available for this program, $2,889,817,000 will become
available on July 1, 2012, and $8,592,383,000 will become
available on October 1, 2012. These funds will remain available
for obligation until September 30, 2013.
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.
Preschool Grants
The Committee recommends $373,351,000, the same amount as
the fiscal year 2011 level, for preschool grants. The budget
request for fiscal year 2012 is $374,099,000. 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 local educational agencies. 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 $443,548,000 for the grants for
infants and families program under part C of the IDEA. The
budget request for fiscal year 2012 is $489,427,000 and the
comparable fiscal year 2011 level is $438,548,000. Part C of
the IDEA authorizes formula grants to States, outlying areas
and other entities to implement statewide systems of
coordinated, comprehensive, multidisciplinary interagency
programs to make available early intervention services to all
children with disabilities, ages 2 and under, and their
families.
State Personnel Development
The Committee recommends $44,000,000 for the State
personnel development program. The budget request for fiscal
year 2012 is $48,000,000 and the comparable fiscal year 2011
amount is $46,846,000. 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 State educational agencies 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.
The Committee encourages funds available for new awards to
be used to support activities devoted to increasing the skills
of general educators in working collaboratively with special
educators, and ultimately, students with disabilities.
Technical Assistance and Dissemination
The Committee recommends $49,306,000 for technical
assistance and dissemination. The budget request for fiscal
year 2012 is $49,549,000 and the comparable fiscal year 2011
amount is $48,806,000. 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 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. The Committee encourages the
Department to strengthen its efforts to align the investments
of the Office of Special Education Programs [OSEP] with a
strategic plan designed to improve outcomes for students with
disabilities and to ensure that OSEP's technical assistance
activities are coordinated with other Department technical
assistance activities.
Personnel Preparation
The Committee recommends $88,966,000 for the personnel
preparation program. The budget request for fiscal year 2012 is
$90,653,000 and the comparable fiscal year 2011 amount is
$88,466,000.
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 has
requirements to fund several other broad areas, including
training for 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 $28,972,000 for parent information
centers. The budget request for fiscal year 2012 is $28,028,000
and the comparable fiscal year 2011 amount is $27,972,000. 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 $30,644,000 for technology and
media services. The budget request for fiscal year 2012 is
$33,289,000 and the comparable fiscal year 2011 amount is
$28,644,000. This program makes competitive awards to support
the development, demonstration and use of technology and
educational media activities of value to children with
disabilities.
The Committee is particularly interested in the fiscal year
2012 competition on Educational Materials in Accessible Formats
for Students with Visual Impairments and Other Print
Disabilities and the recommendation includes no less than the
fiscal year 2012 budget request for this activity. The
Committee notes that the last competition helped improve SEA
and LEA compliance with requirements to provide accessible
instructional materials to students with visual impairments and
other print disabilities by providing 130,000 students with
disabilities with free access to instructional materials and
making over 100,000 books digitally available in multiple
accessible formats. The Committee expects the fiscal year 2012
competition to continue to improve the speed and ease of access
to materials as well as the volume of materials available to
such students.
Mentoring for Individuals With Intellectual Disabilities
The Committee recommends no funds for this proposed
program. The budget proposes $5,000,000 to support grants or
contracts to expand the Best Buddies organization, as well as
support activities to increase the participation of people with
intellectual disabilities in social relationships and other
aspects of community life, including education and employment.
Legislation is pending in Congress that would authorize similar
activities.
PROMISE: Promoting Reading of Minors in SSI
The Committee recommendation includes $4,000,000 for the
PROMISE program and makes these funds available for obligation
through September 30, 2013. The budget request includes
$30,000,000 for this new activity. The Committee provides
additional support for PROMISE through $10,000,000 for the
Social Security Administration and the authority to use
unobligated Vocational Rehabilitation State grant funds for the
PROMISE program. The Committee intends to provide additional
funds for this program in fiscal year 2013 as the planning and
grant competition process described below moves forward and
helps identify any additional funding needed to accomplish the
goal of this program.
The goal of the PROMISE program is to improve outcomes of
children who receive Supplemental Security Income [SSI], as
well as their families. The Committee is aware of the research
showing that less than half of 17- and 18-year-olds receiving
SSI had worked during ages 16-17, almost 60 percent of child
SSI recipients who turn 18, and become ineligible for child
benefits, immediately continue receiving benefits as an adult,
and fewer than a quarter of SSI youth ages 14-17 or their
parents know about various work incentives available to them.
The PROMISE program will primarily address the barriers
preventing more positive outcomes for youths receiving SSI by
encouraging innovation through better coordination between
existing programs and services. The program will provide such
youth with more intense and coordinated services, particularly
around the transition to competitive, integrated employment,
completion of postsecondary education, and other activities
that are likely to reduce the likelihood of future dependency
on SSI. The program also intends to help families of child SSI
recipients through improved services and supports such as
education and training.
The Department, in cooperation with the Social Security
Administration and Departments of Labor and Health and Human
Services, may use funds provided in this bill to undertake a
thorough planning process that includes consultation with
experts on the relevant research base and possible program
outcome measures as well as engagement with stakeholders on the
research base and promising models, barriers to better uses of
funds and improved outcomes, and possible approaches to
evaluation of the PROMISE program. The goal of the process is
to help the administration design and implement a program that
will award grants to States that have proposed projects that
have the greatest potential for transformational impact,
including through the better use of existing resources and
services, and to develop information that can improve program
delivery and outcomes in all States and localities, including
those that do not receive PROMISE pilot funding.
The Committee expects the administration to update the
Committees on Appropriations, Health, Education, Labor and
Pensions, and Finance of its activities related to the PROMISE
program. Such notification and consultation shall occur no
later than 30 days after conclusion of the review of relevant
research and engagement with stakeholders. If the
administration determines, based on stakeholder input, that
legislation is required to allow waivers of statutory barriers,
the administration will request legislative authority to grant
such waivers at least 60 days prior to their proposed issuance
or announcement in notices of priorities or funding
availability. Such requests should also explain the full range
of administrative, regulatory and legislative flexibilities
that would be granted by Federal agencies and the safeguards
that would be instituted to protect program beneficiaries and
taxpayers.
Special Olympics
The Committee recommendation includes $8,079,000, the same
amount as the fiscal year 2011 level, for Special Olympics
education activities. The budget request for fiscal year 2012
is $8,095,000. 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 the
expansion of Special Olympics 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 continues to allow funds to be used to
support Special Olympics National and World Games, as
authorized in the fiscal year 2011 bill and proposed in the
budget request.
Rehabilitation Services and Disability Research
Appropriations, 2011.................................... $3,474,719,000
Budget estimate, 2012................................... 3,521,845,000
Committee recommendation................................ 3,511,735,000
The Committee recommends $3,511,735,000 for rehabilitation
services and disability research. The comparable fiscal year
2011 funding level is $3,474,719,000. The budget request
includes $3,521,845,000 for programs in this account.
Vocational Rehabilitation State Grants
The Committee recommends $3,121,712,000 for vocational
rehabilitation 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 2011
level is $3,084,696,000. The fiscal year 2012 budget request is
$3,140,978,000 and assumes several program consolidations and
eliminations as part of a proposal to reauthorize the Workforce
Investment Act [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.
Authorizing legislation requires States to give priority to
persons with the most significant disabilities. Funds are
allotted to States based on a formula that takes into account
population and per capita income. States must provide a 21.3
percent match of Federal funds with the exception of
construction costs for the development of a facility for
community rehabilitation programs, for which States must
provide a 50 percent match.
The Rehabilitation Act requires that not less than 1
percent and not more than 1.5 percent of the appropriation in
fiscal year 2012 for vocational rehabilitation State grants be
set aside for grants for Indians. Service grants are awarded to
Indian tribes on a competitive basis to help tribes develop the
capacity to provide vocational rehabilitation services to
American Indians with disabilities living on or near
reservations.
The Committee bill includes new language 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 Social Security
Administration. Such funds used for the PROMISE program will
remain available for obligation through September 30, 2013.
Workforce Innovation Fund
The Committee does not recommend any funds for the
Workforce Innovation Fund [WIF] from this account. The budget
request provides $30,000,000. The Committee is supportive of
this initiative and instead recommends funding through the
Department of Labor's Employment and Training Administration.
This program is intended to test innovative strategies or
replicate proven practices that support systemic reform of the
workforce investment system and substantially improve
employment and education outcomes for people with disabilities.
Client Assistance State Grants
The Committee recommends $12,263,000 in discretionary
funds, the same amount provided in fiscal year 2011, for the
client assistance State grants program. The budget request
provides $12,288,000.
The client assistance program funds State formula grants to
assist vocational rehabilitation clients or client applicants
in understanding the benefits available to them and in their
relationships with service providers. States must operate
client assistance programs in order to receive vocational
rehabilitation State grant funds. Funds are distributed to
States according to a population-based formula, except that
increases in minimum grants are guaranteed to each of the 50
States, the District of Columbia, Puerto Rico, and each of the
outlying areas, by a percentage not to exceed the percentage
increase in the appropriation.
Training
The Committee recommends $35,582,000, the same as the
comparable fiscal year 2011 level, for training rehabilitation
personnel. The budget request provides $33,251,000.
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. Long-term, in-service,
short-term, experimental and innovative, and continuing
education programs are funded, as well as special training
programs and programs to train interpreters for persons who are
deaf, hard of hearing and deaf-blind.
Demonstration and Training Programs
The Committee recommends $6,459,000 for this program, which
is the same as the comparable fiscal year 2011 funding level.
The budget request eliminates funding for this program as part
of the administration's proposed program consolidations.
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 recommends continued support for parent
training and information centers. The Committee expects the
Rehabilitation Services Administration to coordinate with the
Office of Special Education Programs in carrying out this
activity.
Migrant and Seasonal Farmworkers
The Committee recommends $1,856,000, the same as the
comparable fiscal year 2011 amount, for migrant and seasonal
farmworkers. The budget request proposes consolidation of this
program into the State Grants Program.
This program provides grants for comprehensive
rehabilitation services to migrant and seasonal farmworkers
with disabilities and their families. The size of the grants is
limited to 90 percent of the costs of the projects. Projects
also develop innovative methods for reaching and serving this
population. The program emphasizes outreach, specialized
bilingual rehabilitation counseling and coordination of
vocational rehabilitation services with services from other
sources.
Protection and Advocacy of Individual Rights
The Committee recommends $18,065,000 for protection and
advocacy of individual rights. This amount is the same as the
comparable fiscal year 2011 funding level. The budget request
provides $18,101,000 for this purpose.
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 $29,123,000, the same as the
comparable fiscal year 2011 amount, for the supported
employment State grant program. The budget request eliminates
funding for this program as part of the administration's
proposed program consolidations.
This program assists the most severely disabled individuals
by providing the ongoing support needed to obtain competitive
employment. Short-term vocational rehabilitation services are
augmented with extended services provided by State and local
organizations. Federal funds are distributed on the basis of
population.
Grants for Independent Living
The budget request includes $103,716,000 to create the
Grants for Independent Living program as part of the
administration's proposed WIA reauthorization. The Committee
does not include any funds for this program because it
recommends retaining the current account structure.
Independent Living State Grants
The Committee recommends $23,403,000, the same as the
comparable fiscal year 2011 amount, for independent living
State grants. The budget request does not include funding for
this program as part of its consolidation proposal.
The independent living State formula grants program
provides funding to improve independent living services,
support the operation of centers for independent living,
conduct studies and analysis and provide training and outreach.
Centers for Independent Living
The Committee recommends $80,105,000 for independent living
centers, which is the same as the comparable fiscal year 2011.
The budget request eliminates funding for this program as part
of the administration's proposed program consolidations.
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 $34,083,000 for independent living
services to older blind individuals. This is the same level as
the comparable fiscal year 2011 amount. The budget requests
$34,151,000 for this program.
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. These services help older individuals age with
dignity, continue to live independently and avoid significant
societal costs associated with dependent care.
Helen Keller National Center
The Committee recommends $9,163,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults. This is the
same amount as the comparable fiscal year 2011 funding level.
The budget request includes $9,181,000 for this purpose.
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. The center serves approximately 75 persons with deaf-
blindness at its headquarters facility and provides field
services to approximately 2,000 individuals and families and
1,000 organizations.
National Institute on Disability and Rehabilitation Research
The Committee recommends $109,023,000, the same as the
comparable fiscal year 2011 level, for the National Institute
on Disability and Rehabilitation Research [NIDRR]. The budget
request includes $110,485,000 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. Future Rehabilitation Research Training Centers'
priorities should advance knowledge of effective strategies to
reduce the impact of poverty, promote affordable housing and
independent living with improved access to long-term supports,
how new technologies can promote independence and self-
sufficiency and facilitate greater individual choice and
control of individualized plans under the Rehabilitation and
Social Security laws.
The Committee is aware that along with the growing
prevalence of diabetes and cardiovascular disease, increasing
numbers of Americans are undergoing amputation. The costs of
limb loss to Medicare, Medicaid, the Department of Veterans
Affairs, Department of Defense and private healthcare systems
are projected to increase dramatically over the coming decades.
The Committee recognizes that, to date, little research has
been done to examine prosthetic outcomes and to link prosthetic
and orthotic treatments, devices and supports to patient
outcomes. In order to support evidence-based healthcare
practice in prosthetics and orthotics, and establish which
approaches work best for which patients, the Committee
encourages NIDRR to work with experts in the field of
prosthetic research to develop a prosthetics outcomes research
agenda and implement needed research.
The Committee strongly supports the Traumatic Brain Injury
Model Systems [TBIMS] Centers program funded by NIDRR. Almost
500 peer-reviewed publications have resulted from TBIMS
research since 1987, bringing dramatic improvements to the
treatment of traumatic brain injury for both civilian and
military populations. The Committee is aware that the TBIMS
Centers will compete for new 5-year awards in fiscal year 2012.
The Committee bill includes sufficient funds to support the
current size of the TBIMS Centers program and to provide
adequate resources to meet the research objectives of the TBIMS
program. The Committee intends that funds provided will enhance
the capability of the TBIMS Centers to conduct critical multi-
center investigations, expand the TBIMS Centers' scope of
intervention studies, maintain the ongoing high quality TBIMS
Centers' longitudinal research while keeping pace with the
increased number of participants followed, and promote
continued collaboration to improve outcomes for civilians and
military populations with traumatic brain injury. The Committee
also commends NIDRR for establishing collaboration between the
TBIMS Centers program and the Department of Veterans Affairs
and encourages continuation of these efforts.
Access Through Cloud Computing
The Committee does not recommend funding for this program.
The program did not receive funding in fiscal year 2011. The
budget requests $10,000,000 for a new initiative that would
improve access to technology for people with disabilities.
Assistive Technology
The Committee recommends $30,898,000 for assistive
technology. This amount is the same as the comparable fiscal
year 2011 funding level. The budget request includes
$30,960,000 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 includes $25,645,340 for State
grant activities authorized under section 4 of the
Rehabilitation Act of 1973, $4,325,720 for protection and
advocacy systems authorized by section 5 and $926,940 for
technical assistance activities authorized under section 6.
Special Institutions for Persons With Disabilities
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriations, 2011.................................... $24,551,000
Budget estimate, 2012................................... 24,600,000
Committee recommendation................................ 24,551,000
The Committee recommends $24,551,000 to help support the
American Printing House for the Blind [APH]. This amount is the
same as the comparable fiscal year 2011 funding level. The
budget request includes $24,600,000 for this purpose.
The 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 and 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.
The Committee continues to support the APH's National
Instructional Materials Center, which was established by the
Individuals with Disabilities Education Act of 2004.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2011.................................... $65,546,000
Budget estimate, 2012................................... 65,037,000
Committee recommendation................................ 65,546,000
The Committee recommends $65,546,000, the same as the
fiscal year 2011 level, for the National Technical Institute
for the Deaf [NTID]. This funding supports operational costs at
NTID. The budget request includes $65,037,000 for this purpose,
of which $2,000,000 is provided for construction.
The Institute, 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. The NTID also provides support services for students
who are deaf, trains professionals in the field of deafness and
conducts applied research.
GALLAUDET UNIVERSITY
Appropriations, 2011.................................... $122,754,000
Budget estimate, 2012................................... 118,000,000
Committee recommendation................................ 125,754,000
The Committee recommends $125,754,000 for Gallaudet
University. The comparable fiscal year 2011 funding level is
$122,754,000 and the budget request includes $118,000,000 for
the 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 $7,990,000 for construction-
related activities at Gallaudet University. The administration
did not request funds for this purpose.
Career, Technical, and Adult Education
Appropriations, 2011.................................... $1,738,946,000
Budget estimate, 2012................................... 1,683,392,000
Committee recommendation................................ 1,738,946,000
The Committee recommends a total of $1,738,946,000 for
career, technical and adult education. This amount is the same
as the comparable funding level in fiscal year 2011. The budget
request provides $1,683,392,000. The recommendation consists of
$1,131,503,000 for career and technical education and
$607,443,000 for adult education.
Career and Technical Education
The Committee recommends $1,131,503,000, the same as the
comparable fiscal year 2011 level, for career and technical
education. The fiscal year 2012 request provides
$1,007,860,000.
State Grants.--The Committee recommends $1,123,659,000, the
same as the comparable fiscal year 2011 level, for Career and
Technical Education [CTE] State grants. The fiscal year 2012
request level is $1,000,000,000.
Funds provided under the State grant program assist States,
localities and outlying areas expand and improve their programs
of career and technical education and provide equal access to
career and technical education for populations with special
needs. Persons assisted range from secondary students in
prevocational courses through adults who need retraining to
adapt to changing technological and labor market conditions.
Funds are distributed according to a formula based on State
population and State per capita income, with special provisions
for small States and a fiscal year 1998 base guarantee.
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, $332,659,000 will
become available July 1, 2012 and $791,000,000 will become
available on October 1, 2012. These funds will remain available
for obligation until September 30, 2013.
National Programs.--The Committee recommends $7,844,000 for
national research programs and other national activities. This
is the same amount as the comparable fiscal year 2011 funding
level. The budget request includes $7,860,000.
Funds will be used to support the national research center
on career and technical education, as well as activities
designed to improve the quality of performance data States
collect and report to the Department.
Adult Education
The Committee recommends $607,443,000, the same as the
fiscal year 2011 level, for adult education. The budget request
includes $658,346,000.
Adult Education State Programs.--For the adult basic and
literacy education State grants program, the Committee
recommends $596,120,000, the same as the fiscal year 2011
level. The budget request is $635,000,000 and includes an 8
percent set-aside to fund WIF. 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,
$74,850,000 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 2011 level. The budget
request includes $75,000,000.
The Committee does not recommend any funds for WIF from
this account as requested by the administration. The Committee
is supportive of this initiative, which is intended to test
innovative strategies or replicate proven practices that
support systemic reform of the workforce investment system and
substantially improve employment and education outcomes for
people with disabilities. However, the Committee recommends
funding through the Department of Labor's Employment and
Training Administration.
National Leadership Activities.--The Committee recommends
$11,323,000, the same amount as the fiscal year 2011 level, for
national leadership activities. The budget request includes
$23,346,000.
Grants to States for Workplace and Community Transition Training for
Incarcerated Individuals
The Committee does not recommend funding for this program.
The program did not receive funding in fiscal year 2011. The
administration requested $17,186,000 for education and training
for incarcerated individuals.
Student Financial Assistance
Appropriations, 2011.................................... $24,670,517,000
Budget estimate, 2012................................... 33,513,957,000
Committee recommendation................................ 24,670,517,000
The Committee recommends an appropriation of
$24,670,517,000 for programs under the student financial
assistance account. This is the same as the fiscal year 2011
level. The budget request includes $33,513,957,000 for this
account and proposes several legislative changes intended to
provide a more sustainable financial foundation for the Pell
Grant program.
Federal Pell Grant Program
The Committee has no higher priority in fiscal year 2012
than maintaining the maximum Pell Grant award. Now more than
ever, students need affordable, quality education opportunities
to help make our economy strong and competitive again. The Pell
Grant program, the foundation of Federal postsecondary student
aid, is essential to helping students enter college and gain
the education and skills needed for jobs in the 21st century
economy. The Bureau of Labor Statistics projects that 21 of the
30 fastest growing occupations will require a postsecondary
degree or credential by the year 2018.
Pell Grants are especially important to our country's
neediest students as the cost of postsecondary education
continues to rise. Since 2000, the cost of tuition and fees has
more than doubled, outpacing the growth rates of healthcare,
energy and housing costs. Of the 8 million students who relied
on Pell Grants in the 2009-2010 award year, 76 percent had
incomes or came from families with incomes less than or equal
to $30,000.
Pell Grants provide need-based financial assistance that
helps low- and middle-income 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.
The HEA allows any eligible student to receive a Pell Grant
award, regardless of whether there are sufficient funds for the
program. Because of higher than projected costs in recent
years, the Pell Grant program has faced a shortfall between the
amount needed to meet actual program costs and the amount
provided in appropriations based on projected program costs.
Mandatory funds have been provided over the past several years
to fill the gap, but the problem of insufficient appropriations
and program costs persists.
The Pell Grant program grows the most in years when the
number of students attending postsecondary education increases.
As usually occurs during difficult economic times, college
enrollment is growing and students are demonstrating greater
financial need. The number of recipients is expected to grow
from 6.2 million in the 2008-2009 award year to a projected 9.4
million in the 2011-2012 award year, a 52 percent increase.
Costs have also risen because of recent changes to the need-
analysis formula that provided additional assistance and
enabled more students to be eligible for the maximum award.
The Budget Control Act of 2011 took an important step
toward closing the Pell shortfall in fiscal year 2012 by
providing $10,000,000,000 in mandatory funding for that fiscal
year. The elimination of the ``year-round Pell'' provision
included in the Department of Defense and Full-Year Continuing
Appropriations Act of 2011 provided another $3,183,000,000 in
mandatory funding for the program in fiscal year 2012.
The Committee recommends $22,955,996,000 in discretionary
funding for Pell in fiscal year 2012. This is the same amount
as the fiscal year 2011 level. Combined with the measures
described above, that leaves a fiscal year 2012 shortfall of
$1,296,000,000.
The Committee recommends closing the fiscal year 2012
shortfall by eliminating the grace period for interest on
subsidized Stafford loans. Making this change also provides
additional funding to address the expected shortfall in fiscal
year 2013. Currently, the Federal Government pays interest on
subsidized Stafford loans during the 6-month grace period that
begins when a borrower leaves school. The Committee
recommendation would still allow a 6-month grace period during
which students would not be required to make monthly payments,
but the interest would accrue to the outstanding loan balance
and would need to be repaid after the grace period.
The Committee makes this change reluctantly, but believes
it is preferable to reducing the maximum Pell Grant award. In
addition, interest subsidies are poorly targeted because they
are based on a student's family's income upon entering school
and not on the student's ability to repay loans after leaving
school. Some students, for example, might obtain a well-paying
job immediately after school and would not need a grace period.
The subsidies also do not necessarily go to the neediest
students. In 2008, 40 percent of subsidized loan recipients
were dependent students from families with annual incomes above
$60,000, and 31 percent of subsidized loan recipients were
independent students with annual incomes over $30,000.
For students whose Federal student loan debt is high in
relation to their income, the Income-based Repayment [IBR]
program provides relief by capping monthly loan payments at an
affordable amount based on income and family size. The Student
Aid and Fiscal Responsibility Act [SAFRA] of 2010 made the IBR
program more generous, and the Committee urges the Department
to educate more borrowers about these improvements and the
program's ability to provide assistance to borrowers struggling
to repay their loans.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $735,990,000 for Federal
supplemental educational opportunity grants [SEOG]. This is the
same amount as the fiscal year 2011 level. The budget request
includes $757,465,000. This program provides funds to
postsecondary institutions for need-based grants to
undergraduate students. Institutions must contribute 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.
Federal Work-Study Programs
The Committee bill provides $978,531,000 for the Federal
work-study program. This is the same amount as the comparable
fiscal year 2011 level. The budget request includes
$980,492,000
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 expects the Department to provide the same
funding from the Federal Work-Study Program appropriation in
fiscal year 2012 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 [FCC], institutional contributions equal to one-
third of the FCC, and student repayments, to provide low-
interest (5 percent) 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 2011. The budget
proposes to restructure the Perkins Loan program as a mandatory
credit program, with nearly $8,500,000,000 a year in new loan
volume--eight and a half times the current Perkins volume.
Congress has not acted on this proposal.
Leveraging Educational Assistance Partnership Program [LEAP]
Neither the Committee nor the budget request recommends
funding for the LEAP program, which was eliminated in fiscal
year 2011. The Committee requests that the Department report on
the impact that the elimination of the LEAP program has had on
the total amount of need-based grant aid available to low- and
moderate-income students in the 2011-2012 academic year. The
report should be submitted to the Committee by August 1, 2012.
Student Aid Administration
Appropriations, 2011.................................... $992,012,000
Budget estimate, 2012................................... 1,095,418,000
Committee recommendation................................ 1,045,363,000
The Committee recommends $1,045,363,000 for the Student Aid
Administration account. The comparable fiscal year 2011 level
is $992,012,000. The budget request includes $1,095,418,000.
These funds are available until September 30, 2013.
Funds appropriated for the Student Aid Administration
account will support the Department's student aid management
expenses. The Office of Federal Student Aid and Office of
Postsecondary Education have primary responsibility for
administering Federal student financial assistance programs.
SAFRA terminated the authority under the Higher Education
Act of 1965 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 [DL] Program. DL program loans are serviced by
private for-profit and not-for-profit servicers under contract
with the Department.
The Committee recommendation includes $675,363,000 for
administrative costs and $370,000,000 for loan servicing
activities. The Committee recommendation for these two
activities represents a $53,351,000 increase over the fiscal
year 2011 level. The Committee recommendation reflects the
increased application, origination and servicing costs
associated with the 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 $725,104,000 for administrative
costs and $370,314,000 for servicing.
Higher Education
Appropriations, 2011.................................... $1,903,946,000
Budget estimate, 2012................................... 2,240,401,000
Committee recommendation................................ 1,903,946,000
The Committee recommends an appropriation of $1,903,946,000
for higher education programs, the same as the fiscal year 2011
level. The fiscal year 2012 requested level is $2,240,401,000
for programs in this account.
The Committee is concerned about the lack of useful,
accurate and comparable information available to students
regarding postsecondary education opportunities. Despite Higher
Education Act [HEA] requirements on institutions of higher
learning to disclose certain student outcome data and the
efforts of the Department to make the National Center for
Education Statistic's College Navigator site more robust,
students still have difficulty obtaining the information they
need to make well-informed decisions on where to invest their
time and financial resources. This is especially true for low-
income students who may be the first in their family to attend
college. These students often have difficulty finding the
College Navigator site and other free resources to aid in the
college search process. Better information on student outcomes
is also important for policymakers who are facing difficult
decisions on where to invest scarce taxpayer resources.
Transfer rates, completion rates for part-time and transfer
students, and rates of students who successfully complete
developmental courses are among the factors that would assist
students and policymakers in determining which institutions are
serving students best. Information such as graduation rates for
Pell Grant recipients, regardless of their first-time, full-
time status, would help students and policymakers determine
which postsecondary education choices provide the best outcomes
for low-income students.
The Committee is aware that some institutions of higher
education are not disclosing information to students as
required by the HEA. While there are institutions not meeting
these obligations, others may be technically in compliance with
the law but provide information in formats that are very
difficult for students to find and understand. Even more of a
challenge to students is comparing information across the
institutions they are considering, since the information is not
disclosed consistently. Additionally, because there is no
systematic effort to evaluate whether all institutions are in
compliance, the Committee is concerned that many schools may be
violating HEA disclosure requirements.
The Committee strongly believes better tools can and should
be developed through the use of technology to assist students
who are making the important decision of where to enroll in
postsecondary education. The Committee also believes more can
be done to evaluate which institutions are following not only
the letter but the spirit of the law. The Committee requests
that the Department submit a report describing how disclosure
requirements can be improved by June 30, 2012. The report
should also address how technology can be used to more
thoroughly evaluate compliance with the HEA.
Aid for Institutional Development
The Committee recommends $552,088,000, the same as the
fiscal year 2011 level, for Aid for Institutional Development.
The fiscal year 2012 requested level is $603,194,000.
Strengthening Institutions.--The Committee bill recommends
$83,832,000 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. This is the same level provided in fiscal year
2011. The budget request is $84,000,000. Applicants may use
these funds to develop faculty, strengthen academic programs,
improve institutional management, and expand student services.
Hispanic-Serving Institutions.--The Committee recommends
$104,395,000, the same as the fiscal year 2011 level, for
competitive grants to institutions at which Hispanic students
make up at least 25 percent of enrollment. The budget request
is $117,429,000. 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.
Promoting Postbaccalaureate Opportunities for Hispanic
Americans.--The Committee recommends $9,336,000, the same as
the fiscal year 2011 level, for competitive 5-year grants to
Hispanic-serving institutions to help Hispanic Americans gain
entry into and succeed in graduate study. The budget request is
$10,500,000. 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
[HBCUs].--The Committee recommends $236,991,000, the same as
the comparable fiscal year 2011 level, for the strengthening
HBCUs program. The budget request is $266,586,000. 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 SAFRA in each fiscal year through
2019.
Strengthening Historically Black Graduate Institutions
[HBGIs].--The Committee recommends $61,302,000, the same as the
fiscal year 2011 level, for the Strengthening HBGIs program.
The budget request is $61,425,000. 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 $9,602,000, the same as the comparable
fiscal year 2011 level, for the Strengthening PBIs program. The
fiscal year 2012 budget request is $10,801,000. 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. Funding is allocated
among PBIs based on the number of Pell Grant recipients
enrolled, the number of graduates and the percentage of
graduates who are attending a baccalaureate degree-granting
institution or a graduate or professional school in degree
programs in which Black American students are underrepresented.
In addition to the Committee-recommended level, this program
will receive $15,000,000 of mandatory funding through SAFRA in
each fiscal year through 2019.
Strengthening Asian American and Native American Pacific
Islander-Serving Institutions [AANAPISIs].--The Committee
recommends $3,199,000, the same as the comparable fiscal year
2011 level, for this program. The budget request level is
$3,600,000. This program provides 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, this program will receive
$5,000,000 of mandatory funding through SAFRA in each fiscal
year through 2019.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions.--The Committee recommends $13,412,000, the same
as the comparable fiscal year 2011 level, for this program. The
budget request level is $15,084,000. In addition to the
Committee-recommended level, this program will receive
$15,000,000 of mandatory funding through SAFRA in each fiscal
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; and the purchase of
library and other educational materials.
Strengthening Native American-Serving Nontribal
Institutions.--The Committee recommends $3,199,000, the same as
the comparable fiscal year 2011 level, for this program. The
fiscal year 2012 budget request is $3,600,000. These
institutions enroll at least 10 percent Native American
students and at least 50 percent low-income students. In
addition to the Committee-recommended level, this program will
receive $5,000,000 of mandatory funding through SAFRA in each
fiscal year through 2019.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $26,820,000, the same
as the comparable fiscal year 2011 level, for this program. The
fiscal year 2012 budget request is $30,169,000. 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 will receive $30,000,000 of
mandatory funding through SAFRA 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
fiscal year 2011 level, for international education and foreign
language programs. The budget request is $125,881,000 for this
program.
The Committee bill includes language allowing funds to be
used to support visits and study in foreign countries by
individuals who plan to utilize their language skills in world
areas vital to U.S. national security in the fields of
government, international development, and the professions.
Bill language also allows up to 1 percent of the funds provided
to be used for program evaluation, national outreach and
information dissemination activities. This language was
proposed in the budget request.
Domestic Programs.--The Committee recommends $66,712,000
for domestic program activities related to international
education and foreign language studies, including international
business education, under title VI of the HEA. This amount is
the same as the fiscal year 2011 level. The budget request is
$108,360,000. Domestic programs include national resource
centers, undergraduate international studies and foreign
language programs, international research and studies projects,
international business education projects and centers, American
overseas research centers, language resource centers, foreign
language and area studies fellowships, and technological
innovation and cooperation for foreign information access.
The Committee funding level includes $2,000,000 to be made
available under section 604 of the HEA to create new and
improve existing undergraduate international student abroad
programs.
Overseas Programs.--The bill includes $7,465,000 for
overseas programs authorized under the Mutual Educational and
Cultural Exchange Act of 1961, popularly known as the
Fulbright-Hays Act. This is the same amount as the comparable
fiscal year 2011 funding level. The budget request is
$15,576,000. Under these overseas programs, grants are provided
for group, faculty or doctoral dissertation research abroad as
well as special bilateral projects. Unlike other programs
authorized by the Fulbright-Hays Act and administered by the
Department of State, these Department of Education programs
focus on training American instructors and students in order to
improve foreign language and area studies education in the
United States.
Institute for International Public Policy.--The Committee
provides $1,552,000 for the Institute for International Public
Policy. This amount is the same as the comparable fiscal year
2011 funding level. The budget request is $1,945,000. This
program is designed to increase the number of minority
individuals in international policy and foreign service
positions by providing a grant to a consortium of institutions
for undergraduate and graduate level foreign language and
international studies. A consortium of institutions of higher
education consisting of one or more of the following entities
is eligible to apply for the grant: Historically Black Colleges
and Universities, Hispanic-Serving Institutions, Tribally
Controlled Colleges and Universities, Alaska Native and Native
Hawaiian-Serving Institutions and institutions with programs to
train foreign service professionals. An institutional match of
50 percent is required.
Fund for the Improvement of Postsecondary Education
The Committee recommends $19,607,000 for the Fund for the
Improvement of Postsecondary Education [FIPSE]. This is the
same as the comparable fiscal year 2011 funding level. The
budget request is $150,000,000.
The budget request includes $122,800,000 to support the
proposed First in the World initiative, which would be modeled
after the Investing in Innovation program for K-12. The
initiative would help ensure institutions of higher education
have access to innovative strategies and practices that have
been shown to be effective in improving educational outcomes.
The Committee recommendation does not include funding for this
initiative because of budget constraints.
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,
childcare, counseling, advising, internship opportunities,
financial aid and financial aid counseling and assistance. The
Committee encourages the Department to promote replication of
best practices that have proven to successfully provide
postsecondary degree completion opportunities for low-income
single parents, the overwhelming majority of whom are women, as
they struggle to balance commitments to family with their need
to pursue a college education and build a career.
Training for Realtime Writers.--Within the total for FIPSE,
the Committee recommendation includes $998,000 for the Training
for Realtime Writers program authorized by section 872 of the
HEA, which is the same as the fiscal year 2011 level. The
budget request does not include funding for this program. This
program 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 creating a barrier to
full-quality captioning of realtime television programming such
as news, weather and emergency messaging.
Model Comprehensive Transition and Postsecondary Programs for Students
With Intellectual Disabilities
The Committee recommendation includes $10,978,000 for this
program as authorized by section 769 of HEA. This is the same
level that was provided in fiscal year 2011. The budget does
not request funds for this program.
These funds are used to award 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
local educational agencies to support students with
intellectual disabilities participating in the model program
who are still eligible for special education and related
services under IDEA. Institutions of higher education receiving
funds under this program are required to match Federal funds in
an amount that is no less than 25 percent of the award amount.
Minority Science and Engineering Improvement
The Committee recommends $9,484,000 for the Minority
Science and Engineering Improvement program. This amount is the
same as the comparable fiscal year 2011 funding level. The
budget request includes $9,503,000 for this program. 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 $8,146,000 for tribally controlled
postsecondary vocational institutions. This amount is the same
as the comparable fiscal year 2011 funding level. The budget
request includes $8,162,000. 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 $826,522,000, the same amount as
the fiscal year 2011 level, for Federal TRIO programs. The
budget request is $920,089,000.
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.
Gaining Early Awareness and Readiness for Undergraduate Programs [GEAR
UP]
The Committee recommends $302,816,000 for GEAR UP. This
amount is the same as the comparable fiscal year 2011 funding
level. The budget request includes $323,212,000. 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.
The Committee is concerned that the Department has not
awarded TRIO and GEAR UP grants in a timely manner. For TRIO
programs, the HEA sets specific timelines for the Department to
notify new, continuing and non-continuing grantees.
Specifically, the law requires that grantees be notified of
their funding status 8 months prior to the start date of their
grant. The Department routinely misses this deadline. For
awards made with fiscal year 2010 funds, Student Support
Services applicants were not notified until August 2010 of
their awards. For fiscal year 2011 awards, the announcement of
the Educational Opportunity Centers grant awards was not made
until September 2011. Similarly, GEAR UP awards are not
expected to be announced before the end of September 2011.
These programs operate on an academic program year. Delays in
making awards compromise the grantees' abilities to serve
students and successfully achieve the goals of the programs.
The Committee expects that the Department provide within 30
days of enactment of this act a report on the causes of the
tardiness in making grant awards for these programs and an
action plan to remedy them.
Javits Fellowships
The Committee recommends $8,084,000, the same amount as the
fiscal year 2011 level, for the Javits Fellowships program. The
administration proposed eliminating this program and
consolidating the funds with the Graduate Assistance in Areas
of National Need program. The Javits Fellowships program
provides fellowships of up to 4 years to students of superior
ability who are pursuing doctoral degrees in the arts,
humanities, and social sciences at any institution of their
choice. Each fellowship consists of a student stipend to cover
living costs and an institutional payment to cover each
fellow's tuition and other expenses.
Graduate Assistance in Areas of National Need [GAANN]
The Committee recommends $30,968,000, the same amount as
the fiscal year 2011 level, for the GAANN program. The budget
request includes $40,717,000 for GAANN, which would have
absorbed the Javits Fellowship program under the
administration's proposal. GAANN awards competitive grants to
graduate academic departments and programs for fellowship
support in areas of national need as determined by the
Secretary. In fiscal year 2010, the Secretary designated the
following areas of national need: biology, chemistry, computer
and information sciences, engineering, mathematics, physics,
nursing, and educational assessment, evaluation and research.
Teacher Quality Partnership Program
The Committee recommends $42,914,000, the same as the
fiscal year 2011 level, for the teacher quality partnership
program. The budget request would eliminate this program and
consolidate it into a proposed new Teacher and Leader Pathways
authority as part of the administration's plan for
reauthorizing 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 $16,002,000
for the Child Care Access Means Parents in School [CCAMPIS]
program. This amount is the same as the comparable fiscal year
2011 funding level. The budget request includes $16,034,000 for
this program. 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 childcare program primarily serving the needs of
low-income students enrolled at the institution.
GPRA/Higher Education Act Program Evaluation
The Committee recommends $608,000 to collect data
associated with the Government Performance and Results Act
[GPRA] and to evaluate programs authorized by the HEA. This
amount is the same as the comparable fiscal year 2011 funding
level. The budget request includes $609,000.
Thurgood Marshall Legal Educational Opportunity Program
The Committee does not recommend funding for the Thurgood
Marshall Legal Educational Opportunity Program, which was
eliminated in fiscal year 2011. The budget request includes
$3,000,000. This program helped provide low-income, minority or
disadvantaged college students with the information,
preparation and financial assistance needed to enter and
complete law school study.
Hawkins Centers of Excellence
The Committee does not recommend funding for the proposed
new Hawkins Centers of Excellence. The budget request included
$40,000,000 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.
Howard University
Appropriations, 2011.................................... $234,507,000
Budget estimate, 2012................................... 234,977,000
Committee recommendation................................ 234,507,000
The Committee recommends an appropriation of $234,507,000
for Howard University. This is the same amount as the
comparable fiscal year 2011 funding level. The budget request
is $234,977,000. Howard University 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 46
percent of the university's projected educational and general
expenditures, excluding the hospital. The Committee recommends,
within the funds provided, not less than $3,600,000 for the
endowment program.
Howard University Hospital.--Within the funds provided, the
Committee recommends $28,888,000 for the Howard University
Hospital. This is the same amount as the fiscal year 2011
funding level. The budget request is $28,946,000. 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
Appropriations, 2011.................................... $460,000
Budget estimate, 2012................................... 478,000
Committee recommendation................................ 460,000
Federal Administration.--The Committee bill includes
$460,000 for Federal administration of the College Housing and
Academic Facilities Loans [CHAFL] program. This is the same
amount as the comparable fiscal year 2011 level. The budget
request is $478,000. These funds will be used to reimburse the
Department for expenses incurred in managing the existing CHAFL
loan portfolio during fiscal year 2012. These expenses include
salaries and benefits, travel, printing, contracts (including
contracted loan servicing activities) and other expenses
directly related to the administration of the CHAFL program.
Historically Black College and University Capital Financing Program
Account
Appropriations, 2011.................................... $20,541,000
Budget estimate, 2012................................... 20,582,000
Committee recommendation................................ 20,541,000
The Committee recommends $20,541,000 for the Historically
Black College and University [HBCU] Capital Financing Program.
This is the same amount as the comparable fiscal year 2011
level. The budget request is $20,582,000 for this activity.
The Committee recommendation includes $20,188,000 to pay
the loan subsidy costs in guaranteed loan authority under this
program. This will support $367,255,000 in new loan volume in
fiscal year 2012. The budget proposes $20,228,000 to pay for
the subsidy costs. 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 includes new
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 recognizes the impact Hurricanes Katrina and
Rita continue to have on institutions of higher education in
the Gulf region, particularly HBCUs. Enrollments at these
institutions declined after the hurricanes and have not
returned to pre-hurricane levels. Given this challenging
circumstance, the Committee includes new bill language that
authorizes the Secretary of Education to modify the terms and
conditions of loans issued through the HBCU Hurricane
Supplemental Loan Program in such a way that does not result in
any net cost to the Federal Government.
Institute of Education Sciences
Appropriations, 2011.................................... $608,788,000
Budget estimate, 2012................................... 760,473,000
Committee recommendation................................ 609,788,000
The Committee recommends $609,788,000 for the Institute of
Education Sciences [IES]. The budget request for fiscal year
2012 is $760,473,000 and the comparable fiscal year 2011 level
is $608,788,000. This account supports education research, data
collection and analysis activities, and the assessment of
student progress.
The Committee commends IES's attempts to improve the
utilization of education research and to enhance classroom
practices and collaborations between researchers and
practitioners. The Committee believes more needs to be done,
particularly with regard to research intended to improve
academic achievement for students with mental, emotional and
behavioral disorders as well as physical, intellectual and
developmental disabilities. The Committee requests that IES
describe its current and planned activities in these areas in
the fiscal year 2013 congressional budget justification.
RESEARCH, DEVELOPMENT, AND DISSEMINATION
The Committee recommends $199,796,000, the same as the
fiscal year 2011 level, for education research, development and
national dissemination activities. The budget request for
fiscal year 2012 is $260,413,000. Funds are available for
obligation for 2 fiscal years. These funds support research,
development and dissemination activities that are aimed at
expanding fundamental knowledge of education and promoting the
use of research and development findings in the design of
efforts to improve education.
The Committee strongly urges IES to continue support for
research and development activities related to gifted and
talented education, particularly for underrepresented
populations, to support a National Research Center on the
Gifted and Talented, and to ensure that the condition of gifted
and talented students is reported in key national reports
produced by the IES.
The Committee notes that some research has shown that
captioned educational television programs have shown potential
to improve literacy, particularly for low-income children. The
Committee encourages IES to examine 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 $109,304,000 for data gathering
and statistical analysis activities of the National Center for
Education Statistics [NCES]. The budget request for fiscal year
2012 is $117,021,000 and the comparable fiscal year 2011 amount
is $108,304,000.
The 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.
The NCES also provides technical assistance to State and local
educational agencies and postsecondary institutions.
The Committee recommendation includes sufficient resources
for NCES to update the report, Condition of America's Public
School Facilities: 1999. The Committee expects a First Look
report on this topic to be published in calendar year 2013.
REGIONAL EDUCATIONAL LABORATORIES
The Committee recommends $57,535,000, the same amount as
the fiscal year 2011 level, to continue support for the
regional educational laboratories. The budget request for
fiscal year 2012 is $69,650,000. Funds available in this bill
will support competitive grants 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. The Committee requests that IES describe in the fiscal
year 2013 congressional budget justification its efforts in
this area, as well as how IES measures the extent of progress
being achieved.
RESEARCH AND INNOVATION IN SPECIAL EDUCATION
The Committee recommends $50,983,000, the same amount as
the fiscal year 2011 funding level, for research and innovation
in special education conducted by the National Center for
Special Education Research. The budget request for fiscal year
2012 is $58,085,000. 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.
SPECIAL EDUCATION STUDIES AND EVALUATIONS
The Committee recommends $11,437,000, the same amount as
the fiscal year 2011 funding level, for special education
studies and evaluations. The budget request for fiscal year
2012 is $11,460,000.
This program supports competitive grants, contracts and
cooperative agreements to assess the implementation of the
Individuals with Disabilities Education Act. 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 $42,166,000, the same
amount as the fiscal year 2011 funding level, for statewide
data systems. The budget request for fiscal year 2012 is
$100,000,000.
This program supports competitive grants to State
educational agencies 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 and systems may be linked to, included in, or
developed with program funds. Funds are available for
obligation for 2 fiscal years.
The Committee bill allows up to $12,500,000 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 $138,567,000 to provide support
for the National Assessment of Educational Progress [NAEP], a
congressionally mandated assessment created to measure the
educational achievement of American students. The budget
request for fiscal year 2012 is $143,844,000 and the comparable
fiscal year 2011 amount is $138,567,000.
The primary goal of NAEP is to determine and report the
status and trends over time in educational achievement, subject
by subject.
Within the funds appropriated, the Committee recommends
$8,706,000, the same amount as the fiscal year 2011 funding
level, for the National Assessment Governing Board [NAGB]. The
budget request for fiscal year 2012 is $8,723,000. NAGB is
responsible for formulating policy for NAEP.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2011.................................... $455,288,000
Budget estimate, 2012................................... 479,038,000
Committee recommendation................................ 449,074,000
The Committee recommends $449,074,000 for program
administration. The budget request for fiscal year 2012 is
$479,038,000 and the comparable fiscal year 2011 level is
$455,288,000.
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 does not include additional
funds for building modernization activities for the Department
of Education. The budget request for these activities for
fiscal year 2012 is $2,711,000 and the comparable fiscal year
2011 amount is $8,184,000.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2011.................................... $102,818,000
Budget estimate, 2012................................... 107,772,000
Committee recommendation................................ 102,818,000
The Committee recommends $102,818,000, the same as the
fiscal year 2011 level, for the Office for Civil Rights [OCR].
The budget request for fiscal year 2012 is $107,772,000.
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 funded by the Department of Education. To carry
out this responsibility, OCR investigates and resolves
discrimination complaints, monitors desegregation and equal
educational opportunity plans, reviews possible discriminatory
practices by recipients of Federal education funds, and
provides technical assistance to recipients of funds to help
them meet civil rights requirements. The Committee encourages
OCR to focus resources on documenting and investigating the use
of restraint and seclusion procedures by school personnel.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2011.................................... $59,933,000
Budget estimate, 2012................................... 67,187,000
Committee recommendation................................ 59,933,000
The Committee recommends $59,933,000, the same as the
fiscal year 2011 level, for the Office of the Inspector
General. The budget request for fiscal year 2012 is
$67,187,000.
The Office of the Inspector General has the authority to
investigate all departmental programs and administrative
activities, including those under contract or grant, to prevent
and detect fraud and abuse, and to ensure the quality and
integrity of those programs. The Office investigates alleged
misuse of Federal funds and conducts audits to determine
compliance with laws and regulations, efficiency of operations
and effectiveness in achieving program goals.
GENERAL PROVISIONS
The Committee bill contains language which has been
included in the bill since 1974, prohibiting the use of funds
for the transportation of students or teachers in order to
overcome racial imbalance (sec. 301).
The Committee bill contains language included in the bill
since 1977, prohibiting the involuntary transportation of
students other than to the school nearest to the student's home
(sec. 302).
The Committee bill contains language which has been
included in the bill since 1980, prohibiting the use of funds
to prevent the implementation of programs of voluntary prayer
and meditation in public schools (sec. 303).
The Committee bill includes a provision giving the
Secretary of Education authority to transfer up to 1 percent of
any discretionary funds between appropriations (sec. 304).
The Committee continues a provision that allows the
outlying areas to consolidate funds under title V of the
Elementary and Secondary Education Act (sec. 305).
The Committee bill continues a provision that allows the
Republic of Palau to receive certain Federal funds (sec. 306).
The Committee bill includes new language related to the
Pell Grant program (sec. 307).
The Committee bill includes a new provision concerning the
HBCU Hurricane Supplemental Loan Program (sec. 308).
The Committee bill includes language clarifying the
authority available under the Race to the Top--Early Learning
Challenge (sec. 309).
TITLE IV
RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriations, 2011.................................... $5,385,000
Budget estimate, 2012................................... 5,841,000
Committee recommendation................................ 5,385,000
The Committee recommends $5,385,000 for fiscal year 2012
for the Committee for Purchase from People Who Are Blind or
Severely Disabled. The fiscal year 2011 comparable level is
$5,385,000. The fiscal year 2012 budget request was $5,841,000.
The primary purpose of the Committee for Purchase from
People Who Are Blind or Severely Disabled 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, 2011.................................... $778,869,000
Budget estimate, 2012................................... 916,390,000
Committee recommendation................................ 781,869,000
The Committee recommends $781,869,000 for the operating
expenses of the Corporation for National and Community Service
[CNCS] in fiscal year 2012. The administration request for
fiscal year 2012 was $916,390,000. The fiscal year 2011
comparable level was $778,869,000.
The Committee recommendation is sufficient to maintain the
number of AmeriCorps members at over 82,000.
CNCS, a corporation owned by the Federal Government, was
established by the National and Community Service Trust Act of
1993 to enhance opportunities for national and community
service and provide national service education awards. 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 $98,876,000, the same as the
fiscal year 2011 level, for the Volunteers in Service to
America [VISTA] Program. The budget request for fiscal year
2012 was $100,000,000.
VISTA, created in 1964 under the Economic Opportunity Act,
provides capacity building for small, community-based
organizations. VISTA volunteers raise resources for local
projects, recruit and organize volunteers, and establish and
expand local community-based programs in housing, employment,
health and economic development activities.
NATIONAL SENIOR VOLUNTEER CORPS
The Committee recommends $207,883,000, the same as the
fiscal year 2011 level, for the National Senior Volunteer Corps
Programs. The fiscal year 2012 budget request was $226,100,000.
The Committee has included sufficient funding to continue
all activities at no less than last year's level.
AMERICORPS STATE AND NATIONAL GRANTS
The Committee recommends $347,360,000, the same as the
fiscal year 2011 level, for AmeriCorps State and National
grants in fiscal year 2012. The budget request for fiscal year
2012 was $399,790,000.
DISABILITY PLACEMENT FUNDS
The Committee recommendation includes $4,990,000 for
Disability Placement funds, the same as the comparable fiscal
year 2011 level. The budget request for fiscal year 2012 was
$5,000,000.
Grant funds are for the placement of, reasonable
accommodation of, and auxiliary services for members and
potential members with disabilities serving in AmeriCorps
programs.
INNOVATION, DEMONSTRATION AND ASSISTANCE ACTIVITIES
The Committee has included $60,379,000 for Innovation,
Demonstration and Assistance Activities. The comparable fiscal
year 2011 level was $60,379,000 and the budget request for
fiscal year 2012 was $80,500,000.
Within the funds provided for the Innovation account, the
Committee has included $49,900,000 for the Social Innovation
fund authorized under section 1807 of the SERVE America Act.
In addition, $3,992,000 is included for the Volunteer
Generation Fund authorized under section 198P of the SERVE
America Act. The Committee has included bill language similar
to that requested by the administration to allow all funds to
be awarded competitively.
EVALUATION
The Committee recommendation includes $5,988,000, the same
as the fiscal year 2011 level, for evaluation activities. The
budget request for fiscal year 2012 was $6,000,000.
NATIONAL CIVILIAN COMMUNITY CORPS
The Committee recommendation includes $31,942,000 for the
National Civilian Community Corps. The comparable fiscal year
2011 level was $28,942,000 and the budget request for fiscal
year 2012 was $35,000,000.
The National Civilian Community Corps is a full-time, team-
based residential program for men and women ages 18 to 24.
Members are assigned to one of five campuses for a 10-month
service commitment.
The Committee is concerned by the pending loss of the
Atlantic campus of the National Civilian Community Corps and
the gap in disaster response services that even a temporary
displacement could create. Therefore, the Committee has
included an additional $3,000,000 for contracting, planning and
services required for the relocation of this campus. The
Committee requests that the Corporation provide the chairs and
ranking members of the appropriations and authorizing
committees of relevant jurisdiction with a proposed plan for
the relocation of the Atlantic campus within 60 days of the
enactment of this act.
LEARN AND SERVE AMERICA
The Committee has not included funding for Learn and Serve
America. The program was eliminated in fiscal year 2011. The
budget request for fiscal year 2012 was $39,500,000.
Learn and Serve America provided direct and indirect
support to K-12 schools, community groups and higher education
institutions to facilitate service-learning projects.
STATE COMMISSION ADMINISTRATION GRANTS
The Committee has included $16,966,000, the same as the
fiscal year 2011 level, for State Commission Administration
grants. The budget request for fiscal year 2012 was
$17,000,000.
TRAINING AND TECHNICAL ASSISTANCE
The Committee recommendation includes $7,485,000, the same
as the fiscal year 2011 level, for Training and Technical
Assistance. The budget request for fiscal year 2011 was
$7,500,000.
NATIONAL SERVICE TRUST
Appropriations, 2011.................................... $201,200,000
Budget estimate, 2012................................... 235,326,000
Committee recommendation................................ 215,200,000
The Committee recommends an appropriation of $215,200,000
for the National Service Trust. The comparable level for fiscal
year 2011 was $201,200,000. The administration request for
fiscal year 2012 was $235,326,000.
The National Service Trust is an account in the Treasury of
the United States from which the Corporation 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 Committee notes that the funding level recommended is
sufficient to support no less than the same number of service
members as were enrolled in fiscal year 2011.
SALARIES AND EXPENSES
Appropriations, 2011.................................... $87,824,000
Budget estimate, 2012................................... 97,694,000
Committee recommendation................................ 87,824,000
The Committee recommends an appropriation of $87,824,000,
the same as the fiscal year 2011 level, for the Corporation's
salaries and expenses. The budget request for fiscal year 2012
was $97,694,000.
The salaries and expenses appropriation provides funds for
staff salaries, benefits, travel, training, rent, advisory and
assistance services, communications and utilities expenses,
supplies, equipment and other operating expenses necessary for
management of the Corporation's activities under the National
and Community Service Act of 1990 and the Domestic Volunteer
Service Act of 1973.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2011.................................... $7,685,000
Budget estimate, 2012................................... 8,450,000
Committee recommendation................................ 7,685,000
The Committee recommends an appropriation of $7,685,000,
the same as the fiscal year 2011 level, for the Office of
Inspector General [OIG]. The administration request for fiscal
year 2012 was $8,450,000.
The goals of the OIG are to increase organizational
efficiency and effectiveness and to prevent fraud, waste and
abuse.
ADMINISTRATIVE PROVISIONS
The Committee has retained language in previous bills
concerning three administrative provisions: language requiring
the Corporation to make any significant changes to program
requirements or policy through rule-making (sec. 401), language
stipulating minimum share requirements (sec. 402), and language
requiring that donations supplement and not supplant operations
(sec. 403). In addition, the Committee has included one new
statutory provision requested in the President's budget,
aligning requirements regarding the use of Education Awards at
GI Bill-eligible institutions (sec. 404).
Corporation for Public Broadcasting
Appropriations, 2011.................................... $435,138,000
Budget estimate, 2012................................... 451,000,000
Committee recommendation, 2012.......................... 450,998,000
Appropriations, 2013.................................... 445,000,000
Budget estimate, 2014................................... 451,000,000
Committee recommendation, 2014.......................... 445,000,000
The Committee recommends $445,000,000 for the Corporation
for Public Broadcasting [CPB] as an advance appropriation for
fiscal year 2014, the same as the advance appropriation
provided last year for fiscal year 2013. The budget request for
fiscal year 2014 is $451,000,000. Two-year advance funding has
been in place since 1975 to ensure the independence of public
broadcasting programming.
In addition to the advance appropriation, the Committee
recommends $5,998,000 in fiscal year 2012 for digital
broadcasting equipment and programming activities related to
the transition from analog to digital broadcasting. This is the
same as the comparable fiscal year 2011 funding level for these
activities. The budget request is $6,000,000. In total,
including $445,000,000 in advanced funding available in fiscal
year 2012, the Committee recommends a fiscal year 2012 program
level of $450,998,000. The comparable fiscal year 2011 program
level is $435,138,000 and the budget request for fiscal year
2012 is $451,000,000.
The majority of funds appropriated to CPB 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 the administration of the CPB.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriations, 2011.................................... $46,559,000
Budget estimate, 2012................................... 48,025,000
Committee recommendation................................ 46,559,000
The Committee recommends $46,559,000, the same as the
comparable fiscal year 2011 funding level, for the Federal
Mediation and Conciliation Service [FMCS]. The budget request
is $48,025,000.
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
$349,000 for labor-management partnership grants. The
comparable fiscal year 2011 funding level is $348,302 and the
budget request is $750,000. 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, 2011.................................... $10,337,000
Budget estimate, 2012................................... 22,417,000
Committee recommendation................................ 17,337,000
The Committee recommends $17,337,000 for fiscal year 2012
for the Federal Mine Safety and Health Review Commission
[FMSHRC]. The comparable funding level for fiscal year 2011 is
$10,337,000 and the budget request is $22,417,000. The
Supplemental Appropriations Act, 2010 included an additional
$3,800,000 for FMSHRC, available over the 12-month period from
July 2010 through June 2011.
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 the
Department of Labor's Mine Safety and Health Administration
[MSHA]. FMSHRC's administrative law judges [ALJs] decide cases
at the trial level and the five-member Commission provides
review of the ALJ decisions.
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 the
passage of the MINER Act of 2006, resulting in a more than
fourfold increase in the number of cases appealed to FMSHRC
annually. As a result, the backlog of cases has increased from
1,300 at the beginning of fiscal year 2005 to over 18,000 at
the beginning of fiscal year 2011.
The disaster at the Upper Big Branch coal mine in April
2010 was a tragic reminder of the importance of mine safety.
The backlog of cases up for review at FMSHRC delays processing
times and creates a dangerous incentive for mine operators,
particularly those with a pattern of serious and substantial
safety violations, to contest violations simply to delay
enforcement. This delay undermines mine safety efforts and puts
miners at risk. The Committee recommendation builds off of
investments in the Supplemental Appropriations Act, 2010 and
will enable FMSHRC to continue to work down the backlog of
cases and reduce case processing times. The Committee
recommendation also includes up to $1,000,000 to continue the
transition to an electronic case management system that will
further improve productivity.
The Committee directs FMSRHC and the Department of Labor to
brief the Committees on Appropriations of the House of
Representatives and the Senate within 30 days of enactment of
this act with an update on its backlog reduction plan based on
the enacted fiscal year 2012 appropriation.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION
Appropriations, 2011.................................... $237,393,000
Budget estimate, 2012................................... 242,605,000
Committee recommendation................................ 237,393,000
The Committee recommends $237,393,393, the same as the
comparable fiscal year 2011 funding level, for the Institute of
Museum and Library Services. The budget request is
$242,605,000.
Within the total for IMLS, the Committee recommendation
includes the amounts below. The Museum Assessment Program and
Conservation Assessment Program were consolidated with the
National Leadership: Museums program in fiscal year 2011. The
Committee supports and maintains this consolidation.
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year Fiscal year Fiscal year
Budget activity 2011 2012 budget 2012 Committee
comparable request recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
Grants to States............................................ 160,032 161,345 160,032
Native American Library Services............................ 3,960 4,000 3,960
National Leadership: Libraries.............................. 12,225 12,250 12,225
Laura Bush 21st Century Librarian........................... 12,818 15,628 12,818
-----------------------------------------------
Subtotal, LSTA............................................ 189,035 193,223 189,035
-----------------------------------------------
Museum Services Act:
Museums for America......................................... 18,453 18,976 18,453
Museum Assessment Program................................... .............. .............. ..............
21st Century Museum Professionals........................... 2,015 2,073 2,015
Conservation Project Support................................ 2,675 2,747 2,675
Conservation Assessment Program............................. .............. .............. ..............
Native American/Hawaiian Museum Services.................... 947 975 947
National Leadership: Museums................................ 6,050 6,062 6,050
-----------------------------------------------
Subtotal, MSA............................................. 30,140 30,833 30,140
-----------------------------------------------
African American History & Culture Act:
Museum Grants for African American History & Culture........ 1,443 1,485 1,443
Administration.................................................. 14,845 15,130 14,845
Research, Analysis & Data Collection............................ 1,930 1,934 1,930
----------------------------------------------------------------------------------------------------------------
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
Appropriations, 2011....................................................
Budget estimate, 2012................................... $11,000,000
Committee recommendation................................ 10,500,000
The Committee recommends $10,500,000 for the Medicaid and
CHIP Payment and Access Commission [MACPAC]. The fiscal year
2012 budget request is $11,000,000. MACPAC was established in
the Children's Health Insurance Program Reauthorization Act of
2009 and is tasked with reviewing State and Federal Medicaid
and CHIP access and payment policies and making recommendations
to Congress, the Secretary of Health and Human Services, and
the States on a wide range of issues affecting those programs.
Medicare Payment Advisory Commission
SALARIES AND EXPENSES
Appropriations, 2011.................................... $12,425,000
Budget estimate, 2012................................... 13,100,000
Committee recommendation................................ 12,425,000
The Committee recommends $12,425,000, the same as the
comparable fiscal year 2011 funding level, for the Medicare
Payment Advisory Commission (MedPAC). The budget request is
$13,100,000. MedPAC was established by Congress as part of the
Balanced Budget Act of 1997 and provides independent policy and
technical advice on issues affecting the Medicare program.
National Council on Disability
SALARIES AND EXPENSES
Appropriations, 2011.................................... $3,264,000
Budget estimate, 2012................................... 3,400,000
Committee recommendation................................ 3,264,000
The Committee recommends $3,264,000, the same as the
comparable fiscal year 2011 funding level, for the National
Council on Disability. The fiscal year 2012 budget request is
$3,400,000.
The Council is mandated to make recommendations to the
President, the Congress, the Rehabilitation Services
Administration and the National Institute on Disability and
Rehabilitation Research on the public issues of concern to
individuals with disabilities. The Council gathers information
on the implementation, effectiveness and impact of the
Americans with Disabilities Act and looks at emerging policy
issues as they affect persons with disabilities and their
ability to enter or re-enter the Nation's workforce and to live
independently.
National Health Care Workforce Commission
SALARIES AND EXPENSES
Appropriations, 2011....................................................
Budget estimate, 2012................................... $3,000,000
Committee recommendation................................ 3,000,000
The Committee recommendation includes $3,000,000 for the
National Health Care Workforce Commission. The budget request
is $3,000,000. The National Health Care Workforce Commission
was authorized in the Patient Protection and Affordable Care
Act but has not yet been funded.
This 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, 2011.................................... $282,833,000
Budget estimate, 2012................................... 287,699,000
Committee recommendation................................ 282,833,000
The Committee recommends $282,833,000, the same as the
comparable fiscal year 2011 funding level, for the National
Labor Relations Board [NLRB]. The fiscal year 2012 budget
request is $287,699,000.
NLRB is a law enforcement agency that adjudicates disputes
under the National Labor Relations Act. The mission of NLRB is
to carry out the statutory responsibilities of the National
Labor Relations Act as efficiently as possible and in a manner
that gives full effect to the rights afforded to employees,
unions and employers under the act.
National Mediation Board
SALARIES AND EXPENSES
Appropriations, 2011.................................... $13,436,000
Budget estimate, 2012................................... 13,961,000
Committee recommendation................................ 13,436,000
The Committee recommends $13,436,000, the same as the
comparable fiscal year 2011 funding level, for the National
Mediation Board [NMB]. The fiscal year 2012 budget request is
$13,961,000.
The NMB protects interstate commerce as it mediates labor-
management relations in the railroad and airline industries
under the Railway Labor Act. It mediates collective bargaining
disputes, conducts elections to determine the choice of
employee bargaining representatives and administers arbitration
of employee grievances.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriations, 2011.................................... $11,689,000
Budget estimate, 2012................................... 12,773,000
Committee recommendation................................ 11,689,000
The Committee recommends $11,689,000, the same as the
comparable fiscal year 2011 funding level, for the Occupational
Safety and Health Review Commission [OSHRC]. The budget request
is $12,773,000.
OSHRC serves as a court to justly and expeditiously resolve
disputes between the Occupational Safety and Health
Administration [OSHA] and employers charged with violations of
health and safety standards enforced by OSHA.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
Appropriations, 2011.................................... $56,886,000
Budget estimate, 2012................................... 51,000,000
Committee recommendation................................ 51,000,000
The Committee recommends $51,000,000, the same as the
fiscal year 2012 budget request, for the Dual Benefits Payments
Account. Of these funds, an estimated $2,000,000 is from income
taxes on vested dual benefits. The comparable fiscal year 2011
funding level is $56,886,000, of which an estimated $3,000,000
is from income taxes.
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, 2011.................................... $150,000
Budget estimate, 2012................................... 150,000
Committee recommendation................................ 150,000
The Committee recommends $150,000 for fiscal year 2011 for
interest earned on non-negotiated checks. This is the same as
the comparable fiscal year 2011 funding level and the fiscal
year 2012 budget request.
LIMITATION ON ADMINISTRATION
Appropriations, 2011.................................... $108,855,000
Budget estimate, 2012................................... 112,239,000
Committee recommendation................................ 108,855,000
The Committee recommends $108,855,000, the same as the
comparable fiscal year 2011 funding level, for the
administration of railroad retirement/survivor and
unemployment/sickness benefit programs. The fiscal year 2012
budget request is $112,239,000.
The Board administers comprehensive retirement-survivor and
unemployment-sickness insurance benefit programs for the
Nation's railroad workers and their families. This account
limits the amount of funds in the railroad retirement and
railroad unemployment insurance trust funds that may be used by
the Board for administrative expenses.
LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2011.................................... $8,170,000
Budget estimate, 2012................................... 9,259,000
Committee recommendation................................ 8,170,000
The Committee recommends $8,170,000, the same as the
comparable fiscal year 2011 funding level, for the Office of
the Inspector General. The fiscal year 2011 budget request is
$9,259,000.
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriations, 2011.................................... $21,404,000
Budget estimate, 2012................................... 20,404,000
Committee recommendation................................ 20,404,000
The Committee recommends $20,404,000, the same as the
budget request, in mandatory funds for payments to Social
Security trust funds. The comparable fiscal year 2011 funding
level is $21,404,000. This account reimburses the old age and
survivors and disability insurance trust funds for special
payments to certain uninsured persons, costs incurred
administering pension reform activities, and the value of the
interest for benefit checks issued but not negotiated. This
appropriation restores the trust funds to the same financial
position they would have been in had they not borne these costs
and they were properly charged to general revenues.
SUPPLEMENTAL SECURITY INCOME PROGRAM
Appropriations, 2011.................................... $39,976,214,000
Budget estimate, 2012................................... 38,083,000,000
Committee recommendation................................ 37,922,543,000
The Committee recommends $37,922,543,000 for the
supplemental security income [SSI] program. This is in addition
to $13,400,000,000 provided in fiscal year 2011 as an advance
appropriation for fiscal year 2012, for a total program level
of $51,216,714,000. The budget request for fiscal year 2012 is
$38,083,000,000, for a total program level of $51,483,000,000.
The comparable fiscal year 2011 appropriation is
$39,976,214,000, plus an additional $13,400,000,000 provided as
an advance appropriation the previous fiscal year for a total
fiscal year 2011 program level of $55,976,214,000. The
significant decrease in the fiscal year 2012 program level is
due to the timing of monthly benefit payments that results in
13 monthly benefit payments in fiscal year 2011 but only 11 in
fiscal year 2012.
In addition to these fiscal year 2012 funds, the Committee
recommends an advance appropriation of $18,200,000,000, the
same as the budget request, for the first quarter of fiscal
year 2013 to ensure benefit payments continue uninterrupted.
The SSI program guarantees a minimum level of income to
financially needy individuals who are aged, blind or disabled.
In fiscal year 2012 the SSI program will provide an average
monthly benefit of $521 to over 8 million recipients. In
addition to benefit payments, these funds support beneficiary
services including vocational rehabilitation and return-to-work
activities; research and demonstration projects; and costs to
administer the program. Except for administrative costs, this
appropriation represents mandatory funding.
Beneficiary Services
The Committee recommendation includes $47,000,000, the same
as the budget request, in mandatory funds for beneficiary
services. The comparable fiscal year 2011 funding level is
$60,000,000. These funds reimburse Vocational Rehabilitation
[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 [EN], 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 $38,000,000, 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
2011 funding level is $42,928,000. Because of the availability
of unobligated balances, these funds will support a fiscal year
2012 program level of $70,254,000, compared to $51,176,000 in
fiscal year 2011.
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 up to $10,000,000 for a new Promoting
Readiness of Minors in SSI [PROMISE] program. This program will
be jointly administered by SSA and the Department of Education
and include interagency collaboration with the Department of
Health and Human Services and the Department of Labor. The goal
of the PROMISE program is to improve outcomes for children, and
the families of children, receiving SSI benefits by encouraging
innovation and improving coordination between existing programs
and services. The committee recommendation for SSA includes
funds for program design and evaluation activities, as well as
for incentive payments to States based on successful
interventions. The Committee has also included funding for this
program within the Department of Education.
Within the total for research and demonstration, the
Committee recommends $5,000,000 for the establishment of a new
Disability Research Consortium [DRC]. The DRC will work to
improve disability policy research by facilitating
collaboration between researchers and focusing on cross-cutting
issues affecting multiple Federal agencies and the disability
population in general. The Committee encourages SSA to consult
with the National Council on Disability in establishing the
DRC.
Administration
The Committee recommendation includes $3,683,543,000 for
SSI program administrative expenses. The comparable fiscal year
2011 funding level is $3,486,286,000 and the budget request is
$3,844,000,000. This appropriation funds the SSI program's
share of administrative expenses incurred through the
limitation on administrative expenses account.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriations, 2011.................................... $11,423,606,000
Budget estimate, 2012................................... 12,513,200,000
Committee recommendation................................ 11,631,948,000
The Committee recommends $11,631,948,000 for the Social
Security Administration's limitation on administrative expenses
[LAE] account. The comparable fiscal year 2011 funding level is
$11,423,606,000 and the budget request is $12,513,200,000.
This account provides resources for SSA to administer the
old age and survivors insurance [OASI], the disability
insurance [DI], and the supplemental security income [SSI]
programs, and to support the Center for Medicare and Medicaid
Services in administering its programs. 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 Committee recommendation includes a $139,516,000
increase for program integrity activities, provided through a
cap adjustment mechanism described below, and a $68,826,000
increase for non-program integrity base administrative
expenses.
In fiscal year 2012 the number of disability claims and
hearings requests SSA receives is expected to remain at near
record levels. The Committee recommendation will allow SSA to
continue towards the goal of eliminating the disability hearing
backlog by the end of 2013 while providing targeted increases
to those parts of the agency facing the greatest demand for
services or abnormal staff attrition. Because of budget
constraints, the Committee was not able to provide the full
amount requested by the administration, so it recognizes that
processing times and pending levels for other key workloads,
including initial disability claims, will rise. The Committee
directs SSA to provide a report to the Committees on
Appropriations of the House of Representative and the Senate
within 30 days of enactment of this act on the impact of
enacted funding levels on key workloads and services.
Program Integrity
Within the total for LAE, the Committee recommendation
includes $896,000,000 for program integrity activities,
including conducting continuing disability reviews [CDRs] and
redeterminations of non-medical eligibility factors under the
SSI program. This amount includes $273,000,000 in base funding
and $623,000,000 in cap adjustment funding provided under
section 251(b)(2)(C)(ii) of the Balanced Budget and Emergency
Deficit Control Act of 1985. The comparable fiscal year 2011
funding level is $746,484,000 and the budget request is
$938,000,000.
This increase in funding in fiscal year 2012 will allow SSA
to conduct 263,000 additional full-medical CDRs and 200,000
additional SSI redeterminations than in fiscal year 2011. In
total, SSA will conduct 569,000 full-medical CDRs and 2,622,000
SSI redeterminations, saving approximately $8,900,000,000 over
10 years to the Social Security, Medicare and Medicaid
programs.
No-Year Information Technology Funding
The Committee maintains bill language allowing SSA to carry
over unobligated LAE balances for use in future fiscal years,
without fiscal year limitation, for investments in information
technology and telecommunications infrastructure. In fiscal
year 2011 SSA made available $461,413,000 in prior-year
unobligated balances for these activities and the Committee
recommendation assumes SSA will make an additional $60,000,000
available in fiscal year 2012. This is in addition to funding
within SSA's annual appropriation used for these activities in
those years. This significant decrease is due to a rescission
of $275,000,000 in fiscal year 2011 that otherwise would have
been available in fiscal year 2012. The Committee also includes
new bill language directing SSA to include information in their
congressional budget justification each year regarding the
estimated amount of prior year unobligated balances that will
be available and used for these purposes, and to notify the
Committees on Appropriations of the House of Representatives
and the Senate before those funds are made available.
Information included in the congressional budget justification
should include a consolidated information technology plan and
include the actual and estimated amounts funded with annually
appropriated and no-year funds.
Social Security Advisory Board
Within the total for LAE, 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 2011 funding level is $2,295,000. 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.
User Fees
Within the total for LAE, the Committee recommendation
includes $155,500,000 for administrative activities funded from
user fees. This amount includes $155,000,000 in fees paid to
SSA by States that request SSA to administer State SSI
supplementary payments and $500,000 from a fee payment process
for non-attorney representatives of claimants.
Acquisition Workforce
The Committee recommendation does not include funding
specified for strengthening the capacity and capability of
SSA's acquisition workforce. The budget request includes
$1,863,000 for this activity.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2011.................................... $102,477,000
Budget estimate, 2012................................... 107,113,000
Committee recommendation................................ 102,477,000
The Committee recommends $102,477,000, the same as the
comparable fiscal year 2011 funding level, for the Office of
the Inspector General. The budget request is $107,113,000. The
recommendation includes $73,535,000 funded from the OASI and DI
trust funds for those programs' share of inspector general
expenses and $28,942,000 funded from general revenues for the
SSI program's share of expenses.
TITLE V--GENERAL PROVISIONS
The Committee recommendation includes provisions which:
authorize transfers of unexpended balances (sec. 501); limit
funding to 1 year availability unless otherwise specified (sec.
502); limit lobbying and related activities (sec. 503); limit
official representation expenses (sec. 504); prohibit funding
of any program to carry out distribution of sterile needles for
the hypodermic injection of any illegal drug without the
approval of appropriate local officials (sec. 505); clarify
Federal funding as a component of State and local grant funds
(sec. 506); limit use of funds for abortion (sec. 507 and sec.
508); restrict human embryo research (sec. 509); limit the use
of funds for promotion of legalization of controlled substances
(sec. 510); prohibit the use of funds to promulgate regulations
regarding the individual health identifier (sec. 511); limit
use of funds to enter into or review contracts with entities
subject to the requirement in section 4212(d) of title 38,
United States Code, if the report required by that section has
not been submitted (sec. 512); prohibit 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 (sec. 513); prohibit Federal
funding in this act for libraries unless they are in compliance
with the Children's Internet Protection Act (sec. 514);
maintain a procedure for reprogramming of funds (sec. 515);
prohibit candidates for scientific advisory committees from
having to disclose their political activities (sec. 516);
require each department and related agency to submit an
operating plan (sec. 517); require 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
(sec. 518); prohibit the use of funds for first-class travel
(sec. 519); prohibit 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 (sec. 520); and a provision rescinding funds from the
State Children's Health Insurance Program performance bonus
fund (sec. 521).
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 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 September 21,
2011, the Committee ordered favorably reported an original bill
(S. 1599) making appropriations the Departments of Labor,
Health and Human Services, and Education, and related agencies
for the fiscal year ending September 30, 2012, and for other
purposes, provided that the bill be subject to amendment and
that the bill be consistent with 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.''
TITLE 20--EDUCATION
Chapter 28--Higher Education Resources and Student Assistance
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) * * *
* * * * * * *
(8) Additional funds.--
(A) In general.-- * * *
(i) * * *
* * * * * * *
[(iv) $3,090,000,000 for fiscal
year 2011;]
(iv) to carry out this section--
(I) $13,500,000,000 for
fiscal year 2011;
(II) $13,583,000,000 for
fiscal year 2012;
(III) $8,940,000,000 for
fiscal year 2013, of which
$896,000,000 shall be available
for the 2012-2013 award year;
(IV) $0 for fiscal year
2014;
(V) $0 for fiscal year
2015;
(VI) $0 for fiscal year
2016;
(VII) $1,640,000,000 for
fiscal year 2017;
(VIII) $1,705,000,000 for
fiscal year 2018;
(IX) $1,775,000,000 for
fiscal year 2019;
(X) $1,870,000,000 for
fiscal year 2020; and
(XI) $2,055,000,000 for
fiscal year 2021 and each
succeeding fiscal year.
* * * * * * *
PART B--FEDERAL FAMILY EDUCATION LOAN PROGRAM
Sec. 1078. Federal payments to reduce student interest costs
(a) Federal interest subsidies
(1) Types of loans that qualify
* * * * * * *
(3) Amount of interest subsidy
(A)(i) * * *
[(I) which accrues prior to the beginning
of the repayment period of the loan, or]
(I) which accrues prior to
the date the student ceases to
carry at least one-half the
normal full-time academic
workload (as determined by the
institution), or
------
TITLE 48--TERRITORIES AND INSULAR POSSESSIONS
Chapter 18--Micronesia, Marshall Islands, and Palau
Subchapter I--Micronesia and Marshall Islands
PART A--APPROVAL AND IMPLEMENTATION OF RIGINALCOMPACT
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]
2012, to the extent the government,
institutions, and people of Palau were
so eligible under such provisions in
fiscal year 2003.
------
AMERICAN RECOVERY AND REINVESTMENT ACT, 2009, PUBLIC LAW 111-5
TITLE XIV--STATE FISCAL STABILIZATION FUND
GENERAL PROVISIONS--THIS TITLE
SEC. 14006. STATE INCENTIVE GRANTS.
(a) In General.--
* * * * * * *
(c) Subgrants to Local Educational Agencies.--(1) In
General.--* * *
(2) Exception.--Paragraph (1) does not apply to grants made
by the Secretary to consortia of States to develop academic
assessments that are aligned with academic standards, or to a
State or States for improving early childhood care and
education except that such a State may use its grant funds to
make subgrants to public or private agencies and organizations
for activities consistent with the purposes of the grant.
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 2012: Subcommittee on Labor, HHS, Education:
Mandatory............................................... 540,370 540,370 540,108 \1\540,108
Discretionary........................................... 157,134 158,027 180,041 \1\180,803
Security............................................ 299 299 NA NA
Nonsecurity......................................... 156,835 157,728 NA NA
Projections of outlays associated with the recommendation:
2012.................................................... ........... ........... ........... \2\612,960
2013.................................................... ........... ........... ........... 68,409
2014.................................................... ........... ........... ........... 14,255
2015.................................................... ........... ........... ........... 2,458
2016 and future years................................... ........... ........... ........... 98
Financial assistance to State and local governments for NA 323,580 NA 289,735
2012.......................................................
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.
NA: Not applicable.
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 $893,000 in budget authority plus associated outlays.
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2011 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2012
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2011 Budget estimate Committee -----------------------------------
appropriation recommendation 2011
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I -- DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
Grants to States:
Adult Training, current year.............................. 58,922 148,527 58,922 ................ -89,605
Advance from prior year............................... (710,576) (712,000) (712,000) (+1,424) ................
FY 2013............................................... 712,000 712,000 712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 770,922 860,527 770,922 ................ -89,605
Youth Training............................................ 825,914 923,913 825,914 ................ -97,999
Dislocated Worker Assistance, current year................ 203,432 314,603 203,432 ................ -111,171
Advance from prior year............................... (858,280) (860,000) (860,000) (+1,720) ................
FY 2013............................................... 860,000 860,000 860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 1,063,432 1,174,603 1,063,432 ................ -111,171
=========================================================================================
Subtotal, Grants to States.............................. 2,660,268 2,959,043 2,660,268 ................ -298,775
Current Year........................................ (1,088,268) (1,387,043) (1,088,268) ................ (-298,775)
FY 2013............................................. (1,572,000) (1,572,000) (1,572,000) ................ ................
Federally Administered Programs:
Dislocated Worker Assistance National Reserve:
Current year.......................................... 24,112 29,160 24,112 ................ -5,048
Advance from prior year............................... (199,600) (200,000) (200,000) (+400) ................
FY 2013............................................... 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 224,112 229,160 224,112 ................ -5,048
-----------------------------------------------------------------------------------------
Subtotal, Dislocated Worker Assistance.................. 1,287,544 1,403,763 1,287,544 ................ -116,219
Native Americans.......................................... 52,652 54,158 52,652 ................ -1,506
Migrant and Seasonal Farmworkers.......................... 84,451 86,620 84,451 ................ -2,169
Women in Apprenticeship................................... 998 1,000 998 ................ -2
YouthBuild................................................ 79,840 115,000 79,840 ................ -35,160
Workforce Innovation Fund................................. 124,750 ................ 100,000 -24,750 +100,000
=========================================================================================
Subtotal, Federally Administered Programs (FAP)......... 566,803 485,938 542,053 -24,750 +56,115
Current Year........................................ (366,803) (285,938) (342,053) (-24,750) (+56,115)
FY 2013............................................. (200,000) (200,000) (200,000) ................ ................
National Activities:
Pilots, Demonstrations and Research................... 9,980 6,616 10,480 +500 +3,864
Green Jobs Innovation Fund............................ ................ 60,000 ................ ................ -60,000
Reintegration of Ex-Offenders......................... 85,390 90,000 75,390 -10,000 -14,610
Evaluation............................................ 9,581 11,600 9,581 ................ -2,019
Workforce Data Quality Initiative..................... 12,475 13,750 12,475 ................ -1,275
-----------------------------------------------------------------------------------------
Subtotal............................................ 117,426 181,966 107,926 -9,500 -74,040
=========================================================================================
Total, Training and Employment Services (TES)........... 3,344,497 3,626,947 3,310,247 -34,250 -316,700
Current Year........................................ (1,572,497) (1,854,947) (1,538,247) (-34,250) (-316,700)
FY 2013............................................. (1,772,000) (1,772,000) (1,772,000) ................ ................
OFFICE OF JOB CORPS
Administration................................................ 29,132 31,430 29,132 ................ -2,298
Operations.................................................... 981,049 998,817 981,049 ................ -17,768
Advance from prior year................................... (589,818) (591,000) (591,000) (+1,182) ................
FY 2013................................................... 591,000 591,000 591,000 ................ ................
Construction and Renovation................................... 4,990 3,500 4,990 ................ +1,490
Advance from prior year................................... (99,800) (100,000) (100,000) (+200) ................
FY 2013................................................... 100,000 75,000 100,000 ................ +25,000
-----------------------------------------------------------------------------------------
Total, Office of Job Corps.............................. 1,706,171 1,699,747 1,706,171 ................ +6,424
Current Year........................................ (1,015,171) (1,033,747) (1,015,171) ................ (-18,576)
FY 2013............................................. (691,000) (666,000) (691,000) ................ (+25,000)
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\........... 449,100 450,000 449,100 ................ -900
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES.................. 721,312 1,100,100 1,100,100 +378,788 ................
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Unemployment Compensation (UI):
State Operations.......................................... 3,239,154 3,275,610 3,231,154 -8,000 -44,456
National Activities....................................... 11,287 11,310 11,287 ................ -23
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation..................... 3,250,441 3,286,920 3,242,441 -8,000 -44,479
Employment Service (ES):
Allotments to States:
Federal Funds......................................... 22,638 83,864 22,638 ................ -61,226
Trust Funds........................................... 679,531 680,893 679,531 ................ -1,362
-----------------------------------------------------------------------------------------
Subtotal............................................ 702,169 764,757 702,169 ................ -62,588
ES National Activities.................................... 20,952 20,994 20,952 ................ -42
-----------------------------------------------------------------------------------------
Subtotal, Employment Service............................ 723,121 785,751 723,121 ................ -62,630
Federal Funds....................................... (22,638) (83,864) (22,638) ................ (-61,226)
Trust Funds......................................... (700,483) (701,887) (700,483) ................ (-1,404)
Foreign Labor Certification:
Federal Administration.................................... 50,418 50,537 50,418 ................ -119
Grants to States.......................................... 15,099 15,129 15,099 ................ -30
-----------------------------------------------------------------------------------------
Subtotal, Foreign Labor Certification................... 65,517 65,666 65,517 ................ -149
One-Stop Career Centers/Labor Market Information.............. 63,593 63,720 63,593 ................ -127
=========================================================================================
Total, State UI and ES.................................. 4,102,672 4,202,057 4,094,672 -8,000 -107,385
Federal Funds....................................... (86,231) (147,584) (86,231) ................ (-61,353)
Trust Funds......................................... (4,016,441) (4,054,473) (4,008,441) (-8,000) (-46,032)
STATE PAID LEAVE FUND......................................... ................ 23,000 ................ ................ -23,000
ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\................... 290,000 ................ ................ -290,000 ................
PROGRAM ADMINISTRATION
Adult Employment and Training................................. 46,765 51,577 46,765 ................ -4,812
Trust Funds............................................... 8,536 9,960 8,536 ................ -1,424
Youth Employment and Training................................. 12,283 14,442 12,283 ................ -2,159
Employment Security........................................... 3,483 4,713 3,483 ................ -1,230
Trust Funds............................................... 39,417 41,298 39,417 ................ -1,881
Apprenticeship Services....................................... 27,728 28,718 27,728 ................ -990
Executive Direction........................................... 7,061 7,083 7,061 ................ -22
Trust Funds............................................... 2,087 2,091 2,087 ................ -4
-----------------------------------------------------------------------------------------
Total, Program Administration........................... 147,360 159,882 147,360 ................ -12,522
Federal Funds....................................... (97,320) (106,533) (97,320) ................ (-9,213)
Trust Funds......................................... (50,040) (53,349) (50,040) ................ (-3,309)
=========================================================================================
Total, Employment and Training Administration (ETA)..... 10,761,112 11,261,733 10,807,650 +46,538 -454,083
Federal Funds....................................... 6,694,631 7,153,911 6,749,169 +54,538 -404,742
Current Year.................................... (4,231,631) (4,715,911) (4,286,169) (+54,538) (-429,742)
FY 2013......................................... (2,463,000) (2,438,000) (2,463,000) ................ (+25,000)
Trust Funds......................................... 4,066,481 4,107,822 4,058,481 -8,000 -49,341
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
Enforcement and Participant Assistance........................ 131,137 149,884 149,884 +18,747 ................
Policy and Compliance Assistance.............................. 21,571 40,926 38,926 +17,355 -2,000
Executive Leadership, Program Oversight and Admin............. 6,655 6,718 6,718 +63 ................
-----------------------------------------------------------------------------------------
Total, EBSA............................................. 159,363 197,528 195,528 +36,165 -2,000
PENSION BENEFIT GUARANTY CORPORATION (PBGC)
Pension Insurance Activities.................................. (74,506) (86,023) (86,023) (+11,517) ................
Pension Plan Termination...................................... (242,300) (243,372) (243,372) (+1,072) ................
Operational Support........................................... (147,261) (147,506) (147,506) (+245) ................
-----------------------------------------------------------------------------------------
Total, PBGC (program level)............................. (464,067) (476,901) (476,901) (+12,834) ................
ENFORCEMENT OF WAGE AND HOUR STANDARDS........................ 227,491 240,937 227,491 ................ -13,446
OFFICE OF LABOR-MANAGEMENT STANDARDS.......................... 41,367 41,367 41,367 ................ ................
FEDERAL CONTRACTOR EEO STANDARDS ENFORCEMENT.................. 105,386 109,010 105,386 ................ -3,624
FEDERAL PROGRAMS FOR WORKERS' COMPENSATION
Salaries and Expenses......................................... 115,939 121,354 115,939 ................ -5,415
Trust Funds............................................... 2,124 2,184 2,124 ................ -60
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses............................ 118,063 123,538 118,063 ................ -5,475
Federal Funds....................................... (115,939) (121,354) (115,939) ................ (-5,415)
Trust Funds......................................... (2,124) (2,184) (2,124) ................ (-60)
SPECIAL BENEFITS
Federal Employees' Compensation Benefits...................... 180,000 347,000 347,000 +167,000 ................
Longshore and Harbor Workers' Benefits........................ 3,000 3,000 3,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Benefits................................. 183,000 350,000 350,000 +167,000 ................
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Benefit Payments.............................................. 198,000 177,000 177,000 -21,000 ................
Administration................................................ 5,220 5,227 5,227 +7 ................
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 203,220 182,227 182,227 -20,993 ................
Less funds advanced in prior year..................... -45,000 -41,000 -41,000 +4,000 ................
-----------------------------------------------------------------------------------------
Total, Current Year................................. 158,220 141,227 141,227 -16,993 ................
New advances, 1st quarter FY 2013................... 41,000 40,000 40,000 -1,000 ................
-----------------------------------------------------------------------------------------
Total, Special Benefits for Disabled Coal Miners........ 199,220 181,227 181,227 -17,993 ................
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND
Part B Administrative Expenses................................ 53,778 52,147 52,147 -1,631 ................
BLACK LUNG DISABILITY TRUST FUND
Benefit Payments and Interest on Advances..................... 237,808 241,689 241,689 +3,881 ................
Employment Standards Administration, Salaries and Expenses.... 33,075 32,906 32,906 -169 ................
Departmental Management, Salaries and Expenses................ 25,394 25,217 25,217 -177 ................
Departmental Management, Inspector General.................... 327 327 327 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability......................... 296,604 300,139 300,139 +3,535 ................
Treasury Department Administrative Costs...................... 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................. 296,960 300,495 300,495 +3,535 ................
=========================================================================================
Total, Federal Programs for Workers' Compensation....... 851,021 1,007,407 1,001,932 +150,911 -5,475
Federal Funds....................................... 848,897 1,005,223 999,808 +150,911 -5,415
Current year.................................... (807,897) (965,223) (959,808) (+151,911) (-5,415)
FY 2013......................................... (41,000) (40,000) (40,000) (-1,000) ................
Trust Funds......................................... 2,124 2,184 2,124 ................ -60
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA)
SALARIES AND EXPENSES
Safety and Health Standards................................... 20,288 25,982 21,288 +1,000 -4,694
Federal Enforcement........................................... 208,146 216,365 208,146 ................ -8,219
Whistleblower enforcement..................................... 14,806 20,948 16,306 +1,500 -4,642
State Programs................................................ 104,393 105,893 104,393 ................ -1,500
Technical Support............................................. 25,868 25,950 25,868 ................ -82
Compliance Assistance:
Federal Assistance........................................ 73,383 74,039 73,383 ................ -656
State Consultation Grants................................. 54,688 55,798 54,688 ................ -1,110
Training Grants........................................... 10,729 12,000 10,729 ................ -1,271
-----------------------------------------------------------------------------------------
Subtotal, Compliance Assistance......................... 138,800 141,837 138,800 ................ -3,037
Safety and Health Statistics.................................. 34,805 34,875 34,805 ................ -70
Executive Direction and Administration........................ 11,513 11,536 11,513 ................ -23
=========================================================================================
Total, OSHA............................................. 558,619 583,386 561,119 +2,500 -22,267
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Coal Enforcement.............................................. 160,369 161,303 164,969 +4,600 +3,666
Metal/Non-Metal Enforcement................................... 87,644 89,990 88,394 +750 -1,596
Standards Development......................................... 4,352 5,550 4,352 ................ -1,198
Assessments................................................... 6,221 6,574 6,221 ................ -353
Educational Policy and Development............................ 38,148 36,338 36,838 -1,310 +500
Technical Support............................................. 31,031 33,403 31,431 +400 -1,972
Program Evaluation and Information Resources (PEIR)........... 18,173 20,654 18,423 +250 -2,231
Program Administration........................................ 15,906 30,465 20,872 +4,966 -9,593
=========================================================================================
Total, Mine Safety & Health Administration MSHA......... 361,844 384,277 371,500 +9,656 -12,777
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
Employment and Unemployment Statistics........................ 210,673 219,043 210,673 ................ -8,370
Labor Market Information...................................... 67,303 69,136 68,303 +1,000 -833
Prices and Cost of Living..................................... 205,410 232,839 205,410 ................ -27,429
Compensation and Working Conditions........................... 80,418 81,197 80,418 ................ -779
Productivity and Technology................................... 12,078 10,201 12,078 ................ +1,877
Executive Direction and Staff Services........................ 34,342 34,614 34,342 ................ -272
=========================================================================================
Total, Bureau of Labor Statistics....................... 610,224 647,030 611,224 +1,000 -35,806
Federal Funds....................................... 542,921 577,894 542,921 ................ -34,973
Trust Funds......................................... 67,303 69,136 68,303 +1,000 -833
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES......................................... 38,953 39,031 38,953 ................ -78
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
Executive Direction........................................... 33,283 33,213 33,283 ................ +70
Departmental IT Crosscut...................................... 19,852 ................ 19,852 ................ +19,852
Departmental Program Evaluation............................... 8,500 18,400 8,500 ................ -9,900
Legal Services................................................ 119,121 132,578 129,121 +10,000 -3,457
Trust Funds............................................... 326 331 326 ................ -5
International Labor Affairs................................... 92,484 101,504 92,484 ................ -9,020
Administration and Management................................. 30,339 30,745 30,339 ................ -406
Adjudication.................................................. 29,227 30,576 29,227 ................ -1,349
Women's Bureau................................................ 11,581 11,620 11,581 ................ -39
Civil Rights Activities....................................... 6,798 7,223 6,798 ................ -425
Chief Financial Officer....................................... 5,350 5,364 5,350 ................ -14
-----------------------------------------------------------------------------------------
Total, Salaries and expenses............................ 356,861 371,554 366,861 +10,000 -4,693
Federal Funds....................................... (356,535) (371,223) (366,535) (+10,000) (-4,688)
Trust Funds......................................... (326) (331) (326) ................ (-5)
VETERANS EMPLOYMENT AND TRAINING
State Administration, Grants.................................. 165,063 165,394 165,063 ................ -331
Transition Assistance Program................................. 6,986 9,000 8,006 +1,020 -994
Federal Administration........................................ 35,242 35,222 35,222 -20 ................
National Veterans Training Institute.......................... 2,444 2,449 2,444 ................ -5
Homeless Veterans Program..................................... 36,257 39,330 38,257 +2,000 -1,073
Veterans Workforce Investment Programs........................ 9,622 9,641 9,622 ................ -19
-----------------------------------------------------------------------------------------
Total, Veterans Employment and Training................. 255,614 261,036 258,614 +3,000 -2,422
Federal Funds....................................... 45,879 48,971 47,879 +2,000 -1,092
Trust Funds......................................... 209,735 212,065 210,735 +1,000 -1,330
OFFICE OF INSPECTOR GENERAL
Program Activities............................................ 77,937 78,453 77,937 ................ -516
Trust Funds............................................... 5,909 5,992 5,909 ................ -83
-----------------------------------------------------------------------------------------
Total, Office of Inspector General...................... 83,846 84,445 83,846 ................ -599
IT MODERNIZATION
Departmental support systems.................................. ................ 17,000 ................ ................ -17,000
IT infrastructure modernization............................... ................ 8,000 ................ ................ -8,000
-----------------------------------------------------------------------------------------
Total, IT Modernization................................. ................ 25,000 ................ ................ -25,000
=========================================================================================
Total, Departmental Management.......................... 696,321 742,035 709,321 +13,000 -32,714
Federal Funds....................................... 480,351 523,647 492,351 +12,000 -31,296
Current Year.................................... (480,351) (523,647) (492,351) (+12,000) (-31,296)
Trust Funds......................................... 215,970 218,388 216,970 +1,000 -1,418
Working Capital Fund.......................................... ................ 4,620 ................ ................ -4,620
=========================================================================================
Total, Workforce Investment Act Programs................ 5,060,290 5,336,335 5,026,040 -34,250 -310,295
Current Year........................................ (2,597,290) (2,898,335) (2,563,040) (-34,250) (-335,295)
FY 2013............................................. (2,463,000) (2,438,000) (2,463,000) ................ (+25,000)
=========================================================================================
Total, Title I, Department of Labor..................... 14,411,701 15,258,361 14,671,471 +259,770 -586,890
Federal Funds....................................... 10,059,823 10,860,831 10,325,593 +265,770 -535,238
Appropriations, fiscal year 2012................ (11,952,701) (12,821,361) (12,209,471) (+256,770) (-611,890)
Appropriations.................................. (4,644,722) (5,043,206) (4,916,992) (+272,270) (-126,214)
Current Year................................ (7,555,823) (8,382,831) (7,822,593) (+266,770) (-560,238)
FY 2013..................................... (2,504,000) (2,478,000) (2,503,000) (-1,000) (+25,000)
Trust Funds......................................... 4,351,878 4,397,530 4,345,878 -6,000 -51,652
=========================================================================================
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)
HEALTH RESOURCES AND SERVICES
Bureau of Primary Health Care
Community Health Centers...................................... 1,580,749 2,117,814 1,580,749 ................ -537,065
Free Clinics Medical Malpractice.............................. 40 40 40 ................ ................
National Hansen's Disease Program............................. 16,077 16,075 16,077 ................ +2
Hansen's Disease Program Buildings and Facilities............. 129 129 129 ................ ................
Payment to Hawaii, Treatment of Hansen's...................... 1,964 1,976 1,964 ................ -12
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,598,959 2,136,034 1,598,959 ................ -537,075
Bureau of Health Professions
National Health service Corps:................................ 24,848 123,477 24,848 ................ -98,629
Health Professions
Health Professions, Training for Diversity:
Centers of Excellence..................................... 24,452 24,602 24,452 ................ -150
Health Careers Opportunity Program........................ 21,998 22,133 ................ -21,998 -22,133
Faculty Loan Repayment.................................... 1,258 1,266 1,258 ................ -8
Scholarships for Disadvantaged Students................... 49,042 52,921 49,042 ................ -3,879
Evaluation Tap Funding................................ ................ (7,079) ................ ................ (-7,079)
-----------------------------------------------------------------------------------------
Subtotal, Training for Diversity........................ 96,750 108,001 74,752 -21,998 -33,249
Training in Primary Care Medicine............................. 39,036 53,018 39,036 ................ -13,982
Evaluation Tap Funding.................................... ................ (86,914) ................ ................ (-86,914)
-----------------------------------------------------------------------------------------
Subtotal, Training in Primary Care Medicine............. 39,036 139,932 39,036 ................ -100,896
Oral Health Training.......................................... 32,781 35,419 32,781 ................ -2,638
Evaluation Tap Funding.................................... ................ (14,509) ................ ................ (-14,509)
-----------------------------------------------------------------------------------------
Subtotal, Oral Health programs.......................... 32,781 49,928 32,781 ................ -17,147
Interdisciplinary Community-Based Linkages:
Area Health Education Centers............................. 33,142 33,345 33,142 ................ -203
Evaluation Tap Funding................................ ................ (1,488) ................ ................ (-1,488)
Allied Health and Other Disciplines....................... 1,933 ................ 1,933 ................ +1,933
Geriatric Programs........................................ 33,542 36,907 33,542 ................ -3,365
Evaluation Tap Funding................................ ................ (6,840) ................ ................ (-6,840)
Mental and Behavorial Health.............................. 2,927 17,945 2,927 ................ -15,018
-----------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Community Linkages.......... 71,544 96,525 71,544 ................ -24,981
Workforce Information and Analysis............................ 2,815 ................ 2,815 ................ +2,815
Evaluation Tap Funding.................................... ................ (20,000) ................ ................ (-20,000)
State Grants for Health Workforce Development................. ................ 51,000 ................ ................ -51,000
Public Health and Preventive Medicine programs................ 9,609 ................ 9,609 ................ +9,609
Evaluation Tap Funding.................................... ................ (10,068) ................ ................ (-10,068)
Prevention and Public Health Fund\3\...................... (20,000) (15,000) (25,000) (+5,000) (+10,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 29,609 25,068 34,609 +5,000 +9,541
Nursing Programs:
Advanced Education Nursing................................ 64,046 64,438 64,046 ................ -392
Evaluation Tap Funding................................ ................ (40,000) ................ ................ (-40,000)
Nurse Education, Practice, and Retention.................. 39,653 40,141 39,653 ................ -488
Evaluation Tap Funding................................ ................ (19,632) ................ ................ (-19,632)
Nursing Workforce Diversity............................... 16,009 16,107 16,009 ................ -98
Evaluation Tap Funding................................ ................ (3,893) ................ ................ (-3,893)
Loan Repayment and Scholarship Program.................... 93,292 93,864 93,292 ................ -572
Comprehensive Geriatric Education......................... 4,539 ................ 4,539 ................ +4,539
Evaluation Tap Funding................................ ................ (5,000) ................ ................ (-5,000)
Nurse Managed Health Centers.............................. ................ 10,000 ................ ................ -10,000
Evaluation Tap Funding................................ ................ (10,000) ................ ................ (-10,000)
Nursing Faculty Loan Program.............................. 24,848 ................ 24,848 ................ +24,848
Evaluation Tap Funding................................ ................ (30,000) ................ ................ (-30,000)
-----------------------------------------------------------------------------------------
Subtotal, Nursing programs.............................. 242,387 224,550 242,387 ................ +17,837
-----------------------------------------------------------------------------------------
Subtotal, Evaluation Tap Funding.................... ................ 108,525 ................ ................ -108,525
=========================================================================================
Subtotal, Health Professions............................ 494,922 553,106 472,924 -21,998 -80,182
=========================================================================================
Subtotal, Evaluation tap funding........................ ................ 255,423 ................ ................ -255,423
Subtotal, Prevention and Public Health Fund\3\.......... (20,000) (15,000) (25,000) (+5,000) (+10,000)
-----------------------------------------------------------------------------------------
Total, Health Professions............................... 514,922 823,529 497,924 -16,998 -325,605
Children's Hospitals Graduate Medical Education............... 268,356 ................ 268,356 ................ +268,356
Patient Navigator............................................. 4,990 ................ ................ -4,990 ................
Teaching Health Centers Planning Grants....................... ................ 10,000 ................ ................ -10,000
National Practitioner Data Bank............................... 23,508 28,016 28,016 +4,508 ................
User Fees................................................. -23,508 -28,016 -28,016 -4,508 ................
-----------------------------------------------------------------------------------------
Subtotal, Bureau of Health Professions (BHP)............ 793,116 686,583 766,128 -26,988 +79,545
Subtotal, Evaluation tap funding........................ ................ (255,423) ................ ................ (-255,423)
Subtotal, Prevention and Public Health Fund\3\.......... (20,000) (15,000) (25,000) (+5,000) (+10,000)
-----------------------------------------------------------------------------------------
Total, BHP program level................................ 813,116 957,006 791,128 -21,988 -165,878
Maternal and Child Health Bureau
Maternal and Child Health Block Grant......................... 656,319 654,489 606,319 -50,000 -48,170
Sickle Cell Anemia Demonstration Program...................... 4,721 4,740 4,721 ................ -19
Traumatic Brain Injury........................................ 9,878 9,918 9,878 ................ -40
Autism and Other Developmental Disorders...................... 47,708 55,000 47,708 ................ -7,292
Heritable Disorders........................................... 9,952 9,992 9,952 ................ -40
Congenital Disabilities....................................... ................ 499 ................ ................ -499
Healthy Start................................................. 104,361 104,776 104,361 ................ -415
Universal Newborn Hearing..................................... 18,884 18,960 18,884 ................ -76
Emergency Medical Services for Children....................... 21,369 21,454 21,369 ................ -85
-----------------------------------------------------------------------------------------
Subtotal, Maternal and Child Health Bureau.............. 873,192 879,828 823,192 -50,000 -56,636
HIV/AIDS Bureau
Ryan White AIDS Programs:
Emergency Assistance...................................... 672,529 679,074 672,529 ................ -6,545
Comprehensive Care Programs............................... 1,308,141 1,358,791 1,323,141 +15,000 -35,650
AIDS Drug Assistance Program (ADAP) (NA).............. (885,000) (940,000) (900,000) (+15,000) (-40,000)
Early Intervention Program................................ 205,564 211,522 205,564 ................ -5,958
Children, Youth, Women, and Families...................... 77,313 77,787 77,313 ................ -474
AIDS Dental Services...................................... 13,511 13,594 13,511 ................ -83
Education and Training Centers............................ 34,607 34,819 34,607 ................ -212
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDS programs...................... 2,311,665 2,375,587 2,326,665 +15,000 -48,922
Evaluation Tap Funding (NA)............................... (25,000) (25,000) (25,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDs program level................. (2,336,665) (2,400,587) (2,351,665) (+15,000) (-48,922)
-----------------------------------------------------------------------------------------
Subtotal, HIV/AIDS Bureau............................... 2,311,665 2,375,587 2,326,665 +15,000 -48,922
Healthcare Systems Bureau
Organ Transplantation......................................... 24,896 25,991 24,896 ................ -1,095
National Cord Blood Inventory................................. 11,910 13,883 11,910 ................ -1,973
Bone Marrow Program........................................... 23,374 26,544 23,374 ................ -3,170
Office of Pharmacy Affairs.................................... 4,480 5,220 4,480 ................ -740
340B Drug Pricing User Fees................................... ................ 5,000 5,000 +5,000 ................
User Fees................................................. ................ -5,000 -5,000 -5,000 ................
Poison Control................................................ 21,866 29,250 21,866 ................ -7,384
-----------------------------------------------------------------------------------------
Subtotal, Healthcare systems bureau..................... 86,526 100,888 86,526 ................ -14,362
Rural Health Programs
Rural Outreach Grants......................................... 55,658 57,266 55,658 ................ -1,608
Rural Health Research/Policy Development...................... 9,885 9,929 9,885 ................ -44
Rural Hospital Flexibility Grants............................. 41,118 26,200 41,118 ................ +14,918
Rural Access to Emergency Devices............................. 236 ................ 2,500 +2,264 +2,500
State Offices of Rural Health................................. 10,055 10,075 10,055 ................ -20
Black Lung Clinics............................................ 7,153 7,185 7,153 ................ -32
Radiation Exposure Screening and Education Program............ 1,939 1,948 1,939 ................ -9
Telehealth.................................................... 11,524 11,575 13,524 +2,000 +1,949
-----------------------------------------------------------------------------------------
Subtotal, Rural health programs......................... 137,568 124,178 141,832 +4,264 +17,654
Healthy Weight Collaborative Prevention and Public Health ................ (5,000) ................ ................ (-5,000)
Fund\3\......................................................
Family Planning............................................... 299,400 327,356 299,400 ................ -27,956
Program Management............................................ 161,815 170,808 161,815 ................ -8,993
Total, Health resources & services program level........ (6,307,241) (7,101,685) (6,254,517) (-52,724) (-847,168)
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT
HEAL Liquidating Account...................................... (1,000) ................ (1,000) ................ (+1,000)
HEAL Program Management....................................... 2,841 ................ 2,841 ................ +2,841
-----------------------------------------------------------------------------------------
Total, HEAL............................................. 2,841 ................ 2,841 ................ +2,841
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Post-FY 1988 Claims........................................... 220,000 235,000 235,000 +15,000 ................
HRSA Administration........................................... 6,489 6,502 6,489 ................ -13
-----------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund........... 226,489 241,502 241,489 +15,000 -13
=========================================================================================
Total, Health Resources & Services Administration....... 6,491,571 7,042,764 6,448,847 -42,724 -593,917
Total, Evaluation tap funding....................... (25,000) (280,423) (25,000) ................ (-255,423)
Total, Prevention and Public Health Fund\3\......... (20,000) (20,000) (25,000) (+5,000) (+5,000)
Total, HRSA program level............................... (6,537,571) (7,343,187) (6,499,847) (-37,724) (-843,340)
CENTERS FOR DISEASE CONTROL AND PREVENTION
DISEASE CONTROL, RESEARCH, AND TRAINING
Immunization and Respiratory Diseases......................... 479,049 647,200 635,393 +156,344 -11,807
Evaluation Tap Funding.................................... (12,864) (12,864) (12,864) ................ ................
Pandemic Flu balances (Public Law 111-32)................. (156,344) ................ ................ (-156,344) ................
Prevention and Public Health Fund\3\...................... (100,000) (61,599) (150,000) (+50,000) (+88,401)
-----------------------------------------------------------------------------------------
Subtotal................................................ (748,257) (721,663) (798,257) (+50,000) (+76,594)
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention............. 1,115,995 1,157,133 1,115,995 ................ -41,138
Prevention and Public Health Fund\3\...................... ................ (30,400) (10,000) (+10,000) (-20,400)
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,115,995 1,187,533 1,125,995 +10,000 -61,538
Emerging and Zoonotic Infectious Diseases..................... 252,443 289,118 252,443 ................ -36,675
Prevention and Public Health Fund\3\...................... (51,750) (60,000) (51,750) ................ (-8,250)
-----------------------------------------------------------------------------------------
Subtotal, Emerging and Zoonotic Infectious.............. 304,193 349,118 304,193 ................ -44,925
Chronic Disease Prevention and Health Promotion............... 773,987 725,207 777,987 +4,000 +52,780
Prevention and Public Health Fund\3\...................... (300,950) (460,301) (487,050) (+186,100) (+26,749)
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,074,937 1,185,508 1,265,037 +190,100 +79,529
Birth Defects and Developmental Disabilities.................. 136,072 143,899 138,072 +2,000 -5,827
Public Health Scientific Services............................. 147,795 205,942 147,795 ................ -58,147
Evaluation Tap Funding.................................... (247,769) (217,674) (247,769) ................ (+30,095)
Prevention and Public Health Fund\3\...................... (72,000) (70,000) (70,000) (-2,000) ................
-----------------------------------------------------------------------------------------
Subtotal, Health Statistics/Public Health Scientific (467,564) (493,616) (465,564) (-2,000) (-28,052)
Services, Program Level................................
Environmental Health.......................................... 134,855 128,715 105,855 -29,000 -22,860
Prevention and Public Health Fund\3\...................... (35,000) (9,000) (35,000) ................ (+26,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 169,855 137,715 140,855 -29,000 +3,140
Injury Prevention and Control................................. 143,714 147,501 129,714 -14,000 -17,787
Prevention and Public Health Fund\3\...................... ................ (20,000) (3,000) (+3,000) (-17,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 143,714 167,501 132,714 -11,000 -34,787
National Institute for Occupational Safety & Health\4\........ 224,355 ................ 188,355 -36,000 +188,355
Evaluation Tap Funding.................................... (91,724) (259,934) (106,724) (+15,000) (-153,210)
-----------------------------------------------------------------------------------------
Subtotal, Occupational Safety & Health Program\4\....... (316,079) (259,934) (295,079) (-21,000) (+35,145)
Energy Employees Occupational Illness Compensation Program.... 55,358 55,358 55,358 ................ ................
Global Health................................................. 340,265 381,245 350,265 +10,000 -30,980
Public Health Preparedness and Response....................... 1,336,901 1,422,618 1,375,416 +38,515 -47,202
Prevention and Public Health fund\3\.......................... (10,000) ................ ................ (-10,000) ................
Pandemic Flu balances (Public Law 111-32)................. (68,515) (30,000) (30,000) (-38,515) ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,415,416 1,452,618 1,405,416 -10,000 -47,202
Public Health Leadership and Support.......................... 121,419 121,368 121,419 ................ +51
Prevention and Public Health Fund\3\...................... (41,200) (41,200) (41,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 162,619 162,568 162,619 ................ +51
Preventive Health and Health Services Block Grant............. 80,094 ................ ................ -80,094 ................
Business Services............................................. 362,026 447,466 427,026 +65,000 -20,440
Total, Centers for Disease Control...................... 5,704,328 5,872,770 5,821,093 +116,765 -51,677
Discretionary....................................... 5,648,970 5,817,412 5,765,735 +116,765 -51,677
Evaluation Tap Funding (NA)......................... (352,357) (490,472) (367,357) (+15,000) (-123,115)
Pandemic Flu balances (Public Law 111-32)........... (224,859) (30,000) (30,000) (-194,859) ................
Prevention and Public Health Fund\3\................ (610,900) (752,500) (848,000) (+237,100) (+95,500)
=========================================================================================
Total, Centers for Disease Control Program Level........ (6,892,444) (7,145,742) (7,066,450) (+174,006) (-79,292)
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute..................................... 5,058,577 5,196,136 5,001,623 -56,954 -194,513
National Heart, Lung, and Blood Institute..................... 3,069,723 3,147,992 3,036,189 -33,534 -111,803
National Institute of Dental & Craniofacial Research.......... 409,608 420,369 404,997 -4,611 -15,372
National Institute of Diabetes and Digestive and Kidney 1,792,224 1,837,957 1,772,045 -20,179 -65,912
Diseases (NIDDK).............................................
Juvenile Diabetes (mandatory)............................. (150,000) (150,000) (150,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, NIDDK program level........................... 1,942,224 1,987,957 1,922,045 -20,179 -65,912
National Institute of Neurological Disorders & Stroke......... 1,622,003 1,664,253 1,603,741 -18,262 -60,512
National Institute of Allergy and Infectious Diseases......... 4,478,668 4,615,970 4,426,288 -52,380 -189,682
Global HIV/AIDS Fund Transfer............................. 297,300 300,000 299,000 +1,700 -1,000
-----------------------------------------------------------------------------------------
Subtotal, NIAID program level........................... 4,775,968 4,915,970 4,725,288 -50,680 -190,682
National Institute of General Medical Sciences................ 2,033,782 2,102,300 2,347,309 +313,527 +245,009
National Institute of Child Health & Human Development........ 1,317,854 1,352,189 1,303,016 -14,838 -49,173
National Eye Institute........................................ 700,828 719,059 692,938 -7,890 -26,121
National Institute of Environmental Health Sciences........... 683,724 700,537 676,033 -7,691 -24,504
National Institute on Aging................................... 1,100,481 1,129,987 1,088,091 -12,390 -41,896
National Institute of Arthritis and Musculoskeletal and Skin 534,349 547,891 528,332 -6,017 -19,559
Diseases.....................................................
National Institute on Deafness and Other Communication 415,155 426,043 410,482 -4,673 -15,561
Disorders....................................................
National Institute of Nursing Research........................ 144,381 148,114 142,755 -1,626 -5,359
National Institute on Alcohol Abuse and Alcoholism............ 458,286 469,197 453,127 -5,159 -16,070
National Institute on Drug Abuse.............................. 1,050,542 1,080,018 1,038,714 -11,828 -41,304
National Institute of Mental Health........................... 1,477,292 1,517,006 1,460,671 -16,621 -56,335
National Human Genome Research Institute...................... 511,497 524,807 505,738 -5,759 -19,069
National Institute of Biomedical Imaging and Bioengineering... 313,802 322,106 333,671 +19,869 +11,565
National Center for Research Resources........................ 1,257,754 1,297,900 ................ -1,257,754 -1,297,900
National Center for Complementary and Alternative Medicine.... 127,713 131,002 126,275 -1,438 -4,727
National Institute on Minority Health and Health Disparities.. 209,713 214,608 272,650 +62,937 +58,042
John E. Fogarty International Center.......................... 69,436 71,328 68,653 -783 -2,675
National Center for Advancing Translation Sciences............ ................ ................ 582,326 +582,326 +582,326
National Library of Medicine (NLM)............................ 336,733 387,153 358,979 +22,246 -28,174
Evaluation Tap Funding.................................... (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 344,933 395,353 367,179 +22,246 -28,174
-----------------------------------------------------------------------------------------
Subtotal............................................ 344,933 395,353 367,179 +22,246 -28,174
Office of the Director........................................ 1,166,963 1,298,412 1,439,064 +272,101 +140,652
Common fund............................................... (543,021) (556,890) (537,811) (-5,210) (-19,079)
Buildings and Facilities...................................... 49,900 125,581 125,581 +75,681 ................
=========================================================================================
Total, National Institutes of Health (NIH).............. 30,688,288 31,747,915 30,498,288 -190,000 -1,249,627
Global HIV/AIDS Fund Transfer out................... -297,300 -300,000 -299,000 -1,700 +1,000
Evaluation Tap Funding.............................. (8,200) (8,200) (8,200) ................ ................
-----------------------------------------------------------------------------------------
Total, NIH Program Level................................ (30,399,188) (31,456,115) (30,207,488) (-191,700) (-1,248,627)
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
(SAMHSA)
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
Mental Health:
Programs of Regional and National Significance............ 338,276 273,342 331,680 -6,596 +58,338
Prevention and Public Health Fund\3\...................... (45,000) (20,000) (45,000) ................ (+25,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 383,276 293,342 376,680 -6,596 +83,338
Mental Health block grant................................. 398,936 413,645 398,936 ................ -14,709
Evaluation Tap Funding................................ (20,997) (21,039) (20,997) ................ (-42)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (419,933) (434,684) (419,933) ................ (-14,751)
Children's Mental Health.................................. 117,803 121,316 117,803 ................ -3,513
Grants to States for the Homeless (PATH).................. 64,917 65,047 64,917 ................ -130
Protection and Advocacy................................... 36,307 36,380 36,307 ................ -73
State prevention grants................................... ................ 90,000 ................ ................ -90,000
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................. 956,239 999,730 949,643 -6,596 -50,087
-----------------------------------------------------------------------------------------
Subtotal, Mental health program level................... (1,022,236) (1,040,769) (1,015,640) (-6,596) (-25,129)
Substance Abuse Treatment:
Programs of Regional and National Significance............ 404,480 401,822 409,575 +5,095 +7,753
Evaluation Tap Funding................................ (2,000) (2,000) (2,000) ................ ................
Prevention and Public Health Fund\3\...................... (25,000) ................ (25,000) ................ (+25,000)
-----------------------------------------------------------------------------------------
Subtotal, Program level................................. (431,480) (403,822) (436,575) (+5,095) (+32,753)
Substance Abuse block grant............................... 1,703,452 1,419,603 1,703,452 ................ +283,849
Evaluation Tap Funding................................ (79,200) (74,711) (79,200) ................ (+4,489)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (1,782,652) (1,494,314) (1,782,652) ................ (+288,338)
-----------------------------------------------------------------------------------------
Substance abuse prevention grants......................... ................ 395,000 ................ ................ -395,000
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment..................... 2,107,932 2,216,425 2,113,027 +5,095 -103,398
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. (2,214,132) (2,293,136) (2,219,227) (+5,095) (-73,909)
Substance Abuse Prevention:
Programs of Regional and National Significance............ 186,061 74,582 186,361 +300 +111,779
-----------------------------------------------------------------------------------------
Subtotal................................................ 186,061 74,582 186,361 +300 +111,779
Health Surveillance and Program Support:
Health Surveillance....................................... 2,000 2,000 2,000 ................ ................
Evaluation Tap Funding (NA)........................... (22,750) (45,428) (27,428) (+4,678) (-18,000)
Prevention and Public Health Fund\3\.................. (18,000) ................ (18,000) ................ (+18,000)
-----------------------------------------------------------------------------------------
Subtotal, Program level............................. 42,750 47,428 47,428 +4,678 ................
Program Management............................................ 77,039 80,166 77,039 ................ -3,127
Health IT..................................................... 5,250 4,000 ................ -5,250 -4,000
Military Families............................................. ................ 10,000 ................ ................ -10,000
Performance and Quality Information Systems................... 30,987 ................ 12,996 -17,991 +12,996
Evaluation Tap Funding (NA)............................... (6,596) (12,996) ................ (-6,596) (-12,996)
Public Awareness and Support.................................. 14,030 ................ 13,571 -459 +13,571
Evaluation Tap Funding (NA)............................... ................ (13,571) ................ ................ (-13,571)
Prevention Prepared Communities--PPHF\3\...................... ................ (22,600) ................ ................ (-22,600)
Tribal Prevention Grants--PPHF\3\............................. ................ (50,000) ................ ................ (-50,000)
-----------------------------------------------------------------------------------------
Subtotal, Program level................................. 56,863 113,167 26,567 -30,296 -86,600
=========================================================================================
Total, SAMHSA........................................... 3,379,538 3,386,903 3,354,637 -24,901 -32,266
Evaluation Tap Funding.............................. (131,543) (169,745) (129,625) (-1,918) (-40,120)
(Prevention and Public Health Fund)\3\.............. 88,000 92,600 88,000 ................ -4,600
-----------------------------------------------------------------------------------------
Total, SAMHSA Program Level............................. (3,599,081) (3,649,248) (3,572,262) (-26,819) (-76,986)
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)
HEALTHCARE RESEARCH AND QUALITY
Research on Health Costs, Quality, and Outcomes:
Evaluation Tap Funding (NA)............................... (245,653) (232,612) (238,768) (-6,885) (+6,156)
Prevention and Public Health Fund\3\...................... (12,000) ................ (12,000) ................ (+12,000)
Medical Expenditures Panel Surveys:
Evaluation Tap Funding (NA)............................... (58,800) (59,300) (59,300) (+500) ................
Program Support:
Evaluation Tap Funding (NA)............................... (67,600) (74,485) (73,985) (+6,385) (-500)
-----------------------------------------------------------------------------------------
Total, AHRQ Program Level............................... (372,053) (366,397) (372,053) ................ (+5,656)
=========================================================================================
Total, Public Health Service (PHS) appropriation........ 46,982,625 48,915,452 47,083,865 +101,240 -1,831,587
Total, Public Health Service Program Level.............. (48,097,637) (50,260,689) (48,017,100) (-80,537) (-2,243,589)
CENTERS FOR MEDICARE AND MEDICAID SERVICES
GRANTS TO STATES FOR MEDICAID
Medicaid Current Law Benefits................................. 242,714,348 253,884,907 253,884,907 +11,170,559 ................
State and Local Administration................................ 13,567,479 12,808,496 12,808,496 -758,983 ................
Vaccines for Children......................................... 3,651,354 4,030,996 4,030,996 +379,642 ................
-----------------------------------------------------------------------------------------
Subtotal, Medicaid Program Level........................ 259,933,181 270,724,399 270,724,399 +10,791,218 ................
Less funds advanced in prior year................... -86,789,382 -86,445,289 -86,445,289 +344,093 ................
-----------------------------------------------------------------------------------------
Total, Grants to States for Medicaid.................... 173,143,799 184,279,110 184,279,110 +11,135,311 ................
New advance, 1st quarter............................ 86,445,289 90,614,082 90,614,082 +4,168,793 ................
PAYMENTS TO HEALTH CARE TRUST FUNDS
Supplemental Medical Insurance................................ 172,697,622 178,041,000 178,041,000 +5,343,378 ................
Federal Uninsured Payment..................................... 275,000 262,000 262,000 -13,000 ................
Program Management............................................ 229,000 222,000 222,000 -7,000 ................
General Revenue for Part D Benefit............................ 55,548,000 51,431,000 51,431,000 -4,117,000 ................
General Revenue for Part D Administration..................... 404,000 475,000 475,000 +71,000 ................
HCFAC Reimbursement........................................... 310,378 580,580 581,000 +270,622 +420
-----------------------------------------------------------------------------------------
Total, Payments to Trust Funds, Program Level........... 229,464,000 231,011,580 231,012,000 +1,548,000 +420
PROGRAM MANAGEMENT
Research, Demonstration, Evaluation........................... 35,529 31,200 31,200 -4,329 ................
Program operations............................................ 2,397,655 3,062,025 2,813,935 +416,280 -248,090
State Survey and Certification................................ 361,276 400,283 361,276 ................ -39,007
High Risk Insurance Pools..................................... 54,890 44,000 44,000 -10,890 ................
Federal Administration........................................ 737,505 859,465 794,465 +56,960 -65,000
=========================================================================================
Total, Program management, Limitation on new BA......... 3,586,855 4,396,973 4,044,876 +458,021 -352,097
HEALTH CARE FRAUD AND ABUSE CONTROL
Part D Drug Benefit/Medicare Advantage (MIP).................. 219,879 345,295 345,715 +125,836 +420
HHS Office of Inspector General............................... 29,730 97,556 97,556 +67,826 ................
Department of Justice......................................... 29,730 93,085 93,085 +63,355 ................
Medicaid/SCHIP................................................ 31,038 44,644 44,644 +13,606 ................
-----------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control.............. 310,377 580,580 581,000 +270,623 +420
=========================================================================================
Total, Centers for Medicare and Medicaid Services....... 492,950,320 510,882,325 510,531,068 +17,580,748 -351,257
Federal funds....................................... 489,053,088 505,904,772 505,905,192 +16,852,104 +420
Current year.................................... (402,607,799) (415,290,690) (415,291,110) (+12,683,311) (+420)
New advance, FY 2013............................ (86,445,289) (90,614,082) (90,614,082) (+4,168,793) ................
Trust Funds......................................... 3,897,232 4,977,553 4,625,876 +728,644 -351,677
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............................ 3,507,323 2,942,035 2,942,035 -565,288 ................
Federal Incentive Payments................................ 513,000 519,000 519,000 +6,000 ................
Access and Visitation..................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement..................... 4,030,323 3,471,035 3,471,035 -559,288 ................
=========================================================================================
Total, Family Support Payments Program Level............ 4,064,323 3,505,035 3,505,035 -559,288 ................
Less funds advanced in previous years............... -1,100,000 -1,200,000 -1,200,000 -100,000 ................
-----------------------------------------------------------------------------------------
Total, Family Support Payments, current year............ 2,964,323 2,305,035 2,305,035 -659,288 ................
New advance, 1st quarter, FY 2013................... 1,200,000 1,100,000 1,100,000 -100,000 ................
LOW-INCOME HOME ENERGY ASSISTANCE (LIHEAP)
Formula Grants................................................ 4,500,653 1,980,000 3,400,653 -1,100,000 +1,420,653
Contingency Fund.............................................. 199,927 589,551 199,927 ................ -389,624
-----------------------------------------------------------------------------------------
Total, LIHEAP, Program Level............................ 4,700,580 2,569,551 3,600,580 -1,100,000 +1,031,029
REFUGEE AND ENTRANT ASSISTANCE
Transitional and Medical Services............................. 352,625 394,224 386,625 +34,000 -7,599
Victims of Trafficking........................................ 9,794 9,814 9,794 ................ -20
Social Services............................................... 153,697 179,005 153,697 ................ -25,308
Preventive Health............................................. 4,739 4,748 4,739 ................ -9
Targeted Assistance........................................... 48,493 48,590 48,493 ................ -97
Unaccompanied Minors.......................................... 149,052 177,225 173,225 +24,173 -4,000
Victims of Torture............................................ 11,066 11,088 11,066 ................ -22
-----------------------------------------------------------------------------------------
Total, Refugee and Entrant Assistance................... 729,466 824,694 787,639 +58,173 -37,055
PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
GRANT
Child Care and Development Block Grant........................ 2,222,627 2,926,757 2,222,627 ................ -704,130
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................................ 7,559,633 8,099,783 7,899,633 +340,000 -200,150
Consolidated Runaway, Homeless Youth Program.............. 97,539 102,734 97,539 ................ -5,195
Prevention Grants to Reduce Abuse of Runaway Youth........ 17,935 17,971 17,935 ................ -36
Child Abuse State Grants.................................. 26,482 26,535 26,482 ................ -53
Child Abuse Discretionary Activities...................... 25,793 29,020 25,793 ................ -3,227
Community Based Child Abuse Prevention.................... 41,606 41,689 41,606 ................ -83
Abandoned Infants Assistance.............................. 11,605 11,575 11,575 -30 ................
Child Welfare Services.................................... 281,181 281,744 281,181 ................ -563
Child Welfare Training/Innovative Approaches to Foster 27,153 27,207 27,153 ................ -54
Care.....................................................
Adoption Opportunities.................................... 39,253 39,332 39,253 ................ -79
Adoption Incentive........................................ 39,421 49,875 39,421 ................ -10,454
Strengthening Communities Fund................................ ................ 20,000 ................ ................ -20,000
Social Services and Income Maintenance Research............... ................ 3,000 ................ ................ -3,000
Evaluation Tap Funding.................................... (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Program Level................................. (5,762) (8,762) (5,762) ................ (-3,000)
Developmental Disabilities Programs:
State Councils............................................ 74,916 75,066 74,916 ................ -150
Protection and Advocacy................................... 40,942 41,024 40,942 ................ -82
Voting Access for Individuals with Disabilities........... 17,375 ................ 5,245 -12,130 +5,245
Developmental Disabilities Projects of National 14,134 8,333 8,333 -5,801 ................
Significance.............................................
University Centers for Excellence in Developmental 38,865 38,943 38,865 ................ -78
Disabilities.............................................
-----------------------------------------------------------------------------------------
Subtotal, Developmental Disabilities Programs........... 186,232 163,366 168,301 -17,931 +4,935
Native American Programs...................................... 48,675 48,773 48,675 ................ -98
Community Services:
Community Services Block Grant Act programs:
Grants to States for Community Services............... 678,640 350,000 678,640 ................ +328,640
Economic Development.................................. 17,964 20,000 21,964 +4,000 +1,964
Rural Community Facilities............................ 4,990 ................ 6,990 +2,000 +6,990
-----------------------------------------------------------------------------------------
Subtotal............................................ 701,594 370,000 707,594 +6,000 +337,594
Job Opportunities for Low-Income Individuals.......... 1,641 ................ ................ -1,641 ................
Individual Development Account Initiative............. 23,977 23,907 23,907 -70 ................
-----------------------------------------------------------------------------------------
Subtotal, Community Services............................ 727,212 393,907 731,501 +4,289 +337,594
Domestic Violence Hotline..................................... 3,203 4,500 3,203 ................ -1,297
Family Violence/Battered Women's Shelters..................... 129,792 135,052 129,792 ................ -5,260
Mentoring Children of Prisoners............................... ................ 25,000 ................ ................ -25,000
Independent Living Training Vouchers.......................... 45,260 45,351 45,260 ................ -91
Faith-Based Center............................................ 1,373 1,376 1,373 ................ -3
Disaster Human Services Case Management....................... 1,996 2,000 1,996 ................ -4
Program Direction............................................. 208,013 224,808 208,013 ................ -16,795
=========================================================================================
Total, Children and Families Services Programs.......... 9,519,357 9,794,598 9,845,685 +326,328 +51,087
Current Year........................................ (9,519,357) (9,794,598) (9,845,685) (+326,328) (+51,087)
Evaluation Tap Funding.............................. (5,762) (5,762) (5,762) ................ ................
-----------------------------------------------------------------------------------------
Total, Program Level.................................... (9,525,119) (9,800,360) (9,851,447) (+326,328) (+51,087)
PROMOTING SAFE AND STABLE FAMILIES............................ 365,000 365,000 365,000 ................ ................
Discretionary Funds....................................... 63,184 63,311 63,184 ................ -127
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Foster Care................................................... 3,967,000 4,288,000 4,288,000 +321,000 ................
Adoption Assistance........................................... 2,480,000 2,495,000 2,495,000 +15,000 ................
Kinship Guardianship.......................................... 32,000 80,000 80,000 +48,000 ................
Independent Living............................................ 140,000 140,000 140,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States............................... 6,619,000 7,003,000 7,003,000 +384,000 ................
Less Advances from Prior Year....................... -1,850,000 -1,850,000 -1,850,000 ................ ................
-----------------------------------------------------------------------------------------
Total, payments, current year................... 4,769,000 5,153,000 5,153,000 +384,000 ................
New Advance, 1st quarter........................ 1,850,000 2,100,000 2,100,000 +250,000 ................
=========================================================================================
Total, Administration for Children & Families....... 30,083,537 28,901,946 29,242,750 -840,787 +340,804
Current year.................................... (27,033,537) (25,701,946) (26,042,750) (-990,787) (+340,804)
FY 2013......................................... (3,050,000) (3,200,000) (3,200,
